It seems Petryna and Taylor (from ‘Paper Tangos’) want to give the exact opposite format to their fieldwork. Petryna wants to weave sociological, political, and statistical histories of an industry together into a “global ethnography (9)” by using mostly interviews and the previous investigations of others. By following this format, she ends up with a well-organized ethnography, but does the reader care? Is this the objectivity everyone in class has been waiting for? While I see validity in this method, I can’t help but think it may be the personal touch and inclusion of “I” that is attractive and engaging in the other works we have read (perhaps Rabinow can be seen as some kind of middle ground?).
The actual interpretation or analysis of “When Experiments Travel” seems to be within the ‘book-end’ statements in the introduction and the conclusion. The presentation and methodology of her fieldwork allow for no surprises on the reader’s part. In the beginning she says, “This book is about the business of clinical trials. It examines the organizational cultures of industry-sponsored clinical research, probing scientific, ethical, and regulatory practices (5).” So right away the reader understands that whatever investigations will take place will be questions that relate back to this framework. Is this a good thing? Would it perhaps be better to allow us to discover what the book is about through the extensive interviews included? In the conclusion she feels she has to explain again what we have just read, “…I questioned the meaning and implications for subjects of the exponential growth in drug trails, and asked about how subjects are protected, how scientific integrity is ensured, and about the value patients bring to clinical trails and, ultimately, to the value of drugs (186).” However, the questions she poses early on are formatted in a way I find to be helpful throughout: “What, precisely, is the relation between the drug industry’s stagnation and the clinical trails industry’s rise? (6).” She sets up her topic, the stakes (why the research matters), and proceeds to draw statistical and political comparisons from various points in history in attempt to allow us to consider the future of the industry.
Part Deux: But why does she rely on the knowledge of others? She uses phrases like “According to..” and “I’ve heard/read accounts that state….” I found myself while reading, considering her a credible source on these matters whereas with Taylor I often questioned how well informed she was and considered why she was allowed to talk to us about the tango. Is this because we never really even meet Petryna so we have no reason to consider why she is a credible source? Because Petryna is almost entirely absent from the book, I feel like I am reading archives in a library. Is this book dry and boring to me because of the subject matter or the method? I am attracted to the idea of allowing the stories and statistics to speak for themselves (in the context of history) while working with the Tibetan people, but I think some analysis is necessary in order to add some activity or vitality to what is being presented. She limits her presence to explanations of how or why she was able to talk with a certain individual/ the context in which the interview occurred. “It was March 2006 and I was at UCSF giving a talk on offshore clinical research. Dr. Sim approached me and told me…..(89).:” The only reason I think she would do this is as a testament to her credibility as a source. Why is she allowed to ask these people questions? Because she was giving a lecture? In her conclusion as well, she has someone else make the actual controversial or political claims, “The inspector general’s report recommends improving information systems, creating a clinical trials database and an institutional review board registry...(187).” A final example of an external objective way to provide a solution.
Unfortunately, I wasn’t able to get the book on time, ‘cause I’d been referring to the old syllabus and forgot it had been added until it Hugh mentioned it on Tuesday. It’s already been checked out at Bobst and none of the three bookstores I went to had it! Anyway, sob story aside, here are my thoughts about the portions I was able to read on Google books:
Compared to Rabinow, Latour, and Taylor’s books, When Experiments Travel struck me as a fairly conventional piece of anthropological writing. However, I think that it does, albeit in a less striking way than any of the former three, call into question certain assumption about the way anthropologists should approach research.
Since a major part of its focus is the production of scientific knowledge, it’s probably most useful to compare Petryna’s book to Laboratory Life. The authors of both books have to contend with a problem very different from that of traditional anthropology: rather than having to decipher social phenomena to which they were completely unexposed before entering the field, they must contend with the problem of researching subjects with which they will inevitably already be somewhat familiar. They deal with subjects that are connected in innumerable ways, through expansive institutional, financial, and cultural networks to the researchers’ own social existence, subjects about which massive amounts of information—both academic and nonacademic—have already been produced. Their problem is not creating “interpretations” (to use Geertz’s term) out of previously un-interpreted cultural phenomena, but of interpreting phenomena about which hundreds of academic interpretations have already been written. What is striking is how different the approaches the two books take to this problem are.
Latour and Woolgar are highly critical of existing scholarship on the production of scientific knowledge, and attempt to overcome the biases of this scholarship, and it’s inattentiveness to the actual conditions of the production of knowledge, by treating the scientists as though they actually were a mysterious, hitherto indecipherable culture. To do this, they limit their research to the space of a single laboratory, ignoring any outside “social” factors until they arrive upon explanations of them based on their own observations of the lab. Petryna, in contrast, from the beginning conceives of the production of knowledge about experimental pharmaceutical products as a vast global network, linking scientists and physicians to an array of financial, political, cultural, and ethical interests.
Petryna’s book is unique among those we have read in that her research is not limited to a particular locale or “culture,” but instead is limited to a particular practice that is strikingly delocalized. Thus the sense, acknowledged at least one point by Petryna herself, that her work is more similar to journalism than ethnography. Her informants are many different people, for the most part unknown to one another, dispersed across the world in locations like Poland, Brazil, and the United States, and her contact with them seems to have been largely in the form of interviews—certainly not the kind of long-term bonding and friendship-building described by Rabinow. Ironically, Petryna partially justifies this wide ranging scope—intent on mapping out the relationship of the value of the knowledge produced in clinical trials to all the other forms of value with which it is connected—by quoting Rabinow: “the challenge for social scientists is to identify instances of this conflation [between capital and other forms of value] and ‘to investigate how “capital” from one market is converted into “capital” (or advantage) in another’” (192).
Petryna conveys her exploration of transnational science as developed through clinical studies and factors that mediate it, such as politics and ethics. She primarily asks leading questions such as "what value systems bring researchers, physicians, and patients into trials?" (Pg. 7). By examining questions about all of the pieces of clinical studies and what brings them together, she defines underlying concepts of motivations for participation and the significance of the outcomes. Thus, she defines the changing standards of the pharmaceutical industry and what this says about the communities/government's needs, for example the willingness of poor people to test drugs as free treatment. Ethical issue revolving clinical studies are key in her process of discovering what the involved costs are in order to provide new medications, and she highlights the importance of regulation in maintaining humane treatment of all those involved in studies. She questions, "How do they see the dimensionality of the problem and the implications of their work in terms of control over methods, researchers, subjects, and ethical issues?" (Pg 7). By doing this, she gets into understanding humanities influence of "scientific innovation" and how people shape science, and the importance of responsibility in this field.
Petryna's methods consist of interviews and analysis of research. While the reader hardly sees her opinion in this book, it helps to immerse oneself in the world of clinical trial, free of imagining the narrator instead of what they are attempting to convey. Her interrogation of firms and individuals involved in the process brings out its complexity, with the multiplicity of opinions, as well as the common goal of improving health care in the safest manner. She grasps the most defining elements of this world through focusing on differing countries such as the U.S. and Poland to explore the process and players involved most vividly and connect the transnational role of clinical studies. She explains that "clinical trials become powerful marketing tools and can significantly alter local and public healthcare priorities" (Pg. 189). Thus, all studies are interconnected into a realm of scientific research for the betterment of mankind, which is only made possible through the many contributors analyzed in this book.
Examining the methods within When Experiments Travel It is effortless to see the stark contrast between Paper Tangos and When Experiments Travel. The book is easily summed up by two sentences, which I believe faithfully express Petryna’s views on her research, “anthropologists strive to gain an insider’s perspective and to understand actors on their own terms—ideally, to situate their practices in a broader historical and comparative light. This takes time, charting networks, entering into the perspectives of multiple actors and juxtaposing their diverse view points and stakes (55).” Petryna goes through strict methodology while analyzing medical trials, and the seriousness of the content within the text is tangible. To approach her complex field of study Petryna employs various strategies. Firstly she posses various questions that she hopes to examine throughout, and which she presumably hopes her readers will pay close attention to. Secondly she makes constant references to statistical data, “According to recent industry statistics, central-eastern Europe has the highest volume of patients (6.27) enrolled per investigative site, followed by the Asia-Pacific region (5.78)… (13).” She asserts that the “anthropological challenge is to engage the transparent and public ways in which private-sector research undergoes global reconstructing today (14).” When talking about the morality of her subject of research, she appears to be doubtful of how scientific integrity is maintained when such great emphasis is placed on “speed and profitability”. The guiding material of her fieldwork is based on sources such as “academic scientists, policy makers, state prosecutors and citizens (18).” I presume that by clarifying these she means to set the reader at ease that she has fully covered all the corners of the spectrum of those involved. The problems she encounters are also amply stated, i.e “the available pool of human subjects in major Western pharmaceutical markets is shrinking. We are using too many drugs (21).” Provided also in chapter one is a detailed historical account of medical trials within the U.S. Her concerns are voiced throughout however, they are done so in passing, “I am intrigued by the temporality of these harm stories—involving suppression of critical data and warning signs, media exposure of manipulations in the drug trial phase, and ongoing legal battles over compensation and remediation—and with the state-market complicities that they reveal (27).” There is also the compare and contrast portion where she examines whether Eastern Europe and Latin America are good fields for trials. Her anthropological conclusions are also arrived at clearly i.e. when she references the tensions between the lab (testing) and the field (the public) (46). There is also inclusion of case studies/interviews such as the one with Dr. Besselaar. So far she appears to leave no possible realm unstudied or unmentioned.
Part #2 Now that I feel that I have done justice to Petryna in mentioning all the ways she goes about giving her research a sense of validity and structure, I would like to analyze whether this method of research works. Did all her facts, figures, statistics, and data make me any more interested in clinical trials than I was when I began reading the book? My answer would have to unfortunately be—no. I don't want to simply leave it at that, I truly spent a good amount of time pondering why none of this information seemed interesting to me at all, especially when it appears to be so controversial and present in the “today”. I believe that I finally came up with a sufficient metaphor as to how I felt while reading the book—the feeling is something similar to watching a movie either with no volume, or in a foreign language with no subtitles. There was no possible way, I could find, to engage in her material. Even her description of her interviews seemed bleak, poor Evan’s description amounts to “Evan my AGR contact, is an articulate and hardworking fifty-year-old businessman. When we met that day at his office, he looked fit and casually dressed in a worn, light-blue oxford shirt with the sleeves rolled up (5).” So what is it that When Experiments Travel is missing? Is it the emotional connection that ties you to the subject that is lacking? Or is the purpose of the text meant to be purely informative disregarding the realm of feeling? Personally I prefer something like Rabinow’s piece, when the reader is able to gain insight into the author’s trajectory and learning process—the personal insight into the discoveries being made.
Petryna’s When Experiments Travel is different, as far as research methods, to all the previous texts we have read. Despite Petryna’s methods of research being similar to Latour and Woolgar’s methods, similar in the sense that their accumulating of information was done less “socially.” Petryna studies the global pharmaceutical market, and its benefits and risks on human test subjects in poor countries. She acquires her information via interviews and from previously documented investigations on the subject; this method is similar to that of Latour and Woolgar’s.
Petryna’s goals are clearly stated in the opening chapter and it is clear why she has included the information that is in the text. Unlike Rabinow’s Reflections of Fieldwork In Morocco, in which Rabinow admits to not knowing what he is investigating or what his goal is, Petryna states that she is examining the effects of clinical trials and practices involved with the process of clinical research. Yet, like Rabinow’s text, When Experiments Travel also explores moral and ethical issues attributed to the subjects and their behaviors; except, Rabinow’s examination was done on a very social and personal level while Petryna’s was done more clinically.
Comparing When Experiments Travel to Paper Tangos, Petryna comes off as, for lack of a better word, unaffiliated. Reading this book, I got the impression that one of her undisclosed goals was to come off as an unaffiliated and uncritical narrator. Petryna’s main goal was to present the practices of the pharmaceutical industry and examine them to allow the reader to decide for himself/herself whether the benefits and risks are justified or morally acceptable. On the other hand, Taylor presented the tango and Argentinean culture as she saw it and with her sentiments attached; her sentiments as a dancer regarding what she saw. Part of the reason Petryna is clear to not submit her opinions directly is due to the fact that she wants to present the information she gathered and not analyze it to coincide with a certain belief. In this sense, her presentation of her research is also similar to that of Latour and Woolgar’s. Her manner of approaching research is clinical, and more dependent on the presentation and accumulation of the information she gathered in order to provide the ability to analyze scientific research.
As previously mentioned by my fellow classmates in their comments "When Experiments Travel" is clearly the total opposite of the other books we have read excluding Latour and Woolgar, which in some ways could be said to have the same non-personal research approach, but at the same time being different in the way the fieldwork was carried out and researched. Many of the other books we have read in class i.e. Paper Tangos were criticized greatly because of the overly personal form of writing and fieldwork study, and in contrast we have Adriana Pertyna books which is very informative, very "distant" in personal relations and a book that I felt gave me a great insight into experimental drug testing, I really felt I learned much about this type of business, however can it really help me in terms of my own research? To answer my own questions, perhaps it can't and mostly because I will be working closely with a specific ethnic group and one that has an unsettling past that only if I had no heart would be able to perform the fieldwork objectively. I also don't think in my research it would really be effective to have such an extensive and for the lack of better words boring historical and statistical compilation of data, which is what we find in Adriana Petryna’s When Experiments Travel. I also feel that even though I learned so much from her research, I almost could say it really was in the beginning of the essay that I was interested everything else became a bit repetitive and I felt as though I were reading a magazine on expose of experimental testing in Poland and Brazil, which is fine but doesn’t say much about her anthropological research goal. Maybe if she had included more of her ways of getting to the information and her decisions into traveling to certain places and also the interactions not only certain pieces of the conversation it would have held my attention and engage me even further into the reading.
Petryna’s “When Experiments Travel” stands in stark contrast to previous texts, and to me, seems to fall under the category of a more standard, archetypal anthropological work. Perhaps most comparable to “Lab Life,” I personally found it extremely interesting and relevant, although not highly “engaging.” From a critical (rather than literary) standpoint, it states the facts plainly without much personal interjection, providing a great deal of extensive, detailed information (e.g., pages 12—14 when Petryna provides a series of facts and dates for her depth discussion of clinical trials) as well as integrating a great deal of quotes from both outside and inside sources. While it does not belong to anthropologists, sociologists or scientists alone, this study does not attempt to appeal to a wide range of readers, and although it is not overly dense, it is not particularly accessible or personal either. Overall, I found this text useful as a tool for learning how to gage my own work and standpoint in the anthropological field—like Zuzu said, in comparison to Taylor’s “Paper Tangos” it is an extreme opposite, but most importantly, it offers perspective: When it comes to anthropology, I believe middle ground should be found between the dry listing of facts and overly personal memoir pieces.
Having had the same problem as Max not being able to find the book at either both Barnes and Noble or the library, I obtained a choppy version of Petryna’s narrative via Google books. Reading what I could of the introduction and first two chapters I gained enough insight to understand Petryna’s style, method, and goals. Medicine may not seem like an obvious source for ethnographic studies, but the global system that it is situated within and the actors involved reveal issues pertaining to science, capitalism, and law that ultimately effect and create forms of social action, thus effecting humanity, the basis of anthropological interest. This book is on the polar opposite end of the spectrum than Julie Taylor’s Paper Tangos, appearing much more emotionally distanced and objective, which was our class’s main gripe with Taylor. I think this approach works better because the audience infers the emotion behind the cold calculative research by developing a similar strength of feeling to the author, even though it was not blatantly expressed in the text. I myself felt uncomfortable thinking about the uncertainties, and risks that the pharmaceutical industry takes by gambling the safety of a large group of individuals for the sake of profit. The ethical issues naturally arise in the mind while reading When Experiments Travel, making it an effective and worthwhile text.
Frankly I found Adriana Petryna to be very dry and anthropologically pedestrian in this particular text, as she takes on a sort of brusque and clinical sort of language throughout the piece. While she is discussing very clinical material, the exploration of pharmaceutical trials and the physicians and corporations that coordinate them, there seems to be this very prominent detachment between her subjects and herself. Almost mirroring the stratified structure she illustrates in the introduction between physicians and their trial patients, “a bedraggled patient-volunteer, accompanied by an escort who appeared to be his caregiver, sat waiting for his name to be called by a physician who was standing behind a glass pane-much like a bank teller. The physician asked the patient whether he had experienced any side affects from taking the experimental drugs. The answer was no, and the doctor passed him a new dose. The patient left” (1). There was a very definitive lack of personal expression present in When Experiments Travel that was exceptional in Paper Tangos and Reflections on Fieldwork in Morocco. Julie Taylor while perhaps a bit self-involved demonstrated her unique connection to the art of the Tango with her disclosure of personal experience, the history of Argentina, as well as the rather artful revelation of the birth of the tango. Subsequently Paul Rabinow greets us with his willingness to depart from traditional academia as well as a few slips of judgment along the way. While these are not unblemished pieces they give the reader a sense of connection and intrigue, the authors were not merely regurgitating facts and stats on a page they were both submerged and emerged in the worlds which they were studying whereas Petryna seems to be randomly glancing at this world through a set of double paned glass. Interacting with her subjects as a seventh grade field trip interacts with the animals at the zoo. This is her method an a traditional anthropological one indeed, and while I feel it appropriate in our little cloister of academia, there is hardly any humanity for her reader to relate to, to be drawn in by, and students can be fickle readers. Consequently it is her methods which restrain her from attaining her true definition of what anthropology seeks to do, “strive to gain an insider’s perspective and to understand actors on their own terms-ideally, to situate their practices in a broader historical and comparative light” (55). Simply because she does not dive into her subjects’ perspectives or understand their situation, she defines them as if they were a noun in a dictionary John Q. Doe M.D. he’s fifty, he’s not wearing a tie and his sleeves are rolled up, and he has a carbon copied response for everything. That doesn’t tell us why he works in the field, it doesn’t tell us how he got in his chosen profession, or even how he feels about the sort of work he does. It is an anthropological piece on the process of global pharmaceutical trials, not it’s facilitators, not it’s producers, coordinators, or participants, but merely the subject at hand.
When we are confronted by mortality, or when someone in our life is diagnosed as terminal we have this thought that medical science has progressed to where there is at least a treatment if not a cure. This is a belief that has a history, but more importantly, is part of a process. It is a belief that, sometimes, is not true. In this instance the patient is burdened with fear and powerlessness. Science needs the aforementioned process. This process is an experimental one. But even experimental processes, if their treatments can offer even the slightest benefit, someone somewhere will find this an attractive prospect. With this being said, it makes me wonder over the validity of regulatory prohibitions over last chance therapies – just a random thought while reading Petryna.
Those trying to regulate this new paradigm have their work cut out for them. Not unrelated to the fact that much clinical research is being outsourced around the world, and the rise of medical tourism, people (who can pay for it) are seeking potential therapeutic benefits from cutting edge stem-cell research or clinical practice taking place in countries like China. This research may well not be taking place in the home country of the beneficiary, due to cost or regulatory/legal prohibitions. There is the possibility that such trials or practices may not be in the best ethical shape, for instance involving unnecessary risks and promising to desperate patients more than they can keep. The underlying ethical principle behind the patient access paradigm -- patient autonomy -- is unlikely to capture all of the ethical concerns associated with globalizing experimental therapy. This is what Petryna has taught me.
In When Experiments travel the author Adriana Petryna investigates the clinical trial industry. It is estimated that 2.3 million people participate in clinical trials but the FDA only monitors less than 1% of those trials. Many of these trials take place off shore where the FDA has limited access. Petryna tries to expose the corporate side of these clinical trails. Although she does a good job at stating facts and statistics the book is missing a more personal aspect. There are very few individuals that are mentioned. She explores the global clinical trial system in countries like Ukraine, Poland, Russia, and the Czech Republic. According to Petryna the healthcare industry gives a lot of reasons why clinical trials are good for the people in them including free healthcare for people with no access to health care. Sometimes they are private public partnerships that form to create voids in the global medicine distribution system. The author also wrote a book about the health problems that were produced by the Chernobyl disaster. Both books are about the misery produced by large institutions like the health care industry and the government of certain countries. Both the former soviet government and the US government both react indifferently to the harms produced.
It seems Petryna and Taylor (from ‘Paper Tangos’) want to give the exact opposite format to their fieldwork. Petryna wants to weave sociological, political, and statistical histories of an industry together into a “global ethnography (9)” by using mostly interviews and the previous investigations of others. By following this format, she ends up with a well-organized ethnography, but does the reader care? Is this the objectivity everyone in class has been waiting for? While I see validity in this method, I can’t help but think it may be the personal touch and inclusion of “I” that is attractive and engaging in the other works we have read (perhaps Rabinow can be seen as some kind of middle ground?).
ReplyDeleteThe actual interpretation or analysis of “When Experiments Travel” seems to be within the ‘book-end’ statements in the introduction and the conclusion. The presentation and methodology of her fieldwork allow for no surprises on the reader’s part. In the beginning she says, “This book is about the business of clinical trials. It examines the organizational cultures of industry-sponsored clinical research, probing scientific, ethical, and regulatory practices (5).” So right away the reader understands that whatever investigations will take place will be questions that relate back to this framework. Is this a good thing? Would it perhaps be better to allow us to discover what the book is about through the extensive interviews included? In the conclusion she feels she has to explain again what we have just read, “…I questioned the meaning and implications for subjects of the exponential growth in drug trails, and asked about how subjects are protected, how scientific integrity is ensured, and about the value patients bring to clinical trails and, ultimately, to the value of drugs (186).” However, the questions she poses early on are formatted in a way I find to be helpful throughout: “What, precisely, is the relation between the drug industry’s stagnation and the clinical trails industry’s rise? (6).” She sets up her topic, the stakes (why the research matters), and proceeds to draw statistical and political comparisons from various points in history in attempt to allow us to consider the future of the industry.
Part Deux: But why does she rely on the knowledge of others? She uses phrases like “According to..” and “I’ve heard/read accounts that state….” I found myself while reading, considering her a credible source on these matters whereas with Taylor I often questioned how well informed she was and considered why she was allowed to talk to us about the tango. Is this because we never really even meet Petryna so we have no reason to consider why she is a credible source? Because Petryna is almost entirely absent from the book, I feel like I am reading archives in a library. Is this book dry and boring to me because of the subject matter or the method? I am attracted to the idea of allowing the stories and statistics to speak for themselves (in the context of history) while working with the Tibetan people, but I think some analysis is necessary in order to add some activity or vitality to what is being presented. She limits her presence to explanations of how or why she was able to talk with a certain individual/ the context in which the interview occurred. “It was March 2006 and I was at UCSF giving a talk on offshore clinical research. Dr. Sim approached me and told me…..(89).:” The only reason I think she would do this is as a testament to her credibility as a source. Why is she allowed to ask these people questions? Because she was giving a lecture? In her conclusion as well, she has someone else make the actual controversial or political claims, “The inspector general’s report recommends improving information systems, creating a clinical trials database and an institutional review board registry...(187).” A final example of an external objective way to provide a solution.
ReplyDeleteI was very interested in the discussion of the difference between a journalist and an anthropologist. She says, “…it is not exposé-oriented and I do not have the entry points to undertake such work (15) .” Later on in the book after presenting more interviews and historical data and reposing questions she says, “…Dr. Besselaar wanted to know the difference between my work and journalism….He had had a bad experience with a journalist, who had “twisted his words” to fit a preconceived line of argument. Anthropologists, on the other hand, take pride in refraining from such an approach. …Both…engage contemporary problems, but methodologically anthropologists strive to gain an insider’s perspective and to understand actors on their own terms-ideally, to situate their practices in a broader historical and comparative light (55).” So I guess this is the answer of what she is trying to do methodologically. She wants to “reveal (188)” but not to analyze or twist words to fit a context of a specific opinion. She compiles a survey of knowledge of the past to inform the future.
Unfortunately, I wasn’t able to get the book on time, ‘cause I’d been referring to the old syllabus and forgot it had been added until it Hugh mentioned it on Tuesday. It’s already been checked out at Bobst and none of the three bookstores I went to had it! Anyway, sob story aside, here are my thoughts about the portions I was able to read on Google books:
ReplyDeleteCompared to Rabinow, Latour, and Taylor’s books, When Experiments Travel struck me as a fairly conventional piece of anthropological writing. However, I think that it does, albeit in a less striking way than any of the former three, call into question certain assumption about the way anthropologists should approach research.
Since a major part of its focus is the production of scientific knowledge, it’s probably most useful to compare Petryna’s book to Laboratory Life. The authors of both books have to contend with a problem very different from that of traditional anthropology: rather than having to decipher social phenomena to which they were completely unexposed before entering the field, they must contend with the problem of researching subjects with which they will inevitably already be somewhat familiar. They deal with subjects that are connected in innumerable ways, through expansive institutional, financial, and cultural networks to the researchers’ own social existence, subjects about which massive amounts of information—both academic and nonacademic—have already been produced. Their problem is not creating “interpretations” (to use Geertz’s term) out of previously un-interpreted cultural phenomena, but of interpreting phenomena about which hundreds of academic interpretations have already been written. What is striking is how different the approaches the two books take to this problem are.
Latour and Woolgar are highly critical of existing scholarship on the production of scientific knowledge, and attempt to overcome the biases of this scholarship, and it’s inattentiveness to the actual conditions of the production of knowledge, by treating the scientists as though they actually were a mysterious, hitherto indecipherable culture. To do this, they limit their research to the space of a single laboratory, ignoring any outside “social” factors until they arrive upon explanations of them based on their own observations of the lab. Petryna, in contrast, from the beginning conceives of the production of knowledge about experimental pharmaceutical products as a vast global network, linking scientists and physicians to an array of financial, political, cultural, and ethical interests.
Petryna’s book is unique among those we have read in that her research is not limited to a particular locale or “culture,” but instead is limited to a particular practice that is strikingly delocalized. Thus the sense, acknowledged at least one point by Petryna herself, that her work is more similar to journalism than ethnography. Her informants are many different people, for the most part unknown to one another, dispersed across the world in locations like Poland, Brazil, and the United States, and her contact with them seems to have been largely in the form of interviews—certainly not the kind of long-term bonding and friendship-building described by Rabinow. Ironically, Petryna partially justifies this wide ranging scope—intent on mapping out the relationship of the value of the knowledge produced in clinical trials to all the other forms of value with which it is connected—by quoting Rabinow: “the challenge for social scientists is to identify instances of this conflation [between capital and other forms of value] and ‘to investigate how “capital” from one market is converted into “capital” (or advantage) in another’” (192).
Petryna conveys her exploration of transnational science as developed through clinical studies and factors that mediate it, such as politics and ethics. She primarily asks leading questions such as "what value systems bring researchers, physicians, and patients into trials?" (Pg. 7). By examining questions about all of the pieces of clinical studies and what brings them together, she defines underlying concepts of motivations for participation and the significance of the outcomes. Thus, she defines the changing standards of the pharmaceutical industry and what this says about the communities/government's needs, for example the willingness of poor people to test drugs as free treatment. Ethical issue revolving clinical studies are key in her process of discovering what the involved costs are in order to provide new medications, and she highlights the importance of regulation in maintaining humane treatment of all those involved in studies. She questions, "How do they see the dimensionality of the problem and the implications of their work in terms of control over methods, researchers, subjects, and ethical issues?" (Pg 7). By doing this, she gets into understanding humanities influence of "scientific innovation" and how people shape science, and the importance of responsibility in this field.
ReplyDeletePetryna's methods consist of interviews and analysis of research. While the reader hardly sees her opinion in this book, it helps to immerse oneself in the world of clinical trial, free of imagining the narrator instead of what they are attempting to convey. Her interrogation of firms and individuals involved in the process brings out its complexity, with the multiplicity of opinions, as well as the common goal of improving health care in the safest manner. She grasps the most defining elements of this world through focusing on differing countries such as the U.S. and Poland to explore the process and players involved most vividly and connect the transnational role of clinical studies. She explains that "clinical trials become powerful marketing tools and can significantly alter local and public healthcare priorities" (Pg. 189). Thus, all studies are interconnected into a realm of scientific research for the betterment of mankind, which is only made possible through the many contributors analyzed in this book.
Examining the methods within When Experiments Travel
ReplyDeleteIt is effortless to see the stark contrast between Paper Tangos and When Experiments Travel. The book is easily summed up by two sentences, which I believe faithfully express Petryna’s views on her research, “anthropologists strive to gain an insider’s perspective and to understand actors on their own terms—ideally, to situate their practices in a broader historical and comparative light. This takes time, charting networks, entering into the perspectives of multiple actors and juxtaposing their diverse view points and stakes (55).” Petryna goes through strict methodology while analyzing medical trials, and the seriousness of the content within the text is tangible. To approach her complex field of study Petryna employs various strategies. Firstly she posses various questions that she hopes to examine throughout, and which she presumably hopes her readers will pay close attention to. Secondly she makes constant references to statistical data, “According to recent industry statistics, central-eastern Europe has the highest volume of patients (6.27) enrolled per investigative site, followed by the Asia-Pacific region (5.78)… (13).” She asserts that the “anthropological challenge is to engage the transparent and public ways in which private-sector research undergoes global reconstructing today (14).” When talking about the morality of her subject of research, she appears to be doubtful of how scientific integrity is maintained when such great emphasis is placed on “speed and profitability”. The guiding material of her fieldwork is based on sources such as “academic scientists, policy makers, state prosecutors and citizens (18).” I presume that by clarifying these she means to set the reader at ease that she has fully covered all the corners of the spectrum of those involved. The problems she encounters are also amply stated, i.e “the available pool of human subjects in major Western pharmaceutical markets is shrinking. We are using too many drugs (21).” Provided also in chapter one is a detailed historical account of medical trials within the U.S. Her concerns are voiced throughout however, they are done so in passing, “I am intrigued by the temporality of these harm stories—involving suppression of critical data and warning signs, media exposure of manipulations in the drug trial phase, and ongoing legal battles over compensation and remediation—and with the state-market complicities that they reveal (27).” There is also the compare and contrast portion where she examines whether Eastern Europe and Latin America are good fields for trials. Her anthropological conclusions are also arrived at clearly i.e. when she references the tensions between the lab (testing) and the field (the public) (46). There is also inclusion of case studies/interviews such as the one with Dr. Besselaar. So far she appears to leave no possible realm unstudied or unmentioned.
Part #2
ReplyDeleteNow that I feel that I have done justice to Petryna in mentioning all the ways she goes about giving her research a sense of validity and structure, I would like to analyze whether this method of research works. Did all her facts, figures, statistics, and data make me any more interested in clinical trials than I was when I began reading the book? My answer would have to unfortunately be—no. I don't want to simply leave it at that, I truly spent a good amount of time pondering why none of this information seemed interesting to me at all, especially when it appears to be so controversial and present in the “today”. I believe that I finally came up with a sufficient metaphor as to how I felt while reading the book—the feeling is something similar to watching a movie either with no volume, or in a foreign language with no subtitles. There was no possible way, I could find, to engage in her material. Even her description of her interviews seemed bleak, poor Evan’s description amounts to “Evan my AGR contact, is an articulate and hardworking fifty-year-old businessman. When we met that day at his office, he looked fit and casually dressed in a worn, light-blue oxford shirt with the sleeves rolled up (5).” So what is it that When Experiments Travel is missing? Is it the emotional connection that ties you to the subject that is lacking? Or is the purpose of the text meant to be purely informative disregarding the realm of feeling? Personally I prefer something like Rabinow’s piece, when the reader is able to gain insight into the author’s trajectory and learning process—the personal insight into the discoveries being made.
Emmanuel said:
ReplyDeletePetryna’s When Experiments Travel is different, as far as research methods, to all the previous texts we have read. Despite Petryna’s methods of research being similar to Latour and Woolgar’s methods, similar in the sense that their accumulating of information was done less “socially.” Petryna studies the global pharmaceutical market, and its benefits and risks on human test subjects in poor countries. She acquires her information via interviews and from previously documented investigations on the subject; this method is similar to that of Latour and Woolgar’s.
Petryna’s goals are clearly stated in the opening chapter and it is clear why she has included the information that is in the text. Unlike Rabinow’s Reflections of Fieldwork In Morocco, in which Rabinow admits to not knowing what he is investigating or what his goal is, Petryna states that she is examining the effects of clinical trials and practices involved with the process of clinical research. Yet, like Rabinow’s text, When Experiments Travel also explores moral and ethical issues attributed to the subjects and their behaviors; except, Rabinow’s examination was done on a very social and personal level while Petryna’s was done more clinically.
Comparing When Experiments Travel to Paper Tangos, Petryna comes off as, for lack of a better word, unaffiliated. Reading this book, I got the impression that one of her undisclosed goals was to come off as an unaffiliated and uncritical narrator. Petryna’s main goal was to present the practices of the pharmaceutical industry and examine them to allow the reader to decide for himself/herself whether the benefits and risks are justified or morally acceptable. On the other hand, Taylor presented the tango and Argentinean culture as she saw it and with her sentiments attached; her sentiments as a dancer regarding what she saw. Part of the reason Petryna is clear to not submit her opinions directly is due to the fact that she wants to present the information she gathered and not analyze it to coincide with a certain belief. In this sense, her presentation of her research is also similar to that of Latour and Woolgar’s. Her manner of approaching research is clinical, and more dependent on the presentation and accumulation of the information she gathered in order to provide the ability to analyze scientific research.
As previously mentioned by my fellow classmates in their comments "When Experiments Travel" is clearly the total opposite of the other books we have read excluding Latour and Woolgar, which in some ways could be said to have the same non-personal research approach, but at the same time being different in the way the fieldwork was carried out and researched. Many of the other books we have read in class i.e. Paper Tangos were criticized greatly because of the overly personal form of writing and fieldwork study, and in contrast we have Adriana Pertyna books which is very informative, very "distant" in personal relations and a book that I felt gave me a great insight into experimental drug testing, I really felt I learned much about this type of business, however can it really help me in terms of my own research? To answer my own questions, perhaps it can't and mostly because I will be working closely with a specific ethnic group and one that has an unsettling past that only if I had no heart would be able to perform the fieldwork objectively. I also don't think in my research it would really be effective to have such an extensive and for the lack of better words boring historical and statistical compilation of data, which is what we find in Adriana Petryna’s When Experiments Travel. I also feel that even though I learned so much from her research, I almost could say it really was in the beginning of the essay that I was interested everything else became a bit repetitive and I felt as though I were reading a magazine on expose of experimental testing in Poland and Brazil, which is fine but doesn’t say much about her anthropological research goal. Maybe if she had included more of her ways of getting to the information and her decisions into traveling to certain places and also the interactions not only certain pieces of the conversation it would have held my attention and engage me even further into the reading.
ReplyDeletePetryna’s “When Experiments Travel” stands in stark contrast to previous texts, and to me, seems to fall under the category of a more standard, archetypal anthropological work. Perhaps most comparable to “Lab Life,” I personally found it extremely interesting and relevant, although not highly “engaging.” From a critical (rather than literary) standpoint, it states the facts plainly without much personal interjection, providing a great deal of extensive, detailed information (e.g., pages 12—14 when Petryna provides a series of facts and dates for her depth discussion of clinical trials) as well as integrating a great deal of quotes from both outside and inside sources. While it does not belong to anthropologists, sociologists or scientists alone, this study does not attempt to appeal to a wide range of readers, and although it is not overly dense, it is not particularly accessible or personal either. Overall, I found this text useful as a tool for learning how to gage my own work and standpoint in the anthropological field—like Zuzu said, in comparison to Taylor’s “Paper Tangos” it is an extreme opposite, but most importantly, it offers perspective: When it comes to anthropology, I believe middle ground should be found between the dry listing of facts and overly personal memoir pieces.
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ReplyDeleteHaving had the same problem as Max not being able to find the book at either both Barnes and Noble or the library, I obtained a choppy version of Petryna’s narrative via Google books. Reading what I could of the introduction and first two chapters I gained enough insight to understand Petryna’s style, method, and goals. Medicine may not seem like an obvious source for ethnographic studies, but the global system that it is situated within and the actors involved reveal issues pertaining to science, capitalism, and law that ultimately effect and create forms of social action, thus effecting humanity, the basis of anthropological interest. This book is on the polar opposite end of the spectrum than Julie Taylor’s Paper Tangos, appearing much more emotionally distanced and objective, which was our class’s main gripe with Taylor. I think this approach works better because the audience infers the emotion behind the cold calculative research by developing a similar strength of feeling to the author, even though it was not blatantly expressed in the text. I myself felt uncomfortable thinking about the uncertainties, and risks that the pharmaceutical industry takes by gambling the safety of a large group of individuals for the sake of profit. The ethical issues naturally arise in the mind while reading When Experiments Travel, making it an effective and worthwhile text.
ReplyDeleteFrankly I found Adriana Petryna to be very dry and anthropologically pedestrian in this particular text, as she takes on a sort of brusque and clinical sort of language throughout the piece. While she is discussing very clinical material, the exploration of pharmaceutical trials and the physicians and corporations that coordinate them, there seems to be this very prominent detachment between her subjects and herself. Almost mirroring the stratified structure she illustrates in the introduction between physicians and their trial patients,
ReplyDelete“a bedraggled patient-volunteer, accompanied by an escort who appeared to be his caregiver, sat waiting for his name to be called by a physician who was standing behind a glass pane-much like a bank teller. The physician asked the patient whether he had experienced any side affects from taking the experimental drugs. The answer was no, and the doctor passed him a new dose. The patient left” (1).
There was a very definitive lack of personal expression present in When Experiments Travel that was exceptional in Paper Tangos and Reflections on Fieldwork in Morocco. Julie Taylor while perhaps a bit self-involved demonstrated her unique connection to the art of the Tango with her disclosure of personal experience, the history of Argentina, as well as the rather artful revelation of the birth of the tango. Subsequently Paul Rabinow greets us with his willingness to depart from traditional academia as well as a few slips of judgment along the way. While these are not unblemished pieces they give the reader a sense of connection and intrigue, the authors were not merely regurgitating facts and stats on a page they were both submerged and emerged in the worlds which they were studying whereas Petryna seems to be randomly glancing at this world through a set of double paned glass. Interacting with her subjects as a seventh grade field trip interacts with the animals at the zoo. This is her method an a traditional anthropological one indeed, and while I feel it appropriate in our little cloister of academia, there is hardly any humanity for her reader to relate to, to be drawn in by, and students can be fickle readers. Consequently it is her methods which restrain her from attaining her true definition of what anthropology seeks to do, “strive to gain an insider’s perspective and to understand actors on their own terms-ideally, to situate their practices in a broader historical and comparative light” (55). Simply because she does not dive into her subjects’ perspectives or understand their situation, she defines them as if they were a noun in a dictionary John Q. Doe M.D. he’s fifty, he’s not wearing a tie and his sleeves are rolled up, and he has a carbon copied response for everything. That doesn’t tell us why he works in the field, it doesn’t tell us how he got in his chosen profession, or even how he feels about the sort of work he does. It is an anthropological piece on the process of global pharmaceutical trials, not it’s facilitators, not it’s producers, coordinators, or participants, but merely the subject at hand.
When we are confronted by mortality, or when someone in our life is diagnosed as terminal we have this thought that medical science has progressed to where there is at least a treatment if not a cure. This is a belief that has a history, but more importantly, is part of a process. It is a belief that, sometimes, is not true. In this instance the patient is burdened with fear and powerlessness. Science needs the aforementioned process. This process is an experimental one. But even experimental processes, if their treatments can offer even the slightest benefit, someone somewhere will find this an attractive prospect. With this being said, it makes me wonder over the validity of regulatory prohibitions over last chance therapies – just a random thought while reading Petryna.
ReplyDeleteThose trying to regulate this new paradigm have their work cut out for them. Not unrelated to the fact that much clinical research is being outsourced around the world, and the rise of medical tourism, people (who can pay for it) are seeking potential therapeutic benefits from cutting edge stem-cell research or clinical practice taking place in countries like China. This research may well not be taking place in the home country of the beneficiary, due to cost or regulatory/legal prohibitions. There is the possibility that such trials or practices may not be in the best ethical shape, for instance involving unnecessary risks and promising to desperate patients more than they can keep. The underlying ethical principle behind the patient access paradigm -- patient autonomy -- is unlikely to capture all of the ethical concerns associated with globalizing experimental therapy. This is what Petryna has taught me.
In When Experiments travel the author Adriana Petryna investigates the clinical trial industry. It is estimated that 2.3 million people participate in clinical trials but the FDA only monitors less than 1% of those trials. Many of these trials take place off shore where the FDA has limited access. Petryna tries to expose the corporate side of these clinical trails. Although she does a good job at stating facts and statistics the book is missing a more personal aspect. There are very few individuals that are mentioned. She explores the global clinical trial system in countries like Ukraine, Poland, Russia, and the Czech Republic. According to Petryna the healthcare industry gives a lot of reasons why clinical trials are good for the people in them including free healthcare for people with no access to health care. Sometimes they are private public partnerships that form to create voids in the global medicine distribution system. The author also wrote a book about the health problems that were produced by the Chernobyl disaster. Both books are about the misery produced by large institutions like the health care industry and the government of certain countries. Both the former soviet government and the US government both react indifferently to the harms produced.
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