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Autonomy and Objectivity as Political Operators in the Medical World: Twenty Years of Public Controversy about AIDS Treatments in France

Published online by Cambridge University Press:  01 September 2008

Nicolas Dodier  and
Janine Barbot
Nicolas Dodier
Affiliation:
Institut national de la santé et de la recherche médicale (INSERM); and Ecole des hautes études en sciences sociales, Paris, France (EHESS); Groupe de sociologie politique et morale, Paris, France(GSPM)
Janine Barbot
Affiliation:
Institut national de la santé et de la recherche médicale (INSERM); Centre de recherche médecine science santé société, Villejuif, France(CERMES)
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Argument

The article is based on the controversies relating to conducting experiments and licensing AIDS treatments in France in the 1980s and 1990s. We have identified two political operators, i.e. two issues around which tensions have grown between the different generations of actors involved in these controversies: 1) the way of thinking about patient autonomy, and 2) the way in which objectivity regarding medical decisions is built. The article shows that there are several regimes of objectivity and autonomy, and that it is at the meeting point of the two dimensions that very different political forms of medicine have developed. In the case of AIDS, the article identifies four of these forms (liberal and conservative clinical traditions and therapeutic modernity – enclosed, then participative) and analyzes the dynamics of their emergence and opposition. We discuss an “objectivity/autonomy” diagram as a conceptual framework which enables us (above and beyond AIDS) to think about changes in contemporary medicine.

Type
Research Article
Information
Science in Context , Volume 21 , Issue 3 , September 2008 , pp. 403 - 434
Copyright
Copyright © Cambridge University Press 2008

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