5 - Colonizing the Clinic: The Adventures of Law in HIV Treatment and Research

Summary

Introduction

Sociolegal scholars have been sensitive to the variety of ways that law in action differs from law on the books. Gaps between the two are especially likely to arise when law moves across boundaries. This chapter looks at the use of law in HIV clinics (in the United States, South Africa, Thailand, and Uganda) that are involved in both treatment and research. In this case, law moves simultaneously across two boundaries when it is transported from legal arenas to medical settings and from the global North to the global South. Because the (new) legal forms are arriving in settings that already have rules, guidelines, and norms, the process of importation is quite complex. Moreover, medical conventions about how to work with rules are different than lawyerly ways of using rules, necessitating further adjustments.

To explore these processes of transnational diffusion of rules and their associated norms, we focus on the role of staff in key intermediary organizations who act as “regulatory wranglers” (Heimer 2013a) both to adapt rules to local realities and to make local realities appear more legible to and in line with what the rules require, thereby contributing to “regulatory success.” Their roles in facilitating organizational and normative change recall the work of Merry's (2006a) “translators,” Silbey's (2011) “sociological citizens,” and Sturm's (2006) “organizational catalysts” who enable uptake and modification of new norms and conventions originally developed at a distance from sites of implementation.

In this way, our research offers a new lens through which to explore mechanisms, processes, and impacts associated with the globalization of law. To date, much of the work in this field of scholarship has taken up processes through which transnational laws, regulations, standards, and norms emerge, diffuse across national borders, and are adopted as national policy, with a focus on state change (Shaffer 2012, 242–243) through national statutes, cases, and regulations (Halliday and Osinsky 2006) and across a variety of legal domains. Further, as Munger (2012) notes, much of this scholarship has focused on formal institutions of law and elite lawyers – and, we would add, elites generally – who create, resist, or facilitate adoption of new national laws, regulations, or governance structures (cf. Dezaley and Garth 1996, 2002, 2010; Halliday and Carruthers 2007).