International Symposium
Governing uncertainty in drugs and medicines : narratives of risk, progress and decline
Strasbourg, France
October 1-2, 2019
Medicines have played a pivotal role throughout the 19th and 20th centuries as both instruments of therapeutic progress and dangerous threats to the health of individuals and populations. A linguistic and rhetorical binary accompanies and facilitates these two modes of action. On the one hand, we often think of pharmaceuticals through progressive narratives framed around stories of medical success and power, one in which risks are considered either the result of regrettable yet often understandable failure to adhere to a treatment regime or as a characteristic imbued within the chemical structure of the drug itself. At the same time, we often think of illicit drugs through declension narratives in which these substances pose a threat to the individual and the nation. The dangers of illicit drugs tend to be framed through the lens of either moral failure or external threat while, simultaneously, articulating risk through overlapping discourses of addiction, violence, and moral and physical decay. Pharmaceuticals and illicit drugs, then, somehow seem to be two distinct types of things, even if they are the same physical object.
However, historical scholarship of the last 30 years has deepened our understanding of our complicated relationship with chemical molecules. The attention given to the porous boundary between illicit drugs and legal medicines; studies on adverse drug events and how they result from complex health systems; the relationship between regulation and the constitution of black and gray markets: these and other interventions have allowed us to move beyond a simplistic reading of heroic devotion to science or moral failure of scientists, physicians, industries, or consumers/patients. They have allowed us to complicate our understanding of the nature of pharmaceutical (drug) risk, who is responsible for it, and how to manage it.
The upcoming conference in Strasbourg seeks to draw on existing literatures about drugs, risk and harm, and governance in order to bring together scholars who share an interest in pharmaceuticals and illicit drugs as objects of scholarly inquiry but who operate in different rhetorical, conceptual, and scholarly domains. We propose to use the concept of “uncertainty” to re-connect scholarly domains that have been structured and separated, in part, according to the historically constructed categories of heroic science and moral failure—to put into intellectual practice the reconfiguration of knowledge implied by the last 30 years of historical scholarship. For example: what might a historian of public health who writes on the tobacco industry have to say to a scholar of the criminal justice system who works on the history of crack cocaine? What might a scholar who studies pharmaceutical pricing have to say to a scholar who studies the black market? How does uncertainty become manifest in those different situations? How does risk as both a way of assessing and governing danger (cf Soraya Boudia) change management of uncertainty throughout the 20th century, in both formal and informal settings (markets and others)? What are the various types of uncertainties associated with drugs and pharmaceuticals, how have they changed over time, and does thinking about one type of uncertainty meaningful implications for other forms of uncertainty? Is the risk of overdosing from impure heroin in the 1950s, for example, similar to the risk of having an allergic reaction to penicillin? Do the dangers posed to the scientific enterprise by pharmaceutical industry corruption say anything about the dangers posed to deliberative political processes by corrupt political regimes? Is the danger of not being able to afford insulin similar to the uncertainty of not developing a useful new product due to an overly burdensome regulatory regime? In other words, what does it mean to use the notion of uncertainty as an analytic framework across boundaries of licit and illicit, market and health, biological and political? We believe that such an approach can generate new ways to think about the many problems and questions associated with the development, manufacture, distribution, and consumption of drugs and pharmaceuticals.
Uncertainty is also useful in one additional way: as a means to analyze futures through aesthetic narrations of promise and peril. How do imagined drug futures depict uncertainty in relation to risk and progress? Are there connections between narrated (or imaged) configurations of uncertainty and pragmatic regulatory regimes? Are aesthetic narrations of uncertainty just a means to an end—a veil to cover the pursuit of profit—and thus only to be taken seriously by the naïve? If so, why and how do they still work (if they do)? Or is it wrong to equate the aesthetic life of uncertainty with drug marketing and the profit imperative? What happens when we see drug aesthetics as multivalent, emerging from multiple locales and carrying more than one agenda?
Conference organisers:
Nils Kessel (Université de Strasbourg)
Joseph Gabriel (Florida State University)
David Herzberg (University at Buffalo)
This symposium is co-organized by University of Strasbourg, University at Buffalo (SUNY), and Florida State University. It is co-funded by the ERC Bodycapital project, the IDEX CONSENS project, UMR SAGE UMR7363 and ANR MEDICIS.
Attendance is free, but registration (via email) is required.
