Power and Meaning in Genomic Medicine: Processes of Field Emergence and Evolution

Abstract

While fields are central concepts in institutional theory, our understanding of them is largely theoretical and we have limited empirical evidence explaining the processes by which they emerge. In this study, set in the emerging field of genomic medicine, I explore the relationships through which power flows between field members, constructing a new field through their interactions. In the context of the nascent field of genomic medicine, I draw on extensive interviews with members of the genomic medicine field and its progenitors, four years of observational study of a field-convening organization shaping field standards, and a rich trove of historical data spanning the period of 1864 to 2020 to ask how genomic medicine evolved as a field and the role of power in shaping the interactions and meanings that constructed the field. My preliminary findings show that socio-political conflict, new technologies and shifting societal norms led to meaning-making that stigmatized genetic research, gave rise to divergent scientific fields and later reunified genomic research in new power relations that established the cultural meanings and institutions evident at the beginning of modern genomic medicine’s emergence. Subsequent analysis of industry news coverage during the emergent period (1990-2000) is anticipated to reveal the power-based interactions that show the clustering of organizations around emergent practices that indicate shifts in meaning, practices, and ultimately the power relations that shape the field’s emergence. These findings make a significant contribution to the dynamics of network emergence, by amassing rare empirical data on pre-emergent structures and interactions, while also explaining how and when heterogenous organization types and forms collaborate, potentially yielding new understandings of complex systems marked by flexible boundaries and changing compositions of organizations and types of ties. I also contribute to the institutional literatures where there is need for clearer understanding of field-to-field interactions that ultimately create opportunity for new fields and institutions to emerge. Lastly, I anticipate these findings contributing to the institutional literature on field-configuring events, as the deep inclusion of context provides evidence that may cause us to reconsider new forms of field-configuring events as individuals, organizations, communities and fields convene and negotiate new norms and structures in entirely new ways.