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the category (a problematic gaze to be sure, as Bruno Latour (forthcoming) has written about tuberculosis). There are epidemiological stories about trying to collect information about a shameful disease; there is a wealth of personal and public narratives about living with it. There is a public health story and a virology story, which use different category systems. There are the standardized forms of insurance companies and the categories and standards of the Census Bureau. When an attempt was made to combine these data in the 1980s to disenfranchise young men living in San Francisco, from health insurance, the resultant political challenge stopped the combination of these data from being so used. At the same time, the San Francisco blood banks refused for years to employ HIV screening, thus denying the admission of another category to their blood labeling, as Shilts (1987) tells us, with many casualties as a result. Whose story has categorical ascendancy here? That question is forever morally mootall of the stories are important and all of the categories tell a different one. |
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The fourth major theme is uncovering the practical politics of classifying and standardizing. This is the design end of the spectrum of investigating categories and standards as technologies. There are two processes associated with these politics: arriving at categories and standards, and, along the way, deciding what will be visible or invisible within the system. |
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It follows from the indeterminacy discussed above that the spread or enforcement of categories and standards involves negotiation or force. Whatever appears as universal or indeed standard, is the result of negotiations, organizational processes, and conflict. How do these negotiations take place? Who determines the final outcome in preparing a formal classification? Visibility issues arise as one decides where to make cuts in the system, for example, down to what level of detail one specifies a description of work, of an illness, of a setting. Because there are always advantages and disadvantages to being visible, this becomes crucial in the workability of the schema. As well, ordinary biases of what should be visible, or legitimated, within a particular scheme are always in action. The trade-offs involved in this sort of politics are discussed in chapters 5 on tuberculosis and 7 on nursing work. |
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Someone, somewhere, must decide and argue over the minutiae of classifying and standardizing. The negotiations themselves form the |
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