This article first describes the unique place of emergency medicine (EM) within the American healthcare system. Second, it examines the uncertainty that underlies the practice of emergency medicine. It then describes how risk is perceived, negotiated and minimised by emergency physicians in their day-to-day practice. Finally, it explores how the management of medical risk is related to the establishment of trust within the physician–patient interaction and to the construction of the 'competent physician'. In caring for patients, the emergency physician must minimise risk and instil trust within a pressured, time-sensitive environment. Consequently, the management of risk and display of competence to patients are simultaneously accomplished by symbolic representations, the use of medical diagnostic tools in decision-making, and narrative construction within the clinical interaction.
The Case of Emergency Medicine
Transparency, risk, and good governance in Indonesia
Early childhood education and care programs in Indonesia developed rapidly in the aftermath of the 2006 earthquake centered south of Yogyakarta. The newly empowered self-directed learner at the center of these programs seemed to follow from the emergence of another child in this devastated landscape: the traumatized child in need of healing. The appearance of these images of childhood along with Indonesia’s neoliberal democratization reiterates the long-standing relationship between childhood and rule. Grounded in long-term ethnographic work in the Yogyakarta area, this article traces a conceptual link between the shift to transparent and accountable good governance in post-Suharto Indonesia and the desire to produce a newly transparent childhood ready for intervention. The generative power of history, trauma, and the interior self is contrasted with risk management, nongovernmental governance, and the exteriorization of self and state to challenge the unquestioned good of empowerment and transparency.
Asbestos, Aids and Genetically Modified Agriculture
David Vogel and Jabril Bensedrine
This article compares three health, safety and environmental policies in France and the United States: the regulation of asbestos, the regulatory impact of the health crisis associated with AIDS, and the regulation of genetically modified foods and seeds. These cases illustrate the evolution of regulatory policies and politics in France and the United States over the last three decades. In brief, risk management policies have become less politicized and risk averse in the United States, while they have become more politicized and risk averse in France. In many respects, regulatory politics and policies in France during the 1990s resemble those of the United States from the 1960s and through the late 1980s.
This article investigates direct-to-consumer advertising in Sweden for Gardasil, the HPV vaccine, as a contemporary gendered technology of the adolescent girl body. It explores how, by constructing girls as ideal users of the vaccine, advertising campaigns encourage adolescent girls to vaccinate themselves. Using a feminist visual discourse analysis, the article examines how different girl subjectivities are constructed through advertising, and presented as fit for Gardasil use and consumption. It highlights how, along with their parents, adolescent girls in Sweden are encouraged to assume responsibility for managing the risks of cervical cancer in order to help secure their future health, sexuality and normality. It argues that the Gardasil campaign, in being addressed to individual members of the population, serves to articulate global and national discourses of girlhood, sexuality, (sexual) health responsibility, risk management and consumption.
Early twenty-first century North American journalists often claim that social changes such as women's liberation and civil rights have had a dark side for girls. For supposedly abandoning the safety of their traditional role in the home, girls are disproportionately characterized as being at risk of victimization, while also being increasingly cast as risks to themselves and others. Using mixed-methods content analysis, this article demonstrates that the social construct of risky girls crystallized for Toronto news after the 1997 murder of Reena Virk in British Columbia through a raced, classed, and gendered moral panic over bad girls. Discourses changed from talk of youth violence before the murder to talk of risky girls after it. By conflating victimization with offending, risky girl discourses prioritize risk management over needs. This conflation results in the increased policing and incarceration of girls and youth of color, ultimately reinforcing social inequalities like racism and patriarchy.
Jeffrey A. Sluka
The ethnography of state terror is “high risk” research and there are real personal dangers for anyone who conducts fieldwork on this issue. Managing such dangers has particularly become an issue for those conducting primary research with perpetrators of state terror—the “rank and file” who apply the electric cattle prods and pull the triggers—and all of the researchers I know who have taken this path have been threatened in one form or another. Th is article reviews the core literature and latest developments in managing the physical dangers inherent in the ethnography of political violence and state terror, particularly fieldwork or primary research with the actual perpetrators themselves, makes practical recommendations for managing such dangers, and presents some ideas for developing risk management plans or protocols for researcher survival in perilous field sites.
Mobilizing Children’s Voices in UK Flood Risk Management
Alison Lloyd Williams, Amanda Bingley, Marion Walker, Maggie Mort and Virginia Howells
This article reports on a project, led jointly by Lancaster University and Save the Children UK, that used mobile, creative, and performance-based methods to understand children’s experiences and perceptions of the 2013–2014 UK winter floods and to promote their voices in flood risk management. We argue that our action-based methodology situated the children as “flood actors” by focusing on their sensory experience of the floods and thus their embodied knowledge and expertise. The research activities of walking, talking, and taking photographs around the flooded landscape, as well as model making and the use of theater and performance, helped to “mobilize” the children not only to recall what they did during the floods but also to identify and communicate to policy makers and practitioners how we can all do things differently before, during, and after flooding.
The Ethnography of the University Initiative (EUI) joins a long history of critique, challenge and transformation of higher education. EUI courses are an important site for the creation of non-traditional narratives in which students challenge 'business-as-usual' in higher education. For under-represented students, this includes inquiry and analysis of the racial status quo at the University. In this article, I provide a student's perspective on EUI through my own experiences with EUI research as both an undergraduate and later graduate student investigating race and racism at the University of Illinois at Urbana-Champaign (U of I). Using ethnographic methods and drawing on critical race theory, I provide two examples of EUI research that critiqued the University's management of race. The first example is a collaborative ethnography of the Brown versus Board of Education Commemoration at U of I – a project that I joined as an undergraduate (Abelmann et al. 2007); and the second is my own dissertation on 'racial risk management', a project that emerged from my encounter with EUI. I discuss both projects as examples of Critical Race Ethnography, namely works based on empirical research that challenge institutions' racial composition, structure and climate.
This article examines current debates for and against Humanitarian Mine Action (HMA) in Myanmar. The analysis, based on interviews with key local, national, and international actors involved in HMA, reveals why so many of them regard the mapping and removal of “nuisance” landmines as posing a security threat to the peace process. (Landmines deny people access to territory; when conflict ends, these landmines no longer serve a strategic purpose and thus become a dangerous nuisance.) These same debates also shed light on the growing role risk management approaches now take in Myanmar as a response to decades of authoritarian misrule by a succession of military regimes. The landmines, although buried in the ground, actively unsettle such good governance initiatives and the neoliberal development projects to which they are often linked, most often by reterritorializing military, humanitarian, political, and economic authority in overlapping and conflicting ways at multiple scales. The findings reveal why HMA actors resist labeling the crisis landmine contamination poses to civilians as a “crisis” that requires immediate humanitarian action.