Identifying ontologies in a clinical trial

Abstract

For a number of years, clinical trials have been the focus of a growing body of social science research and have come to represent the gold standard of evidence-based medicine. While a considerable and wide-ranging body of research has been devoted to trial participants, the approach is partial in that the participants’ reality tends to be cut loose from the very practices that constitute the beating heart of the trials. The practices of clinical research tend to be accepted as an unquestioned premise from which myriad actions and consequences emerge. Following the praxiological turn initiated by Mol and basing my analysis on my fieldwork and an ethnographic account of the running of a clinical trial, I hope to propose a new reading of trial participation. Indeed, whatever their form or their objectives, trials are essentially scientific experiments and are invariably grounded in a clinical design. The individuals who take part in trials must also contend with these two types of practices – the clinical and the scientific – yet in terms of their significance for participants, the latter are often obscured by or reduced to the former. Using my account of a routine visit in a trial conducted in Burkina Faso, I would like to examine the specific nature of these research practices, and in doing so, identify the ontologies they involve. How do these practices do the body? And what might the consequences be?