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Standardization In Action: Achieving Local Universality Through Medical Protocols

Stefan Timmermans, Marc Berg

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In this paper, we argue that universality is always `local universality'. The achievement of local universality depends on how standards manage the tension involved in transforming work practices, while simultaneously being grounded in those practices. We investigate how this is done in two case studies — an oncology protocol and the Cardio Pulmonary Resuscitation (CPR) protocol. These protocols are viewed as technoscientific scripts which crystallize multiple trajectories. In the process of obtaining local universality, we illustrate how protocols feed off previous standards and practices. We then indicate how the protocols function through the distributed work of a multitude of heterogeneous actors. Finally, we argue that, in this process, the protocols themselves are necessarily changed and partially reappropriated.