This thesis explores the processual nature of agency and constraints in the experience of medicalized conception in a not yet explored locale: Bogota, Colombia. In ten months of ethnographic research at two fertility centers in Bogota, and interview data from over 100 in-depth interviews with women and men undergoing ARTs and clinic staff, a complex ART industry driven by both doctors (qua entrepreneurs) and the couples seeking medicalized conception was explored. This thesis identifies how relationships in the clinic combined with understandings of “the fragmented body” (as a medicalized object under scrutiny) and “the self” (as a conscious agent), to produce intricate dynamics of agency and constraints that co-evolved in a processual manner. Tracing the experiences of women in infertility treatment chronologically, the thesis explores how knowledge was established and renegotiated through productive power fields that relationally incorporated embodied, personal knowledge and authoritative medical expertise. Women adapted to constraints in both active and passive ways to create and assert their ever-transforming agentive capacities. In these processes, they were constantly reflecting on, and renegotiating their position in the treatment process, as well as in their social lives more broadly. Drawing on, and seeking to contribute to, literature on agency in ARTs from across the world, particularly literature that considers agency as a process co-established by the constraints it confronts, this thesis makes two key arguments: First, that agency in Colombian ART clinics is defined as reflection and renegotiation, rather than as something which occurs at a singular moment of reflection and renegotiation. Second, that this negotiated process is constrained, but not contained. In other words, agency is a process that looks both backwards and forwards. Women and couples incorporated different personal histories and embodied knowledge into negotiating the treatment process and constraints they encountered, and adapted their experiences of ART treatments to other aspects of their lives, negotiating constraints that reach beyond the clinical setting.

This thesis documents a qualitative research study of twenty postmodern therapy practitioners in Aotearoa New Zealand, focusing on their experiences in the wider field of therapy. The participants were aligned in their subscribing to postmodern critiques of therapy as a instrument of power, and in their interest in, and use of, therapy techniques and approaches that have grown out of those critiques – including narrative therapy, critical psychology, “Just Therapy”, and feminist poststructuralist therapy approaches. I argue that these practitioners represent a social movement within the field of therapy. The thesis examines the nature of the wider therapy field in Aotearoa New Zealand, analysing the perspectives of the participants. I demonstrate how this field has become increasingly dominated by the twin forces of neoliberalism and bio-science, making postmodern therapy work difficult, particularly within public sector services. In the final substantive part of the thesis, I critically examine and appraise the strategies used by participants to negotiate and resist these forces. This discussion is divided into two main chapters, dealing first with the participants who have difficulty in engaging in official politics and who consequently attempt to operate “under the radar” of management surveillance: these participants are characterised as “battlers”, “burn-outs” and “blow-outs”. Then, I turn my attention to the second group of participants – “infiltrators”, “outsiders” and “accepters” – who strategically utilise symbolic capital to pose resistance, or simply leave the public system. I also consider the professed abilities of this second group to cultivate a postmodern sensibility and to tolerate contradiction and compromise. I conclude this investigation of the possibilites for resistance to neoliberal and bio-scientific discourses by recommending greater strengthening of this local postmodern therapy movement.

La thématique de recherche est d’analyser les tenants et les aboutissants du mythe moderne de santé parfaite via les démarches socio-anthropologique, philosophique et théologico-religieuse, afin de saisir sa problématique éthique. Examiner les transformations des pratiques thérapeutiques a demandé de retranscrire d’abord, sous un mode théorique, les principes qui sont aux fondements de l’exigence sanitaire pour étudier ensuite des expériences ad hoc. Aussi, supposé incarner cette idéologie, le dépistage systématique néonatal de la mucoviscidose relié aux centres de suivi génétique a été la base empirique d’un questionnement éthique spécifique, comme la responsabilité de l’homme face à la vulnérabilité et à la finitude humaine. Orientée par une éthique de la parole suggérant la création d’espaces de réflexion d’où émane une pensée créative, le concept de rite de passage - doté de sa dynamique d’accompagnement - apporte des indications sur la fonction d’une éthique du soin déterminée. / The topic of research is to analyze the ins and outs of modern myth of perfect health through socio-anthropological approaches, philosophical and theological-religious to grasp its ethical problems. Examining changes in treatment practices needed to transcribe first, from a theoretical mode, the principles are the foundations of sanitary requirement then consider ad hoc experiments. Also supposed to embody this ideology, systematic neonatal screening for cystic fibrosis related centers of genetic monitoring was the empirical basis for an ethical questioning sui generis, as the responsibility of the man facing the vulnerability and human finitude. Guided by an ethic of speech suggesting ultimately creating spaces for reflection where creative thinking follows the concept of “rite of passage" - with its accompanying dynamics - provides indications on reality based an ethic of care determined.