The baby as a virtual object: Agency and stability in a neonatal care unit
Abstract
Neonatal care work is a complex social practice. It maybe understood as a network in which doctors, babies, parents, technology and medicalcare are aligned together in relationships dominated by issues of accountability. The nature of neonatal care means that the boundaries of what counts as the unit are always shifting. The regular appearance of new members, new patients and new technologies mean that much effort must be expended to hold the unit together as a functional entity. Thus stability in the unit's practice, rather than change, is something to be explained. Equally, ambiguity and uncertainty rather than clarity and procedure are important features of neonatal care.
We examine how the baby (i.e. the neonate receiving care) acts the 'object' around which the unit is continuously ordered. The identity of the baby — what it is, what attributes are considered important, what effects it generates — is changeable. Staff constantly 'scale up' and 'scale down' what the baby is from a child to a biological system in accord with contextual demands (i.e. the baby's likely trajectory of care). The agency of the baby is often a resource that is worked up and generated by the network itself during this process of scaling. In this sense the baby is a 'virtual object' which cycles through various identities and relationships. We outline how this cycling appears to operate and the way in which it serves to hold together neonatal care work.
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