Every day research animals of different species are made to live and die in research facilities as part of biomedical research. This article looks at the killing of livestock pigs for organs to be used in transplant science; a science driven by goals to save human lives by improving the use of donated organs. Based on an ethnographic study carried out in Denmark and the US, we explore how people engage in killing pigs and what it takes for humans to kill pigs for research, beyond the technical and procedural work. The article investigates the experiences and reflections related to killing pigs for organ research in three different contexts: the barn, the operating room and the slaughterhouse. The article proposes that killing pigs for organs in scientific contexts is an ethico-emotional practice where both emotions and ethics unfold through negotiations of nearness to the pig, the pig’s organs and the overall purpose of the research. Through three killing stories we show how emotions are evoked, calibrated and redirected to make killing legitimate, doable and bearable for those doing it.

The development of replacing human organs with those from genetically modified pigs holds immense potential for alleviating the shortage of organs necessary for patients in need of transplants. This medical advancement is also accompanied by significant social changes, including the emergence of a bioeconomy, new modes of biotechnology governance, altered human-animal relations and increased public engagement. Some aspects, such as the impact on the transplant allocation system, effects on clinical practice and healthcare provision, global trajectories and most importantly the consequences for patients and their families remain unpredictable. Given that xenotransplantation occurs within a societal context and its success or failure will not be confined to technical feasibility alone, it is essential to engage a social sciences perspective to highlight the social implications and emphasise the importance of social research in accompanying future developments.

ObjectiveTo analyse the mechanisms at play in the adjudications made by professionals and socially vulnerable patients with type 2 diabetes about their eligibility for care.Design, setting and subjectsThe study included 14 patients and 10 health professionals in seven general practice surgeries in deprived areas in Greater Copenhagen. The study data consist of 17 semi-structured interviews with patients and 22 with health professionals immediately after observation of 23 consultations. Our analytical approach was inspired by Systematic Text Condensation and the concept of 'candidacy' for access to health care.ResultsAdjudications of patients not being candidates for services were common, but we also found that both patients and health professionals worked to align the services to the needs of the patients. This could include using services differently than was intended by the providers or by changing routines to make it easier for patients to use the services. We discuss these processes as 'tinkering'. This usually implies that the best individual solution for the patient is aimed for, and in this study, the best solution sometimes meant not focusing on diabetes.ConclusionThe study adds to existing knowledge about access to services for socially vulnerable patients by demonstrating that both patients and professionals in general practice engage in tinkering processes to make services work. Unequal use and benefits of health services play a significant role in relation to social inequality in healthFlexibility in services and alternatives to school-like rehabilitation are needed to reduce inequality in access to health carePatients were sometimes judged as unsuitable for available routine services, but professionals 'tinkered' with services to make them fitAdaptation of services by professionals in general practice implies a longer time frame for obtaining goals

The COVID-19 pandemic has been a data-political spectacle. Data are omnipresent in prediction and surveillance, and even in resistance to governmental measures. How have citizens, whose lives were suddenly governed by pandemic data, understood and reacted to the pandemic as a data-political phenomenon? Based on a study carried out in Denmark, we show how society became divided into those viewing themselves as supporters of the governmental approach to the COVID-19 pandemic, and those who oppose it. These groups seem to subscribe to very different truths. We argue, however, that both sides share a positivist ideal and think that data and facts ought to rule. Both sides have also come to acknowledge that data are not unambiguous, and both cast increasing doubts on political uses of data. Though the people agreeing with, and the people opposing, the government strategy are in many ways surprisingly similar with respect to epistemic norms, they differ in what they perceive as dangerous or desirable, and in who they believe are telling the "truth" about the pandemic. These different perceptions result in different types of pandemic-related activism. Resistance against restrictions is often understood as inspired by conspiracy theories and in some countries anti-restrictions activism has turned violent. In our case, however, we suggest that when looking at similarities and differences across both groups, the gap between those opposing and those agreeing with the government approach is not as unbridgeable as might be suggested by their beliefs in differing truths and the emerging societal division.

Previous research has shown social inequality in type 2 diabetes prevalence and that socially vulnerable type 2 diabetes patients benefit less than average from health services. Based on ethnographic fieldwork carried out between February 2017 and March 2018 in a Danish specialized outpatient clinic, this article focuses on patient work among socially vulnerable type 2 diabetes patients. Through attending to the border zone between formal health care and self-care, we show that patients do a lot of work requiring skills, resources, and initiative, to access and benefit from formal care. This work is complex and implicit in the organization of care. Patients’ social situations, especially their employment situation, complicate getting patient work done. Attending to patient work and implicit tasks in care organization may help us to see how social inequality in type 2 diabetes outcomes develops, and may be combated.

Background Type 2 diabetes cluster in lower social groups and people with type 2 diabetes from lower social groups experience more complications, benefit less from health services and live shorter lives than people with type 2 diabetes from higher social groups. Different logics govern diabetes care and potentially influence the possibility of socially vulnerable type 2 diabetes patients to access and benefit from health services. In order to understand which practice and underlying logic enable socially vulnerable type 2 diabetes patients to access and benefit from diabetes care we aim to describe what professionals at a specialized diabetes clinic do to adjust services to patient’s needs and make the tasks involved in diabetes care doable for socially vulnerable patients and how this work is embedded in an organizational and moral context. Methods Ethnographic fieldwork combining participant observation and interviews was carried out between February 2017 and March 2018 in a specialized diabetes clinic located in a socially deprived area in the capital region of Denmark. Sixteen patients (9 male, 7 female, aged 35-73 years) and 12 professionals (7 doctors, 4 nurses, 1 secretary) participated in the study. We used Annemarie Mol’s concept of “the logic of care” to guide our analysis. Results Our analysis shows that the logic of care and the care practices in this clinic are characterized by a needs-based approach to treatment involving adjustment of services (permeability, timing, and content) and seeing the patient as a person with many needs. Throughout our description of selected care practices, we both characterize how health professionals practice this particular logic of care and the organizational and normative conditions that this logic is entangled with. Conclusions Practicing diabetes care based on patients’ needs involves individualization, something often described as an element of patient centred care. Our study shows that this ideal of individualization and adjustment of treatment is possible in practice. Organizational flexibility and an organizational culture that values patient needs enable needs-based care. In order for socially vulnerable type 2 diabetes patients to benefit from health services it is necessary to create conditions under which professionals can attend to these patients’ multiple and complex needs. Adjusting care to these needs demand a variety of professional efforts some of which are hardly predictable or standardisable.

The rhetoric of need is commonplace in discourses of technology and innovation, as well as in global health. Users are said to have a need for innovative technology, and citizens in resource-poor regions to have a need for improved health care. In this article we follow a global health technology—more specifically, a piece of software for monitoring diabetes quality—from Denmark, where it was developed, to Jakarta, Indonesia, where it was introduced in 2012–13. Using ethnographic material, we show how the need for a specific technology is constituted through the very process of moving a technology from one setting to another. Central to this process of a technology traveling, we suggest, is the role played by comparisons invoked by actors and the technology itself. These comparisons become instances of evaluating local practices, thus determining what is needed in tackling a health challenge locally. With this focus on the interrelations among technological innovation, local needs, and comparisons across global distances, we aim to contribute to critical discussions of the prospects of traveling technologies for global health, as well as drawing attention to the recipient's agency in (re)shaping the capacity of the technology and thus the need-solution complex even in the face of powerful asymmetries.

Objectives To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion. Design Cohort study. Setting 1996–2002, Denmark. Participants All first time participants, a total of 89 829 pregnant women, enrolled in the Danish National Birth Cohort were included in the present study. Overall, 4062 pregnancies ended in spontaneous abortion. Information on education, income and labour market attachment in the year before pregnancy was drawn from national registers. Main outcome measure Spontaneous abortion, that is, fetal death within the first 22 weeks of pregnancy, was the outcome of interest. The authors estimated HRs of spontaneous abortion using Cox regression analysis with gestational age as the underlying time scale. Results Women with <10 years of education had an elevated risk of spontaneous abortion when compared with women with >12 years of education (HR 1.19 (95% CI 1.05 to 1.34)). The HR estimates for the four lowest income quintiles were all increased (HRs between 1.09 and 1.15) as compared with the upper quintile but did not differ considerably from each other. In general, no statistically significant association was found between labour market attachment and the risk of spontaneous abortion; however, the group of women on disability pension had an increased HR of spontaneous abortion when compared with women who were employed (HR 1.32 (95% CI 0.82 to 2.13)). Conclusions Educational level and income were inversely associated with the risk of spontaneous abortion. As these factors most likely are non-causally related to spontaneous abortion, the findings indicate that factors related to social position, probably of the environmental and behavioural type, may affect spontaneous abortion risk. The study highlights the need for studies addressing such exposures in order to prevent spontaneous abortions.