"Strategies of Ignorance: Mapping the Uses of Uncertainty within Medicine," was a one-year ESRC postdoctoral research fellowship held by Dr Linsey McGoey, and carried out under the mentorship of Professor Andrew Barry.
The project expanded on Linsey's doctoral research, completed at the LSE in December 2007. Her PhD examined the uses of ignorance and uncertainty employed by UK government regulators, policymakers and practitioners in debates over whether selective serotonin reuptake inhibitors (SSRI) antidepressant drugs lead to suicide in some users. Her main findings were as follows:
- Drawing on the case of SSRIs, she demonstrates 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, she suggests 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, the thesis suggests 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 she terms the "moral authority of objectivity" in medicine.
- Fourth, drawing on interviews with expert advisors to the MHRA, the thesis argues that UK drug 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 fourth finding in particular formed the basis of Linsey's work at the School of Geography and the Environment. Although the relationship between forms of knowledge and regimes of governance has been a significant focus of sociology and social theory, the role of ignorance has elicited less theoretical attention. Despite some recent attention from scholars such as Luhmann, Rabinow and Proctor, social scientists and philosophers have been relatively slow to examine the value of ignorance, and to assess the ways that the strategic use of ignorance serves as a form of political capital. An aim of this research project was to explore emergent work on ignorance and related work in the area of secrecy and transparency.
Linsey worked with Professor Andrew Barry who recently completed an empirical study of the construction of an oil pipeline in Georgia and Azerbaijan. Conceptually, this research has led to a number of novel theoretical findings, such as his exploration of the relationship of secrecy and discretion in the strategic communication of "non-knowledge" amongst the complex hybrid of NGOs, governmental bodies, and commercial firms working on the pipeline's construction (Barry, forthcoming).
- McGoey, L. (2009) Sequestered evidence: access to RCT data and the distortion of clinical guidelines. Perspectives in Biology and Medicine, 52(2): 203-217.
- Kendall, T. and McGoey, L. (2007) Truth, disclosure and the influence of industry on the development of NICE guidelines: An interview with Tim Kendall. BioSocieties, 2(1): 129-140.
- McGoey, L. (2007) On the will to ignorance in bureaucracy. Economy and Society, 36(2): 212-235.
- Wahlberg, A. and McGoey, L. (2007) An elusive evidence base: The construction and governance of randomized controlled trials (Introduction to Special Issue). BioSocieties, 2(1): 1-10.
- May 2008 - "Prozac, RCTs and the profitability of uncertainty and failure." Invited talk at the ENSN-Department for History and Philosophy of Science workshop, "Our Brains, our Selves?" Harvard University, May 1-3.
- Feb 2008 - "The perils and advantages of 'elite' interviewing: a case analysis of the Prozac controversy". Invited talk at the LSE Methodology Institute / National Centre for Social Research Joint Seminar Series, February 13, London School of Economics.
- June 2007 - "Productive ambiguity: RCTs and the uses of inconsistency." Invited talk at LSE's Centre for Philosophy of Natural and Social Sciences workshop on "Contingency in Science: Its origins and outcomes" June 21-22. LSE, London.
- March 2007 - "Adverse evidence: RCTs and the political value of uncertainty" Making Medicine Count: Evidence-based medicine in practice. March 23, Cambridge University, England.
- Sept 2006 - "Drugs, democrats and dissent: on the relationship between objectivity and democracy." The Social Science and Democracy: A philosophy of science perspective. University of Ghent, Belgium.