The baby as virtual object: agency and difference in a neonatal intensive care unit

摘要

Neonatal intensive care work may be understood as a network in which doctors, babies, parents, technology, and medical care are associated together in a complex social topology. The boundaries of what counts as the neonatal intensive care unit (NICU) are always shifting. The regular appearance of new members, new patients, and new technologies means that much effort must be expended to hold the unit together as a functional entity. We examine how the baby (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. We present an argument, drawing variously on debates in the sociology of translation (that is, John Law, Bruno Latour, Kevin Hetherington and Nick Lee, Annamarie Mol, and Marilyn Strathern), the monism of Henri Bergson, and the 'objectivity' of Michel Serres, which identifies two 'functionally blank' actors in the NICU—a bilirubin machine and the baby itself. Both act to slow down and to stabilise networked relations. However, the 'hybrid agency' of the baby also acts as a resource that enables the network to turn back on itself or to be 'cut'. We outline how this process appears to operate and the way in which it serves to resolve issues of accountability.