Objetividad regulatoria y sistemas de pruebas en medicina: el caso de la cancerología

• Autores: Alberto Cambrosio, Michael Keating , Pascale Bourret
• Localización: Convergencia: Revista de ciencias sociales, ISSN-e 2448-5799, ISSN 1405-1435, Nº. 42, 2006, págs. 135-152
• Idioma: español
• Enlaces
  • Texto completo
• Dialnet Métricas: 8 Citas
• Resumen

  • La evolución de la medicina occidental desde la Segunda Guerra Mundial ha resultado en la emergencia de nuevas prácticas basadas en la interacción directa entre biología y medicina. El realineamiento de la biología y medicina de la posguerra ha sido acompañada de la emergencia de un nuevo tipo de objetividad, objetividad regulatoria, que ha sido sustentada sobre el recurso a la producción colectiva de la evidencia. A diferencia de las formas de objetividad que emergieron en épocas tempranas, la objetividad regulatoria repercute de manera consistente en la producción de convenciones, algunas veces tácitas y sin intencionalidad, pero frecuentemente arriba a través de programas concertados de acción. Las convenciones producidas por la objetividad regulatoria crean las condiciones para una objetividad clínica, que confía en la existencia de entidades y protocolos creados y mantenidos fuera del encuentro íntimo en tre doctor y paciente. Estableciendo formas endógenas de regulación, la objetividad reguladora funciona en un plano y en un modo diferente de aquellos sugeridos por los analistas que tratan toda la regulación como una forma de racionalización impuesta sobre la medicina de fuera.

• Referencias bibliográficas
  • AGREE Collaborative Group (2000), “Guideline development in
  • Europe. An international comparison”, en International journal of
  • technology assessment in health care, vol. 16.
  • Baird, Davis (2004), Thing knowledge: a philosophy of scientific instruments,
  • Berkeley, CA: University of California Press.
  • Berg, Marc (1996), “Practices of reading and writing. The constitutive
  • role of the patient record in medical work”, en Sociology of health and
  • illness, 18.
  • Berg, Marc y Annemarie Mol [eds.] (1998), Differences in medicine.
  • Unraveling practices, techniques and bodies, Durham: Duke University Press.
  • Berg, Marc et al. (2000), “Guidelines, professionals and the production of
  • objectivity. Standardisation and the professionalisation of insurance
  • medicine”, en Sociology of health and illness, 22.
  • Berlivet, Luc (1999), “Argumentation scientifique et espace publique. La
  • quête de l’objectivité dans les controversies autour des ‘risques de
  • santé’”, en François, Bastien y Erik Neveu [eds.], Espaces publics
  • mosaïques. Acteurs, arènes et rhétoriques des débats publics contemporains, Rennes: Presses Universitaires de Rennes.
  • Bodewitz, Henk et al. (1987), “Regulatory science and the social
  • management of trust in medicine”, en Bijker, Wiebe et al. [eds.], The
  • social construction of technological systems, Cambridge, MA: MIT Press.
  • Bourret, Paul (2005), “BRCA Patients and clinical collectives: new
  • configurations of action in cancer genetics practices”, en Social studies of
  • science, vol. 35.
  • Bourret, Paul et al. (2006), “A new clinical collective for french cancer
  • genetics: a heterogeneous mapping analysis”, en Science, technology &
  • human values, vol. 31.
  • Burgers, Jako et al. [for the AGREE Collaboration] (2003), “Towards
  • evidence-based clinical practice: an international survey of 18 clinical
  • guideline programs”, en International journal for quality in health care, vol.
  • Cambrosio, Alberto (2004), “Mapping collaborative work and innovation
  • in biomedicine: a computer-assisted analysis of antibody reagent
  • workshops”, en Social studies of science, vol. 34.
  • Cambrosio, Alberto et al. (2006), “Regulatory objectivity and the
  • generation and management of evidence in medicine”, en Social science
  • & medicine, 63.
  • _______, “A paraître. Mapping the emergence and development of
  • translational cancer research”, en European journal of cancer (en prensa).
  • Canguilhem, Georges (1972), Le normal et le pathologique, Paris: Presses
  • Universitaires de France.
  • Castel, Patrick y Ivanne Merle (2002), “Quand les normes de pratiques
  • deviennent une ressource pour les medecins”, en Sociologie du Travail,
  • vol. 44.
  • Casper, Mónica y Adele Clarke (1998), “Making the pap smear into the
  • ‘right tool’ for the job: cervical cancer screening in the USA, Circa
  • 95”, en Social studies of science, vol. 28.
  • Christian, Michaele et al. (2002), “A central institutional review board for
  • multi-institutional trials”, en New England journal of medicine, vol. 346.
  • Daly, J. (2005), Evidence-based medicine and the search for a science of clinical care, Berkeley, CA: University of California Press.
  • Daston, Lorraine (1992), “Objectivity and the escape from perspectiva”,
  • en Social studies of science, vol. 22.
  • Daston, Lorraine y Peter Galison (1992), “The image of objectivity”, en
  • Representations, vol. 40.
  • Ferguson, John y Charles Sherman (2001), “Panelists’ views of 68 NIH
  • Consensus conferences”, en International journal of technology assessment in health care, vol. 17.
  • Galison, Peter (1998), “Judgment against objectivity”, en Jones, C. y P.
  • Galison [eds.], Picturing science, producing art, New York: Routledge.
  • Gaudillière, Jean y Hans Rheinberger [eds.] (2004), From molecular genetics to genomics. The mapping cultures of twentieth-century genetics,...
  • Hafferty, F. y D. Light (1995), “Professional dynamics and the changing
  • nature of medical work”, en Journal of health and social behavior, núm. 35
  • [Extra issue: Forty years of medical sociology].
  • Howell, Joel (1995), Technology in the hospital. Transforming patient care in the early twentieth century, Baltimore: The Johns Hopkins University...
  • Kaufert, Patricia (2000), “Screening the body: the pap smear and the
  • mammogram”, en Lock, Margaret et al. [eds.], Living and working with the
  • new medical technologies: intersections of inquiry, Cambridge, UK: Cambridge University Press.
  • Keating Peter y Alberto Cambrosio (2005), “The production of
  • biomedical measures: three platforms for quantifying cancer
  • pathology”, en Jorland, Gérard et al. [eds.], Body counts: medical
  • quantification in historical and sociological perspectives, Montreal:
  • McGill-Queen’s University Press.
  • _______ (1998), “Interlaboratory life: regulating flow cytometry”, en
  • Gaudillière, J. e I. Löwy [eds.], The invisible industrialist: manufacturers and
  • the construction of scientific knowledge, London: Macmillan; New York: St.
  • Martin’s Press.
  • _______ (2000), “Real compared to what?: diagnosing leukemias and
  • lymphomas”, en Lock, M. et al. [eds.], Living and working with the new
  • medical technologies. Intersections of inquirí, Cambridge: Cambridge
  • University Press.
  • _______ (2003), Biomedical platforms. Realigning the normal and the pathological in late-twentieth-century medicine, Cambridge, MA: MIT Press.
  • _______ (2004), “Does biomedicine entail the successful reduction of
  • pathology to biology?”, en Perspectives in biology and medicine, vol. 47.
  • Meunier, F. y A. van Oosterom (2002), “40 years of the EORTC: The
  • evolution towards a unique network to develop new standards of
  • cancer care”, en European journal of cancer, vol. 38 (Suppl. 4).
  • Mossé, Philippe (1998), “La rationalisation des pratiques médicales.
  • Entre efficacité et effectivité”, en Sciences sociales et santé vol. 16, núm. 4.
  • O’Connell, Joseph (1993), “Metrology: the creation of universality by the
  • circulation of particulars”, en Social studies of science, vol. 23.
  • Porter, Theordore (1995), Trust in numbers. The pursuit of objectivity in science and public life, Princeton, NJ: Princeton University Press.
  • Robelet, Magali (1999), “Les médecins placés sous observation.
  • Mobilisation autour du développement de l’évaluation médicale en
  • France”, en Politix, vol. 46.
  • _______ (2001), “La profession médicale face au défi de la qualité. Une
  • comparaison de quatre manuels qualité”, en Sciences sociales et santé, vol.
  • núm. 2.
  • Schaffer, Steve (1992), “Late victorian metrology and its instrumentation:
  • a manufactory of Ohms”, en Bud, R. y S. Cozzens [eds.], Invisible
  • connections. Instruments, institutions, and science, Bellingham, WA: SPIE
  • Optical Engineering Press.
  • Setbon, Michel (2000), “La qualité des soins. Nouveau paradigme de
  • l’action collective?”, en Sociologie du Travail, vol. 42.
  • Singleton, Vicky y Mike Michael (1993), “Actor-networks and
  • ambivalence: general practitioners in the UK Cervical Screening
  • Programme”, en Social studies of science, vol. 23.
  • Sournia, Jean (1995), Histoire du diagnostic en médecine, Paris: Éditions de
  • Santé.
  • Thévenot, Laurent (1985), “Les investissements de forme”, en Cahiers du
  • centre d’études de l’emploi, vol. 29.
  • Timmermans, Stefan y Marc Berg (2003), The gold standard. the challenge of evidence-based medicine and standardization in health care, Philadelphia:...
  • Tournay, V. (2005), Produire des biens publics médicaux: Contribution
  • pragmatique à une sociologie de l’action publique, Thèse de doctorat,
  • Science-Politique, Université de Paris I-Sorbonne.
  • Willems, Dick (1998), “Outcomes, guidelines and implementation in
  • France, the Netherlands and Great Britain”, en Boyle, P. [ed.], Getting doctors to listen. The ethics of outcome research in practice, Washington,...