Knowing and Feeling in Surgery
For a number of years, I have been engaged in collaborative research at the intersection of knowledge, perception, ethicality, technology, economies, and emotions in the work of pelvic floor surgeons. Pelvic floor surgeons are collectively responsible for the widespread use of permanent, synthetic, transvaginally-implanted polypropylene mesh for the treatment of several common pelvic floor conditions experienced by women — especially urinary incontinence and pelvic organ prolapse. The widespread use of transvaginal mesh resulted in irreparable harm to tens of thousands of women globally, and manufacturers of the mesh and kits for its implantation are now the target of one of the largest mass tort actions in United States’ history.
Our research — including in-depth interviews with surgeons, ethnographic observations of major medical conferences and surgical practice, and archival research — supplies conceptual and sociohistorical details missing from many recent accounts of why and how patients are harmed. This is especially important given the raft of recent cases of harms caused by new medical devices, and the scale and scope of these devices’ reach into medical practice and the bodies of patients.
I most recently served as the team lead for this work and took it in a sociological direction as PI of a grant from the Canadian Institutes of Health Research. However, this line of work was initiated by my collaborators Drs. Sue Ross and Magali Robert. Dr. Claudio Donoso contributed to every aspect of the research as the project manager for the duration of the CIHR grant. The papers below are the product of years of collaboration. In addition several sociology students at the University of Calgary contributed to the research: Erica Wiebe, Daniel Stefulic, Katie O’Brien.
Ducey, Ariel, with Barry Hoffmaster, Magali Robert, and Sue Ross. “Making Sense of Vaginal Mesh,” Ch. 10 in Health Matters: Evidence, Critical Social Science and Health Care in Canada, Eric Mykhalovskiy, Jacqueline Choiniere, Hugh Armstrong, Pat Armstrong, eds. University of Toronto Press, 2020. PDF Download
Ducey, Ariel, Claudia Donoso, Sue Ross, Magali Robert. “From Anatomy to Patient Experience in Pelvic Floor Surgery: Mindlines, Evidence, Responsibility, and Transvaginal Mesh,” Social Science and Medicine 260: 113151, 2020. PDF Download
Ducey, Ariel and Shoghi Nikoo. “Formats of Responsibility: Elective Surgery in the Era of Evidence-Based Medicine,” Sociology of Health and Illness, 40(3): 494-507, 2018. PDF Download
Ross, Sue, Magali Robert, Ariel Ducey. “The Short Lifecycle of a Surgical Device: Literature Analysis Using McKinlay’s 7-Stage Model.” Health Policy and Technology, 4:168-188 2015. PDF Download