Health Expertise in the Making within and Beyond 'the Clinic'

In sociological discourse, biomedical expertise is recognized as central to biopolitical dynamics in Western countries, shaping the commodification of health, self-surveillance, risk forecasting models, and the growing ties between scientific laboratories, clinical settings, and the marketplace. However, this perspective captures only one dimension of the shifting biomedical landscape.

Increasingly, societal segments are relying on knowledge and expertise that are refused by mainstream biomedicine. This calls for a reconsideration of health expertise and emerging ways of understanding the human body, in light of the growing public interest in alternative scientific and medical facts. This study, based on a three-year mixed-method investigation of various Italian communities mobilizing knowledge refused by biomedical institutions, provides a conceptual and methodological framework for understanding how health expertise is discursively and materially performed at the boundaries of biomedical science. Positioned at the intersection of social studies of science and medicine, our analysis explores the social and epistemic conditions under which this "refused" health expertise is enacted.

We argue that health expertise, when practiced outside the boundaries of biomedical sciences, to some extent reflects the expansion of biomedical gaze beyond, and at times in opposition to, mainstream biomedical professions and institutions. We demonstrate that this instance of health expertise, as it emerges in forms of knowing situated at the epistemic margins of biomedicine, can be understood as emblematic of current challenges to biomedical authority over human bodies, while simultaneously becoming increasingly embedded in the contemporary politics of life.

Our contribution offers a twofold approach: first, it provides a conceptual framework for analyzing these rejected forms of health knowledge; second, it offers methodological reflections on researching such expertise. By adopting an agnostic, non-normative, and reflexive stance, we enable a nuanced exploration of alternative health practices without judging their ethical-political validity or assessing their rationality based on traditional scientific standards.