ESHS/HSS Annual Meeting

The Politics, Epistemology and Ethics of Medical Evidence, ca. 1960–ca. 2000

Session Submission Type: Organized Session

English Abstract

What has, historically, counted as evidence in medicine at any given time? Which types of evidence were given precedence, by whom, and why? And, conversely, which types of evidence were seen to deserve little trust? Which methodologies were epistemologically and/or ethically permissible or preferrable? How did historical actors collate, compare, rank and analyse different kinds of evidence, and how did they then interpret and apply the results of this synthesis?

These questions have been extensively studied by historians and philosophers of science. Yet, we lack studies that contextualize debates over medical evidence production, interpretation and evaluation against political, economic and social conditions. Our comparative approach throws differences in sharp relief. Our panel looks at three cases of clinical research (broadly construed), in the second half of the twentieth century, across Western and Eastern Europe and the United States,
to showcase the variety of historical practices regarding medical evidence, exposed by the questions above. Juliette Ferry-Danini shows the disconnect between debates about the ethics of human research participation and methodological choices of clinical researchers in 1960s’ France. Tatjana Buklijas uses the international reception of a New Zealand trial to outline the contest between the population-based, statistics-grounded antecedent of evidence-based medicine (EBM) in the UK and
the consensus-led approaches in the US in the 1970s. Nils Graber examines the reasons behind the difference in epistemological standards for (cancer) drug assessment within individual socialist countries and the transnational clinical trials organized by the Council for Mutual Economic Assistance (COMECON). Hanna Worliczek takes the case of internationally diverging management strategies for congenital toxoplasmosis to discuss the difficulties and deficiencies caused by the exclusive adherence to standards of EBM and its antecedents, 1960s–1990s. Together our presentations will show how in practice ethical, epistemological, economic and political concerns and contexts complicated the ostensibly universally accepted standards of medical evidence.

Sub Unit

• Organized Session

Chair

• Thomas Schlich, McGill University

Individual Presentations

• Intentional harm in human experiments on phloroglucinol, Paris (1960–1961) - Juliette Ferry-Danini, Université de Namur

• Evidence and consensus: Healthcare systems, clinical data and the reception of the antenatal steroid trial, 1969 to 1993 - Tatjana Buklijas, University of Auckland

• Evaluating ‘Socialist’ Cancer Drugs: The Case of the Clinical Trials within the COMECON’s Oncology Program - Nils Graber, Humboldt University

• Defying the logic of the randomised controlled trial: Evidential disparity of treatment strategies for congenital toxoplasmosis in a (proto-)EBM-world, 1960s–1990s - Hanna Lucia Worliczek, University of Vienna, Faculty center for transdisciplinary historical-cultural studies

Session Organizer

• Tatjana Buklijas, University of Auckland