By Andrew D. Thibedeau

In her new book Ordinary Genomes: Science, Citizenship, and Genetic Identities, University of Minnesota Anthropologist Karen-Sue Taussig offers an insightful though repetitive ethnographic analysis of the coproduction of Dutch social norms and clinical genetics practice in the Netherlands. Drawing principally on the work of Foucault, she explores how discourses of ordinariness and tolerance particular to the Netherlands interact with genetic knowledge to shape Dutch identity. The book follows three themes. The first is the Dutch social phenomena of verzuiling or "pillarization," whereby difference is mediated through bounded social institutions in a way that promotes tolerance. The second is the Dutch self-conscious imperative to be gewoon or "ordinary." Finally, Taussig touches upon the legacy of the Second World War in shaping modern Dutch identity and genetics practice.

Historically, Taussig explains, the different religious groups in the Netherlands constructed a social system that delineated sharp boundaries between themselves. Nevertheless, these bounded groups cut across all other social lines, such as class or education. In this way, they formed integrated "pillars" that together supported Dutch society. As religion became less central to Dutch life and people ordered themselves differently - by political affiliation, for example - the essential "pillarized" structure remained. "The strategy of pillarization," Taussig writes, "allows for the general tolerance of social heterogeneity by bounding difference and minimizing its social threat while containing it within the larger commonality of Dutch society." In other words, she argues, pillarization permits the management of difference through tolerance.

Pillarization allows Dutch people to negotiate the social ideal of tolerance because difference is bracketed off and limited within acknowledged categories. For the Dutch, the social strategy of tolerance "involves recognizing, understanding, and accepting difference without rendering it hierarchical." A second Dutch value that works in concert with tolerance is ordinariness: the people of the Netherlands are self-consciously "ordinary." When viewed together with pillarization, Taussig claims, ordinariness imposes consistency by situating all individuals within groups and demanding "conformity to characteristics that are socially understood as ordinary from that group." This "simultaneous emphasis on similarity and difference" enters the genetic context by producing both a "resounding silence" around genetic syndromes alongside a powerful desire to categorize them through the process of diagnosis.

One central focus of Taussig's ethnographic analysis is the weekly meeting held among the geneticists at the clinic where she made her field observations. There, difficult diagnoses were drawn out in an exercise of group problem solving. When one physician was unable to diagnose a patient, she presents that patient's case at the meeting where she and her colleagues work to find a diagnosis. Taussig observed the discomfort the geneticists felt when they had difficulty assigning a patient with diagnostic criteria for one or another genetic syndrome. Her analysis proceeds to analogize the search for a diagnostic category with the process of pillarization. Both, she argues, involve the bounding of difference within defined groups in which difference is normalized, i.e. made normal in comparison to other members of the group. In other words, a child suffering from a rare genetic syndrome appears at first highly abnormal. When placed in a diagnostic category, alongside other individuals also suffering from the same disorder, however, the same child appears normal in relation. In this way, the clinical production of genetic knowledge parallels the mediation of difference facilitated by the practice of pillarization, both in the clinic and in Dutch society at large.

The specter of the Second World War features prominently in Taussig's final chapter, where she examines the Dutch reaction against the biotechnology that combined the DNA of a human and a bull. Examining several posters produced by a local campaign against this technology, she describes how the images represent Dutch fear of crossing of species boundaries. More precisely, the image of cows and a woman with blond hair used in the posters - which Taussig finds symbolic of Dutch identity - she reads as also expressing a dual fear of crossing both species and national borders. The Dutch ideal of tolerance, she argues, is constructed in opposition to the intolerance they perceive in the Nazi program of "racial hygiene." "[T]he explicit reference the posters make to genetic manipulation and their implicit allusion to eugenics," she claims, "arouse Dutch memories of the Second World War and antipathy toward Nazi science." In this way, Taussig concludes that the genetic knowledge they represent challenge both Dutch personal and cultural identity.

Taussig's book is strongly cast in the idiom of critical theory. As noted, her principal theoretical framework is drawn from Foucault and his interpreters. However, the book does not contain a sufficient explanation of the theory underlying its analysis. This is a significant flaw. The concepts of biopower and the social production of truth originated by Foucault and utilized by Taussic are both complex and abstract. The concrete aspects of Taussig's book - her clinical field work and accompanying observations - offer good examples of these ideas as produced in the "real world." However, without sufficient theory to integrate these facts, Taussig's analysis lacks depth.

A second criticism can be found in the nearly twenty years that have passed since she conducted the field observations that comprise the heart of her analysis. The science and practice of genetics has seen seismic shifts since her time in the Netherlands. Her observations - though keen - and the science she describes are both outdated, which detracts from the other aspects of her work. Finally, her grander aspirations to "break down the monolithic treatment of Western science" fall far short. She fails to provide any point of comparison between the Dutch and non-Dutch production of genetic knowledge. Only by comparative analysis could the local character that she ascribes to Dutch genetics practice be adequately demonstrated. Without it, the reader is left to question whether what is described is unique to the Netherlands or is simply characteristic of genetics practice in the early 1990s.

Andrew Thibedeau, J.D., is a fellow with the Council for Responsible Genetics.

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