Disputed expertise and chaotic disinformation: COVID-19 and denialist physicians in Brazil.

This article aims to show how incorrect ideas about COVID-19 were promoted by physicians in Brazil, contributing to a catastrophic response at the cost of hundreds of thousands of lives, and to examine the implications of this episode for the social studies of science, technology and medicine. The literature on the relationship between science and society takes two broad approaches, which are sometimes at odds with each other: (i) there is a traditional critique of science that points to unsupported claims of certainty and thus undue interference in general human affairs; (ii) there are many examples of attempts to undermine reasonable scientific claims, when they clash with economic and/or political interests of certain groups. Navigating those extremes is particularly critical in situations in which accurate knowledge is necessary for intervening in people's lives, as is the case in health-related issues. Determining who has actual epistemic expertise is a key factor in solving this conundrum. This became painfully clear during the unfolding of the COVID-19 pandemic, which highlighted the uncertainties of science in guiding decisions being made in real time, and provided opportunities for many forms of disinformation and conspiracy theories that hampered public health measures and promoted useless or even dangerous "treatments". This article discusses an instructive example of such developments in the chaotic response to the pandemic challenge in Brazil, which saw, among other unfortunate situations, physicians aligned with the denialist federal government advocating for unproven - or proven as ineffective - treatments and disseminating unfounded doubts about vaccines. Presumed expertise on the basis of professional training clearly did not translate into actual expertise in the necessary domains to ascertain the validity of such claims and scientific advice was overridden by ideology.

Da imaginação à neuroimagem: uma análise antropológica sobre a racionalidade do efeito placebo em ensaios clínicos / From imagination to neuroimage: An anthropological analysis on the rationality of the placebo effect in clinical trials

Resumo O efeito placebo é um ponto de passagem obrigatório para a compreensão da racionalidade envolvida nos ensaios clínicos randomizados. A partir da antropologia da ciência e da tecnologia, este artigo analisa como a noção de efeito placebo tem sido utilizada pela ciência na produção de fronteiras biossociais. Assim, enfoca fenômenos que inicialmente eram atribuídos à imaginação e analisa as consequências de novas metodologias científicas que têm reconhecido outras potencialidades desse efeito, mas tendem a privilegiar marcadores biológicos. O argumento central é que a disputa epistemológica oculta a existência múltipla do efeito placebo que pode ser reconhecida em função das diferentes práticas às quais ele confere racionalidade.

Abstract The placebo effect is an obligatory passage point to understand rationality in randomized clinical trials. From the perspective of science and technology studies, this paper analyzes how the notion of the placebo effect has been used by science in the production of biosocial borders. Thus, it will pay attention to the phenomena considered caused by imagination, and we will analyze the consequences of new methodologies that have recognized other potentialities of this effect but tend to favor biological markers. The central argument is that the epistemological dispute hides the multiple existences of the placebo effect to be recognized due to the different scientific practices to which it confers rationality.

Science, health, and human rights.

A solid knowledge base is one of the necessary conditions to assure health as a human right. The contemporary source of such knowledge are the sciences at large, which however presents a problem, since the scientific enterprise can - and has been - a source of human rights violations as well. The field of social studies of science (STS) takes an iconoclast approach to the science, providing much needed criticism of its claims of authority. Recently, however, when attacks from multiple sources attempt to undermine perfectly reasonable scientific developments, the STS approach may not provide the adequate tools to deal with such challenge, especially with regard to health issues. This essay explores, with examples, ways in which the critical stance of STS may be compatible with a defense of proper scientific knowledge - in fact, helping to define what that actually means - without falling in the trap of scientism.

Health, environment and colonial legacies: Situating the science of pesticides, bananas and bodies in Ecuador.

Pesticide-related health impacts in Ecuador's banana industry illustrate the need to understand science's social production in the context of major North-South inequities. This paper explores colonialism's ongoing context-specific relationships to science, and what these imply for population health inquiry and praxis. Themes in postcolonial science and technology studies and critical Latin American scholarship guide this exploration, oriented around an ethnographic case study of bananas, pesticides and health in Ecuador. The challenge of explaining these impacts prompts us to explore discursive and contextual dynamics of pesticide toxicology and phytopathology, two disciplines integral to understanding pesticide-health linkages. The evolution of banana phytopathology reflects patterns of banana production and plant science in settings made accessible to scientists by European colonialism and American military interventions. Similarly, American foreign policy in Cold War-era Latin America created conditions for widespread pesticide exposures and accompanying health science research. Neocolonial representations of the global South interacted with these material realities in fostering generation of scientific knowledge. Implications for health praxis include troubling celebratory portrayals of global interconnectedness in the field of global health, motivating critical political economy and radical community-based approaches in their place. Another implication is a challenge to conciliatory corporate engagement approaches in health research, given banana production's symbiosis of scientifically 'productive' military and corporate initiatives. Similarly, the origins and evolution of toxicology should promote humility and precautionary approaches in addressing environmental injustices such as pesticide toxicity, given the role of corporate actors in promoting systematic underestimation of risk to vulnerable populations. Perhaps most unsettlingly, the very structures and processes that drive health inequities in Ecuador's banana industry simultaneously shape production of knowledge about those inequities. Public health scholars should thus move beyond simply carrying out more, or better, studies, and pursue the structural changes needed to redress historical and ongoing injustices.

From esterilología to reproductive biology: The story of the Mexican assisted reproduction business.

This paper provides the first overview of how assisted reproduction emerged and developed in Mexico. In doing so it addresses two broad points: when and how treatments using assisted reproductive technology became common practice within reproductive medicine; and how the Mexican assisted reproduction industry emerged. The paper begins in 1949, when the first medical association dedicated to esterilología - the biomedical area focused on the study of infertility - was established, thus providing the epistemic and professional ground upon which assisted reproductive technology would later thrive. The paper then traces the way in which this biomedical industry developed, from individual doctors in their practices to networks of clinics and from a clinical practice to a reproductive industry. It also describes the different ways in which the professional community and the government have worked towards developing a regulatory frame for the practice of assisted reproduction. The paper is informed by ethnographic work conducted at clinics, conferences, online forums and websites, as well as by analysis of the contemporary national media, government documents and national medical journals from the early mid-twentieth century to the those published today.

Variations of the social: some reflections on public health, social research and the health-society relation / Variaciones de lo social: algunas reflexiones sobre salud pública, investigación social y la relación salud-sociedad

The idea of a social dimension of health is widely accepted as unavoidable and relevant for public health. This article proposes a reflection around the notion of the social examining some of the manifold ways in which it might be inherited by researchers, professionals, administrative staff and material settings involved in the practices of public health care. It will be argued that this inheritance has deep consequences for efforts of care inasmuch these different versions of the social characterise, circumscribe and reframe the health-society relation, modifying the scope under which public health issues are tackled or dismissed. To ground this seemingly abstract discussion I will work considering a specific public health problem: the case of frequent attenders in public health. Drawing on two approaches from the Sociology of Health (i.e. illness-behaviour and the user-professional relation) and the field of Science and Technology Studies, I will show how these ways of framing the study of frequent attenders assume and simultaneously promote three different versions of the social. The article aims to explore how social research in these traditions participate in the achievement and promotion of specific health-society relations, in which certain notions of the social operate helping or limiting research and care efforts by creating richer or poorer possibilities for posing, examining and facing the problems of public health.

La idea de una dimensión social de la salud ha sido ampliamente aceptada como inevitable y relevante para la salud pública. Este artículo propone una reflexión en torno a la noción de lo social examinando algunas de las muchas formas en que ésta puede ser heredada por los investigadores, profesionales, personal administrativo y contextos materiales involucrados en las prácticas sanitarias. Se propondrá que esta herencia tiene consecuencias importantes para los esfuerzos de atención en la medida en que distintas versiones de lo social caracterizan, circunscriben y replantean la relación salud-sociedad, modificando el alcance bajo el cual se enfrentan o descartan los problemas de salud pública. Para situar esta discusión, aparentemente abstracta, se trabajará a partir de un problema específico de salud pública: el caso de los pacientes policonsultantes. Tomando elementos de dos aproximaciones de la Sociología de la Salud (el comportamiento de enfermedad y la relación usuario-profesional) y del campo de los Estudios de Ciencia, Tecnología y Sociedad, mostraré cómo estas maneras de dar forma al estudio de los policonsultantes asumen y simultáneamente promueven tres versiones distintas de lo social. El artículo busca explorar cómo la investigación social situada en estas tradiciones participa en el logro y promoción de relaciones específicas entre salud y sociedad, en las cuales ciertas nociones de lo social operan ayudando o limitando los esfuerzos de cuidado e investigación, creado posibilidades más ricas o pobres para plantear, examinar y enfrentar los problemas de la salud pública.

Behavior Therapy and Modelo Latinoamérica; Assembling and Demarcating Psychology in Colombia / Terapia del Comportamiento y Modelo Latinoamérica; ensamblando y demarcando la psicología en Colombia

The set of psychological techniques known as Behavior Therapy is reframed as a sociotechnical device and its circulation from the US to Colombia in the 1970s is reconstructed. The circulation of Behavior Therapy is described in academic spaces such as Universidad Nacional de Colombia and Universidad Javeriana. The possibility of Behavior Therapy as a Boundary Object as a mean for demarcation from psychiatry, and as a way for promoting and mobilizing scientific discourses about subjectivity. Thus, a relation between the training guidelines for psychology curricula known as Modelo Latinoamérica and the assemblage of Behavior Therapy is outlined. Finally, some considerations for future interdisciplinary research on the history of psychology are proposed.

El conjunto de técnicas psicológicas conocido como Terapia del Comportamiento es replanteado como un dispositivo sociotécnico y se realiza una reconstrucción de su circulación desde EEUU hacia Colombia en los años 70. Posteriormente, se describe la circulación de la Terapia del Comportamiento en espacios académicos como la Universidad Nacional de Colombia y la Universidad Javeriana. Adicionalmente se discute la posibilidad de entender la Terapia del Comportamiento como un Objeto-Frontera, un medio para la demarcación con respecto a la psiquiatría, y una forma de promover y movilizar discursos científicos sobre la subjetividad. De esta manera, se delimita una relación entre los lineamientos de entrenamiento para currículos en psicología conocidos como Modelo Latinoamérica y el ensamblado de la Terapia del Comportamiento. Por último, se ofrecen algunas consideraciones para futuras investigaciones interdisciplinarias en el campo de la historia de la psicología.