In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a (...) policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. (...) This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations. The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice. Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine. (shrink)

"Is there any such thing as political philosophy?" So begins this provocative book by one of the foremost figures in Continental thought. Here, Jacques Ranciere brings a new and highly useful set of terms to the vexed debate about political effectiveness in the face of a new world order. What precisely is at stake in the relationship between "philosophy" and the adjective "political"? In Disagreement, Ranciere explores the apparent contradiction between these terms and reveals the uneasy meaning of their union (...) in the phrase "political philosophy" -- a juncture related to age-old attempts in philosophy to answer Plato's devaluing of politics as a "democratic egalitarian" process. According to Ranciere, the phrase also expresses the paradox of politics itself: the absence of a proper foundation. Politics, he argues, begins when the "demos" (the "excessive" or unrepresented part of society) seeks to disrupt the order of domination and distribution of goods "naturalized" by police and legal institutions. In addition, the notion of "equality" operates as a game of contestation that constantly substitutes litigation for political action and community. This game, Ranciere maintains, operates by a primary logic of "misunderstanding". In turn, political philosophy has always tried to substitute the "politics of truth" for the politics of appearances. Disagreement investigates the various transformations of this regime of "truth" and their effects on practical politics. Ranciere then distinguishes what we mean by "democracy" from the practices of a consensual system in order to unravel the ramifications of the fashionable phrase "the end of politics". His conclusions will be of interest toreaders concerned with political questions from the broadest to the most specific and local. (shrink)

"This volume emerged from workshops held at Pennsylvania State University in 2003 and Stanford University in 2005"--P. vii.

The now-classic Metaphors We Live By changed our understanding of metaphor and its role in language and the mind. Metaphor, the authors explain, is a fundamental mechanism of mind, one that allows us to use what we know about our physical and social experience to provide understanding of countless other subjects. Because such metaphors structure our most basic understandings of our experience, they are "metaphors we live by"--metaphors that can shape our perceptions and actions without our ever noticing them. In (...) this updated edition of Lakoff and Johnson's influential book, the authors supply an afterword surveying how their theory of metaphor has developed within the cognitive sciences to become central to the contemporary understanding of how we think and how we express our thoughts in language. (shrink)

Around the globe, economists affect markets by saying what markets are doing, what they should do, and what they will do. Increasingly, experimental economists are even designing real-world markets. But, despite these facts, economists are still largely thought of as scientists who merely observe markets from the outside, like astronomers look at the stars. Do Economists Make Markets? boldly challenges this view. It is the first book dedicated to the controversial question of whether economics is performative--of whether, in some cases, (...) economics actually produces the phenomena it analyzes.The book's case studies--including financial derivatives markets, telecommunications-frequency auctions, and individual transferable quotas in fisheries--give substance to the notion of the performativity of economics in an accessible, nontechnical way. Some chapters defend the notion; others attack it vigorously. The book ends with an extended chapter in which Michel Callon, the idea's main formulator, reflects upon the debate and asks what it means to say economics is performative.The book's insights and strong claims about the ways economics is entangled with the markets it studies should interest--and provoke--economic sociologists, economists, and other social scientists.In addition to the editors and Callon, the contributors include Marie-France Garcia-Parpet, Francesco Guala, Emmanuel Didier, Philip Mirowski, Edward Nik-Khah, Petter Holm, Vincent-Antonin Lépinay, and Timothy Mitchell. (shrink)

IRBs in action -- Everyone's an expert? Warrants for expertise -- Local precedents -- Documents and deliberations: an anticipatory perspective -- Setting IRBs in motion in Cold War America -- An ethics of place -- The many forms of consent -- Deflecting responsibility -- Conclusion: the making of ethical research.

A predominant ethical view holds that physician‐investigators should conduct their research with therapeutic intent. And since a physician offering a therapy wouldn't prescribe second‐rate treatments, the experimental intervention and the best proven therapy should appear equally effective. "Clinical equipoise" is necessary. But this perspective is flawed. The ethics of research and of therapy are fundamentally different, and clinical equipoise should be abandoned.

The claims of RCTs to be the gold standard rest on the fact that the ideal RCT is a deductive method: if the assumptions of the test are met, a positive result implies the appropriate causal conclusion. This is a feature that RCTs share with a variety of other methods, which thus have equal claim to being a gold standard. This paper describes some of these other deductive methods and also some useful non-deductive methods, including the hypothetico-deductive method. It argues (...) that with all deductive methods, the benefit that the conclusions follow deductively in the ideal case comes with a great cost: narrowness of scope. This is an instance of the familiar trade-off between internal and external validity. RCTs have high internal validity but the formal methodology puts severe constraints on the assumptions a target population must meet to justify exporting a conclusion from the test population to the target. The paper reviews one such set of assumptions to show the kind of knowledge required. The overall conclusion is that to draw causal inferences about a target population, which method is best depends case-by-case on what background knowledge we have or can come to obtain. There is no gold standard. (shrink)