Stefan Timmermans - Profile on Academia.edu (original) (raw)
Papers by Stefan Timmermans
7. Problem-Solving in Action: a Peirceian account
Columbia University Press eBooks, Dec 31, 2022
We argue for a sociology of health, illness, and disease. Under the influence of Talcott Parsons,... more We argue for a sociology of health, illness, and disease. Under the influence of Talcott Parsons, the social study of health began as medical sociology and then morphed into sociology of health and illness, focusing largely on the social aspects of health-related topics. Social scientists have been reluctant to tackle disease in its physiological and biological manifestations. The result is an impoverishment of sociological analysis on at least three levels: social scientists have rarely made diseases central to their inquiries; they have been reluctant to include clinical endpoints in their analysis; and they have largely bracketed the normative purpose of health interventions. Consequently, social scientists tend to ignore what often matters most to patients and health care providers, and the social processes social scientists describe remain clinically unanchored. A sociology of disease explores the dialectic between social life and disease; aiming to examine whether and how soci...
Does Patient-centered Care Change Genital Surgery Decisions? The Strategic Use of Clinical Uncertainty in Disorders of Sex Development Clinics
Journal of health and social behavior, Jan 10, 2018
Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies... more Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies about the appropriateness and timing of surgery, generating clinical uncertainty about decision making. Since 2006, medical experts and patient advocates have argued for putting the child's needs central as patient-centered care. Based on audio recordings of 31 parent-clinician interactions in three clinics of disorders of sex development, we analyze how parents and clinicians decide on genital surgery. We find that clinicians and parents aim for parent-centered rather than infant-centered care. Parents receive ambivalent messages about surgery: while clinicians express caution, they also present the surgery as beneficial. We examine how parents and clinicians reach agreement about surgery-differentiating parents who push strongly for surgery from parents who do not express any preconceived preferences about surgery and parents who resist surgery. We conclude that clinicians use cli...
Journal of community genetics, Jan 5, 2018
This study examines the interface between newborn screening and prenatal diagnosis from the point... more This study examines the interface between newborn screening and prenatal diagnosis from the point-of-view of parents of screen-positive children. Many conditions covered by newborn screening represent classic (autosomal recessive) Mendelian disorders. Parents of screen-positive infants therefore often come to learn that they are carriers of the disease, and face a decision whether to test for it in future pregnancies. Semi-structured interviews were conducted in 2015-2017 with 34 Israeli parents whose child was screen positive. Three major themes emanated from the parents' attitudes toward prenatal testing for the disease in prospective hypothetical pregnancies: rejection of prenatal testing for the disease associated with the screen positive, and relying instead on newborn screening to reveal if a future baby is also sick (18/34, 53%); support of prenatal testing to get more information (7/34, 21%) and support of prenatal testing in order to abort in case of a test positive (9/...
The American Journal of Bioethics, 2017
Death Signals Life
Routledge Handbook of Body Studies, 2013
Order and their others: On the constitution of universalities in medical work
Configurations, 2000
... Akrich, “The De-scription of Technical Objects,” in Shaping Technology— Building Society: Stu... more ... Akrich, “The De-scription of Technical Objects,” in Shaping Technology— Building Society: Studies in Sociotechnical Change, ed. Wiebe E. Bijker ... Mickey Eisenberg et al., “Survival Rates from Out-of-Hospital Cardiac Arrest: Rec-ommendations for Uniform Definitions and Data ...
Population Screening for Emergent Conditions: The Clinic As Site of Genetic Knowledge Production
According to the WHO's Wilson-Junger criteria formulated in the early sixties, public health... more According to the WHO's Wilson-Junger criteria formulated in the early sixties, public health researchers should justify the decision to screen large populations for rare conditions with their understanding of the nature of a disease, the importance of a disease, the availability of treatment and ...
Racist Encounters: A Pragmatist Semiotic Analysis of Interaction
Sociological Theory, 2020
Complementing discourse-analytic approaches, we develop C. S. Peirce’s semiotic theory to analyze... more Complementing discourse-analytic approaches, we develop C. S. Peirce’s semiotic theory to analyze how racism is enacted and countered in everyday interactions. We examine how the semiotic structure of racist encounters depends on acts of signification that can be deflected and that take shape in the ways actors negotiate interactions in situ. After outlining the semiotic apparatus Peirce pioneered, we trace the dynamic processes of generalization and specification in recorded racist encounters as specific forms of semiotic upshifting and downshifting. We demonstrate how attending to racist encounters and engaging the sociology of race sharpen key assumptions that pragmatist semiotics makes about the structure of signification, as it forces one to examine the interplay of marked and unmarked categories and identities in interaction, and to take the differential power to signify into account in shaping the potential effects of semiotic strategies.
Urban Ethnography, 2019
We examine what makes urban ethnography unique as a sociological subfield and how to convey this ... more We examine what makes urban ethnography unique as a sociological subfield and how to convey this method to aspiring urban ethnographers. As a qualitative research approach, methodological sensibilities about observing, sampling, and data analysis cross boundaries and transcend the urban setting. We suggest a short observational exercise of checking out in a grocery store to stimulate the ethnographic imagination. Next, we turn to three ways to cultivate an ethnographic eye toward the urban: walking the city, paying attention to interactions and institutions, and examining communities and networks. We end with an appeal to engaging with a community of inquiry.
Chapter Six. Does Expanded Newborn Screening Save Lives
Review Essay: Being and Becoming Mead1
American Journal of Sociology, 2018
Sharing Spaces, Crossing Boundaries
This chapter contains sections titled: Marginal Man, The Concept of a Boundary Object, STS Resear... more This chapter contains sections titled: Marginal Man, The Concept of a Boundary Object, STS Research Tacks across Disciplinary Boundaries While Tracking Boundary Crossings of Its Subjects, Scientific Work Involves Tracking Work, Tracking Commitments Reflect a Pragmatic Ethical-Epistemic-Ontology, Conclusion, Acknowledgments, Notes, References
Mechanism-based Explanation: An Ethnographic view
Chapter Four. Is My Baby Normal
Conclusion. The Future of Newborn Screening
Journal of Community Genetics, 2021
While genomic medicine is becoming an important part of patient care with an ever-increasing diag... more While genomic medicine is becoming an important part of patient care with an ever-increasing diagnostic yield, recontacting patients after reclassification of variants of uncertain clinical significance (VUSs) remains a major challenge. Although periodical reinterpretation of VUSs is highly desired, recontacting former patients with new classifications is commonly not fulfilled in practice. We draw on semi-structured interviews with 20 Israeli healthcare professionals and stakeholders involved in communicating the results of genome-wide sequencing to patients. Findings show agreement that an individual health care professional cannot address the task of recontacting patients after re-classification, and that responsibility should be shared among the medical specialties, laboratory scientists, as well as patients. In the absence of established guidelines, many respondents suggested that the patient should be informed about reclassification during a follow-up contact but they disagreed who should be responsible for informing the patient. HCPs agreed that the solution to this challenge involves a centralized automated database that is accessible, continuously updated, and facilitates retrospective as well as prospective flagging of reclassification for patients who can benefit from this information. National and international policies providing concrete guidelines on the optimal way to recontact patients with new valuable genomic information are needed.
Speaking for the Dying: Life-and-Death Decisions in Intensive Care
Contemporary Sociology: A Journal of Reviews, 2021
Americans raised funds and opened the Broadway Federal Bank in 1947. As a community bank, the goa... more Americans raised funds and opened the Broadway Federal Bank in 1947. As a community bank, the goals focused on providing services that mainstream banks were reluctant to offer to better the lives of residents. For example, the bank offered home mortgages to help increase homeownership and student loans to help residents gain an education. Considering the long history of redlining that forced minorities to use predatory home loans with high interest rates and fees, the bank served an important role in the community. Rosas examines how the bank adjusted to changing demographics and worked to survive financially and attract Latino customers, while retaining and not alienating its original African American clientele. As Rosas explains, the bank hired Latinos and in the 1990s, 25 percent of its workers were Latino, including three of the five branch managers, which raised concerns among African Americans. Whereas the bank worked to serve African Americans, to combat the history of neglect and predatory practices of ‘‘mainstream’’ banks, and to transmit this message to African Americans, Rosas points out that it did not try to educate Latinos about its community mission. The failure to do this may have led to the bank’s destruction in 1992. In an oral history, the bank chairman explains that the bank survived the 1965 Watts rebellion but was burned down in the 1992 civil unrest (and rebuilt). He noted that the ‘‘Hispanic population didn’t really get the history of the bank’’ and that ‘‘instead of seeing us as a community bank, they saw us as a federal bank’’ (p. 180). As Rosas points out, the bank could have educated the Latino population about the bank’s community mission. In fact, during her interviews with Mexican immigrants, when she shared the bank’s history, the immigrants responded that this was ‘‘good to know’’ and ‘‘things make sense now’’ (p. 190). Rosas notes that even as the bank focused on the needs of Latinos as clients and hired Latino staff, it overlooked one important area: transferring funds to other countries, a service offered by Bank of America and Wells Fargo. In California, about $10 billion dollars were sent in 2004 to Latin America. Not only did the bank fail to provide this critical service; the bank also missed a major source of profit. There are some areas where Rosas could have provided more information and analysis to better develop her key concept of relational community formation. She describes conflict between the groups, and more could have been said about how the community dealt with these issues, especially from the perspective of African Americans who were seeing a decline in resources. For example, how did the community address funding and hiring for bilingual classes and teachers in the Head Start program? Her portrayal of the bank shows that there was little interaction between the African American and Latino clientele. While this can be a form of accommodation and a way of handling conflict, especially considering the concerns of African Americans over the increasing number of Latinos hired by the bank, Rosas could say more about the overall process of community formation at the bank. While she provides important examples of community formation in particular arenas, such as in the local Head Start councils and among residents, her discussion is less clear about how these different arenas contribute to relational community formation for South Los Angeles as a whole.
Research on Language and Social Interaction, 2017
Research on news deliveries has focused on monovalently good or bad news and their associated int... more Research on news deliveries has focused on monovalently good or bad news and their associated interactional trajectories. We examine American English video recordings of geneticists delivering genetic test results to families with children who have disabilities. We find that speakers offering bright sides against a backdrop of bad news work to achieve bivalent equilibrium-a state where speakers can reach agreement that the news is appropriately understood as a mix of bad with good elements. We propose that bivalent equilibrium facilitates affiliation through a two-step process that is distinct from affiliation to a monovalently positive or negative evaluative stance. Data are in American English. Since its inception, conversation analysis has documented prosociality as a source of order in social interaction. Socially preferred actions-those that are generally "affiliative in character" and "supportive of social solidarity" (Heritage, 1984, p. 269)-include accepting invitations, granting requests for action, confirming requests for confirmation, and upgraded second assessments in response to first assessments. Preferred actions are delivered more frequently, quicker, and without accounts in
7. Problem-Solving in Action: a Peirceian account
Columbia University Press eBooks, Dec 31, 2022
We argue for a sociology of health, illness, and disease. Under the influence of Talcott Parsons,... more We argue for a sociology of health, illness, and disease. Under the influence of Talcott Parsons, the social study of health began as medical sociology and then morphed into sociology of health and illness, focusing largely on the social aspects of health-related topics. Social scientists have been reluctant to tackle disease in its physiological and biological manifestations. The result is an impoverishment of sociological analysis on at least three levels: social scientists have rarely made diseases central to their inquiries; they have been reluctant to include clinical endpoints in their analysis; and they have largely bracketed the normative purpose of health interventions. Consequently, social scientists tend to ignore what often matters most to patients and health care providers, and the social processes social scientists describe remain clinically unanchored. A sociology of disease explores the dialectic between social life and disease; aiming to examine whether and how soci...
Does Patient-centered Care Change Genital Surgery Decisions? The Strategic Use of Clinical Uncertainty in Disorders of Sex Development Clinics
Journal of health and social behavior, Jan 10, 2018
Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies... more Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies about the appropriateness and timing of surgery, generating clinical uncertainty about decision making. Since 2006, medical experts and patient advocates have argued for putting the child's needs central as patient-centered care. Based on audio recordings of 31 parent-clinician interactions in three clinics of disorders of sex development, we analyze how parents and clinicians decide on genital surgery. We find that clinicians and parents aim for parent-centered rather than infant-centered care. Parents receive ambivalent messages about surgery: while clinicians express caution, they also present the surgery as beneficial. We examine how parents and clinicians reach agreement about surgery-differentiating parents who push strongly for surgery from parents who do not express any preconceived preferences about surgery and parents who resist surgery. We conclude that clinicians use cli...
Journal of community genetics, Jan 5, 2018
This study examines the interface between newborn screening and prenatal diagnosis from the point... more This study examines the interface between newborn screening and prenatal diagnosis from the point-of-view of parents of screen-positive children. Many conditions covered by newborn screening represent classic (autosomal recessive) Mendelian disorders. Parents of screen-positive infants therefore often come to learn that they are carriers of the disease, and face a decision whether to test for it in future pregnancies. Semi-structured interviews were conducted in 2015-2017 with 34 Israeli parents whose child was screen positive. Three major themes emanated from the parents' attitudes toward prenatal testing for the disease in prospective hypothetical pregnancies: rejection of prenatal testing for the disease associated with the screen positive, and relying instead on newborn screening to reveal if a future baby is also sick (18/34, 53%); support of prenatal testing to get more information (7/34, 21%) and support of prenatal testing in order to abort in case of a test positive (9/...
The American Journal of Bioethics, 2017
Death Signals Life
Routledge Handbook of Body Studies, 2013
Order and their others: On the constitution of universalities in medical work
Configurations, 2000
... Akrich, “The De-scription of Technical Objects,” in Shaping Technology— Building Society: Stu... more ... Akrich, “The De-scription of Technical Objects,” in Shaping Technology— Building Society: Studies in Sociotechnical Change, ed. Wiebe E. Bijker ... Mickey Eisenberg et al., “Survival Rates from Out-of-Hospital Cardiac Arrest: Rec-ommendations for Uniform Definitions and Data ...
Population Screening for Emergent Conditions: The Clinic As Site of Genetic Knowledge Production
According to the WHO's Wilson-Junger criteria formulated in the early sixties, public health... more According to the WHO's Wilson-Junger criteria formulated in the early sixties, public health researchers should justify the decision to screen large populations for rare conditions with their understanding of the nature of a disease, the importance of a disease, the availability of treatment and ...
Racist Encounters: A Pragmatist Semiotic Analysis of Interaction
Sociological Theory, 2020
Complementing discourse-analytic approaches, we develop C. S. Peirce’s semiotic theory to analyze... more Complementing discourse-analytic approaches, we develop C. S. Peirce’s semiotic theory to analyze how racism is enacted and countered in everyday interactions. We examine how the semiotic structure of racist encounters depends on acts of signification that can be deflected and that take shape in the ways actors negotiate interactions in situ. After outlining the semiotic apparatus Peirce pioneered, we trace the dynamic processes of generalization and specification in recorded racist encounters as specific forms of semiotic upshifting and downshifting. We demonstrate how attending to racist encounters and engaging the sociology of race sharpen key assumptions that pragmatist semiotics makes about the structure of signification, as it forces one to examine the interplay of marked and unmarked categories and identities in interaction, and to take the differential power to signify into account in shaping the potential effects of semiotic strategies.
Urban Ethnography, 2019
We examine what makes urban ethnography unique as a sociological subfield and how to convey this ... more We examine what makes urban ethnography unique as a sociological subfield and how to convey this method to aspiring urban ethnographers. As a qualitative research approach, methodological sensibilities about observing, sampling, and data analysis cross boundaries and transcend the urban setting. We suggest a short observational exercise of checking out in a grocery store to stimulate the ethnographic imagination. Next, we turn to three ways to cultivate an ethnographic eye toward the urban: walking the city, paying attention to interactions and institutions, and examining communities and networks. We end with an appeal to engaging with a community of inquiry.
Chapter Six. Does Expanded Newborn Screening Save Lives
Review Essay: Being and Becoming Mead1
American Journal of Sociology, 2018
Sharing Spaces, Crossing Boundaries
This chapter contains sections titled: Marginal Man, The Concept of a Boundary Object, STS Resear... more This chapter contains sections titled: Marginal Man, The Concept of a Boundary Object, STS Research Tacks across Disciplinary Boundaries While Tracking Boundary Crossings of Its Subjects, Scientific Work Involves Tracking Work, Tracking Commitments Reflect a Pragmatic Ethical-Epistemic-Ontology, Conclusion, Acknowledgments, Notes, References
Mechanism-based Explanation: An Ethnographic view
Chapter Four. Is My Baby Normal
Conclusion. The Future of Newborn Screening
Journal of Community Genetics, 2021
While genomic medicine is becoming an important part of patient care with an ever-increasing diag... more While genomic medicine is becoming an important part of patient care with an ever-increasing diagnostic yield, recontacting patients after reclassification of variants of uncertain clinical significance (VUSs) remains a major challenge. Although periodical reinterpretation of VUSs is highly desired, recontacting former patients with new classifications is commonly not fulfilled in practice. We draw on semi-structured interviews with 20 Israeli healthcare professionals and stakeholders involved in communicating the results of genome-wide sequencing to patients. Findings show agreement that an individual health care professional cannot address the task of recontacting patients after re-classification, and that responsibility should be shared among the medical specialties, laboratory scientists, as well as patients. In the absence of established guidelines, many respondents suggested that the patient should be informed about reclassification during a follow-up contact but they disagreed who should be responsible for informing the patient. HCPs agreed that the solution to this challenge involves a centralized automated database that is accessible, continuously updated, and facilitates retrospective as well as prospective flagging of reclassification for patients who can benefit from this information. National and international policies providing concrete guidelines on the optimal way to recontact patients with new valuable genomic information are needed.
Speaking for the Dying: Life-and-Death Decisions in Intensive Care
Contemporary Sociology: A Journal of Reviews, 2021
Americans raised funds and opened the Broadway Federal Bank in 1947. As a community bank, the goa... more Americans raised funds and opened the Broadway Federal Bank in 1947. As a community bank, the goals focused on providing services that mainstream banks were reluctant to offer to better the lives of residents. For example, the bank offered home mortgages to help increase homeownership and student loans to help residents gain an education. Considering the long history of redlining that forced minorities to use predatory home loans with high interest rates and fees, the bank served an important role in the community. Rosas examines how the bank adjusted to changing demographics and worked to survive financially and attract Latino customers, while retaining and not alienating its original African American clientele. As Rosas explains, the bank hired Latinos and in the 1990s, 25 percent of its workers were Latino, including three of the five branch managers, which raised concerns among African Americans. Whereas the bank worked to serve African Americans, to combat the history of neglect and predatory practices of ‘‘mainstream’’ banks, and to transmit this message to African Americans, Rosas points out that it did not try to educate Latinos about its community mission. The failure to do this may have led to the bank’s destruction in 1992. In an oral history, the bank chairman explains that the bank survived the 1965 Watts rebellion but was burned down in the 1992 civil unrest (and rebuilt). He noted that the ‘‘Hispanic population didn’t really get the history of the bank’’ and that ‘‘instead of seeing us as a community bank, they saw us as a federal bank’’ (p. 180). As Rosas points out, the bank could have educated the Latino population about the bank’s community mission. In fact, during her interviews with Mexican immigrants, when she shared the bank’s history, the immigrants responded that this was ‘‘good to know’’ and ‘‘things make sense now’’ (p. 190). Rosas notes that even as the bank focused on the needs of Latinos as clients and hired Latino staff, it overlooked one important area: transferring funds to other countries, a service offered by Bank of America and Wells Fargo. In California, about $10 billion dollars were sent in 2004 to Latin America. Not only did the bank fail to provide this critical service; the bank also missed a major source of profit. There are some areas where Rosas could have provided more information and analysis to better develop her key concept of relational community formation. She describes conflict between the groups, and more could have been said about how the community dealt with these issues, especially from the perspective of African Americans who were seeing a decline in resources. For example, how did the community address funding and hiring for bilingual classes and teachers in the Head Start program? Her portrayal of the bank shows that there was little interaction between the African American and Latino clientele. While this can be a form of accommodation and a way of handling conflict, especially considering the concerns of African Americans over the increasing number of Latinos hired by the bank, Rosas could say more about the overall process of community formation at the bank. While she provides important examples of community formation in particular arenas, such as in the local Head Start councils and among residents, her discussion is less clear about how these different arenas contribute to relational community formation for South Los Angeles as a whole.
Research on Language and Social Interaction, 2017
Research on news deliveries has focused on monovalently good or bad news and their associated int... more Research on news deliveries has focused on monovalently good or bad news and their associated interactional trajectories. We examine American English video recordings of geneticists delivering genetic test results to families with children who have disabilities. We find that speakers offering bright sides against a backdrop of bad news work to achieve bivalent equilibrium-a state where speakers can reach agreement that the news is appropriately understood as a mix of bad with good elements. We propose that bivalent equilibrium facilitates affiliation through a two-step process that is distinct from affiliation to a monovalently positive or negative evaluative stance. Data are in American English. Since its inception, conversation analysis has documented prosociality as a source of order in social interaction. Socially preferred actions-those that are generally "affiliative in character" and "supportive of social solidarity" (Heritage, 1984, p. 269)-include accepting invitations, granting requests for action, confirming requests for confirmation, and upgraded second assessments in response to first assessments. Preferred actions are delivered more frequently, quicker, and without accounts in
Biopolitical Citizenship in the Immigration Adjudication Process
We apply the concept of “biopolitical citizenship” to show how and with what consequences biology... more We apply the concept of “biopolitical citizenship” to show how and with what consequences biology and medicine are mobilized as political techniques in the legal immigration procedures of permanent residency acquisition and family reunification. Medical examinations and DNA testing are employed by the U.S. state as objective sorting criteria in the immigration legal process. Based on qualitative examination of immigrants' and their attorneys' participation in the legalization process, we demonstrate how these biological screening mechanisms create added uncertainty and problems that disproportionately affect particular people. In this context, aspiring citizens undergo biological evaluations that appear transparent, objective, and democratic. However, because of how evaluations are structured, they actually lower the chances of certain individuals to succeed in their citizenship endeavors.