Cultural studies of biomedicine: an agenda for research.

This paper outlines a 'cultural studies' approach to investigations of the transnational world of contemporary biomedicine. Although biomedicine is fostered by an international political economy and global community of medical educators and bioscientists, it is taught, practiced, organized and consumed in local contexts. This essay argues that cultural studies of contemporary biomedicine should focus on the dynamic relationship between local and international worlds of knowledge, technology and practice. Three issues illustrate this approach: (1) an exploration of the tensions inherent in the local and cosmopolitan shaping of 'clinical narratives', with examples drawn from comparative studies of oncology; (2) an exploration of the influence of biomedical research findings and international clinical trials on the production of clinical narratives, with examples drawn from current research on breast cancer; and (3) an exploration of the local or national and 'international' or 'transnational' dimensions of the production of biotechnologies and pharmaceutical therapeutics. The essay concludes with a discussion of the limits that privilege either universal or local perspectives and claims to knowledge and the ethical challenges that become apparent from this perspective.