Abstract
The rapid, recent emergence of new medical knowledge models has engendered a dizzying number of new medical initiatives, programs and approaches. Fields such as evidence-based medicine and translational medicine all promise a renewed relationship between knowledge and medicine. The question for philosophy and other fields has been whether these new models actually achieve their promises to bring about better kinds of medical knowledge—a question that compels scholars to analyze each model’s epistemic claims. Yet, these analyses may miss critical components that explain how these models actually work and function. Using the case of translational medicine, this paper suggests that analyses which treat these models as a primarily epistemic interventions miss the way that new approaches are increasingly shaped by specific financial and commercial agendas. Ultimately, social epistemological analyses that are attentive to market forces are required to make sense of emerging bioscientific research models, which are increasingly tethered to or a manifestation of increasingly financialized models of science research and innovation.
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Notes
According to Solomon (2015), Translational Medicine is certainly not a paradigm in the Kuhnian sense. I do not deal with whether Translational Medicine constitutes a paradigm shift in the classic sense. Nevertheless, in what follows I will use “paradigm” without scare quotes, consistent with its colloquial usage in Translational Science and Medicine rather than its technical meaning in philosophy of science.
One will also find the term Molecular Medicine used to describe research that seeks to exploit molecular understandings in biomedicine towards greater therapeutic application. In Europe one finds greater expansion of the use of the term and its institutionalization as a field and discipline. Both European and U.S. centers focused on Translational Science and Medicine have programs that include both Translational Science or Translational Medicine and Molecular Medicine in its title or as the title of graduate programs. For example, as of the writing of this article, Boston University’s translational program is named, “Translational and Molecular Medicine.” Institutes dedicated to Molecular Medicine proliferated in Europe, with many adding Translational Medicine to their name alongside the global spread of TrM. Given the often vicissitudinal nature of terminologies and names used for scientific efforts (Boniolo and Nathan 2016), it is important to note that not all name changes necessarily signal a clear shift in activities. Too, while desires for translational outputs (in terms of medicines) of TrM and Molecular Medicine tie the two areas together definitionally, an argument can be made that each field encompasses distinct endeavors and histories that possess significant areas of overlap. See Boniolo and Nathan’s volume, Philosophy of Molecular Medicine: Foundational Issues in Research and Practice (2016) for a much more expert and in-depth review of Molecular Medicine.
http://officeofbudget.od.nih.gov/, accessed January 2013.
By this I don’t mean to suggest that all TrM laboratories do nothing other than replicate commercial R&D models. There are a variety of activities that mark TrM programs globally. However, the emphasis on translatability compels activities designed to make work in TrM laboratories more conducive to external partnership. Additionally, I also don’t wish to suggest in this analysis a one-way linear model of influence in which industry is merely apprehending the methods, norms and on-the-ground realities of academic science. The notion of asymmetrical convergence (Kleinman and Vallas 2001) gets at the many dualities and bidirectionality of industry-university relations. It is also important to avoid ontological distinctions between “industry” and “universities” which treat each category as distinct and unchanging. Indeed, modern universities increasingly function/appear as corporations in a variety of domains. Thus, my discussion in this paper references biopharmaceutical industry stakeholders specifically and their relationship to specific universities and TrM programs.
Interestingly, the use of the word, antagonism to describe the gulf between standard academic measures and the evaluative paradigm of TrM in Chubb’s keynote meshes with Holman’s notion of what is essentially a fundamental antagonism between science and commerce (Holman 2015).
While this article is focuses on TrM, several other scholars have explored the increasingly market-oriented nature of new or emergent national and international science projects, including synthetic biology (Rossi 2017) and environmental science (Randalls 2017). Pfotenhauer and Jasanoff’s discussion (2017) of the global circulation of innovation models is an especially important discussion of the international spread of the Silicon Valley or “MIT-Model” of science and innovation “...circulated most prominently as a governance framework for research and innovation in the European Union (as witnessed for example by the Horizon 2020 funding programs), with increasing spillovers into North America and Asia” (Ptofenhauer and Jasanoff 2017). In all of these models, commercialization becomes both the endpoint and precondition for the creation and funding of projects and the assessment of success—a quality also found in the emergence of TrM. One similarity between the now globalized “MIT-Model” impacting global science projects and TrM lay in the importance of shifts in State funding upon the on-the-ground realization of these imperatives, the sense of the university as a source of economic growth and recovery, especially for fields such as molecular biology (Kenney 1986: 33), as well as a desire to commercialize State-funded science. More work is needed to fully compare and contrast the impacts of increasingly market-oriented science schemas upon each field in various national and local contexts.
See the webpage for the University of Nebraska Medical Center’s Biopharmaceutical Research & Development Symposium (http://www.unmc.edu/pharmacy/programs/symposium/). In the section on Goals and Objectives, the description includes “A guide to successful industry-academia collaboration with the opportunity to explore scale-us challenges and collaborate on how academia can more closely model industry level pharmaceutical processes.”
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Robinson, M.D. Financializing epistemic norms in contemporary biomedical innovation. Synthese 196, 4391–4407 (2019). https://doi.org/10.1007/s11229-018-1704-0
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DOI: https://doi.org/10.1007/s11229-018-1704-0