Wednesday, October 24, 2012

Class Notes 10/24

Here you go! Notes after jump.





10/24 – Asian Regeneration: Asia's Stem Cell Bloom (notes by Stephen Rong)

Midterm Feedback. Discussion good. Blog enjoyable. Respond to other posts as your second post. Readings dense. Last session on bench science/biomedical complex! Next up, science fiction and virtual ethnographies. More media and popular articles.

Ethnography 1 Due Next Week. Include cover letter addressing feedback and revisions. Also, Trekkies! And Ursula Le Guin science fiction short stories (who's father was an anthropologist). Open for suggestions for science fiction shorts. Open office hours on Friday.

Discussion Time!

Wrapping up clinical trial discussion, biomedical science production. Later, geopolitics of stem cell treatment, in Asia.

Recap: Watershed developments in the development of ethical guidelines. Sub-Saharan African HIV/placebo trials vs standing HIV treatments. Resulted in two competing standards:
1) Helsinki Declaration (2000) – new treatment methods should be tested against best current methods, not placebo (ie. African trials were unethical). Ethical imperialism. Dangerous to hold research carried out in marginal societies to different ethical standards.
2) A different standard for most current clinical trials from International Conference on Harmonization, expediting data for international regulation. Concluded ethical standards should be contingent on local ethical standards (ie. unfeasible in African trials to give them the best care, but something is provided; placebo comparison is much clearer). Relativization of ethics.

    Exploitation? Takes advantage of disadvantaged populations which have limited access to health care otherwise. Stopping trial midway is problematic, because it takes away their treatment, and may lead to drug resistance.
    Necessary? Necessary to do studies, health care from trials is better than no health care.
    eg. Poland (from Petryna article)
    Ethical discussion too focused? On say, consent. But what about justice and remittance. eg. Song's stem cell research.
Ethical vs functional feasibility. Long course HIV treatment expensive, do people actually finish treatment.

The social life of pharmaceuticals. eg. People sharing doses with people who didn't have access to trial. Local conceptions of disease. What happens on the ground is complex. Argument for anthropologists on trial research teams. Argument for placebo?

Are we privileging biomedical knowledge? Are there alternative or local models that are better than this expedited model that conforms to International Conference on Harmonization.

Tibetan Case:

Alternative medicine, quacks, not licensed or regulated. Crime? Translation of knowledge. Tibetan medical knowledge being exploited by pharmaceutical companies. Use of medicine taken out of context, mapped to Western conceptions of body and disease. Extracting active agents, taking out of context of other agents and local diagnostic categories. No efficacy or money compensation for their local knowledge. Biopiracy. Privileging biomedical conceptions of knowledge over local holistic knowledge. eg. Western representation of body vs Eastern representation (acupuncture). Translation error. Eg. Western pulse taking (one vital sign) vs Chinese pulse taking (multiple pulses and their variations). Scientific knowledge or cultural heritage? Recall distinction between what happens at bench in a laboratory and what is formally published.

Break Time!

Discussion of Asian stem cell research and treatment geopolitics. Interesting case study of intersection of biocapital, biopolitics, biotechnology. Globalization, business, state, markets. Challenge the idea that there is an “Asian” approach to stem cells, however, quite divergent between regions.

Japan Stem Cells:

High valuation of unborn individuals by some groups, though a lot of people don't believe it. Ethical problems. Regulated but hard to do research. Induced pluripotent stem cells revitalized research But egg basket, is scientifically reckless, in that science should be diverse. Stem cells are really attractive, “holy grail” of biomedical research.

Problem of balancing people's beliefs and religious tenets and potential of science.

NYT article, when iPSC was getting a lot of media attention. Presented as a way to sidestep ethical problems of ESC. Questions of media representation.

Interesting that in US stem cells is an issue of public concern and debate, but in Japan this ethical discomfort is expressed very differently.

Korean vs Singapore:

US Bush era regulations. No more funding. Obama reversed. Have other countries been given head start, or in the case of South Korea dissolved in scandal?

Confucian ethical principles guiding stem cell research. In these countries, science and technology going fast, and culture, society, and law catching up. Trying to get society to catch up to science (vs US where science is kept back in line with society). South Korean fraud case brings to questions views of science in society, politics, nationalism and pride.

Recent case of 6 Italian seismologists convicted of manslaughter for failing to provide adequate warning for earthquake. Scientist as omniscient authority in public perception.

History of science, scientists can not escape social component, contingent on funding, discourse of importance of science in seeking funding. Intent to further knowledge, but appropriated by society and politics. Harvard stem cell lab case, two sets of equipments, one for privately funded research, one for government funded research.

South Korean case. Nationalistic sentimentality. Felt like author over emphasized religious/Confucian aspect. Author not accustomed to doing research in Asia.

China:

Interesting how companies were using ethics as a marketing strategy, when they used adult stem cells in place of embryonic stem cells. Justify practices by claiming they allow a way to get around the red tape of new therapies in other countries and that they provide hope. Despite sketchy practices and claims. Medical pilgrimage. Practice of renting out hospitals reminds of illegal organ transplants.

IVF, status of children in Japan, source of embryonic stem cells. Reproductive technologies not well regulated in US.

Back to the low key public discourse in Japan. Taboo of talking about abortion. Surprising, given our situation in the US context.

China: What can hospitals do when they aren't being given as much funding, but can't charge too much for essential care? Clinical economy promotes the research practices of new therapies that we see.


Articles:

Thompson, Asian Regeneration? Nationalism and Internationalism in Stem Cell Research in South Korea and Singapore

Liu, Making Taiwanese (Stem Cells): Identity, Genetics, and Hybridity

Song, The Proliferation of Stem Cell Therapies in Post-Mao China: Problematizing Ethical Regulation

Sleeboom-Faulkner: Regulating Cell Lives in Japan: Avoiding Scandal and Sticking to Nature

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