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6. The value of ignorance : antidepressant drugs and the policies of objectivity in medicine

Author

McGoey, Linsey

Subjects
361
Abstract

This thesis explores the strategies of ignorance and uncertainty employed by UK regulators, practitioners and policymakers during the controversy over whether selective serotonin reuptake inhibitor (SSRI) antidepressants such as Prozac contribute to suicidal and homicidal reactions in some users. Empirically, the thesis is based on archival research, textual analysis, and interviews with UK policymakers and clinicians involved with efforts to determine the safety of SSRIs. By analyzing these materials with methodological and conceptual tools from the fields of science studies and the sociology of reason and objectivity, the thesis demonstrates the following four findings. First, drawing on the case of SSRIs, I demonstrate that many policymakers within the UK's National Health Service are frustrated with their inability to access clinical trial data necessary for developing treatment guidelines. Second, I argue that problems surrounding access to clinical trial data illustrate weaknesses within evidence-based medicine, a model of medicine that has become dominant in the UK and internationally over the past three decades. Third, I argue that when practitioners and policymakers wish to criticize the socio-political factors that make it difficult to access clinical trial data, their dissent must be limited to the universe of numbers, a phenomena which I term the "moral authority of objectivity" in medicine. Fourth, drawing on interviews with expert advisors to the MHRA, I argue that, in the case of SSRIs, regulators employed a strategic use of ignorance in order to absolve themselves of liability in not disclosing the knowledge of adverse effects when they first learned of them. This final finding has theoretical implications for recent studies of uncertainty and ignorance. I suggest that the SSRI controversy illuminates the regulatory value of inconsistent, uncertain and contradictory facts. The usefulness of uncertainty lies in its performative nature: uncertainty creates a demand for solutions to the ambiguity which it perpetuates, often consolidating the authority of those who have advanced a position of uncertainty to begin with.

Published
2007

8. Liberal fatalism, COVID 19 and the politics of impossibility.

Author

Bacevic, Jana and McGoey, Linsey

Subjects
COVID-19, COVID-19 pandemic, FATE & fatalism, POLITICAL change, PRACTICAL politics
Abstract

How liberal governments manage knowledge, ignorance, prediction and uncertainty has attracted increased attention across the social sciences. In this paper, we analyse the strategy and rhetoric of the UK government during the COVID-19 pandemic, with particular attention to the first half of 2020. We see the initial UK policy response – as well as its later legitimation – as a form of 'politics of impossibility', effecting political change through claims of incapacity or impotence. We argue this approach departs from the uses of knowledge and ignorance in both classical liberalism and neoliberalism, and suggests the emergence of a new, hybrid form of governance which can be dubbed liberal fatalism. We discuss the relevance of this new form of governance for political futures of an increasingly volatile world. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Nigel Dodd: An appreciation

Author

Langley, Paul, primary, Ashenden, Samantha, additional, Barry, Andrew, additional, Bear, Laura, additional, Kelly, Ann, additional, McGoey, Linsey J., additional, Molyneux, Maxine, additional, Neyland, Daniel, additional, Parry, Bronwyn, additional, Tonkiss, Fran, additional, and Weszkalnys, Gisa, additional

Published
2023
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30. Routledge International Handbook of Ignorance Studies

Author

Gross, Matthias and McGoey, Linsey

Subjects
ignorance, thema EDItEUR::J Society and Social Sciences::JB Society and culture: general
Abstract

Once treated as the absence of knowledge, ignorance today has become a highly influential topic in its own right, commanding growing attention across the natural and social sciences where a wide range of scholars have begun to explore the social life and political issues involved in the distribution and strategic use of not knowing. The field is growing fast and this handbook reflects this interdisciplinary field of study by drawing contributions from economics, sociology, history, philosophy, cultural studies, anthropology, feminist studies, and related fields in order to serve as a seminal guide to the political, legal and social uses of ignorance in social and political life.

Published
2015

31. Hiding the Rentier Elephant in Plain Sight: The Epistemology of Vanishing Rent

Author

McGoey, Linsey

Subjects
Ignorance Studies, Billionaires, Rentier Capitalism, Economic Inequality, Exploitation
Abstract

Economic rent is defined as excessive financial returns made possible by control or monopoly over a particular market. A minority of economists suggest that we live in an era of ���rentier capitalism��� characterized by exploitative extreme wealth. Their arguments are framed in new and powerful ways, but their focus has a long heritage, flowing back to classical economists such as Adam Smith who criticized the wealthy for reaping ���where they never sowed.��� While interest in rentierism is growing, other economists, including on the left, disagree that rentier gains underpin most extreme fortunes today. I introduce the concept of ���ignorance pathways��� to raise new points about the perceptual divide between those who ���see��� rent and those who do not. Mapping different ignorance pathways within modern economic thought, I theorize the reasons for why rentier returns remain ���unseen���. Terminology is policy: it is harder to make a policy case for redistributing rentier returns when the contentious object of scrutiny ��� in this case ���rent��� ��� is believed to be something that does not exist., Sociologica, Vol. 15 No. 2 (2021)

Published
2021

32. Why Billionaires Like Bill Gates Can't Fix the Problems They Helped Create

Author

McGoey, Linsey

Subjects
Philanthropy, Charities, General interest
Abstract

Byline: Linsey McGoey Bill Gates hasn't changed. His public image has. Mr. Gates's personal behavior and his troubling comanagement of the Gates Foundation are being reported more openly. The question [...]

Published
2021

33. Billionaires Can't Fix the World

Author

McGoey, Linsey

Subjects
Philanthropy -- Forecasts and trends -- Evaluation, Conflict of interests (Agency) -- Forecasts and trends -- Evaluation, Company business management, Market trend/market analysis, General interest, News, opinion and commentary, Bill and Melinda Gates Foundation -- Officials and employees -- Management
Abstract

Bill Gates hasn't changed. His public image has. Mr. Gates's personal behavior and his troubling comanagement of the Gates Foundation are being reported more openly. The question is why it [...]

Published
2021

37. On the will to ignorance in bureaucracy

Author

McGoey, Linsey

Subjects
Serotonin uptake inhibitors -- Analysis, Serotonin uptake inhibitors -- Usage, Antidepressants -- Health aspects, Patients -- Care and treatment, Social sciences
Abstract

Drawing on narrative interviews with psychiatrists and health analysts in Britain, the article provides an analysis of debates over the safety of SSRI antidepressants such as Prozac and Seroxat. The focus of the article is on what I describe, drawing on Foucault, Nietzsche, Niklas Luhmann and Michael Power, as a 'will to ignorance' within regulatory bureaucracies which works to circumvent a regulator's ability to carry out its explicit aims and goals. After a description of the regulatory processes that have influenced the efforts of patients and practitioners to reach conclusions on the risks and benefits of antidepressants, I conclude by suggesting that the article's analysis of the regulation of SSRIs carries theoretical insights for the study of regulation and bureaucracy in general. Keywords: antidepressants; regulation; Nietzsche; Luhmann; strategic ignorance.

Published
2007

40. Action to protect the independence and integrity of global health research

Author

Storeng, Katerini T., Abimbola, Seye, Balabanova, Dina, Mccoy, David, Ridde, Valery, Filippi, Veronique, Roalkvam, Sidsel, Akello, Grace, Parker, Melissa, Palmer, Jennifer, Abejirinde, Ibukun, Adebiyi, Babatope, Affun-Adegbulu, Clara, Ahlgren, Jhon Alvarez, Ahmad, Ayesha, Al-Awlaqi, Sameh, Aloys, Zongo, Amul, Gianna Gayle, Arthur, Joshua, Asaduzzaman, Muhammad, Asgedom, Akeza Awealom, Assarag, Bouchra, Atchessi, Nicole, Atkins, Salla, Badejo, Okikiolu, Baeroe, Kristine, Molleh, Bailah, Bazzano, Alessandra, Behague, Dominique P., Beisel, Uli, Belaid, Loubna, Bernays, Sarah, Bhuiyan, Shafi, Biermann, Olivia, Birungi, Harriet, Blanchet, Karl, Blystad, Astrid, Bodson, Oriane, Bonnet, Emmanuel, Bose, Shibaji, Bozorgmehr, Kayvan, Brear, Michelle, Burgess, Rochelle, Byskov, Jens, Carillon, Severine, Cavallaro, Francesca L., Chabeda, Sophie, Chandler, Clare, Chapman, Rachel, Chikuse, Francis F., Chinwe, Juliana Iwu, Cislaghi, Beniamino, Closser, Svea, Colvin, Christopher J., Cresswell, Jenny, da Cunha Saddi, Fabiana, Daire, Judith, Dalglish, Sarah, de Brouwere, Vincent, de Sardan, Jean-Pierre Olivier, Delvaux, Therese, Desgrees du Lou, Annabel, Diallo, Brahima A., Diarra, Aissa, Dixon, Justin, Doherty, Tanya, Dumont, Alexandre, Eboreime, Ejemai, Engelbrecht, Beth, Erikson, Susan, Faye, Adama, Fischer, Sara, Fournet, Florence, Fox, Ashley M., Francis, Joel Msafiri, Gautier, Lara, George, Asha, Gilson, Lucy, Gimbel, Sarah, Glenn, Jeff, Gopinathan, Unni, Gordeev, Vladimir S., Gradmann, Christoph, Graham, Janice E., Gram, Lu, Greco, Giulia, Grepin, Karen, Guichard, Anne, Gupta, Pragya Tiwari, Guzman, Viveka, Haaland, Marte E. S., Haggblom, Anna, Hagopian, Amy, Hammarberg, Karin, Handschumacher, Pascal, Hann, Katrina, Hasselberg, Marie, Hawkes, Sarah, Howard, Natasha, Hurtig, Anna-Karin, Hussain, Sameera, Hutchinson, Eleanor, Idoteyin, Ezirim, Infanti, Jennifer J., Irwin, Rachel, Islam, Shariful, Joarder, Taufique, John, Preethi, Johnson, Ermel, Johri, Mira, Justice, Judith, Kabore, Charles, Kadio, Kadidiatou, Kamwa, Matthieu, Kelly, Ann H., Kenworthy, Nora, Kittelsen, Sonja, Kloster, Maren Olene, Kocsis, Emily, Koon, Adam, Kumar, Pratap, Lal, Arush, Lange, Isabelle, Lanthorn, Heather, Lees, Shelley, Lexchin, Joel, Lie, Ann Louise, Limenih, Gojjam, Litwin-Davies, Isabel, Lodda, Charles Clarke, Lonnroth, Knut, Manton, John, Manzi, Anatole, Manzoor, Mehr, Marchal, Bruno, Marten, Robert, Matsui, Mitsuaki, Mbewe, Allan, Mc Sween-Cadieux, Esther, McGoey, Linsey, McNeill, Desmond, Mendenhall, Emily, Mendez, Claudio A., Mirzoev, Tolib, Mohammed, Shafiu, Moland, Karen Marie, Molyneux, Sassy, Mumtaz, Zubia, Murray, Susan Fairley, Nambiar, Devaki, Nelson, Erica, Nieto-Sanchez, Claudia, Norheim, Ole Frithjof, Nouvet, Elysee, Obare, Francis, Okungu, Vincent, Onarheim, Kristine Husoy, Ostebo, Marit Tolo, Ouattara, Fatoumata, Ozawa, Sachiko, Pai, Madhukar, Paina, Ligia, Parashar, Rakesh, Paul, Elisabeth, Peeters, Koen, Pennetier, Cedric, Penn-Kekana, Loveday, Peters, David, Pfeiffer, James, Pot, Hanneke, Prashanth, N. S., Preston, Robyn, Puyvallee, Antoine de Bengy, Rahmalia, Annisa, Reid-Henry, Simon, Rodriguez, Daniela C., Ronse, Maya, Sacks, Emma, Samb, Oumar Malle, Sanders, David, Sarkar, Nandini, Sarriot, Eric, Scheel, Inger Brummenaes, Schwarz, Thomas, Scott, Kerry, Seeley, Janet, Seward, Nadine, Shannon, Geordan, Shearer, Jessica, Shelley, Katharine, Sherr, Kenneth, Shiffman, Jeremey, Simard, Frederic, Singh, Neha S., Soors, Werner, Springer, Rusla Anne, Strong, Adrienne, Sundby, Johanne, Taylor, Stephen, Tetui, Moses, Topp, Stephanie M., Tsofa, Benjamin, Turcotte-Tremblay, Anne-Marie, Undie, Chi-Chi, Van Belle, Sara, Van Heteren, Godelieve, van Rensburg, Andre Janse, Sriram, Veena, Venkatapuram, Sridhar, Wagenaar, Bradley H., Wallace, Lauren, Walugembe, David R., Wariri, Oghenebrume, Whiteside, Alan O. B. E., Yakob, Bereket, Zakayo, Scholastica, Zitti, Tony, Zwi, Anthony, Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), and Signatories

Subjects
Project commissioning, media_common.quotation_subject, environmental health, Commission, Public administration, 03 medical and health sciences, Politics, 0302 clinical medicine, Political science, Agency (sociology), Global health, 030212 general & internal medicine, media_common, 030503 health policy & services, Health Policy, Public Health, Environmental and Occupational Health, Censorship, 16. Peace & justice, 3. Good health, Negotiation, Editorial, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Human medicine, 0305 other medical science, International development
Abstract

In a recent Viewpoint in the Lancet , some of us shared our experience of censorship in donor-funded evaluation research and warned about a potential trend in which donors and their implementing partners use ethical and methodological arguments to undermine research.1 Reactions to the Viewpoint—and lively debate at the 2018 Global Symposium on Health Systems Research —suggest that similar experiences are common in implementation and policy research commissioned by international donors to study and evaluate large-scale, donor-funded health interventions and programmes, which are primarily implemented in low resource settings. ‘We all have the same stories’, was one of the first comments on the Viewpoint, followed by many private messages divulging instances of personal and institutional pressure, intimidation and censorship following attempts to disseminate unwanted findings. Such pressure comes from major donors and from international non-governmental organisations (NGOs) obliged to have an external assessment but who then maintain a high degree of confidentiality and control. That such experiences are widespread reflects the deeply political nature of the field of ‘global health’ and the interconnections between priority setting, policy making and project implementation, which sit within a broader set of deeply entrenched power structures.2 3 Researchers in this field routinely find themselves working within—and studying—complex power relations and so experience challenges in negotiating their own position between interests of commissioning agencies and funders, implementers and country governments, as well as those of their own research institutions and their partnerships with other researchers spanning high-income, middle-income and low-income countries.4–7 They often receive research funding from major donor agencies like the UK Department of International Development (DFID), the US Agency for International Development (USAID), the Agence Francaise de Developpement (AFD), UNITAID and the Bill and Melinda Gates Foundation,8 who commission evaluations for their own funded projects, even though they have …

Published
2018
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49. Power and money don't necessarily buy smart philanthropy

Author

McGoey, Linsey

Subjects
Philanthropy, Sociology and social work, Bill and Melinda Gates Foundation
Abstract

Most people probably don't think of university teaching as a dangerous job, but it is at times. The institution where I work has a large criminology division, so I have [...]

Published
2015

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