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This book delves into the complex and controversial realm of fertility care. It analyses the clash between evidence-based medicine and market dynamics in fertility treatments, with a unique focus on "add-on" treatments. It reveals how these contentious treatment options are now common practice and how they lead to an emerging market for hope.
With an interdisciplinary approach, this is an essential resource for readers in the fields of science and technology studies and medical sociology.
The Conclusion underscores the significance of promoting responsible innovation within the field of fertility care. It raises concerns regarding the use of the concept of informed choice in context where evidence is lacking and information transparency is not guaranteed, discussing its impact on decision-making processes. Moreover, the chapter explores the regulatory challenges faced by the field and advocates for exploring various forms of corporate responsibility among stakeholders in biomedical innovation. Finally, it considers the broader implications of the growing commercialization of healthcare beyond the field of fertility care.
Chapter Two explores the complexities surrounding evidence in fertility care. It begins by examining the relationship between evidence-based medicine and fertility care, discussing the challenges of generating evidence in a highly commercialized sector. It highlights the premises for rapid innovation, based on the common understanding that the absence of evidence does not imply the evidence of absence of effectiveness. Furthermore, it discusses the delicate balance between the time needed to establish robust evidence and the urgency of providing care, further propelling innovation. In conclusion, the chapter explores patients’ perspectives on evidence, shedding light on their diverse views and concerns.
Chapter Three explores the intricate dynamics of the fertility market, analysing its multifaceted nature where medical assistance, innovation hype, and hope converge with significant ramifications. It offers a detailed examination of the marketing strategies employed in promoting biomedical innovation and contextualizes treatment decision-making within the framework of the hope market. Furthermore, it sheds light on the appeal of these treatments, rooted in their potential to support individuals in achieving their aspirations for parenthood, even in the absence of solid evidence. Finally, the chapter presents scholarly insights into the intricate process by which individuals navigate the complex landscape of informed choice amidst the compelling allure of hope.
The introduction sets the stage for exploring fertility treatment add-ons, showcasing them as a prime example of biomedical innovation in fertility care. It traces the rapid evolution of the field, from the groundbreaking start of in vitro fertilization (IVF) to fertility care becoming a routine treatment. Additionally, it outlines the impact of limited public funding on the commercialization of fertility care, revealing how this shapes the landscape of reproductive medicine worldwide. Lastly, by presenting the concept of the ‘hope market’, the introduction sheds light on the characteristics of a market driven by emotive factors rather than purely economic ones. This lays the groundwork for exploring the broader socio-cultural factors at play in this field.
Chapter Four navigates the crucial realm of regulating a market driven by hope. It meticulously examines the complexities of regulating medical innovation within fertility care, underscoring the importance of fairness in disseminating information to facilitate informed decision-making. The chapter explores pricing strategies and their impact on the affordability of fertility treatments, shedding light on the challenges faced by individuals seeking access to these services.
Chapter One provides an overview of fertility treatment add-ons. It starts by defining what these add-ons entail and then examines the HFEA add-on rating system, exploring the perspectives of both patients and professionals. The chapter addresses the financial aspect by discussing the costs associated with treatment add-ons. Moreover, it scrutinizes the criteria used to classify interventions as treatment add-ons from the viewpoints of patients and professionals alike. Lastly, it challenges conventional assumptions about treatment add-ons, prompting readers to reconsider their understanding of these interventions.
In this afterword, I ask what comes after the attention economy. I revisit Lyotard’s concept of the postmodern to discuss and reinterpret the postdigital beyond mere historic periodization. On the basis of this framework, I ask what will replace the attention economies of large platforms as large language models are entering the scene.
The development of an alternative theory of the firm suitable to contemporary capitalism involves a shift towards focusing on communication practices as constitutive of organization, as opposed to the traditional representational/transmissive view. The chapter connects Communication as Constitutive of Organization (CCO) scholarship with new materialist thinking, focusing on the immanent potentialities and relational processes that comprise the practices of organizing. It then builds on the work of philosopher Gilles Deleuze to highlight difference and the virtual, assemblage and (hybrid, dispersed) agency, machinic practices, and the contrast between arborescent and rhizomatic models of organization to further hone CCO thinking. Through an exploration of these conceptual resources, the chapter establishes the theoretical foundation for a Communicative Theory of the Firm (CTF).
The final case study explores the evolving landscape of corporate purpose and social responsibility, particularly in the context of B Corporations (B Corps). The chapter delves into the various forms of binding associated with B Corps, from the legal structure and certification process to the platform’s role in shaping firms’ authoritative texts and, in turn, their decision-making. It also addresses the tensions and contradictions inherent in B Corp operations, highlighting the complex interplay of values and property rights in shaping firms’ trajectories and decision-making processes.
As in the other empirical chapters, a dis/organizational consequence of the particular constitution of the authoritative text emerges. In this case, ‘collective atomization’ signifies the tension, even contradiction, of situating a firm as a collective in terms of its participation in a ‘socially responsible’ movement while, at the same time, understanding its atomization with respect to individualized sites for decision-making and value propagation. That outcome, however, can foster new potential trajectories for these firms.
