Monday, March 6, 2017

Rapporteur Notes: March 3, 2017

Guideline for Blind Peer Review
  • ·        Keep it confidential
  • ·        Use the electronic manuscript review form
  • ·        Email it to Dr. Song by Monday, March 13, 2017 (note the extended deadline)
  • ·        Final version of paper is due Friday, March 24, 2017

Next Week’s Session on Ultrasound Technology
  • ·        We will be going to SLU to have a hands-on experience with ultrasound technology
  • ·        We will be meeting at Crave Coffee House at 9:30AM (see Dr. Song’s email regarding this)

Discussion: Globalizing Clinical Trials
  • ·        Discussant: Jake Eaton
  • ·        Experimentality: term at the heart of the book; knowledge is produced through multi-layered experiments; essence of an experiment (for humans to go out and acquire knowledge—acts as a justification)

o   Companies are profiting without giving anything back to the participants
o   Colonial-esque relationship
o   This process creates a new subject: a trial-participant subject (willing, docile, passive, consent-giving)
  • ·        Who are “they”?: Western pharmaceutical companies partnering with native doctors to implement trials

o   Researchers working with the CRO’s (contract research organizations)
§ Bureaucratic nature led to the creation of CRO’s and other aspects of modern day clinical trials
·        Created in order to protect patients/subjects, but are they actually?
§  Redefining ethics in ways that will allow them to continue experimentation
§  Tinkering with data and population to show the effectiveness
·        Seeing data instead of patients
  • ·        Paternalistic: term was used in many different cases throughout the book

o   Not employed properly in this context
o   Everyone knows it’s bad
  • ·        Brazil

o   Grassroots movements of patient activists to gain access to experimental drugs for HIV/AIDS
§  Universal healthcare system
§  A lot of spending in Brazil now goes to rare pharmaceutical treatments due to the public’s demand
·        Patients can sue doctor for the right to the treatment
·        Demand is generated through the companies offering these trials
  • ·     On Petryna
    •   How did she get access to these people? How did she establish rapport? Her explanation seems insufficient. 
    • Petryna argues that she is not anti-science yet her ethnography illustrates that science is not infallible, not just facts, not unbiased
      •   Science and technology are about generalizability but people are not generalizable
      • Manipulation of data: artificially selecting things so that the data can say something that they want
    •  Patients lack of trust in clinical trials shows that people don’t trust science anymore
      • Analogy: textbook is perceived as truth when you are in elementary school yet the knowledge inside of it is flushed out based on who wrote it
  • Transnational surrogacy
    •  Paying poor people—justification was “at least they’re getting paid”
    • Similar to the drug justification being used in clinical trials
      • People are benefiting from the drugs that they would otherwise not have access to
        • But what about after the clinical trials? Will they have access to the final drugs?
    •  Value of human life; can you put a price in it? Capitalistic in nature; how do we put a price on human life?
    • Overarching institutional problems related to government (economy, health, etc.)
  • ·        Mice research

o   Maya’s post
§  Dilemma—horrible conditions of mice yet need to test medicine
§  Can these mice stand in for human experience?
o   Scientific language: use of specific words to justify actions
§  “Sacrificing” mice for the greater good instead of “killing”
o   Taking it (mice and drugs being tested) out of context and bringing it into the lab for research
o   We must acknowledge that this has brought a lot of progress
o   Ethics about care—how is this process incorporated into bureaucratic processes?
§  Claiming to be ethical while still doing it
§  Bureaucracy does not have the burden of responsibility
o   When you distill people/mice to mere experimental subjects, it is harder to empathize
§  Forced disassociation; remove yourself from your moral/ethics in order to do what you need to do
§  Ex. Physicians preferred to be distant in Petryna’s book
o   Killing animals/mice: data can be different based on the corporation in control/financially backing the experiments
  • ·        Knowledge production

o   Who produces what knowledge, and who gets the profits?
o   Shows historical imbalances in power
o   EX. Cultural knowledge extracted from its peopleàsold to publishing companies, yet some people in the Native American tribe don’t even have access to their own basic ancestral knowledge
§  Argument can essentially be made for all of academic papers in academia
§  Field is based on exploitation
·        Power dynamic

o   Need to democratize knowledge

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