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Clinical trials have become key technologies for decision making in the contemporary world. Their results shape medical practice and determine priorities across health care systems, but the work that goes into producing credible data is often hidden. Medical Proofs, Social Experiments draws upon detailed case studies to argue that to understand their value, we need to pay more attention to the contexts for these modern medical experiments, recovering the diverse ways in which they involve doctors, patients and the public, the local practices that contribute to their completion, and the complex negotiation of their results in professional and statutory institutions. Presenting research from the UK, USA, Sweden and The Netherlands, the ethnographic perspective adopted by the authors provides a space to explore the investments of different state, market, professional and other actors in particular forms of evaluation, and the ways in which trial methodologies may be re-designed or re-imagined to satisfy social and political expectations. As such, this volume will be of interest to those working in the fields of science and technology studies, the sociology and anthropology of medicine and researchers of policy and organisation in health care.
Clinical trials have become key technologies for decision making in the contemporary world. Their results shape medical practice and determine priorities across health care systems, but the work that goes into producing credible data is often hidden. Medical Proofs, Social Experiments draws upon detailed case studies to argue that to understand their value, we need to pay more attention to the contexts for these modern medical experiments, recovering the diverse ways in which they involve doctors, patients and the public, the local practices that contribute to their completion, and the complex negotiation of their results in professional and statutory institutions. Presenting research from the UK, USA, Sweden and The Netherlands, the ethnographic perspective adopted by the authors provides a space to explore the investments of different state, market, professional and other actors in particular forms of evaluation, and the ways in which trial methodologies may be re-designed or re-imagined to satisfy social and political expectations. As such, this volume will be of interest to those working in the fields of science and technology studies, the sociology and anthropology of medicine and researchers of policy and organisation in health care.
Clinical trials have become key technologies for decision making in the contemporary world. Their results shape medical practice and determine priorities across health care systems, but the work that goes into producing credible data is often hidden. Medical Proofs, Social Experiments draws upon detailed case studies to argue that to understand their value, we need to pay more attention to the contexts for these modern medical experiments, recovering the diverse ways in which they involve doctors, patients and the public, the local practices that contribute to their completion, and the complex negotiation of their results in professional and statutory institutions. Presenting research from the UK, USA, Sweden and The Netherlands, the ethnographic perspective adopted by the authors provides a space to explore the investments of different state, market, professional and other actors in particular forms of evaluation, and the ways in which trial methodologies may be re-designed or re-imagined to satisfy social and political expectations. As such, this volume will be of interest to those working in the fields of science and technology studies, the sociology and anthropology of medicine and researchers of policy and organisation in health care.
The provision and use of traditional, complementary and alternative medicine (CAM) has been growing globally over the last 40 years. As CAM develops alongside - and sometimes integrates with - conventional medicine, this handbook provides the first major overview of its regulation and professionalization from social science and legal perspectives. The Routledge Handbook of Complementary and Alternative Medicine draws on historical and international comparative research to provide a rigorous and thematic examination of the field. It argues that many popular and policy debates are stuck in a polarized and largely asocial discourse, and that interdisciplinary social science perspectives, theorising diversity in the field, provide a much more robust evidence base for policy and practice in the field. Divided into four sections, the handbook covers: analytical frameworks power, professions and health spaces risk and regulation perspectives for the future. This important volume will interest social science and legal scholars researching complementary and alternative medicine, professional identify and health care regulation, as well as historians and health policymakers and regulators.
Health and Other Unassailable Values sets out to examine health as a core cultural value. Taking ‘health’, ‘evidence’ and ‘ethics’ as her primary themes, Bell explores the edifice that underpins contemporary conceptions of health and the transformations in how we understand it, assess it and enact it. Although health, evidence and ethics have always been important values, she demonstrates that the grounds upon which they are grasped today are radically different from how they were formulated in the past. Divided into three parts, Part I focuses on the rise of epidemiology, Part II examines the emergence of evidence-based medicine, and Part III explores the broader ethical turn in health and medicine. Through an examination of core concepts including health behaviour, the randomised controlled trial, informed consent and human rights, Bell illustrates the ways in which certain entrenched ideas and assumptions about how human beings think and act recur across a variety of settings. An array of topical case studies, including cigarette packaging legislation, the incorporation of male circumcision as an HIV prevention tool, cancer screening technologies and e-cigarettes, ground the arguments presented. Written in a clear and engaging style, this volume will be of interest to a wide range of scholars and students, especially those in medical anthropology, medical sociology and public health. Clear chapter delineations make the work easy to engage with at the individual chapter level as well as a whole.
This book provides a compelling scholarly statement about the interrelation and pliability of values in the life sciences, medicine and health care. The volume aims to aid our understanding of the roles of power, knowledge production, and economic action in the heavily scientised and economised areas of life science and medicine.
The Pharmaceutical Studies Reader is an engaging survey of the field that brings together provocative, multi-disciplinary scholarship examining the interplay of medical science, clinical practice, consumerism, and the healthcare marketplace. Draws on anthropological, historical, and sociological approaches to explore the social life of pharmaceuticals with special emphasis on their production, circulation, and consumption Covers topics such as the role of drugs in shaping taxonomies of disease, the evolution of prescribing habits, ethical dimensions of pharmaceuticals, clinical trials, and drug research and marketing in the age of globalization Offers a compelling, contextually-rich treatment of the topic that exposes readers to a variety of approaches, ideas, and frameworks Provides an accessible introduction for readers with no previous background in this area
Clinical trials used to be conducted overwhelmingly in the US and Europe but for a range of economic, technical and ethical reasons, the number of multicentre studies recruiting subjects in different regions of the World has grown exponentially. New medicines are tested in vast research networks involving several countries, hospitals and other medical institutions, and hundreds of individual subjects. In Pharmaceutical Research, Democracy and Conspiracy, Edison Bicudo examines the connections between global and local scales, exploring how it is possible for social actors as different as global companies and patients of local hospitals to come together and establish social relationships that may last many years. He also identifies the implications of these global-local relationships for the financial, technical and cultural structures of the participating hospitals. His study draws on fieldwork conducted in five countries: the UK, Spain, France, Brazil and South Africa. Shining a light on the social mediations that enable the encounter between these rationalities, the author concludes that this has the practical effect of subjecting countries hosting trials to institutional engineering. Hospitals and research agencies create new, sometimes surprising, institutional arrangements to cope with international research projects, which change relations between physicians and patients, as they acquire new roles as clinical investigators and research subjects. Frequently, such shifts deviate the institutional structures of medical institutions away from democratic, and towards conspiratorial, schemes. The book reviews the concept of mediation in sociological thought, proposes further developments in Habermas’ theory of communicative action, and offers some political reflection about the role of institutions in contemporary democracies.
The past three decades have seen enormous changes in the organisation of health care. This book explores the role of knowledge production and technology on these transformations, focusing on the market (attempts to embed principles of economic rationality and efficient use of resources in the shaping and delivery of health care), the laboratory (science, experiments and 'evidence' in the management of research, practice and policy) and the forum (the application of deliberative procedures and other forms of public consultation to health care decision making).
In Research as Development, Salla Sariola and Bob Simpson show how international collaboration operates in a setting that is typically portrayed as "resource-poor" and "scientifically lagging." Based on their long-term fieldwork in Sri Lanka, Sariola and Simpson bring into clear ethnographic focus the ways international scientific collaborations feature prominently in the pursuit of global health in which research operates "as" development and not merely "for" it. The authors follow the design, inception, and practice of two clinical trials: one a global health charity funded trial and the other a pharmaceutical industry-sponsored trial. Research as Development situates these two trials within their historical, political and cultural contexts and thus counters the idea that local actors are merely passive recipients of new technical and scientific rationalities. While social studies of clinical trials are beginning to be an established niche in academic writing, Research as Development helps fill important gaps in the literature through its examination of clinical research situated in cultures in low-income settings. Research as Development is noteworthy for the way it highlights the critical and creative role that local researchers play in establishing international collaborations and making them work into locally viable forms. The volume shows how these clinical and research interactions bring about changes in culture, technologies and expertise in Sri Lanka, contexts that have not previously been written about in any detail.