Showing papers in "Contemporary Sociology in 2009"

Imprisoning Communities: How Mass Incarceration Makes Disadvantaged Neighborhoods Worse

Abstract: refugee children, Watters’ book provides more generally significant insights into a wide array of issues relevant to contemporary refugees. Rather than concentrating on those who receive refugee status from host societies, Watters asserts “the focus of this book is not restricted to legal and administrative definitions of refugee children, but instead accords with what Zolberg has referred to as a ‘sociological’ definition ‘grounded in observable social realities’” (p. 2). In addition, Watters draws extensively from contemporary theorists of inequality, exclusion and domination—Michel Foucault, Aihwa Ong, Pierre Bourdieu, Homi Bhabha, Liisa Malkki among them—to create a refined appreciation of the ways that states and bureaucracies affect refugees’ understandings of themselves, their social position and their ability to act in their own interest. Refugee Children is based upon the analysis of refugees in several (mostly European) countries of settlement, including Germany, the Netherlands, Belgium, France and especially the U.K., which according to the author is regarded by many stateless persons as the most desirable point of settlement. In addition, the book examines populations originating from and travelling through multiple world regions. Drawing from his own research as well as his reviews of journalistic and academic literature, Watters gives readers numerous first-hand accounts of the settings, interactions and assistance programs that refugee youth encounter. The author carefully attends to the origins of refugees, considering their history, religion and cultural background. Based on this, he questions both the assimilationist approach to refugee resettlement that would compel recent arrivals into the acceptance of host society practices in order to facilitate access to jobs and health care, as well as multicultural models that see refugees as inextricably immersed in the cultural and religious patterns of their country of origin, and as such, fundamentally unlike persons native to the host society. Championing neither, he regards both as paternalistic and potentially limiting to refugee children’s ability to make choices based upon their own outlooks, goals and understandings. In a like manner, Watters assesses models of resettlement in terms of their allocation of resources. He critiques both tight-fisted programs that fail to provide minimal levels of support as well as therapeutic regimes that assume all forced migrants to be deeply wounded and as such, in immediate need of culturally alien and sometimes unwanted rehabilitation. Despite its impressive scholarship, Refugee Children: Towards the Next Horizon is not simply an exercise in academic analysis. Rather, it offers valuable information with many practical examples drawn from successful programs devoted to refugee youth. If there is one downside to this book, it is that the volume is so rich in theories, examples, case studies, suggestions for practice and evaluations of the political and ethical implications of various approaches to working with young refugees, that readers may become overwhelmed. Its scholarly exuberance notwithstanding, Refugee Children: Towards the Next Horizon is a thought-provoking and sophisticated resource for scholars and practitioners interested in the experience of forced migrants in general and refugee youth in particular. The book does an impressive job of filling the conceptual, contextual and theoretical gaps that have, until recently, limited the breadth and quality of research on forced migrants.

Promises I Can Keep: Why Poor Women Put Motherhood Before Marriage:

Abstract: essentially UMC evangelicals who have been mobilizing against the liberals in the Church leadership on many social issues. As is well known, the mainline leadership is more liberal than the membership, and evangelical leadership is more conservative than the membership. How is it that the leadership in the mainline can be forced to the right by its members? Tipton touches upon ecclesiology as the answer, but he does not sufficiently develop the insight. The most interesting part of the book is what I think is his implicit answer: conservatives from outside of the mainline facilitate the activism of the conservatives within it in order to achieve secular political goals. For example, Chapter Five examines the Institute for Religion and Democracy (IRD), an independent activist group dedicated to fighting the liberal tendencies within mainline political activism, particularly in foreign affairs. The chapter shows how nonor marginal mainliners associated with the neo-conservatives in the Reagan administration such as Elliot Abrams, Michael Novak and Jeane Kirkpatrick worked to de-legitimate mainline activism both within and outside of the church. With 89 percent of the funding at one point coming from foundations on the political far right, such as the Scaife Family Charitable trusts (p. 175), and with connections to secular conservative institutions such as the American Enterprise Institute, the conclusion is clear—the liberal advocacy of the elites was being suppressed by secular conservatives, not by a dissenting group within the mainline. Chapter Six shows how the IRD evolved from a primary concern with foreign affairs advocacy of the mainline to fighting against the liberal leadership on culture wars issues like abortion and homosexuality. Chapter Eight is a case study of the rise and fall of a mainline dominated interfaith coalition named “Interfaith Impact for Justice and Peace.” This group died due to its inability to master another tension in the mainline, between the church as focused on “broad social teaching and focused policy research” or “mass mobilization and political organizing.” (p. 283) Chapter Nine is a case study of the advocacy of the National Council of Churches and Chapter Ten of the creation of mainline-oriented parachurch advocacy groups like the Interfaith Alliance. Unfortunately, this book lost an opportunity to provide deeper insights into the mainline’s political influence because it focuses on the trees with little view of the forest. There are extensive discussions of particular trees—profiles of directors of agencies from decades ago, details of who said what to whom, and page-long block quotes from interviews. The reader must dig through all the detail to find the unifying themes in the analysis. I learned a lot from the book, but primarily because I could put Tipton’s detailed data into my existing theoretical narrative about the mainline. For those lacking such a narrative, Tipton does not clearly provide one. But, for any scholar hoping to make an argument about the mainline’s advocacy, they must read this book, because its data will show you that certain hypotheses are just dead wrong, and others should be pursued further.

The Great American Crime Decline

Abstract: Few criminologists were surprised when crime rates rose sharply in the 1960s. The upturn reflected demographic causes, one of the “usual suspects” of criminological theory. As the baby boomers matured, crime rates would fall just as sharply as they had risen. When crime rates continued to rise well into the 1980s, criminologists blamed fundamental societal changes for the failure of their theoretical predictions. Some of the more daring predicted that this “brave new world” would result in higher crime rates until at least the end of the century. But this prediction failed too. Describing the course of a complex, highly aggregated time series is an art, not unlike fiction writing. With that said, sometime between late 1991 and early 1994, the rates of virtually all common crimes began a steady decade-long decline. Criminologists were initially skeptical of the decline—and more so when politically savvy big city police officials stepped forward to take credit for it. By late 1995 or early 1996, the skeptics had become a small, ignored minority of the discipline. Although the length and breadth of the great decline embarrassed a few criminologists, most recognized it as an historic opportunity to extend and refine their theories. Symposium volumes sponsored by the National Institute of Justice (Travis, 1998) and the National Consortium for Violence Research (Blumstein and Wallman, 2000) outlined an emerging disciplinary research program. By June 2008, the two symposium volumes had racked up several hundred citations, demonstrating that the historic downturn had become a “cottage industry,” if not a subdiscipline. This large and growing literature raises the question of whether The Great American Crime Decline adds anything new. It does. Readers who need closed-form answers to narrow policy questions may not appreciate the book’s novelty. The book reports no “results” to speak of and has few “findings.” Zimring’s conservative rhetoric and reliance on soft visual evidence—plots and charts— may also frustrate. Conservative rhetoric and soft evidence are well suited to larger questions, on the other hand. Readers who are interested in the sociological significance of the phenomenon will appreciate this book. After describing the length and breadth of the great decline, Zimring considers the “usual suspects” of criminological theory— the big three. By apparent coincidence, demographic and economic trends favored declining crime rates during the 1990s. At about the same time, California and other states enacted Draconian sentencing reforms that might also produce lower crime rates. Could this “perfect storm” explain the great decline? Zimring argues that, although the big three “usual suspects” might explain some part of the great decline, the onset, duration, and depth of the decline implicate other causes. Searching retrospectively for these other causes, criminologists suggested in the late 1990s that the great decline might be due to the joint effects of innovative policing strategies and the stabilization of big city drug markets. At about the same time, economists suggested that the great decline was due to the coincidental, independent effects of two causes: first, increases in the number of police in big cities—more police, less crime; and second, greater access to abortion in the wake of the 1973 Roe v. Wade decision—fewer unwanted pregnancies in 1974, fewer poorly socialized young men in 1991. Zimring dismisses all four explanations. His arguments about the effects of innovative policing and stabilized drug markets will not be controversial. The criminologists who proposed these explanations would probably agree. Zimring’s arguments about the effects of beefed-up police forces and liberalized abortion policies may be controversial, in contrast, especially in light of the on-going turf war between criminologists and economists. The weight of opinion across the social science disciplines has tilted towards Zimring’s view, I think. But since the contrary view is cited prominently, readers can draw their own conclusions.

Lone Pursuit: Distrust and Defensive Individualism Among the Black Poor

Abstract: parative analysis of New Zealand and South African consumer politics regarding local issues in the global red meat chain, revealing the distinctive ecologies and political cultures shaping local negotiations over food safety, which in turn play out the multiple politics of rights (citizen/consumer) and responsibilities (state/market) in regulating the meat industry. The editors, Wynne Wright and Gerad Middendorf, wrap up the collection observing that the diversity of human agency produces a contradictory agrifood system. Thus, they note from Skladany’s chapter that the vexed choice between farmed and wild salmon means that “one actor’s agency is another’s structural obstacle,” and that “many of these contradictions are a product of socially disembodied eaters,” suggesting ultimately that consumer and citizen roles need reintegration, starting with reflexive eating, and proceeding to the realization of the late Thomas Lyson’s concept of ‘civic agriculture.’ Thus the editors guide the spirit of this collection away from agency fetishism toward recognition that a civic agriculture collapses the agency/structure dualism. It is structured by and through social relations as spatial and temporal processes within an ontology that respects the multiplicity of social and ecological needs, and contributions, of food. While this volume is limited to/by a North-American focus, and while the resistances do not appear to accumulate, it is the sustained focus on the multiple and often paradoxical challenges that unifies this collection, signaling a heightening of social, ecological and cultural contradictions in the food system. STRATIFICATION

The Making of Minjung: Democracy and the Politics of Representation in South Korea:

Abstract: 1954. The existence of an unjust and defective colonial domination does not mean that people are going to rebel against it. For example, the British comfortably dominated India and the Ottoman Arab countries for several centuries. Although a minority, these settlers occupied a strategic location in the French ruling hierarchy that gives them virtual veto power over policies deemed inimical to their interests, contributing to the radicalization of the Algerian nationalist movement. Another key factor is the violent method used by the FLN against the settlers and Algerians. Lazreg only devotes a few pages to FLN and notes that the FLN methods were “also at times despicable and uncompromising” (p. 86), but ends by asserting that “their full range has yet to be documented” (p. 86). If, as Lazreg has made emphatically clear, the end does not justify the means, then FLN violence should have been a key explanatory factor in the creation of the mindset that was tolerant of torture, not just the generals’ loss of honor. And also, if the FLN violence was not defensible, then one should be as critical of the Islamic institutions for not speaking against it as one is against the Church for its failure to condemn torture against Algerians. Giving due weight to all these factors by no means diminishes French responsibility for the destruction of lives and property in Algeria. Nonetheless, it sheds light on the other side of the equation—Algerian culture and the methods Algerians used in the name of national liberation against the French. Arguably, the Algerian war was against the French but not for the liberation of the country, as it ended by substituting one system of despotic rule for another. If this is true, Lazreg is not justified in blaming colonialism for the actions of the Algerian government about half a century later against an Islamic fundamentalist guerrilla movement from 1992 to 2002 by stating that “the colonial method was replicated in a gesture that reinstalled the past into the present” (p. 258). Finally, Lazreg’s discussion of torture in Iraq under American occupation is cursory and unreflective. The violence committed by the Sunni insurgents and more so by the Islamic terrorists was widespread and despicable enough to raise a serious question about the nature of culture of “resistance” and challenge us to consider that what is at work is not just an “runaway” empire. If the reckless hatred perpetrated by religious extremists in Iraq is a serious factor hindering the formation of a functioning and responsive government, maybe we should revisit the situation of Algeria in this light. Can it be the case that the root of Algerian problems today may not lie in the colonialism of the past, but in the very mode of struggle the FLN chose to wage against France that produced a dysfunctional political order? And if one considers the situational factors seriously, then for those of us who are seriously interested in understanding the cultural impediments to democracy in the Middle East, a reasonable subtitle would have been “from Baghdad to Algiers.”

Getting the Goods: Ports, Labor, and the Logistics Revolution

Abstract: According to Bernstein’s research, it is predominately middle-class and indoor sex workers who endeavor to create “authentic” experiences of genuine sexual interest for their male clients, which often require greater emotional labor. Interestingly, and unsurprisingly, it’s not just men who seek bounded authenticity in their sexual encounters, Bernstein argues. She writes that women too are increasingly involved in the purchase of sexually suggestive and erotic novels, performances, classes, sex toys, lingerie, and even “how to” and self-help manuals. For her, it is this kind of participation and consumption in the sexual economy that provides “evidence that for growing numbers of both women and men, sexuality is currently being reconstructed as a series of isolatable techniques that provide personal meaning and pleasure, as opposed to an expression of an ongoing relationship with a particular individual” (p. 174–175). While Bernstein’s inquiry is innovative and important in pushing the boundaries of contemporary research on prostitution and conceptualizations of sex work, the theoretical concepts of sexual labour and bounded authenticity that she employs are perhaps less relevant for advancing theories of prostitution in non-Western and non-post-industrial urban centers. Nevertheless, Bernstein’s text comes highly recommended for its indepth analysis and examination of commercial sexual activity and the social, cultural, and economic meanings attached to market mediated sex.

The Price of Independence: The Economics of Early Adulthood

Abstract: Who is an “adult?” Compared to their parents’ generation, the typical markers— completing schooling, working, living independently, marrying and having children—are occurring later, and in a less traditional order for today’s young adults. Many have speculated as to what has made the transition to adulthood more complex and variable. Everything from improved health and increased life expectancy to smaller family size to the rising cost of housing have been offered as explanations. Though many cite economic changes as causal factors, few have provided strong empirical evidence. Establishing a causal relationship between economic conditions and the lengthening transition to adulthood is difficult, because social norms have also changed. The eleven chapters in The Price of Independence, a volume sponsored by the Research Network on Transitions to Adulthood, present findings on what we do and do not know about the interplay between economic changes and changes in the transition to adulthood.

Been A Heavy Life: Stories of Violent Men:

Abstract: of Elijah Anderson’s discussion of how inner city residents often “see but don’t see” illegal or illicit behavior (Anderson 1999)—deters onlookers from intervening in public acts of violence involving girls. Miller writes that she is careful not to demonize black men and boys yet the most extreme accounts of violence excerpted in the book paint a picture of an intra-racial gender war taking place in school and the neighborhood. Much of this violence is trivialized or dismissed as “play.” Girls and boys often find other girls culpable for their own victimization. The book extends Miller’s scholarship by examining not only how inequalities shape girls’ participation in delinquency (One of the Guys 2001) but also how these inequalities shape girls’ exposure to gender-specific harassment and violence. Sociologists interested in intersections of race, gender, and class, and black feminist scholars in particular, may be somewhat disappointed with the author’s treatment of intersectionality; the significance and analysis of race and gender slowly disappears as the book progresses. Miller does not cite Ladner’s earlier study and does not draw much from black gender scholarship generally. Black feminist scholars such as Patricia Hill Collins, Kimberlee Crenshaw, Audre Lorde and Beth Richie, among others who have studied the nature and complicated politics of violence against black women and girls, are conspicuously absent from the author’s discussion and analysis. A deeper engagement with this scholarship (beyond the few footnotes provided in the book) would have produced a better analysis of violence against black women and girls in distressed urban areas. Overall, Miller does a fine job of systematically and objectively analyzing girls’ accounts of violence, some of which are extreme and will be troubling to readers who care deeply about the lives of these girls. Miller, who did not conduct the first-hand interviews on which the book is based, comments on the richness of interviews by two members of her research team: an African American female doctoral candidate and an African American male colleague. A methodological appendix reflecting their experiences in the field, as well as Miller’s experiences interpreting these interviews, would have strengthened the book’s contribution to qualitative sociology. Miller is right that more attention should be given to the experiences of African American girls in distressed urban areas. She is also right in making the point that such studies should extend beyond the segment of the population to which criminologists have the easiest access—such studies alone cannot tell us all we need to know about the social worlds of adolescent African American girls, most of whom are not involved in serious delinquency. Getting Played is an obvious contribution to courses in criminology and criminal justice that explore gender and violent victimization in the context of extreme urban poverty. The book will be complemented by the work of feminist criminologists like Meda Chesney Lind and Beth Richie, who have examined how race and class intersect to shape women’s and girls’ victimization and their subsequent entrance into the juvenile or criminal justice system.

On Scandal: Moral Disturbances in Society, Politics, and Art:

Abstract: (apparently confusing assistance given to Sudanese refugees with what is available for other immigrants) and the perceived reluctance of newcomers to learn English and “blend in.” Yet this was tempered by generally positive feelings towards the immigrants who the respondents had come to know personally on the job and in their neighborhoods. Particularly interesting is the impact of immigration on southern communities, which until recently were often starkly divided between blacks and whites, neither of whom knew what make of newcomers who did not fit traditional racial categories. Helen Marrow’s article on how the size and history of the black populations in southern towns effects intergroup relations is a particularly fascinating example of how dynamic and complicated these local impacts can be. Equally interesting is Debra Lattanzi Shutika’s analysis of a Pennsylvania town’s attempts to come to grips with its increasing multi-culturalism as seen through its “Cinco de Mayo” celebration, hosted by the town’s native majority on behalf of the growing Mexican population. All the articles in New Faces in New Places stand on their own as informative pieces of scholarship. Yet aside from Massey’s short concluding essay, there is little attempt to bring the methodologically and geographically diverse studies together to say something about what it all means. Many begin by reviewing basic facts about the new destinations, often covering the same material in other chapters. This is, of course, a common problem in edited volumes, and given the strength of the individual pieces it is probably churlish of me to raise it. After all, as a reviewer I am probably one of the very few readers who actually read the book as a book—in order, cover to cover—rather than as a collection of articles to be cherry-picked for topics of interest (if I was not reviewing it, I would probably have read it that way, too!). Yet the fact that the pieces don’t really speak to each other is a missed opportunity. The commonalities and contrasts between the various studies in the book are the most valuable aspects of New Faces in New Places, yet it is largely up to the reader do the synthetic work of putting it all together. That said, New Faces in New Places is a groundbreaking first look at an important social issue—one that will be shaping the politics of immigration for a long time to come.

Tracing Mobilities: Towards a Cosmopolitan Perspective:

Abstract: In conclusion, the Sourcebook of Family Theory and Research is an excellent and stimulating resource for advanced graduate students and new professionals. It is also supplemented by a website, http://www.ncfr.org/ sourcebook, which offers additional diagrammatic representations of theoretical models, annotated bibliographies, video clips, and links to relevant websites. However, it does not seem to us to be comprehensive enough to be used as the sole textbook for a course on family theory, nor do we think it replaces the earlier volume. For classes or as a reference book, it would be optimal to use both volumes in tandem; they complement each other and are equally important in the way each views families.

Identifying Consumption: Subjects and Objects in Consumer Society:

Abstract: auditory self. However, if I have read Bull correctly the rebellion is illusory, or perhaps pyrrhic. At the end of the day, and in spite of all the rebellion and active reconfiguration of the social, subjectivity remains fundamentally dependent on commodified culture; the mechanism of control is the consumption of the products of the culture industry itself. The auditory self is empowered through a technology that ironically tethers us to the very structures of control we fear. Further, and crucially, the ultimate outcome of this dialectic of iPod culture is the intensification of the “urban chill” that the privatized strategies of control are reacting to in the first instance. Sociality, let alone civility, is weakened as rapidly as the auditory self is empowered. The hyper-individualized, atomized self feels liberated, though his or her liberation in turn intensifies an alienating social condition. Bull’s theoretical generalizations are deftly woven, though they would benefit from a more direct discussion of the consequences of generalizing from the fairly affluent set of iPod users he interviews. If iPod culture is indeed to encompass more than simply the use of the iPod per se, how would the generalizations Bull makes be tempered, or perhaps enhanced, by a closer analysis of working-class urban residents’ auditory selves, for example? Nevertheless, Sound Moves is a rich, compelling read that will be sure to spark spirited discussion and debate in advanced undergraduate or graduate courses in urban sociology, media studies, and critical theory.

Nations Matter: Culture, History and the Cosmopolitan Dream:

Abstract: Assaults on the analytic utility and political viability of the nation have provided a lingua franca that unites a disparate group of academics, as well as activists on the left and the right. Some view nations as dangerous—sites of old genocides and wars and potential venues of new atrocities—best kept in check with supranational forms of political organization. Ethnic cleansing is a recurring reference point among those who hold this view. Others claim that nations and their less than pristine pasts represent the old world. The new world is global. Its citizens are postnational, trans-cultural and partake of multiple modernities. In this view, nations, vestiges of a pre-global and territorial era, are simply irrelevant. Lastly, market fundamentalists, the entrepreneurs of globalization, see nations (and their regulatory structures and tax laws) as impediments to the march of global capitalism. Craig Calhoun’s Nations Matter challenges all of these positions. His analysis begins with the cogent observation that neither academic nor popular discourse has taken sufficient account of the fact that nations and nationalism are simply not “vanishing.” If anything, they seem to be acquiring new salience. But Nations Matter is not a romanticized defense of the nineteenth century European national model. Calhoun views the nation as a “historical phenomenon.” Nations are dynamic, not static, entities that embody culturally as well as politically specific processes. Any analysis that intends to understand nations as enduring political entities must take their historicity into account. Calhoun argues that nations are not only relevant to the contemporary political sphere but they are a core and necessary component of democratic practice and its constitutive rule of law. Calhoun is at home in various academic disciplines. He has a particular talent for wedding political theory and philosophy to sociological analysis. Hannah Arendt, John Rawls, Charles Taylor and Jurgen Habermas figure prominently in his analysis. Nations Matter is a collection of seven essays that read as variations on a theme. Taken together, the essays form a cogent and coherent whole that synthesizes and extends in novel and exciting ways Calhoun’s previous writings on nationalism. In his earlier work Nationalism (1997), Calhoun emphasized the discursive quality of nationalism. Nations Matter broadens and deepens Calhoun’s earlier positions to argue for the creativity of culture (collective agency), the dynamism of history and the human capacity to be both rooted and to imagine worlds outside the immediate self— what he calls, the “cosmopolitan dream.” Nations Matter opens with a characteristically elegant phrase, “Nationalism is not a moral mistake,” that sets the tone of much of what follows. According to Calhoun, the nation, more appropriately the nation state, and democracy are inextricably linked. In Calhoun’s view, post nationalists are as off the mark as extreme nationalists. Nations with their constitutive discourse of nationalism were part of an Enlightenment liberal project that made democracy possible because they provided material and physical sites of imaginable social solidarities. As Calhoun argues, “we the people” had to feel that they belonged somewhere if they were to have fellow citizens with which to engage in democratic practice. From this initial premise, the chapters advance and develop the different shades and complexities of the argument. Some of the chapters have been published elsewhere but they have been revised and re-crafted to enforce Calhoun’s central claims. Chapter One challenges whether post-nationalism is viable as either an analytic concept or a way of life. Chapter Two takes up the distinction between nationalism and ethnicity. Chapter Three, “Nationalism Matters,” lays out three “misrecognitions” that have dominated discussions of nationalism. First, the European model of the nation relies on a jurisprudence of individualism that does not hold up under international law. Second, the juxtaposition of nations and empires presents a historically questionable dichotomy. Lastly, nations do not give legal status to pre-political natural “peoples” which political projects simply

Medical Research for Hire: The Political Economy of Pharmaceutical Clinical Trials:

Abstract: Jill Fisher tells a fascinating yet often disturbing story about the process of testing pharmaceuticals on human subjects. Based on observations at several private-sector, non-academic sites and interviews with various participants, Fisher takes us through the stages of clinical trials while focusing on participants’ motives, roles and perspectives. We learn that physicians are considered principal investigators but largely delegate tasks to their staff, creating a problem of “phantom investigators.” The ten physicians Fisher managed to interview freely admitted that the primary reason for their involvement was the money they receive for recruiting patient-subjects and overseeing the progress of trials. Nurses or “coordinators” are, unsurprisingly, the most important actors in clinical trials—educating patients about the protocols, monitoring patients’ diaries, and encouraging patients to fulfill their responsibilities. Dedicated as they are, however, coordinators are not above using “manipulative explanation” to convince patient-subjects who are not improving that compliance is in their best interest (p.196). Most of the physicians and nurses Fisher interviewed had bought into the pharmaceutical industry’s “rhetoric” that clinical trial research promotes the “benefit of humanity” and “medical progress.” But some were torn between the ethics of care and the requirements of science. Unable to handle the duplicity and role conflict, one of the coordinators quit her job. The others apparently rationalized their continued participation by emphasizing the positive outcomes they had witnessed and the hope they and their patients harbored. Although patient-subjects may benefit from participation in clinical trials, Fisher’s main concern is the many ways in which participants are misled and misused. Some patients become subjects because their debilitating conditions have not responded well to available treatments and they are desperate for relief. Although they are told that they may be randomized to a placebo group and the fine print in consent forms may indicate that their conditions could worsen, Fisher finds that coordinators tend to “emphasize the logistics” and “downplay the .|.|. risks” (p.172) of participation. Patients have the right to withdraw at any time during the study. But pharmaceutical companies judge study sites on their ability to retain subjects; new contracts are a reward. Accordingly, coordinators engage in considerable re-education, walking a fine line between coercion and self-interest on one hand and patient care on the other. This situation exists in all countries where clinical trials occur; other circumstances that Fisher discusses, in which patient-subjects’ vulnerabilities are interwoven with socioeconomic disparities and lack of health care, may be more specific to the United States. For instance, Phase II clinical trials test new products for safety and commonly call for healthy subjects. Fisher finds that lowincome minority men, drawn by financial compensation, predominate in these studies. Of course, these men are also highly likely to be uninsured. Phase III trials, which test for efficacy, attract primarily white middle-class women, who are more “altruistic” and have the time to comply with record-keeping and site visits. Uninsured women are also attracted to Phase III (and sometimes Phase II) trials, especially when recruiters frame the study as offering access to health care. As Fisher emphasizes, however, clinical trials are not oriented toward care; their purpose is data collection. Even when investigators or coordinators suspect that a patient-subject is receiving the placebo and deteriorating, or suffering from overly adverse side effects, their contractual obligation is to enable “soldiering on.” These dilemmas make for captivating reading. Those who are new to the subject will learn much, but should be cautioned that Fisher writes within a limited framework. She tries to weave her own assessments into what is essentially an ethnographic and descriptive study. But the analysis does not go beyond the concept of neoliberalism, which Fisher overuses. It is intended to capture the structural failings of our health and