PO Box 217
7500 AE Enschede
Telephone: (053) 489 3348
Fax: (053) 489 2159
Dirk Stemerding was trained in biology and is now working as assistant professor in the field of Science and Technology Studies.
General theme of his research is the study of societal embedding of technology as a process in which actors have to articulate the potentialities of a new technology, the demand for the technology, the network of production and maintenance, and issues of political and cultural acceptability. In the past ten years he has worked on a range of projects studying (1) the introduction of new forms of genetic (DNA-)diagnosis in clinical genetics as well as other clinical practices, and (2) issues of government regulation in the field of the new genetics. As principal investigator of the recently established Dutch Centre for Society and Genetics Dirk Stemerding is currently planning work which aims at a prospective analysis and interactive scenario study focussing on the dynamics and implications of the shift from established practices of clinical genetics to emerging practices of community genetics.
Stemerding D. (1993), “How to deal with the implications of human genome research? On the bounds of a politics of regulation”, in: H. Haker, R. Hearn and K. Steigleder (eds.), Ethics of Human Genome Analysis. European Perspectives, Tübingen, Attempto Verlag: 217-235.
Koch L., Stemerding D. (1994), “The sociology of entrenchment: a cystic fibrosis test for everyone?”, Social Science & Medicine 39 (9): 1211-1220.
Stemerding D. (1995a), “The entrenchment of human genome technology in society: on shifting boundaries between private and public discourses”, in: R. von Schomberg (ed.), Contested Technology. Ethics, Risk and Public Debate, Tilburg, International Centre for Human and Public Affairs: 143-154.
Stemerding D., Jelsma J. (1995b), “Wege zur sozialverträglichen Gentechnologie in den Niederlanden”, Österreichische Zeitschrift für Soziologie 20 (3): 56-69.
Stemerding D., Jelsma J. (1996), “Compensatory ethics for the human genome project”, Science as Culture 5 (3): 335-351.
Stemerding D., Koch L., Bourret P. (1997), “DNA-diagnosis and the emergence of cancergenetic services in European health care”, European Journal of Human Genetics 5 (suppl. 2): 25-30.
Bourret P., Stemerding D., Koch L. (1998a), “L’oncogénétique: une activité nouvelle entre recherche et médecine”, Bulletin Cancer 85 (3): 239-242.
Bourret P., Koch L., Stemerding D. (1998b), “DNA diagnosis and the emergence of cancer-genetic services in European health care”. In: P. Wheale, R. von Schomberg, P. Glasner, The Social Management of Genetic Engineering, London, Ashgate: 117 -138.
Stemerding D., Hilgartner S. (1998c), “Means of coordination in making biological science: on the mapping of plants, animals and genes”. In: C. Disco, B. van der Meulen (eds.), Getting New Technologies Together. Studies in making sociotechnical order. Berlijn, de Gruyter: 39-69.
Berkel D. van, Stemerding D. (1999), “Maternale serumscreening, politieke besluitvorming en de rol van maatschappelijke leerprocessen”, Tijdschrift voor Gezondheidswetenschappen 77 (4): 225-234.
Stemerding D., D. van Berkel (2001), “Maternal serumscreening, political descision-making and social learning”, Health Policy 56: 111-125.
Stemerding D., J. Jelsma (2003), “Dutch roads to a socially acceptable gene technology”, International Journal of Biotechnology 5(1): 47-57.
Stemerding D., A.P. Nelis (2004), “New practices of screening in the field of cancer genetics: a co-evolutionary perspective”. In: P. Glasner (ed.), Reconfigurating Nature. Issues and Debates in the New Genetics. Aldershot, Ashgate: 203-222.
Stemerding D., A.P. Nelis (te verschijnen), “Choices and choosing in cancer genetics”, in H. Harbers (ed.), Inside the Politics ofTechnology: Agency and normativity in the co-production of technology and society.
General theme of research is the study of societal embedding of technology as a process in which actors have to articulate the potentialities of a new technology, the demand for the technology, the network of production and maintenance, and issues of political and cultural acceptability. Particular point of interest in the study of societal embedding is the way in which processes of articulation take shape in, and are framed by socio-technical regimes. In a number of different research projects studies have been made of the introduction of new forms of genetic (DNA-)diagnosis in clinical genetics as well as other clinical practices.
Studies have been made of (1) the introduction of DNA diagnosis for cystic fibrosis in clinical genetics and the (Danish) debate on the prospect of population based carrier testing for this genetic disease (in collaboration with Lene Koch, University of Copenhagen: 1994 and also 1995a), (2) the introduction of DNA diagnosis for hereditary forms of colon- and breast cancer in three European countries - Denmark, France and the Netherlands. This latter study was made (in collaboration with Lene Koch and Pascale Bourret, University of Aix-en-Provence) as partner in a EU Concerted Action Programme on Genetic Services in Europe. In these studies, the dynamics of societal embedding is understood in the context of pre-existing regimes of diagnosis and screening in the fields of clinical and cancer genetics (1997, 1998a and 1998b).
Based on the earlier studies in the field of cancer genetics, a project has been started (in collaboration with Annemarie Mol, University of Twente) focussing on the norms incorporated in cancergenetic practices and regimes. In (studies of) medical practices, normativity is pre-dominantly connected with matters of choice, especially choices of patients - whether or not to take a genetic test for example. In this project we are interested in the ways in which patient choices are shaped by earlier decisions incorporated in technical and organizational practices in the fields of oncology and clinical genetics.
In processes of societal embedding, the political and cultural acceptability of a new technologies frequently becomes an important subject of debate. Thus, societal embedding may be seen as a learning process about the (potential) effects of a new technology, involving a variety of actors. From this perspective, government regulation as a way to control the effects of new technologies often appears as a too limited approach. The limitations of existing regimes of regulation have been studied in three different projects relating to the introduction of new genetic technologies.
A study of the ways in which issues of regulation have been defined (in the Netherlands) by actors involved in the human genome innovation network and by the government and parliament (1993 and also 1996).
Attempts of the Dutch government to regulate activities in the field of genetic modification of animals on the basis of animal welfare legislation – the so-called ‘Herman’ case - have been contrasted (in a study in collaboration with Jaap Jelsma, University of Twente) with the impact of interactive learning processes in the field of novel foods initiated by a Dutch consumer organisation (1995b).
The introduction of a new genetic (serum)screening test in Dutch prenatal care has been studied (in collaboration with Dymphie van Berkel, University of Utrecht) as a complex learning process, revealing a clear and unresolved tension between the promotional activities of professionals in the field and wider debates about possible effects, involving actors like the Dutch Health Council, the government, and midwifes, social scientists or philosophers speaking for those directly affected by the new technology (1999).
Currently planning work which aims at a prospective analysis of the shift from established practices of clinical genetics to emerging practices of community genetics, a shift related to developments in genomics and visible in particular on the level of expectations.
1 March 2004
- Dirk Stemerding
- Department of Science, Technology & Society
- School of Management and Governance
- University of Twente
In genomics research we see a shift from relatively rare monogenetic hereditary disorders to the multi-factorial genetic component of a variety of common diseases. In relation to this shift we see also attempts to move from established practices of clinical genetics to more wide-ranging practices of community genetics, with the aim to create ways in which genomics may be used on a broad front for new prevention oriented forms of public health (Cornel 2002; Broertjes et al. 2002; Khoury et al. 2000). The notion of community genetics thus provides us with a model for the societal embedding of genomics and as such it raises both high expectations and concerns. There is the promise of increasing possibilities to take care of individual health risks, but also fear of growing pressures and responsibilities put on individuals. In this project we will develop an interactive scenario study as a means to involve a variety of professional and public stakeholders in interaction and debate about the future prospects of community genetics and the relevant policy questions related to these futures.
Scenario’s have been made in many different fields with different purposes and using a variety of approaches (Notten et al. 2003). Many of these scenario’s have a very general nature and often the relationship between technological and societal developments is not very well specified. In this project we will approach developments in the field of community genetics as outcomes of a co-evolution of scientific, technological and societal developments in which patterns emerge – of shared expecations and networks – indicating directions in which further developments and possible impacts may arise (Rip and Kemp 1998; Geels 2002a). From our co-evolutionary perspective developments in the field of community genetics will be analysed at three different levels:
The microlevel of socio-technical ‘niches’: locations (laboratories, clinics) where scientists and professionals work on new technological options (new forms of neonatal screening for example) and where promises and expectations are articulated about the future potential and impacts of these options. Patterns may emerge here in the form of more widely shared expecations and agenda’s stimulating particular activities.
The mesolevel of socio-technical ‘regimes’: established practices where particular options or services (like prenatal diagnosis) are offered on a wide scale and are embedded in extended networks and regulatory and financial arrangements. Patterns may arise here in the form of path dependencies, whereby particular innovations are facilitated or constrained by existing networks, investments, or regulations.
The macrolevel of a socio-technical ‘landscape’ in the form of a relatively stable environment characterised by long-term patterns, like the organisation of the national health care system or dominant scientific, technological or cultural trends.
In addition to a multilevel analysis of developments and patterns in the field of community genetics, the scenario exercise in this project will also be informed by different notions and regimes of responsibility, giving priority either to the individual consumer, or to political decision-making. Future developments in the field of community genetics may be perceived as opportunities to enhance the individual responsibility for an increasing variety of personal health risks (in accordance with established models of clinical genetics), but may also be perceived as strengthening the need for political decision-making (in accordance with existing regulations of population screening) (Horstman et al. 1999). In this project we may thus conceive of different scenario’s, both in terms of the dynamics shaping future developments, and in terms of the ensuing distribution of responsibilities in the field of community genetics.
What we propose in this project is a form of ‘controled speculation’. It is controlled speculation because the scenario’s will be developed in close interaction with those involved in the field, and because the scenario’s are informed by a co-evolutionary framework emphasizing ongoing dynamics of technological development, the actors and networks involved, and the further (and possibly conflictual) embedding in society, with particular attention to existing and emerging patterns. It is controlled speculation because the scenario’s are open-ended and will serve to identify different possible futures and a variety of values implicated in these futures. In this way the project will serve as an instrument to make explicit the hopes and fears projected on the notion of community genetics, and to stimulate and inform professional, public and policy debates about the various and complex impacts of genomics for the development of public health care. In order the realize this aim, we will also take advantage in this project of methods and experiences available in the field of interactive technology assessment (Grin et al. 1997; Reuzel et al. 2001).
The approach and objectives of this project can be summarized in the following research question: how to articulate the endogenous futures of community genetics in such a way that potential normative and policy dilemma’s can be anticipated and thus be made subject of debate both among professionals and the broader public? The notion of endogenous futures expresses the idea that future developments in the field of community genetics are shaped by a variety of promises, expectations, concerns, initiatives, networks, values and rules which are part of present-day practices and which promote or constrain further actions and interactions in this field (Rip 2002a). In this project we will articulate endogenous futures through a number of steps, each involving specific questions and methods of research.
Analysis of promises, expectations and activities which shape emerging practices in the field of community genetics. Our approach in this step is based on empirical and theoretical work about the dynamics of expectations in science and technology (Van Lente 2000; Van Lente and Rip 1998), about ‘scripts of the future’ embodied in activities of research, design and development (De Laat 2000; De Laat and Larédo 1998), and about the role of learning in processes of societal embedding of new technologies (Stemerding and Van Berkel 2001; Deuten et al. 1997; Rip 1995; Koch and Stemerding 1994). In our analysis we will distinguish various learning processes in which the co-evolution of technology and society is taking shape, and we will show how, in the emerging field of community genetics, promises, expectations and activities relate to these various learning processes. More specifically the analysis will focus on:
- proposed (technological) options for screening, prevention and intervention and related (clinical) research programmes;
- prospective users and demand;
- required organisation of services;
- potential ethical implications and issues of regulation;
- implied (cultural) notions of health, risk and responsibility.
Mapping of existing configurations on the level of niches, regimes and landscapes which constitute relevant experiences and contexts for the societal embedding of emerging notions and activities of community genetics. This step in our analysis is based on a multilevel approach to the dynamics of technological development, showing patterns of co-evolution as a result of interactions between various levels of socio-technical change: novelties emerging from particular niches (at the microlevel), which are taken up in and may modify existing regimes (at the mesolevel), and thus may interact (at the macrolevel) with slowly changing socio-technical landscapes (Geels 2002b; Rip 2002b; Kemp et al. 2001). From this multilevel perspective, our analysis will include:
- existing practices and arrangements of primary and preventive care;
- established screening programmes;
- current patterns of demand;
- established forms of regulation;
- materially, institutionally and culturally entrenched normative assumptions and distributions of responsibility.
Identification and anticipation of ways in which emerging promises, expectations and activities in the field of community genetics might relate to and interact with existing configurations at the level of niches, regimes and landscapes. The aim of this step is a prospective analysis of potential patterns of co-evolution, which may imply more or less radical modifications of existing configurations and thus involve various challenges, tensions and dilemma’s (Geels 2002a). In this prospective analysis we will in particular focus on the possible ways in which new technological options and related transformations in the field of community genetics might impinge on and interact with current normative assumptions and distributions of responsibility. For this part of our analysis, we will take as a starting-point a recently proposed pragmatist approach to the interaction between technology and ethics (Keulartz et al. 2004; Schermer and Keulartz 2002).
The outcomes of our prospective analysis will be translated in a scenario exercise presenting potential and alternative patterns of co-evolution as a basis for discussion of the normative and policy dilemma’s relating to emerging practices of community genetics. In these scenario’s we will articulate different ways in which emerging practices may interact with and be promoted or constrained by (relatively) stable or changing (material, institutional and normative) configurations at different levels of socio-technical development. Although there is relevant experience available with the construction of socio-technical scenario’s (Elzen et al. 2002), this project will also imply further development of the proposed scenario methodology (on this point we also see possibilities for fruitful cooperation with other groups within the CSG).
Data needed in these various steps will be collected from literature and interviews with professionals in genetics and medicine, representatives from patient organisations, and actors in the field of policy-making. The third and fourth step in the workplan will be supported through interactive workshops (and perhaps also focusgroups) involving participants with different backgrounds.
The first year of the project will be mainly devoted to the first two steps of the workplan and will result in two publications:
- Discussion of the concept and ‘future history’ of community genetics in both a national and international context.
- Review of available scenario’s in the field of genetics and predictive/preventive medicine and discussion of our own scenario methodology.
In the second year work will be focussed on the elaboration of the prospective analysis and its translation in a scenario-exercise. At the start of this year an interactive workshop will be organised with the aim to discuss potential patterns of co-evolution and to identify challenges, tensions and (normative) dilemma’s related to these developments. The design and results of the scenario exercise will be presented and discussed in a second workshop at the end of that year. From this work two publications will result:
- Discussion of the prospects for societal embedding of community genetics (in terms of co-evolution), including the elaboration of a pragmatist perspective on the potential normative implications.
- Report with discussion of the design, content and implications of different scenario’s in the field of community genetics.
The project will be managed by Dr Dirk Stemerding (Department of Science, Technology and Society, University of Twente).
For supervision an advisory committee will be established with the following members:
- Prof. dr. Martina Cornel (Community Genetics EMGO VUMC)
- Prof. dr. John Grin (Interactive Technology Assessment, Dep. of Political Sciences UA)
- Prof. dr. Arie Rip (Science and Technology Studies UT)
- Dr Dirk Stemerding (2 year 0,25 fte Science, Technology and Society UT)
- Dr Tsjalling Swierstra (2 year 0,05 fte Ethics of Technology, Dep. of Philosophy UT)
- Junior staff member (2 year 1,0 fte, to be appointed UT).
- Senior staff 0,3 x 2: 48.000 euro
- Junior staff 1,0 x 2: 96.000 euro
- Travel, interviews, organisation: 10.000 euro
- Workshops and publication costs: 6000 euro
- Broertjes JJS, Henneman L, Beemer FA (eds), Community Genetics. Past and Future. Utrecht University 2002.
- Cornel MC, Community Genetics: Van vermenigvuldigen en delen (inaugural lecture). Medical School, Free University Amsterdam 2002.
- Deuten JJ, Rip A, Jelsma J, Societal embedding and product creation management, Technology Analysis & Strategic Management 9, 1999: 131-148.
- Elzen B, Hofman P, Geels F, Sociotechnical Scenarios – A new methodology to explore technological transitions, Report, University of Twente 2002.
- Geels FW, Towards socio-technical scenario’s and reflexive anticipation: Using patterns and regularities in technology dynamics, Williams R, Sorensen KH (eds), Shaping Technology, Guiding Policy: concepts, spaces and tools, Edward Elgar 2002a: 355-381.
- Geels FW, Understanding the Dynamics of Technological Transitions. A co-evolutionary and socio-technical analysis, Twente University Press 2002b.
- Grin J, Graaf van der H, Hoppe R, Technology Assessment through Interaction – a guide, Rathenau Instituut Den Haag 1997.
- Horstman K, de Vries GH, Haveman O, Gezondheidspolitiek in een risicocultuur, Rathenau Instituut, Den Haag 1999.
- Kemp R, Rip A, Schot J, Constructing transition paths through the management of niches, Garud R, Karnøe P (eds), Path Dependence and Creation, Lawrence Erlbaum Ass., 2001: 269-299.
- Keulartz J, Schermer S, Korthals M, Swierstra T, Ethics in technological culture: a programmatic proposal for a pragmatist approach, Science, Technology & Human Values, 29, 2004: 3-29.
- Khoury MJ, Burke W, Thomson EJ (eds), Genetics and Public Health in the 21st century. Using genetic information to improve health and prevent disease. OUP 2000.
- Koch L, Stemerding D, The sociology of entrenchment: a cystic fibrosis test for everyone?, Social Science & Medicine 39, 1994: 1211-1220.
- Laat B de, Scripts for the future: using innovation studies to design foresight tools, Brown N, Rappert B, Webster A (eds), Contested Futures. A sociology of prospective techno-science, Ashgate 2000: 175-208.
- Laat B de, Larédo Ph, Foresight for research and technology policies: from innovation studies to scenario confrontation, Coombs R, Green K, Richards A, Walsh V (eds), Technological Change and Organization, Edward Elgar 1998: 150-179.
- Lente H van, Forceful futures: from promise to requirement, Brown N, Rappert B, Webster A (eds), Contested Futures. A sociology of prospective techno-science, Ashgate 2000: 43-64.
- Lente H van, Rip A, Expectations in technological developments: An example of prospective structures to be filled in by agency, Disco C, Meulen B. van der (eds), Getting Technologies Together. Studies in Making Sociotechnical Order, de Gruyter 1998: 203-230.
- Notten PhWF, Rotmans J, Asselt MBA van, Rothman DS, An updated scenario typology, Futures 35, 2003: 423-443.
- Reuzel RPB, Wilt van der GJ, Have ten HAMJ, Vries de PF, Interactive technology assessment and wide reflective equilibrium, The Journal of Medicine and Philosophy 26 (2001): 245-261.
- Rip A, Introduction of new technology: making use of recent insights from sociology and economics of technology, , Technology Analysis & Strategic Management 7, 1995: 417-431.
- Rip A, Challenges for Technology Foresight/Assessment and Governance. Report, University of Twente, 2002a.
- Rip A, Co-evolution of Science, Technology and Society. Expert Review, University of Twente 2002b.
- Rip A, Kemp R, Technological Change, Rayner S, Malone EL (eds), Human Choice and Climate Change, Volume 2, Battelle Press 1998: 327-399.
- Schermer M, Keulartz J, How pragmatic is bioethics? The case of in vitro fertilization. Keulartz J, Korthals M, Schermer M, Swiertstra T (eds), Pragmatist Ethics for a Technological Culture, Kluwer 2002: 41-68.
- Stemerding D, Berkel D van, Maternal Serumscreening. Political Decision-making and Social Learning. Health policy, 56, 2001: 111-125.