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Impure Science: Aids, Activism, And The Politics Of Knowledge
by Steven Epstein
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From Library Journal
Epstein (sociology, Univ. of California, San Diego) provides an exhaustive analysis of how credibility is established within the field of science. He shows how a group of laypersons gained credibility within the system and what effects their "lay expertise" had on the scientific process, in particular, the effort to treat AIDS. In the first section, he discusses the origin of AIDS, showing how HIV came to be accepted as the cause of AIDS and how that theory was challenged by some renowned scientists. In the second section, Epstein offers a particularly fascinating examination of the development of "expertise" among AIDS treatment activists, who eventually played a significant role in changing the methodology of clinical drug trials. This volume, based on the author's award-winning dissertation, is highly recommended for academic and health science collections of public libraries.?Tina Neville, Univ. of South Florida at St. Petersburg Lib.
Copyright 1996 Reed Business Information, Inc.
The New York Times Book Review, Jeffrey Goldberg
... AIDS activists have mastered the science of their disease in a manner that changed the history of medicine. For the first time, Mr. Epstein says, a group of patients had transformed themselves from a "disease constituency" to an "alternative basis of expertise" ... a perceptive and useful analysis of this revolution in the democratization of medicine.
A well-trained physician can diagnose AIDS as a disease, but sociologist Epstein does more. He diagnoses AIDS as a political and cultural event requiring us to rethink the place of medical science within society. He shows that since its deadly appearance in the 1980s, AIDS has let loose forces subversive to the status quo. Because it has claimed so many homosexual victims, AIDS has galvanized gay activists determined to overcome the indifference and even hostility of the medical and research bureaucracy. Many others--including hemophiliacs and women's groups--have joined in the fight for a place in the professional councils discussing what causes AIDS, what available treatments should be researched, and what possible cures should be researched. These debates have made medicine and research more democratic than ever before. But they have also forced activists, public officials, and doctors to confront vexing questions about the limits of politics and the prerogatives of expertise. Nowhere else will readers find a more carefully documented chronicle of how AIDS has brought these questions to the fore. Bryce Christensen
Paul Volberding, New England Journal of Medicine
"Important, timely, and well written."
Phyllida Brown, New Scientist
"Amid the dozens of books about AIDS, one stands out Impure Science. . . . Epstein has documented the fast-moving history of the epidemic's first years in an eloquent, readable narrative. . . . Intelligent and original."
In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles."
Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH-sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties.
Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.
From the Inside Flap
"The best empirical piece of work on the AIDS epidemic that I have read--detailed, well-informed, and expressed in lucid and accessible prose."--Charles E. Rosenberg, University of Pennsylvania
"This study surpasses all the best current writing in the AIDS field and bids fair, in my opinion, to set the standard for some time to come--not only in relation to the policy problems and the scientific and political conflicts associated with AIDS but also in the academic arenas of sociology of science, sociology of knowledge, and sociological theory."--Virginia Olesen, University of California, San Francisco
From the Back Cover
"The best empirical piece of work on the AIDS epidemic that I have read (detailed, well-informed, and expressed in lucid and accessible prose." (Charles E. Rosenberg, University of Pennsylvania)
About the Author
Steven Epstein is Assistant Professor of Sociology at the University of California, San Diego. The work on which this book is based won the American Sociological Association's award for best dissertation of the year.
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