Sky Edith GROSS | Ministry of Science, Technology and Innovation (original) (raw)

Papers by Sky Edith GROSS

Science, Technology, & Human Values

The introduction of respiratory machines in the 1950s may have saved the lives of many, but it al... more The introduction of respiratory machines in the 1950s may have saved the lives of many, but it also challenged the notion of death itself. This development endowed “machines” with the power to form a unique ontological creature: a live body with a “dead” brain. While technology may be blamed for complicating things in the first place, it is also called on to solve the resulting quandaries. Indeed, it is not the birth of the “brain-dead” that concerns us most, but rather its association with a web of epistemological and ethical considerations, where technology plays a central role. The brain death debate in Israel introduces highly sophisticated religious thought and authoritative medical expertise. At focus are the religious acceptance and rejection of brain death by a technologically savvy group of rabbis whose religious doctrine––along with a particular form of religious reasoning––is used to support the truth claims made from the scientific community (brain death is death) but ch...

Supportive Care in Cancer, 2016

There is increased awareness of the issue of exceptional survival beyond expectations among cance... more There is increased awareness of the issue of exceptional survival beyond expectations among cancer patients with poor prognosis, and researchers are starting to look closely at this phenomenon. In this study, we explored the perceptions of these "exceptional patients" as to their understanding and insight into their unusual experience. We used a qualitative approach consisting of in-depth, open-ended interviews with exceptional patients in two locations, Texas and Israel, from 2007 to 2014. The interviews were audio-recorded and qualitatively analyzed, and gave rise to illness narratives entailing detailed descriptions of patients experience over the course of their disease and treatment. A qualitative content analysis focusing on contextual meaning was utilized. Twenty-nine patients participated in our study. The mean years since diagnosis was 9.55 years (range, 4-23 years). All patients had received conventional treatment, including surgery, chemotherapy, and radiation therapy. One of the prevailing themes in these interviews was related to the patient-doctor relationship. Most participants mentioned that the support they received from one or more physicians was a crucial factor for their exceptional survival. The significance of patient-doctor relationship in cancer survival requires further research. This research is especially important as it adds to the current trend of patient centered care and points to the added value of relationship between health providers and patients. This relationship, as perceived by these exceptional patients, can be a factor that adds to improved survival in cancer care.

Future Oncology, 2015

ABSTRACT Aim: Unexplained prolonged survival given a diagnosis of incurable advanced cancer is a... more ABSTRACT Aim: Unexplained prolonged survival given a diagnosis of incurable advanced cancer is a puzzling phenomenon that recently has attracted more scientific research. The purpose of this study was to add to the understanding of how exceptional patients perceive and explain their unusual experience. We recruited patients for interviews from a population registry, patients with advanced lung or pancreatic malignancy who experienced exceptional survival. In total, 15 participants were interviewed. The main recurrent themes in most of the interviews were patient-doctor communication, family support and the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s proactive attitude. In this study, patients attribute their longevity to relationships with their doctor and their family - not the type of treatment they received. Further research on this phenomenon is needed.

Journal of Contemporary Medical Education, 2013

Innovation: The European Journal of Social Science Research, 2007

The paper seeks to provide an insider's view into the implementation of goals set by the... more The paper seeks to provide an insider's view into the implementation of goals set by the European Commission for socio-economic research. By analysing project coordinators' responses to questionnaires (n= 88), several aspects of the emergence of a European social science research community are examined. Focus is placed on three 'European Added Values', defined within two subsequent calls for research proposals and funding opportunities: framework programmes 4 and 5 (1994–1998, and 1998–2002 accordingly). ...

Annals of Pharmacotherapy, 2011

Over a decade after medical sociologist Phil Brown called for a sociology of diagnosis, Putting a... more Over a decade after medical sociologist Phil Brown called for a sociology of diagnosis, Putting a Name to It provides the first book-length, comprehensive framework for this emerging subdiscipline of medical sociology. Diagnosis is central to medicine. It creates social order, explains illness, identifies treatments, and predicts outcomes. Using concepts of medical sociology, Annemarie Goldstein Jutel sheds light on current knowledge about the components of diagnosis to outline how a sociology of diagnosis would function. She ...

World trends in educational aims and goals between the 1980s and the 2000s.(erişim tarihi 16.05. 2006) http://portal. unesco. org/education/en/ev. phpURL_ID= 37331&URL_DO= DO_TOPIC&URL_S ECTION, 2004

Background This study looks at the aims and goals of education as stated by national authorities ... more Background This study looks at the aims and goals of education as stated by national authorities from a broad range of countries worldwide in two time frames: the 1980s and the most recent period (2000s). The overall purpose is to ascertain the relation between stated intentions over time with progress towards and promotion of goal 6 of the Dakar Framework for Action, which has a particular focus on “improving every aspect of the quality of education” worldwide. To this end, we examined the content of national policy statements ...

Risk-medicine represents a form of medicalisation that is based on the calculation of health-rela... more Risk-medicine represents a form of medicalisation that is based on the calculation of health-related risks rather than on current medical statuses. While the study of risk-medicine has produced ample research, one aspect is critically understudied: its epistemological grounds, and the effects of its conception of knowledge on the social enactment of, and response to, its associated practices. Using prenatal screening and diagnosis as a focal point, this paper proposes a sustained look into a most particular epistemological feature of risk-medicine, i.e. its quest for knowledge of the uncertain and for control over the indeterminate. The author takes on the notions of uncertainty as advanced by quantum mechanics to point to the indeterminacy of statistically evaluated but undiagnosed conditions, and the mechanisms of social control (‘governmentality’) associated with it: ‘indignation’ and blame allocation. The reading women’s resistance to definitions of ‘high risk’ as a sign of ‘bad motherhood’ reflects such governmental attention to a responsible personal management of risks. The analysis uses the story of a baby whose Downs Syndrome diagnosis was only ascertained days after his birth – as narrated by his mother. In a society where the presence/absence of congenital abnormalities stands as a major axis upon which a newborn’s identity is defined, this “high risk” baby remains in a liminal, between and betwixt state for which the mother is blamed, not so much for not having terminated the pregnancy, as for not having gone through diagnostic tests which would have settled this ambiguous state.

The article discusses patient objectification from the viewpoint of the objectifying, rather than... more The article discusses patient objectification from the viewpoint of the objectifying, rather than the objectified party. Resisting a dichotomy between physician-objectifying and ethnographer-humanising, the author portrays objectification not as an essential by-product of professional tendencies, epistemological bases, practical necessities and processes of socialisation but as highly dependent upon context. A further look is given to the settings within which the discursive dynamics of ‘objectivity’ and ‘experience’ come about through artefacts, space, symbols, bodily appearances and so on. The author portrays her relationship with Omer, a brain cancer patient whom she has followed over a period of 18 months and then focuses on her observations of his brain surgery. The fluctuations in the author’s relationship with Omer (as a subject and as a body, alternately) are brought within their immediate contextual elements.

"This chapter presents findings of ethnographic work in a neuro-oncology clinic in Israel. It is... more "This chapter presents findings of ethnographic work in a neuro-oncology
clinic in Israel. It is claimed that patients, close-ones and physicians
engage in creating metaphorical visions of the brain and brain tumours
that reaffirm Cartesian dualism. The ‘brain talk’ involved visible and
spatial terms and results in a particular kind of objectification of the
organ of the self. The overbearing presence of visual media (i.e., magnetic
resonance imaging, computed tomography, angiographic studies) further
gave rise to particular forms of interactions with patients and physicians
where the ‘imageable’ (i.e., the image on the screen) became the
‘imaginable’ (i.e., the metaphor). The images mostly referred to a domain
of mundane objects: a meatball in a dish of spaghetti, a topping of olives
over a pizza, the surface of the moon, a stone, an egg, an animal, a dark
cloud. Furthermore, conversations with family members showed that
formal facts and informed compassion were substituted by concrete
representations. For them, and especially for the patient, these
representations redefined an ungraspable situation, where a tumour – an object – can so easily affect the organ of their subjectivity, into something
comprehensible through the materialistic, often mechanistic actions of
most mundane objects. This, however, also created alienated objects
within the boundaries of their own embodied selves. Patients, on the one
hand, did not reject their own sense of ‘own-ness’, of having a lifeworld
(lebenswelt) as subjective agents, but on the other, did talk about their
own interiors as being an ‘other’: an object visible, observable and
imaginable from a third-person standpoint – a standpoint drawing its
authority from biomedical epistemology and practice."

This paper provides a close, in situ look into the life of a neuro-oncology (brain cancer) clinic... more This paper provides a close, in situ look into the life of a neuro-oncology (brain cancer) clinic of a large hospital in Israel, based on a six-month participant observation. It points to the many challenges involved in the solidification of brain tumour diagnoses by different experts, and presents these epistemological and practical complexities as they uncover in daily routine. The paper’s task is two-fold: first, to underline the technological and epistemological grounds of ‘expertise’ in the medicoscientific practice of diagnosis, and their roles in the assertion of expert authoritativeness; and second, to provide analytical tools to approach the complexity of diagnostic processes, the potential frictions it may create, and the
related mechanisms of resolution. These mechanisms include Hierarchisation: ranking the relative validity and reliability of the different sources of information, eventually prioritising reports from more authoritative expertises (e.g. imaging reports would be considered more reliable than patients’ accounts); Sequencing: relying upon the temporal dimension, and defining the discrepancy itself as a diagnostic sign (e.g. the degradation or amelioration of the disease); Negotiation: adjusting diagnoses
via a preliminary exchange between experts and a consequent ‘‘fine tuning’’ of the reports (e.g. radiologists being aware of clinical evaluations before finalising their reports); Peripheralising: turning to other expertises to ‘‘explain away’’ symptoms that do not fit with a well established initial diagnosis
(e.g. asserting that a symptom’s source was orthopaedic rather than neurological); and pragmatism: using information only as far as it provided sufficient grounds for treatment decisions, leaving ambiguities unresolved. These five mechanisms are presented here in the context of the daily work of the clinic.

"The study explores the process of boundary demarcation within hospital settings by examining a ... more "The study explores the process of boundary demarcation within
hospital settings by examining a new phenomenon in modern
medicine: collaboration between alternative and biomedical
practitioners (primarily physicians) working together in
biomedical settings. The study uses qualitative methods to
examine the nature of this collaboration by calling attention
to the ways in which the biomedical profession manages to
secure its boundaries and to protect its hard-core professional
knowledge. It identifies the processes of exclusion and
marginalization as the main mechanisms by which symbolic
boundaries are marked daily in the professional field. These
processes enable the biomedical profession to contain its
competitors and at the same time to avoid overt confrontations
and mitigate potential tensions between the two medical systems."

This paper presents the concept of 'risk-medicine' through the analysis of the rejection of prena... more This paper presents the concept of 'risk-medicine' through the analysis of the rejection of prenatal screening among ultra Orthodox Jews in Israel. The foundations of this phenomenon are examined, defining 'risk' as a major socio-cultural feature of late modern Western society. The authors describe eight possible components of resistance to biomedicine, some being specifically applicable to risk-medicine: cultural discrepancy, lack of information, religious prohibitions, risk-aversion, incompatible health and illness cosmologies, fear and mistrust, governmental control, and irreconcilable epistemological differences. The analysis identifies two fundamental dimensions associated with risk-medicine: its epistemological basis, and the governmental surveillance that it involves. While the former stems from diverging conceptions on the values of different forms of 'gnosis' (probabilities vs. certainty) the latter draws upon the relationship between the state and risk-medicine, portraying ultra Orthodox women's rejection of prenatal screening as a form of resistance to nationalist, secular forces. The paper advances new concepts (namely 'risk-medicine' and 'gnosis' as related to 'pro-gnosis' and 'dia-gnosis') that may constitute a ground for further research on forms of medical epistemologies and practices and their related forms of resistance, namely in the context of religious and ideological incompatibilities.

This article focuses on midwives who practice complementary and alternative medicine (CAM) in Isr... more This article focuses on midwives who practice complementary and alternative medicine (CAM) in Israel. After qualifying as nurses in mainstream biomedical institutions, these midwives have, at some point in their careers, opted to study a variety of CAM skills and practice them in hospital delivery rooms in Israel. The authors explore the relationship of selected elements of feminist ideology to the epistemology of CAM midwives. Seven context-specific themes are viewed as central to their epistemological stance: rejection of the medicalization of birth; a strong belief in the "naturalness" of childbirth; rejection of the overuse of technology; empowerment of women; nostalgia and reverence for the past; centrality of intuition, feeling, and emotion; and active advocacy. In-depth, semistructured interviews were carried out during 2004 to 2005 with 13 midwives. These narratives provided empirical material for a qualitative analysis. Evidence is shown to demonstrate the unique feminist quality of the core beliefs of the CAM midwives.

This comparative study of nurses and midwives practicing CAM is an additional link in our on-goin... more This comparative study of nurses and midwives practicing CAM is an additional link in our on-going research concerning the co-habitation of bio and alternative medicine in Israel. We have been interested in negotiative processes of boundary crossing which take place when alternative practitioners work within the organizational context of bio medical institutions.
The present paper expands the context of our research by focusing on two groups of allied health professionals who utilize CAM practices. Like increasing numbers of physicians who practice CAM, the nurses and midwives under study are trained and experienced in mainstream bio medicine and have at some point in their careers opted to study and practice a variety of CAM skills. Their experiences in the processes of boundary crossing are analyzed in terms of 'boundary work' to include practices utilized in the work context.

The paper seeks to provide an insider's view into the implementation of goals set by the European... more The paper seeks to provide an insider's view into the implementation of goals set by the European Commission for socio-economic research. By analysing project coordinators' responses to questionnaires (n=88), several aspects of the emergence of a European social science research community are examined. Focus is placed on three 'European Added Values', defined within two subsequent calls for research proposals and funding opportunities: framework programmes 4 and 5 (1994-1998, and 1998-2002 accordingly). These 'Added Values' will set the expected features of European-funded research projects, and will include: (1) transnationality - the involvement of researchers from a variety of EU states; (2) applied research - the potential implementation of outcomes in socioeconomic policy; and (3) interdisciplinarity - the integration and collaboration of different disciplinary perspectives. These 'ideals' were tested against reports as to the reality of the research practices, and found to have a significant compatibility, as well as several discrepancies, with the objectives set out by the EU research committee. This paper allows for an understanding of the dynamics of European research consortia, and the factors involved in the success or failure in attaining the overarching goals of the EU Commission.

I tend to be weary of calls for new subdisciplines. We are all familiar with the news of a creati... more I tend to be weary of calls for new subdisciplines. We are all familiar with the news of a creative and ambitious scholar drawing a circle and “putting a name to it.” The “it” then desperately seeks epistemological status as conferences and journals thrive under ever more imaginative terms en vogue. These enterprises often whither without a voice.

Science, Technology, & Human Values

Supportive Care in Cancer, 2016

Future Oncology, 2015

Journal of Contemporary Medical Education, 2013

Innovation: The European Journal of Social Science Research, 2007

Annals of Pharmacotherapy, 2011

Are we our brains? This question has troubled Western society for centuries, and still does today... more Are we our brains?
This question has troubled Western society for centuries, and still does today. Philosophers, psychologists, psychiatrists and neuroscientists - as much as the lay public - battle with the question of whether our personality, sense of self and states of mind can truly be explained through a scientific study of the brain, and whether one can at least correlate these with brain activity and structure. With the recent hyperbolic advances made in neuroscience, these questions arise in the form of intensive and broad debates on whether one may be able, at some point in the future, to fully account for what we cherish more than all, our sense that we are more than a lump of flesh.
This "more" however, does not belong to the realm of science: in the laboratory, one must deal with observable and operalizationable phenomena – everything core subjectivity (’qualia’- e.g. the experience of pain, of seeing the color red) is not. How can neuroscience approach the mind without losing its brain? How well has it done thus far, and what may we expect in the future?
This talk will suggest one – among many – approaches to this quandary, by looking at the history and current practices of brain localization. By introducing the mind-body conundrum into the study of this enterprise, we will consider the extent to which localization and classification of brain/mind functions serve as a way to materialize what is/was believed to be beyond ’matter’. The following debate will allow a discussion of an issue that concerns us all

Notions such as "cerebral subject" and "neurochemical self" have inspired recent research in the ... more Notions such as "cerebral subject" and "neurochemical self" have inspired recent research in the social studies of the neurosciences by providing useful interpretive tools. The belief according to which we are essentially defined by cerebral anatomy and neurochemical states, or that the brain is the organ of personhood, are not rooted on research alone. They involve the interests of policy-makers and of the economic actors in the public health marketplace, public statements by high-profile neuroscientists, media reports of selected neuroscientific results, speculations about the present and future applications of those results, the proliferation of neuroimaging studies on topics of potential moral and ethical import. In short, the anthropological figures we are interested in are part of an expanding "neurocultural" universe. This "universe" is both the driving force and the consequence of the premise that the neurosciences constitute the most important scientific frontier of the twenty-first century. In a context where every field of knowledge seems to acquire its own “neuro” version, from neuroeducation and neurolaw to neuroesthetics, neurotheology, neuroanthropology and neuromarketing, the cerebral subject seems to represent a view of the human dominant in both the individual and the collective spheres. I would like to present these ideas and show how relevant these may be to researchers in neuroscience.

Are we our brains? This question has troubled Western society for centuries, and still does toda... more Are we our brains?
This question has troubled Western society for centuries, and still does today. Philosophers, psychologists, psychiatrists and neuroscientists - as much as the lay public - battle with the question of whether our personality, sense of self and states of mind can truly be explained through a scientific study of the brain, and whether one can at least correlate these with brain activity and structure. With the recent hyperbolic advances made in neuroscience, these questions arise in the form of intensive and broad debates on whether one may be able, at some point in the future, to fully account for what we cherish more than all, our sense that we are more than a lump of flesh.
This "more" however, does not belong to the realm of science: in the laboratory, one must deal with observable and operalizationable phenomena – everything core subjectivity ('qualia'- e.g. the experience of pain, of seeing the color red) is not. How can neuroscience approach the mind without losing its brain? How well has it done thus far, and what may we expect in the future?
This talk will suggest one – among many – approaches to this quandary, by looking at the history and current practices of brain localization. By introducing the mind-body conundrum into the study of this enterprise, we will consider the extent to which localization and classification of brain/mind functions serve as a way to materialize what is/was believed to be beyond 'matter'. The following debate will allow a discussion of an issue that concerns us all.