This paper examines the role of Contract Research Organisations (CROs) in Swedish health care and pharmaceutical development. Before the recent rise of CROs - which are centrally placed between pharmaceutical companies, public sector health care organisations and test participants in an industry noted for its high financial turnover - recruitment of participants and management of clinical trials were undertaken by academic researchers. Things have changed. In the US, this new state of affairs has been argued to be the outcome of decreasing revenue for physicians and decreasing access to treatment for patients (Fisher 2009). This paper seeks to extend our understanding of the purpose and operation of CROs by reviewing existing literature (cf Mirowski and Van Horn 2005; Fisher 2009), comparing this with data on CROs in Sweden, and placing the study within its neo-liberal context marked as it is by notions of individualism, the politics of choice, self-responsibilisation, and risk. This will enable us explore the changes that CROs have brought to the interrelated practices and processes of risk reduction, prevention and health care in Sweden.

This paper examines changes in local working conditions instigated by the development of contract research organisations in pharmaceutical development. These developments are seen as occurring in the context of Sweden’s ‘circumscribed neoliberalization’. It is shown how staff remain ambivalent about theshifts of location and identity that these developments imply.

Petra Jonvallen, from Luleá University of Technology in Sweden, gave a presentation of ethnographies she conducted surrounding two new technologies used in Scandinavian maternity wards. The technologies she investigated are called "STAN" and "Milou", and roughly speaking, they are used in maternity wards to monitor the mother's contractions and the fetus heartbeat throughout labor. The difference between these systems and similar systems used since the 70's, is that there are digital monitors placed in casual places, such as the lunch room and doctor/nurse break rooms. This new feature, allowed the doctors to monitor several patients at once in more casual places. When something was going wrong in the labor room, they could see it, and go to intervene in time.While these technologies seem ideal, their use led to some unexpected consequences. First, by having monitors outside of the patients rooms, this meant that doctors and midwives didn't need to spend as much time in the rooms with the to-be mothers to monitor their progress. In hospital terms, this made the doctors and midwives "more efficient" in the use of their time, but this pushed other duties usually performed by the midwives to the men, or soon-to-be fathers, that accompanied the soon-to-be mothers. These tasks include getting water or ice, massaging sore backs, and giving reassurance. Dr. Jonvallen also discussed how midwives are usually in charge of the "normal" births, while doctors were in charge of the abnormal or "pathological" births. Usually, when a normal birth started becoming suspicious or worrisome, the midwives would be in charge of contacting the doctors. Thus, the midwives were the point of negotiation between "natural" births and births that require surgical intervention. With "STAN" or "Milou", doctors began casually monitoring different soon-to-be mothers, and instead of waiting for a midwife's call, they would just intervene as they felt necessary. This point of negotiation, and part of the midwives duties, changed, for better or for worse.