At 10:42 23/05/02 -0400, Djulbegovic, Benjamin wrote:
>I would not completely reject a notion of social construct. While scientific
>theory is either true or not, what constitutes acceptable evidence to
>support one view over another is often socially derived. Obviously, evidence
>regarding life expactancy in the example you provided below is so
>overwhelming and is therefore axiomatically accepted by all of us, without
>need for further delibaration. However, the truth is often elusive, and
>sometimes is defined by social consensus. For example, it took an act of
>Congress in the US to pass a FDA act in 1962, which in essence stated that
>for the drug to be approved in humans, it has to be first tested in humans
>(no such requirement existed before 1962; prior to this date it was left in
>hands of "experts"). Similarly, FDA in general requires 2 RCTs to approve
>drug (again, the rules for interpretation of evidence is socially
>constructed); then, look at the way how data safety and monitoring boards
>interpret interim analyses of trials (often a trial is stopped with no
>uniform consensus on "truth"). Also, I was also told that until 1975
>homosexuality is considered a disease, and then by vote at the American
>Psychiatry Association meeting it was decided that it was not a disease any
>more, but rather individual choice, etc
>
>I am not defending postmodernism here. All, I am saying here that
>comprehension of what constitutes true picture of the world around us may be
>more complex than it appears (which is one of the reason why logical
>positivism failed; and which is probably reason why EBM is now moving away
>from simple axiomatic interpretation of rule of evidence, which we all hoped
>would give us an answer to the "truth"- whatever that may be).
>
>ben djulbegovic
>
How so very wise! I would add that what is perceived to be relevant,
ethical and/or worthwhile research is also very often strongly influenced
by social construct. That is very true in the midwifery field with which I
am more acquainted. Often the very reductionist aspects of pregnancy have
been examined and the experiences of women ignored. RCTs have ruled - and
quite rightly so in many instances - but too often the effects of the
interventions tested have been far too limited and have ignored the effects
of the tested interventions on the experiences of women. I have no doubt
that most of this research was extremely well intentioned and I am not
sufficiently qualified to criticise anyone particularly. I am just
suggesting that some research projects are simply too restrictive in their
scope. How I wish I knew so much more than I do!
Marianne Mead
Dr Marianne Mead
Principal Lecturer and Research Leader
Department of Midwifery and Child
University of Hertfordshire
Tel 01707 285286
Fax 01707 285299
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