Writing speculative fiction is a valuable method for exploring the potential societal transformations elicited by advances in science and technology. The aim of this project is to use speculative fiction to explore the potential consequences of precision medicine for individuals’ daily lives. Precision medicine is a vision of the future in which medicine is about predicting, and ultimately preventing disease before symptoms arise. The idea is that identification of all the factors that influence health and contribute to disease development will translate to better and less expensive healthcare and empower individuals to take responsibility for maintaining their own health and wellness. That future, as envisioned by the leaders of the Human Genome Project, the Institute for Systems Biology, and the Obama administration’s Precision Medicine Initiative, is assumed to be a shared future, one that everyone desires and that is self-evidently “better” than the present. The aim of writing speculative fiction about a “precision medicine” future is to challenge that assumption, to make clear the values underpinning that vision of precision medicine, and to leave open the question of what other possible futures could be imagined instead.

This dissertation is an historical analysis of the science of human origins, paleoanthropology, examining the intersection of science and culture around fossil human ancestors (hominins) over the last century and a half. Focusing on fossils as scientific objects, this work examines three controversial fossils from the science’s history asking, how do fossils formulate, challenge, and reconfigure notions of what it means to be human? The introduction reviews the historiography of paleoanthropology and the gaps that exist in the literature. Chapter two examines the first case study, the type specimen of Homo neanderthalensis, known as the Feldhofer Neanderthal, providing a biography of the object from its discovery in Germany in 1856 until its species designation in 1864. Chapter three briefly links the Neanderthal’s story in time and space to the next fossil’s story. Chapter four picks up the story of paleoanthropology in 1924 in South Africa, with the discovery and initial analysis of a specimen nicknamed the Taungs Baby, which was labeled a new hominin species, Australopithecus africanus. Chapter five is another brief chapter connecting the Taungs Baby story in time and space to the final specimen examined in this work at the end of the century. Chapter six examines the final case study, a specimen discovered in 2003 in Indonesia, designated a new species named Homo floresiensis and nicknamed the Hobbit. Through comparing contrasting, and connecting the stories of these three specimens, three major conclusions emerge about the field. First, the fossils themselves play an important role in knowledge production about the hominin past. Second, scientific practice shaped both interpretations of fossils and larger questions of what it means to be human. Third, the scientific practice is itself shaped by local culture, which continually interacts with attempts to establish a global perspective about the human past. The perspective gleaned through the eyes of these three fossils therefore reveals the way shifting, rather than eternally true, claims are embedded in culture and intertwined with the perspectives of the humans conducting the science.

Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.

Spongiform Encephalopathies are a rare family of degenerative brain diseases characterized by the accumulation of plaques and formation of tiny holes in the brain tissue making it look "spongy". Spongiform Encephalopathies have a relatively short history but their origins date back to a time long before they were recognized as a disease. It was not until the 1700s that the first record of their existence was made. In 1732 a shepherd in England noticed that some sheep in his flock had become itchy and were "scraping" themselves on nearby trees and fence posts; he reported it to the agricultural authorities of the time. As the symptoms seen in his sheep progressed they also developed problems walking and began to have seizures. Eventually their neurological symptoms progressed to an unmanageable level and they died. In 1794, over 50 years later, the Board of Agriculture in the UK termed this illness in sheep "the Rubbers". In the following years while coming in and out of mention in many flocks of sheep "the Rubbers" remained a disease of minimal consequence showing negligible ability to spread among sheep and having no precedence for jumping the species barrier and affecting humans. The first mention of "the Rubbers" as Scrapie was in 1853, and it is still the designation of the disease in sheep today.

In 2004, the South Korean geneticist Woo-Suk Hwang published what was widely regarded as the most important research result in biotechnology of the year. In the prestigious American journal Science, he claimed that he had succeeded in cloning a human blastocyst, an embryo in its early stages (Hwang et al. 2004). A year later, in a second Science article, he made the earth-shattering announcement that he had derived eleven embryonic stem cell lines using his cloning technique (Hwang et al. 2005). The international scientific community was stunned. American scientists publicly fretted that President George W. Bush‘s 2001 executive order limiting federal funding for stem-cell research in the United States had put American bioscience behind the Koreans‘ (Paarlberg 2005). These breakthroughs offered potential solutions to immune system rejection of transplanted organs and possible cures for diseases such as rheumatoid arthritis, Parkinson‘s, Down‘s syndrome, and paralysis (Svenaeus 2007). However, within a year, Hwang was exposed as a fraud who had faked his results and pressured his female colleagues to donate eggs without informed consent. Despite protests against his methods from Korean religious and nongovernmental organizations, Hwang had used his prestige to ignore his ethical obligations. The Korean government, too, was slow to investigate Hwang and to subject his work to appropriate regulation.

American Indian literature is replete with language that refers to broken or hollow promises the US government has made to American Indians, one of the most prominent being that the US government has not kept its promises regarding health services for American Indians/Alaska Natives (AI/AN). Some commenters refer to treaties between tribes and the US government as the origin of the promise for health services to AI/AN. Others point to the trust relationship between the sovereign nations of American Indian tribes and the US government, while still others assert that the Snyder Act of 1921 or the Indian Health Care Improvement Act (IHCIA) contained the promise for health care. While the US has provided some form of health care for AI/AN since the country was in its infancy, and continues to do so through the Indian Health Service, the promise of health services for AI/AN is not explicit.

Philosophers have articulated that a promise contains a moral obligation to fulfill it because of others’ expectations created by that promise. As the US government made its first promises in early treaties with AI/AN tribes and subsequently made promises in the years since, it is morally obligated to fulfill those promises, be they lying promises or not, because of resulting expectations. Yet, the US government has historically acted to restrict the rights of AI/AN—rights that include access to health services—through assimilation, separation, or termination policies. Further, the policies of the US government have kept the AI/AN populations socioeconomically impoverished, dependent on the US government for basic needs, and susceptible to health-compromising conditions.

Using case studies, this dissertation looks not only at the policies and events that directly affected health services and health status, but also at how those policies and events contributed to health outcomes and the expectations of AI/AN. Given the history of the US government in fulfilling (or not fulfilling) its promises, this dissertation examines the expectations of AI/AN for their own future health outcomes under the policy of self-governance.

In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol. To situate such phenomena I first observe the closest regulatory precedents, the public health responses to thalidomide and cigarettes, which established a federal response to fetal risk. I then examine the history of how the US defined and responded to the social problem of alcoholism, paying particular attention to the role of women in that process. Those chapters inform my discussion of how the US reengaged with alcohol control at the federal level in the last quarter of the twentieth century. In the 1970s, FAS allowed federal agencies to carve out disciplinary authority, but robust public health measures were tempered by uncertainty surrounding issues of bureaucratic authority over labeling, and the mechanism and extent of alcohol’s impact on development. A socially conservative presidency, dramatic budgetary cuts, and increased industry funding reshaped the public health approach to alcoholism in the 1980s. The passage of labeling in 1988 required several conditions: a groundswell of other labeling initiatives that normalized the practice; the classification of other high profile, socially unacceptable alcohol-related behaviors such as drunk driving and youth drinking; and the creation of a dual public health population that faced increased medical, social, and political scrutiny, the pregnant woman and her developing fetus.

This is a project about medicine and the history of a condition called premenstrual syndrome (PMS), its “discovery” and conceptual development at both scientific and socio-cultural levels. Since it was first mentioned in medical literature, PMS has been explored empirically as a medical condition and conceptually as non-somatic cultural phenomenon. Many attempts have been made to produce scientific, empirical evidence to bolster the theory of PMS as a biological disease. Some non-medical perspectives argue that invoking biology as the cause of PMS medicalizes a natural function of the female reproductive system and shallowly interrogates what is actually a complex bio-psycho-social phenomenon. This thesis questions both sides of this debate in order to reveal how criteria for PMS were categorized despite disagreement surrounding its etiology.

This thesis illustrates how the concept of PMS developed and was informed by the discovery of hormones and the resulting field of endocrinology that provided a framework for conceptualizing PMS. It displays how the development of the medical diagnostic category of PMS developed in tandem with the emergence of the field of endocrinology and was legitimized and effectively medicalized through this connection. The diagnosis of PMS became established though the diagnostic techniques like questionnaires in spite of persistent disagreement over its definition. The thesis shows how these medical concepts and practices legitimated the category of PMS, and how it has become ubiquitous in contemporary culture.

Researchers in the twentieth and twenty-first centuries identify the study of the intrinsic and external factors that influence human aging as senescence. A commonly held belief in the year 2015 is that at least some kinds of cells can replicate over long periods or even indefinitely, thereby meaning the cell does not undergo senescence (also known as replicative senescence) and is considered immortal. This study aims to provide information to answer the following question: While some scientists claim they can indefinitely culture a stem cell line in vitro, what are the consequences of those culturing practices? An analysis of a cluster of articles from the Embryo Project Encyclopedia provides information to suggest possible solutions to some potential problems in cell culturing, recognition of benefits for existing or historical culturing practices, and identification of gaps in scientific knowledge that warrant further research. Recent research suggests that hESCs, and immortalized cell lines in general, do not escape the effects of senescence. While there exists a constant change in the practices of cell culturing, a large portion of scientists still rely on practices established before modern senescence research: research that seems to suggest that cultured hESCs, among other immortal cell lines, are not truly immortal.

This dissertation explores the intersection of two major developments in global

environmental governance: the vision for a Green Economy and the growing influence of non-state actors. The work draws on multi-sited thick description to analyze how relationships between the state, market, and civil society are being reoriented towards global problems. Its focus is a non-binding agreement between California and Chiapas to create a market in carbon offsets credits for Reducing Emissions for Deforestation and forest Degradation (REDD). The study draws on three bodies of scholarship. From the institutionalist study of global environmental politics, it uses the ideas of orchestration, civil regulation, and private entrepreneurial authority to identity emerging alignments of state and non-state actors, premised on an exchange of public authority and private expertise. From concepts borrowed from science and technology studies, it inquires into the production, certification, and contestation of knowledge. From a constitutionalist perspective, it analyzes how new forms of public law and private expertise are reshaping foundational categories such as territory, authority, and rights. The analysis begins with general research questions applied to California and Chiapas, and the international space where groups influential in these sites are also active: 1) Where are new political and legal institutions emerging, and how are they structured? 2) What role does scientific, legal, and administrative expertise play in shaping these institutions, and vice versa? And 3) How are constitutional elements of the political order being reoriented towards these new spaces and away from the exclusive domain of the nation-state? The dissertation offers a number of propositions for combining institutionalist and constructivist approaches for the study of complex global governing arrangements. It argues that this can help identify constitutional reconfigurations that are not readily apparent using either approach alone.