Race, Space, and Design: RCTs as Concept, Practice, and Material Arrangement

• In Event: Randomized Controlled Trials: The “Gold Standard” Between Theory and Practice

Abstract

STS scholars have shown that research designs incorporate and make possible some forms of knowledge while neglecting to activate others. STS scholars have usefully documented how the randomized controlled trial (RCT) as a research design supports standardization and de-emphasizes embodied or singular forms of knowledge. Yet in addition to their conceptual and practice-based implications, RCTs also demand material rearrangements of space. Learning from Critical Design Studies this talk asks: what spatial configurations do RCTs prompt or stifle, and what material-political worlds do the designs allow or foreclose? Empirically, this talk examines the space of the Clinical Center of the US National Institutes of Health between 1950 and the present, the period during which the RCT design became the “gold standard” for clinical research. The talk is based on the author’s original “vernacular archive” of former “normal controls” and the scientists who researched them at the Clinical Center, as well as on published scientific papers and the formal archives of churches, colleges, unions, and US federal government. Methodologically, the talk sets the RCT in relation to other research designs, such as self-comparisons and field trials, as scientists deployed them within the Clinical Center and at other NIH spaces during this period. In doing so, the talk locates RCTs in relation to other designs and ways of knowing the human. The talk argues that the RCT demanded a practical arrangement of research space that produced patterned differences in who participated as “human subjects” of studies. The talk suggests that the RCT design upheld a racialization of medical knowledge around who was considered “normal” and who was “pathological.” Together with the audience, the talk aims to consider responses and responsibilities of STS scholars, given the racialization of knowledge that stems from research designs in the present day.

Author

• Laura Stark, Vanderbilt University