Newsletter: March 2003
Nancy Vuckovic and Janelle Taylor, Contributing Editors
Take
a Stand!
One of the special features of SMA’s recently
revamped website, www.medanthro.net,
is a forum devoted to “SMA Takes a Stand,”
which is an intiative designed to facilitate a
greater level of involvement by our organization
with issues having national and international
health importance. Mark Nichter, President, describes
the process thus:
“What I would like to introduce is a participatory process enabling SMA members to spend a year considering an issue in depth. Here is the process I envision. The SMA Board will select one issue each year for deliberation. During this year, a task force will be formed to facilitate this process of consciousness raising. Background readings will be made available to all SMA members on the website, and a bulletin board will be established allowing members to express opinions and exchange ideas. At the end of the year, an invited session will then be organized at the AAA (or SMA meetings) and a policy paper will be written by members of the task force explaining the role(s) that anthropologists can play in addressing the focal issue.”
We present here brief summaries of two discussions that have been initiated. Please visit the website, weigh in with your considered views, and help SMA “take a stand” on these important issues.
Clinical Drug Trials
An increasing proportion of clinical drug trials
are conducted in developing countries where access
to health care and government oversight of research
are limited to nonexistent. Are vulnerable populations
being exploited for benefits that accrue to people
elsewhere? How do we protect against exploitation
without unduly constraining much-needed health
research that could, in fact, benefit vulnerable
populations? What role should anthropologists
play in the process of introducing and translating
the purpose of clinical trials to local populations,
insuring that they understand their rights, monitoring
clinical trials in an environment subject to stakeholder
and political economic interests, and serving
as a watchdog?
Is the point of informed consent conveying information as facts or enhancing the understanding of a potential participant in a research project or clinical trial? Is enhancing understanding by analogical reasoning an acceptable form of cultural translation? Is the point of informed consent to provide information to a potential participant in a clinical trial (or any research project) or to educate them? What kinds of translational research are necessary? What is the role of translation research in better understanding how participants understand informed consent forms and learning? What kinds of communication approaches might improve their comprehension?
Are Fieldnotes Privileged Information?
Some ethnographers may not be aware that their
fieldnotes, unlike the records kept by doctors
for example, are not privileged information, and
can be subpoenaed as legal evidence even when
the anthropologist is not one of the defendants
in the case, unless one has applied for (in advance)
and been granted a "Certificate of Confidentiality"
from DHHS. Should we as a scholarly community
work to establish and defend the confidentiality
of our research materials? Under what conditions
would this be appropriate? How might we go about
it?
What are the costs and the consequences of collective scholarly inaction on this issue, if individual ethnographers working in biomedical settings, such as Sheldon Zink (Pennsylvania) whose case is discussed on the website, must either turn over their fieldnotes or face jail time? Will this create an environment of distrust that would prevent ethnographers’ access to biomedical research settings in the future? Does it send a message that raw anthropological data is part of the public domain in all issues of conflict? Will it be impossible to ethically conduct fieldwork in locations where subjects could be vulnerable to any legal proceedings? Will anthropologists will be required to anticipate the risk of legal proceeds as part of their work/consent process/research design?
What should we as medical anthropologists
have to say or wish to do concerning these important
issues? What do you think? … Take
a stand!
Please send your comments, contributions, news and announcements to the SMA Contributing Editors Nancy Vuckovic (nancy.vuckovic@kpchr.org) or Janelle Taylor (jstaylor@u.washington.edu).