Impure Science: AIDS, Activism, and the Politics of KnowledgeIn the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles." Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH–sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties. Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists. |
Contents
The Crisis of Credibility | 5 |
Analyzing AIDS Controversies | 14 |
The Plan of the Book | 26 |
The Nature of a New Threat | 45 |
Lifestyle vs Virus 19821983 | 55 |
The Triumph of Retrovirology 19821984 | 66 |
HIV and the Consolidation of Certainty | 79 |
HIV as Obligatory Passage Point | 90 |
Drugs into Bodies | 208 |
A KnowledgeEmpowered Movement | 216 |
The Critique of Pure Science | 235 |
Activism and the Manufacture of Knowledge | 246 |
Dilemmas and Divisions in Science and Politics | 265 |
Inside and Outside the System | 280 |
Clinical Trials and Tribulations | 295 |
Living with Uncertainty 19931995 | 310 |
Reopening the Causation Controversy | 105 |
Consolidation and Refinement 19891991 | 127 |
The Debate That Wouldnt Die | 143 |
Causation and Credibility | 170 |
Points of Departure | 181 |
Clinical Trials Take Center Stage | 194 |
Other editions - View all
Impure Science: AIDS, Activism, and the Politics of Knowledge Steven Epstein No preview available - 1996 |
Common terms and phrases
ACTG AIDS activists AIDS Drug AIDS movement AIDS patients AIDS research AIDS Treatment AIDS virus Altman analysis Anthony Fauci antibodies antiviral approval April argued biomedical cancer cause of AIDS Celia Farber cells claims clinical trials conference credibility David debate disease dissenters doctors England Journal etiology expertise experts Fauci Gallo gay communities Gina Kolata groups hemophilia HIV causes AIDS HIV infection homosexual HTLV HTLV-III immune system Immunodeficiency interview by author issue James Kaposi's sarcoma knowledge Koch's postulates lesbian mainstream Mark Harrington Martin Delaney ment Montagnier NIAID opportunistic infections participants percent Peter Duesberg placebo political Press Project Inform question quote retrovirus risk Robert Gallo role San Francisco Science scientists sexual social movements Sonnabend strategies surrogate marker syndrome T-cell tape recording theory therapy tion treatment activists Univ unqualified reference viral virus viruses York Native Zidovudine