Thursday, May 10, 2012

FEMMSS 4: Day 1

At FEMMSS 4, at Penn State.
First plenary session "Where Theory and Practice Meet: Pragmatist Feminism as a Means of Knowing and Doing Scientific Practice."

The speakers each approach the problem of objectivity in science and what a problem-solving feminist response would be. The problem is that empiricist approaches to scientific practice have (with reasonable success) identified ways to improve objectivity by eliminating unwanted bias from scientific research and policy applications.
Shari Clough: Feminist empiricism identifies social, institutional procedures for scientific inquiry which are less likely to produce the kinds of systematic bias which feminist scientists and philosophers of science have criticized.
Alessandra Tanesini: Empiricist commitments undergird the compliance with (obedience to?) the "Green Book" and the "Magenta Book" which contain the rules for civil servants who do social science research. Policies are developed insofar as they are based on standardized research methods and cost-benefit analysis, and the only research models which influence policy are those which best approximate random controlled trials (controls are not often available in social research for ethical reasons, but randomizing trial groups is). (Though Alessandra does not say it, the implication is that these shared methods do manage to prevent poor or unethical research designs, and at least certain forms of inappropriate and biased uptake of research into policy production.)
Nancy McHugh: Evidence-based medicine has become the norm in medical research and the translation of research into clinical practice. (Again, though she doesn't emphasize this, the reason is that prior to the widespread adoption of EBM, clinical practice varied widely and clinicians often did not change or improve the practices they learned in medical school. This resulted in the continued use of out-of-date, unsupported, and ineffective practices.) EBM replaces "intuitive" clinical practices with those shown by randomized controlled trials to be best practices for "average" patients.

But there is also a problem with empiricist approaches. They are successful at eliminating some unwanted bias from policy or practice. But at the same time, they also eliminate the possibility of applying values (which we would not want to call biased) in ways that positively contribute to developing policies. Each of the speakers shows that there is a cost to eliminating/averaging values, such that empiricist science is less accurate than it could be.

Shari: Empiricism doesn't take personal, subjective, embodied forms of knowledge seriously. Example: a woman's understanding of her body's needs when giving birth.
Alessandra: In the development of social policy to address poverty, empiricist research methods and the standardized definition of poverty are skewed toward identifying easy-to-measure quantities (such as income) rather than subjective harms (such as not being able to afford healthful food). In addition to counting some people as poor who can rely on savings rather than income, this approach also devalues the professional expertise of civil servants and the people who perform the research by relying on 'objective' measures rather than researchers' judgment.
Nancy: People who are marginalized (due to gender, race, ability, income status, language, etc.) don't benefit as much from EBM because they are less likely to fit the model of the 'average patient,' in part because people who belong to marginalized groups are less likely to be included in the randomized controlled trials which establish the 'best' clinical practice. The best practices are best for the average or mainstream patient, but side effects are more likely to affect the non-typical patient. This is particularly true because people from marginalized communities are likely to be excluded from RCT's because they suffer from multiple morbidities. (Nancy also brings John Dewey to bear.)

No comments: