researchers can be catty.
whole articles are dedicated to poo-poo-ing someone else's theory or ideal, or simply pouting about the language with which it was conveyed. the worst of these kinds of papers succeed only in pointing out another's philosophical shortcomings, proposing no alternatives or real suggestions aside from the academic version of "get a life."
that said, there can be illuminating critique, offering close-but-no-cigar something to actually put in its pipe and smoke.
dr. terese lysaught wrote a very compelling article about the political nature (and think germain greer here, the personal is the political etc etc) of medical research. there is a lot of talk about resources, economics, power imbalances and culture gaps in transnational research - north american researchers are often called "mosquitos" ... they fly in, collect blood, and fly away again leaving everyone a little more itchy than they had been. but at the end of the day, medicine (research or clinical) comes down to the experiences of individual bodies, trying to be alive.
applauding some thinkers and dismissing others, lysaught referred to a colleague, dr. rita rhodes who proposed that, like military service in some countries and jury duty in most, participation in medical research should be obligatory for all citizens. we all stand to benefit from its discoveries, so why should we not equally contribute to its efforts?
most of the world's medical discoveries take place on north american soil. most north american people are over the age of 30 and are middle class. but most research is largely performed on university students or upon vulnerable populations -- institutionalized, incarcerated or impoverished people who need the system as much as it needs them. perhaps by virtue of proximity we should discern whether university students are in fact a vulnerable population as well...?
while lysaught crouched to lay a steamer on rhodes' theories (which are extremely... extreme) i wondered if rita wasn't onto something.
what is so special about middle aged, middle class bodies that exempts them from biomedical research? all of this effort and energy is spent belaboring the question of "how can high income countries conduct research with low income countries with SANS exploitation?" but maybe the better question is to really examine "why are the high incomes there in the first place?" viagra, the world's top-selling drug was tested in the "Third World." really? is erectile dysfunction really the issue in Uganda?
there are very good, passionate physicians who want nothing more than to create opportunities to heal, say, the HIV pandemic in africa, and they conduct their research where the disease lives. but alongside, Big Pharma has built its barn in the developing world to cut overhead, circumvent ethical guidelines that govern research in north america, and most of all to gain access to an almost limitless source of bodies to test. if the bodies under scrutiny were middle aged middle class (and, imagine, maybe even UPPER class!) north americans, with their compliment of self-assigned entitlements, biomedical ethics would be lightyears ahead of where it is now. with the vast VAST majority of experimentation having been conducted on vulnerable persons, it is only the voice of advocates - first informed, then compelled and finally resourced sufficiently to speak out about mistreatment of patients/participants alike - that have driven the momentum behind bioethical change. imagine how much faster that would have transpired if the research subjects were CEOs and CMAs and even MDs in the first place!
whole articles are dedicated to poo-poo-ing someone else's theory or ideal, or simply pouting about the language with which it was conveyed. the worst of these kinds of papers succeed only in pointing out another's philosophical shortcomings, proposing no alternatives or real suggestions aside from the academic version of "get a life."
that said, there can be illuminating critique, offering close-but-no-cigar something to actually put in its pipe and smoke.
dr. terese lysaught wrote a very compelling article about the political nature (and think germain greer here, the personal is the political etc etc) of medical research. there is a lot of talk about resources, economics, power imbalances and culture gaps in transnational research - north american researchers are often called "mosquitos" ... they fly in, collect blood, and fly away again leaving everyone a little more itchy than they had been. but at the end of the day, medicine (research or clinical) comes down to the experiences of individual bodies, trying to be alive.
applauding some thinkers and dismissing others, lysaught referred to a colleague, dr. rita rhodes who proposed that, like military service in some countries and jury duty in most, participation in medical research should be obligatory for all citizens. we all stand to benefit from its discoveries, so why should we not equally contribute to its efforts?
most of the world's medical discoveries take place on north american soil. most north american people are over the age of 30 and are middle class. but most research is largely performed on university students or upon vulnerable populations -- institutionalized, incarcerated or impoverished people who need the system as much as it needs them. perhaps by virtue of proximity we should discern whether university students are in fact a vulnerable population as well...?
while lysaught crouched to lay a steamer on rhodes' theories (which are extremely... extreme) i wondered if rita wasn't onto something.
what is so special about middle aged, middle class bodies that exempts them from biomedical research? all of this effort and energy is spent belaboring the question of "how can high income countries conduct research with low income countries with SANS exploitation?" but maybe the better question is to really examine "why are the high incomes there in the first place?" viagra, the world's top-selling drug was tested in the "Third World." really? is erectile dysfunction really the issue in Uganda?
there are very good, passionate physicians who want nothing more than to create opportunities to heal, say, the HIV pandemic in africa, and they conduct their research where the disease lives. but alongside, Big Pharma has built its barn in the developing world to cut overhead, circumvent ethical guidelines that govern research in north america, and most of all to gain access to an almost limitless source of bodies to test. if the bodies under scrutiny were middle aged middle class (and, imagine, maybe even UPPER class!) north americans, with their compliment of self-assigned entitlements, biomedical ethics would be lightyears ahead of where it is now. with the vast VAST majority of experimentation having been conducted on vulnerable persons, it is only the voice of advocates - first informed, then compelled and finally resourced sufficiently to speak out about mistreatment of patients/participants alike - that have driven the momentum behind bioethical change. imagine how much faster that would have transpired if the research subjects were CEOs and CMAs and even MDs in the first place!
i haven't been a guinea pig for anything more complicated than a beep-test during psychology 101. kind of hard to justify becoming a medical professional if i'm not willing to be a lab rat for a day. just who do i think i am?
who does the biomedical community think that people in the poorest countries aren't?
if i were made queen for a day, i would want to implement a new layer of ethical requirement. researchers submit their proposals for ethics-board scrutiny, but they have never been asked to justify the locale of their learning. but shouldn't research for a given treatment/disorder be conducted upon its target population... tested upon the persons for whom it is designed?
there are no disposable bodies in the human family. until we can genuinely appreciate that and abandon the practice of farming vulnerable populations for inexpensive and compliant test materials there cannot BE ethical research in transnational practice.
there are no disposable bodies in the human family. until we can genuinely appreciate that and abandon the practice of farming vulnerable populations for inexpensive and compliant test materials there cannot BE ethical research in transnational practice.
hwb
Lysaught, MT (2009). Docile Bodies: Transnational Research Ethics as Biopolititcs. Journal of Medicine and Philosophy, 34:384-408
When you got it right you got it right!
ReplyDeleteAnd right now, Canada is negotiating a trade agreement with the EU (CETA) that would impose more extensive protections on Big Pharma's monopolies to a degree that it would be difficulty--if these clauses remain intact--for the generic manufacturing industry to even survive here. And if we can't get generics for ourselves, we won't be able to supply them to people like the poor in developing countries. How much bigger piece of the pie does Big Pharma need?
can you post some links to information sources for this? i would be interested to read up, fine print and all, before my next conference call. this week's challenge: how does Big Pharma fit into bioethics and policies, and is it even conceivable that they might conform to regulatory ideals...
ReplyDeleteHere you go: http://www.theglobeandmail.com/news/opinions/opinion/what-you-dont-know-about-a-deal-you-havent-heard-of/article1859216/ and
ReplyDeletehttp://www.canadians.org/trade/issues/EU/index.html and http://healthcoalition.ca/main/issues/ceta-trade-deal-threatens-medicare
There may be better sites to be found but the Council of Canadians is again giving a lead here. The Eu is also trying to finalize a trade agreement with India that would put an end to that country being able to provide generic drugs to treat diseases like HIV/AIDS in sub-Saharan Africa. It is said that Big Pharma dollars are driving a very large piece of these initiatives.
thanks!
ReplyDelete