I examined the slogan, “Mental illnesses are illnesses like any other,” widespread in psychiatry and medicine, and in society more generally, to determine if it accurately and usefully characterizes mental illnesses, given current neurological and neurophysiological knowledge. Rather than focus on disease entities for comparison, I scrutinized the symptoms of somatic illnesses and mental illnesses and compared them in three areas: their production, their relationship to social and cultural context, and their potential use as indicators of underlying disease or dysfunction. In all three areas, I found that, contrary to the claim of the slogan, the symptoms of mental illness are not like the symptoms of somatic illness and therefore, by extension, mental illness is not “illness like any other.” I briefly surveyed the implications of this difference between mental illnesses and somatic illnesses, and provided some broad suggestions regarding how this finding might help to inform the characterization of mental illnesses, as well as help direct research and treatment of these conditions.

This dissertation investigates the convergence of the nation-state, biomedicine and (bio)capital around the construction of sickle cell disease as a subaltern disorder in the caste-based society of India. It inquires how sickle cell disease that developed evolutionarily due to environmental factors—and that is also globally racialized as a “Black disease”—has come to be associated with subaltern communities, particularly the indigenous, traditionally non-Hindu Adivasi communities of India. Such a subaltern association characterizes Adivasi biologies as inherently genetically “risky” thereby providing a biopolitical mandate to the Hindu-majoritarian Indian State to carry out biomedical interventions through promissory biocapital in the name of democratic inclusion. I center on the illness narratives of subaltern sickle cell sufferers to highlight how the caste-ization of sickle cell bodies in biomedical and policy discourses, and the attendant biocapital prospecting of subaltern biologies, are nonetheless challenged by communities through their lived experiences. Viewing this association from the Adivasi standpoint—marked by continuous dispossession and displacement—illuminates not only the biopolitical governance of subaltern reproduction by the Indian State. A primary objective of my dissertation project is also to use precarity as an epistemic site for interrogating the scopes and limits of a novel biopower formed by the nexus between the State, national biomedicine and transnational biocapital. This dissertation is therefore an attempt at unearthing the subjugated knowledges of Adivasi communities regarding alternative modes of existing in the world that continuously resist the assimilatory power of race, caste and capital. In ethnographically centering narratives of suffering among doubly (socially/economically) marginalized communities, the project illuminates the contradictions between public health measures that emphasize on sickle cell management through biomedical technologies of reproductive screening and the material conditions of sickle cell sufferers struggling to access basic medical care. This dissertation therefore juxtaposes policy interventions against community articulations of reproductive freedom that posits community health work as the fulcrum for developing reproductively just ecologies. At the same time, in utilizing multi-modal and multi-sited ethnographic methods, the project also contributes towards developing decolonial and digital ethnographic methods that are attentive to the aggravated precarity of marginalized communities in a pandemic prone world.

Moral status questions, (who and what counts morally) are of central concern to moral philosophers. There is also a rich history of psychological work exploring the topic. The received view in psychology of moral status accounts for it as a function of other mind perception. On this view, entities are morally considerable because they are perceived to have the right sort of minds. This dissertation analyzes and tests this theory, pointing out both empirical and conceptual issues with the received view. The results presented show that important moral intuitions (for example about unjustifiable interpersonal killing) cannot be explained by appealing to other mind perception. Some alternative views of the psychology of moral status are presented, as well as avenues for further research.

This dissertation investigates and describes the concept of precision medicine from historical, conceptual, capital investment, industry strategic, regulatory oversight, and medicalization perspectives. The study examines the various current and ongoing challenges, impacts, assimilations, and actual adaptive measures occurring within each of these areas as a result of the emergence and continued evolution of precision medicine as a medical discipline, as well as the technosocial advancements characteristic of precision medical products, such as companion diagnostics and targeted therapeutics, seeking market entry in the United States. The dissertation argues that there is a disjunction between precision medicine and historical governance, oversight, and medical practice mechanisms. Through case studies of two case products, Foundation Medicine’s F1CDx companion diagnostic and Novartis’ Kymriah CAR-T Cell therapeutic, the dissertation illustrates the impacts, destabilization and destandardization effects, and re-standardization efforts around a precision medicine diagnostic and therapy. As a central contribution, this dissertation demonstrates and illustrates the impact(s) that precision medicinal technologies are having on the technoscientific network involved in the creation, development, evaluation, governance, and implementation of medical products in the United States. Results revealed an emerging precision medical innovation model between and among member components of a precision medical ecosystem comprised of the above-mentioned focal areas and that, to fully understand the emerging precision medical innovation model, it is critical to understand not only the impacts of precision medical technologies on the individual components of the precision medicine ecosystem, but also the impacts, adaptations, assimilations, and occlusions inherent to the ecological relations within and across the ecosystem itself. Findings include the destabilization of the traditional drug development process across all stakeholder areas, characterized by the development of non-linear adaptive processes at both the premarket and post-market phases. Although the findings from this study are significant, it is likely that they are temporary in nature and will continue to evolve in accordance with the further advancement of precision medicine, ultimately re-stabilizing the precision medical development ecosystem.

Threatcasting is a foresight methodology that examines the worst of potential future changes by imagining and crafting a fictional (but very plausible) story of a person, in a detailed setting, experiencing a threat. In this dissertation, I investigate the processes and techniques of threatcasting, focused primarily on the post-analysis phase, and demonstrate it as an open methodology that can embrace varied ways to analyze raw data and seek conclusions. I incorporate best practices of narrative and thematic analysis, qualitative analysis, grounded theory, and hypothesis-driven theories of inquiry. I use interviews from futurists trained on threatcasting ways of thinking and compare two case studies - one using a grounded theory approach on the future of weapons of mass destruction and cyberspace and the other using a hypothesis-driven approach on the future of extremism - to investigate the efficacy of different theoretical approaches to analysis. I introduce definitions of novelty and ways to assess how a novel finding may have more impact on the future than it appears at first glance. Often, this impact comes more from what is not present in threat scenarios than what is included. Finally, I illustrate how threatcasting, as a practice, is a valuable contribution to those in a position to be responsible architects of a better future.

This thesis reviews the initial cases of fetal surgery to correct myelomeningocele, a severe form of spina bifida, and discusses the human and social dimensions of the procedure. Myelomeningocele is a fetal anomaly that forms from improper closure of the spinal cord and the tissues that surround it. Physicians perform fetal surgery on a developing fetus, while it is in the womb, to mitigate its impacts. Fetal surgery to correct this condition was first performed experimentally in the mid-1990and as of 2020, it is commonly performed. The initial cases illuminated important human and social dimensions of the technique, including physical risks, psychological dimensions, physician bias, and religious convictions, which affect decision-making concerning this fetal surgery. Enduring questions remain in 2020. The driving question for this thesis is: given those human and social dimensions that surround fetal surgery to correct myelomeningocele, whether and when is the surgery justified? This thesis shows that more research is needed to answer or clarify this question.

Prior to the first successful allogeneic organ transplantation in 1954, virtually every attempt at transplanting organs in humans had resulted in death, and understanding the role of the immune mechanisms that induced graft rejection served as one of the biggest obstacles impeding its success. While the eventual achievement of organ transplantation is touted as one of the most important success stories in modern medicine, there still remains a physiological need for immunosuppression in order to make organ transplantation work. One such solution in the field of experimental regenerative medicine is interspecies blastocyst complementation, a means of growing patient-specific human organs within animals. To address the progression of immune-related constraints on organ transplantation, the first part of this thesis contains a historical analysis tracing early transplant motivations and the events that led to the discoveries broadly related to tolerance, rejection, and compatibility. Despite the advancement of those concepts over time, this early history shows that immunosuppression was one of the earliest limiting barriers to successful organ transplantation, and remains one of the most significant technical challenges. Then, the second part of this thesis determines the extent at which interspecies blastocyst complementation could satisfy modern technical limitations of organ transplantation. Demonstrated in 2010, this process involves using human progenitor cells derived from induced pluripotent stem cells (iPSCs) to manipulate an animal blastocyst genetically modified to lack one or more functional genes responsible for the development of the intended organ. Instead of directly modulating the immune response, the use of iPSCs with interspecies blastocyst complementation could theoretically eliminate the need for immunosuppression entirely based on the establishment of tolerance and elimination of rejection, while also satisfying the logistical demands imposed by the national organ shortage. Although the technology will require some further refinement, it remains a promising solution to eliminate the requirement of immunosuppression after an organ transplant.

In this paper I will be addressing whether Judaism accepts organ donation. A problem that faces society today is the lack of people who are registered as organ donors. This is not only a problem in the religious world, but also the secular world. A common issue for individuals is the belief that their religion is against organ donation and does not support it. Even people who don’t practice their religion strictly bring up this issue. While this might be the case for some religions and certain parts of a religion, the majority of religions are in favor of and support organ donation to save another life. This paper explores what the religion of Judaism has to say on the matter of organ donation. There are different types of ways that one can donate their organs and this paper seeks to understand what Judaism has to say about each type of organ donation. Each type of donation brings up issues of their own because of the importance that Judaism puts on life. Judaism believes that humans are put on Earth by God and will be taken off Earth by God. This brings up the issue of what defines death, especially in regard to people who have been pronounced brain dead. As a result, each situation should be dealt with on a case by case basis and one should consult with their local rabbi on whether it would be permissible to donate their organs.