5LH81501404 Vulnerable Evidence: Trust and Trustworthiness in Medical Knowledge within and Beyond the Pandemic

Questions about the production and application of medical knowledge are highly topical in both scientific and public debate. Medical knowledge is central to how contemporary individuals understand and relate to themselves and others. Medicine underpins key areas of political governance, and is linked to major economic interests.

The corona pandemic, with discussions about the spread of infection, mortality and countermeasures, has recently contributed to foreground medical knowledge even further within the public arena and day-to-day politics. This development clearly shows how medical knowledge is intimately intertwined with political, social and cultural processes.

The course thus aims to interdisciplinary highlight and provide a deeper understanding of the social role of medical knowledge.

The course aims to provide an in-depth study of key issues at the intersection of medicine and society - on the democratization of knowledge, trust, mistrust and decision-making, as well as key critical instruments for understanding both the emergence of medical knowledge and its implementation and reception, both at the local and global level.

The course underscores epistemological and socio-political issues related to evidence-based medicine and global health. Structured around concrete cases, the course provides an historical, philosophical and anthropological understanding of medical knowledge in context. The course illustrates what can we learn from the limitation and problems in making medical evidences.

The course is of interest for students at the master and doctoral level in the humanities, social sciences and medical faculties, interested in medical humanities, interested in medical humanities, the history of evidence-based medicine and public health, its reception and application, and how social and cultural aspects interact with medical knowledge.

COURSE STRUCTURE:

The course lasts 10 weeks and its structure is thematic. It is composed of three modules each one having a lecture and a seminar. 

We meet every other Monday for a lecture and a seminar or a lecture only from the 24th of January to the 18th of March 2025.

The 18th of March is also the only time we meet on a Tuesday. 

NOTE: some of the information on the course is preliminary and might change. We don't recommend you to buy any books, you will be able to access all literature online or by borrowing reading copies.

During the course you will meet several different researchers. They are: 

Mirko Pasquini (mirko.pasquini@gu.se)

Ylva Söderfeldt (ylva.soderfeldt@idehist.uu.se)

Otto H. Sibum (otto.sibum@idehist.uu.se)

Mats Målqvist (mats.malqvist@uu.se)

Sharon Rider (Sharon.Rider@filosofi.uu.se)

If you have any queries about the specific seminars and events ask the relevant teacher. If you have general questions about the course, please email Mirko Pasquini, who is in charge of the course, or the administrator at the Department of the history of ideas and knowledge (info@idehist.uu.se). 

LEARNING OUTCOMES  

Upon completing the course, the student will be able to:

• account critically for the historical development of medical knowledge and evidence.
• use a number of analytical concepts that are central to the understanding of knowledge in medicine and global health, and how these relate to global and local processes as well as agents and social structures.
• Draw from an in-depth analysis of ethnographic accounts of how medical evidences are produced in context and applied in both well and under-resourced settings.
• Illustrate in details the social dynamics and political decision-making implied in the production of evidence in emergency situations
• Being analytically independent in highlighting opportunities, challenges and limitations in the production and application of medical evidences

TEACHING:

The language of teaching is English. The course consists of compulsory seminars and lectures.

The course is composed of 10 weeks, organised in 3 modules. Each module of the course is composed of two lectures and a seminar. We meet every other Monday, starting from the 24th of January and ending the on Tuesday the 18^th of March, that is also the only Tuesday we meet.

EXAMINATION: 

Assessment will be based upon written examinations of the final essay of 3000 words valid for 70% of the final evaluation. Before each seminar students will be asked to deliver a brief one-page (800 words max) reaction paper for a total of 3 (one for each module). The submission of the reaction papers in time counts as 10% of the final evaluation. In class active participation during lectures and seminars will also be evaluated. This will impact as 20% over the final grade.

IMPORTANT DATES:

Reaction papers of 800 words max are always due the Friday before the seminars at 4 pm.

The deadline for the final essay of 3000 words is on the 28th of March 2025.

LITERATURE:

You will be able to access all reading material either online or as paper copies in the University library. 

 

READINGS Module 1, Lecture 1:

Arksey, Hilary. 1994. ”Expert and lay participation in the construction of medical knowledge”. Sociology of Health and Illness 16 (4): 448–68.

Condrau, Flurin. 2007. ”The Patient’s View Meets the Clinical Gaze”. Social History of Medicine 20 (3): 525–40. https://doi.org/10.1093/shm/hkm076.

Hacking, Ian. 2007. ”Kinds of People: Moving Targets”. Proceedings of the British Academy 151:285–318.

Söderfeldt, Ylva. 2021. ”The truth within. Making medical knowledge in the Hay Fever Association of Heligoland, 1899-1909”. Isis 112 (3): 531–47.

 

READINGS, Module 1, Lecture 2:

Otto Sibum. “Providing Evidence. C.A. Coulomb’s ‘Balance Électrique’ and the Culture of French Enlightened Rationality.” In Baosheng Yhang, Shijun Tong, Jing Cao, Chuanming Fan  (eds.) Facts and Evidence. A Dialogue between Law and Philosophy.  Beijing: China University of Political Sciences and Law Press, 2018, pp. 53-67 EvidenceSibum140.pdfOpen this document with ReadSpeaker docReader 

Otto Sibum. “When is enough enough? Accurate measurement and the integrity of scientific research.” History of Science, vol. 58, issue 4, Dec 2020, pp. 437-457 https://doi.org/10.1177/0073275320939696Links to an external site. 

Steven Shapin. The Scientific Revolution. Chicago and London: University of Chicago Press 1996, Chapter 2, What is Known? pp. 65-117 The_Scientific_Revolution-Stvene Shapin[2].pdfOpen this document with ReadSpeaker docReader Download The_Scientific_Revolution-Stvene Shapin[2].pdfOpen this document with ReadSpeaker docReader

 

READINGS, Module 2, Lecture 3: 

Pasquini, Mirko. 2023. “Like Ticking Time Bombs. Improvising Structural Competency to ‘Defuse’ the Exploding of Violence against Emergency Care Workers in Italy.” Global Public Health 18 (1): 2141291. https://doi.org/10.1080/17441692.2022.2141291Links to an external site.. 

Solomon, Harris. 2017. “Shifting Gears: Triage and Traffic in Urban India.” Medical Anthropology Quarterly 31 (3): 349–64. https://doi.org/10.1111/maq.12367Links to an external site.. 

Stonington, Scott D. 2020. “‘Making Moves’ in a Cardiac ICU: An Epistemology of Rhythm, Data Richness, and Process Certainty.” Medical Anthropology Quarterly 34 (3): 344–60. https://doi.org/10.1111/maq.12557Links to an external site.. 

Street, Alice. 2011. “Artefacts of Not-Knowing: The Medical Record, the Diagnosis and the Production of Uncertainty in Papua New Guinean Biomedicine.” Social Studies of Science 41 (6): 815–34. https://doi.org/10.1177/0306312711419974Links to an external site.. 

 

READINGS, Module 2, Lecture 4: 

Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, van der Meer JW, Schnabel P, Smith R, van Weel C, Smid H. How should we define health? BMJ. 2011 Jul 26;343:d4163. doi: 10.1136/bmj.d4163. PMID: 21791490.

International Conference on Primary Health Care. Declaration of Alma-Ata. WHO Chron. 1978 Nov;32(11):428-30. PMID: 11643481.

Malqvist M, Powell N. Health, sustainability and transformation: a new narrative for global health. BMJ Global Health 2022; 7:e010969. doi:10.1136/bmjgh-2022-010969

Målqvist M. Beyond global health: Redefining the 'public' in public health. Scand J Public Health. 2022 Nov;50(7):1059-1061. doi: 10.1177/14034948221109712. Epub 2022 Sep 16. PMID: 36114648; PMCID: PMC9578087.

Mosley WH, Chen LC. An analytical framework for the study of child survival in developing countries. 1984. Bull World Health Organ. 2003;81(2):140-5. PMID: 12756980; PMCID: PMC2572391.

Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion
Paper 2 (Policy and Practice)

 

READINGS, Module 3, Lecture 5:

The Plague by Albert Camus (any edition). If you cannot read the novel in its entirety, read at least Parts 1 and 5, and consult online summaries of Part 2-4 for context.

 

 READINGS, Module 3, Lecture 6: 

Elisa J. Sobo and Elżbieta Drążkiewicz, 2021, "Rights, responsibilities, and revelations: COVID-19 conspiracy theories and the state" in Manderson, Lenore, Nancy J. Burke, and Ayo Wahlberg. 2021. Viral Loads: Anthropologies of urgency in the time of COVID-19. UCL Press. https://uclpress.co.uk/book/viral-loads/Links to an external site.

Norris, Pippa. 2006. “Skeptical Patients: Performance, Social Capital, and Culture.” In The Trust Crisis in Healthcare: Causes, Consequences, and Cures, edited by David A. Shore, 0. Oxford University P. https://doi.org/10.1093/acprof:oso/9780195176360.003.03Links to an external site..

Pasquini, Mirko. 2023. “Mistrustful Dependency: Mistrust as Risk Management in an Italian Emergency Department.” Medical Anthropology 42 (6): 579–92. https://doi.org/10.1080/01459740.2023.2240942Links to an external site..