(CAD1a) Institutional Ethnographies and Critical Sociologies of Health and Health Care in Canada

This session features novel work from critical scholars who employ Canadian feminist sociologist Dorothy Smith’s approach to studies in the social organization of knowledge, known as institutional ethnography (IE). IE’s focus on exploring and critiquing ruling relations that organize contemporary capitalist societies offers a particular contribution to scholarship and activism committed to creating equitable futures. Scholars working with IE have created a trajectory of research that critically interrogates social relations that shape inequities across health care, education, and the social service sector. More recently, scholars have developed creative applications of IE in studies that traverse such settings as digital online spaces, urban landscapes, and the criminal legal system. This panel features papers that reflect on how IE can contribute to broad efforts to challenge hate and sustain shared futures through discussions of examples of institutional ethnographic projects and/or through methodological reflections on the core features of institutional ethnography. Tags: Canadian Sociology, Health and Care, Knowledge

Organizers: Colin Hastings, University of Waterloo, Eric Mykhalovskiy, York University; Chair: Colin Hastings, University of Waterloo

Presentations

Alexander McClelland, Institute of Criminology and Criminal Justice

Carceral Public Health: Mapping HIV Public Health Surveillance Systems from the Ground Up

This paper reflects my expanding research program examining carcerality or “the carceral” and considers its usefulness for examining coercive public health practices. The concept of carcerality is often narrowly applied to describe the nature of penal systems and punishment. Here however, as a critical scholar interested in ways that criminal legal regulation merges and intersects with public health regulation, I adopt a broader perspective to highlight how carceral logic expands beyond prison walls. In this analysis, I examine how biomaterial and personal information from people living with HIV travels through a range of information management systems across different jurisdictions to enable surveillance in the background, without peoples knowledge and consent, and which intersects with forms of policing and surveillance. This paper is organized into three sections. First, I situate myself within a tradition of literature (that spans from Michel Foucault to Ruha Benjamin) that focus on the ongoing expansion of carceral logic across various sectors of society. Scholars sometimes refer to this expansion as the “carceral continuum” to call attention to less-obvious forms of incarceration and punishment and to highlight how individuals and communities are caught up in the crosshairs of various carceral regimes. Next, I describe ongoing research into the Ontario public health system and forms of carceral public health such as public health orders, including how In some regions, local provincial public health authorities directly access electronic medical records, including viral load and other diagnostics, via a range of diverse databases connected to the Ontario healthcare system, the shelter system, and policing. In this project, I think across critical criminology, abolitionist thought, critical social science studies of public health, science and technology scholarship, and critical race studies in an effort to expose, illuminate and transform how carceral public health practices are enacted, particularly on groups made vulnerable by social structures. Finally, I close by describing our approach to activist research in this project and reflect on how an understanding of some public health practices as “carceral” in nature may be mobilized to contribute to ongoing activist efforts.

Eric Mykhalovskiy, York University

Institutional Ethnography, Activism, and Social Change

This paper explores questions and assumptions about the relationship between social transformation and the forms of knowledge about institutional relations made possible by institutional ethnography (IE). While the use of research for progressive social change and the political commitments of inquiry are key dimensions of IE, they have not been the subject of sustained or focused discussion beyond general accounts of practices that center experience as a point of departure for inquiry and the need to counter objectified forms of knowing upon which contemporary forms of ruling rely.  This paper poses questions about assumptions about institutional ethnographic inquiry and social change. It emphasizes multiple traditions within institutional ethnography that express a relation between knowledge, knower, object of inquiry and change including community-engaged research, institutional “tinkering,” and political activist ethnography. The paper asks whether these traditions expresse a modernist logic of knowledge through which the researcher “makes the unknown known”, whether IE is limited to a reformist politics, and how IE might relate to a radical or utopian ethic of social transformation. 

Charlotte Smith, York University

Drug User Activism and Institutional Ethnography

The past few decades have witnessed the growth of a trajectory of critical drug policy activist research that is informed by the goals and demands of drug user activism and takes seriously the need to be grounded in the lived experiences of people who use drugs. This body of scholarship includes drug user activists as researchers, researchers working alongside drug-user activists in community and/or co-publishing articles with drug users, and working within or alongside drug user organizations to lend legitimacy to their movements and/or goals via scholarship and its associated social and institutional capital. This area of scholarship is explicitly critical of criminal law, the regulation and punishment of people who use drugs, and punitive approaches to drug use. This scholarship has also been important in promoting the health and well-being of drug users, as well as explicating the harms produced by drug prohibition - such as increase in risks fatal and nonfatal overdoses, incarceration, marginalization and isolation, poverty, violence, and trauma. At the same time, there has been a trajectory of activist scholarship wherein researchers working with institutional ethnography, as well as political activist ethnography, have sought to address questions activists encounter in their work and produce knowledge that is useful to them by making visible how the ruling regimes that they are up against and that organize their experiences are organized. Despite the recognition of institutional ethnography as an activist research methodology, it has been seldom employed within critical drugs research. In this presentation, I place institutional ethnography in dialogue with this body of critical drug policy work. I argue that the ethical and political implications of institutional ethnography are commensurate with the core commitments of the body of critical drug policy work I discuss above and consider how institutional ethnography might aid in forwarding the goals of this scholarly/activist work. As institutional ethnographers take everyday and lived experiences as an entry to inquiry, it is a promising method of inquiry for scholarship that is grounded in the questions and problems facing people who use drugs. While the existing scholarship in this area of critical drugs research has explicated people’s experiences of drug prohibition through voicing their experiences and concerns, drugs researchers working with institutional ethnography can make visible how these experiences are hooked into and organized by ruling relations that organize drug prohibition – such as criminal law, medicine, public health services and regulation in these systems. Focusing on some of its core tenets, in this presentation I consider how institutional ethnography as a method of inquiry might propel the ways that drug criminalization and punitive policies are typically analyzed and written about in this area of drugs scholarship. Might different sorts of questions might be asked - and answered - that contribute to meeting peoples experienced needs and movement goals? And how might institutional ethnographys focus on transforming institutional relations dismantle ruling regimes that organize the experiences of people who use drugs and open up avenues that contribute to drug user liberation? 

Matthew Strang, York University

Spare Parts/Priceless: the anatomy of living organ donation

Sustainability, natural resources, and living green are likely terms most would connect to life extension via environmental movements rather than the biotechnology of living organ donation. However, living organ donation is often presented as the “alternative” option to extend some sick folks lives while potentially risking others. My Institutional ethnography investigates the social organization of living organ donation. For this paper I overview what living organ donors have to do in practice to be donors and present preliminary analysis from my interview with living organ donors that point to social relations that create inequities. Some thoughts on my secondary interviews and ongoing investigational pathways are also discussed. Finally, I think through how might living organ donation be connected to broader interrogations of capitalism and the right to life, and how I as a scholar bring my critical lenses to living organ donation.