| 1. |
- Ozieranski, Piotr, et al.
(författare)
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A “patient-industry complex”? Investigating the financial dependency of UK patient organisations on drug company funding
- 2022
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Ingår i: Sociology of Health & Illness. - : Wiley. - 1467-9566 .- 0141-9889. ; 44:1, s. 188-210
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Tidskriftsartikel (refereegranskat)abstract
- We examined the minimum extent of dependency of UK patient organisations on pharmaceutical industry funding using drug company disclosure reports and patient organisation financial accounts from 2012 to 2016. We used linear regression to explain the overall share of industry funding (‘general dependency’) and top donor funding (‘company-specific dependency’) in organisations’ income. Predictors included patient organisations’ goal; having members and volunteers; geographical scope of activity; headquarter location; expenditure/income ratio; and disease area. The prevalent low levels of general dependency (IQR, 0.1%–6.0%) and company-specific dependency (IQR, 0.1%–4.3%) made a widespread capture of patient organisations unlikely, though only if one excludes the possibility of significant payment under-reporting. However, organisations with considerably higher dependency than others might be more prone to co-optation by industry. Of the 398 organisations, 18 (4.5%) and 8 (2.0%) had general and company-specific financial dependency over 50%, respectively. However, the shares of outliers exceeding the third quartile plus 1.5 times IQR were 51 (12.8%) and 56 (14.1%) for each dependency type. Certain characteristics including activity profile (advocacy) or indicating limited access to resources (remote location) made organisations vulnerable to developing financial dependency. Future research should examine both financial and non-financial links between the two sides and their impact on patient organisations’ activity.
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| 2. |
- Mulinari, Shai
(författare)
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Regulating drug information in Europe: a pyrrhic victory for pharmaceutical industry critics?
- 2013
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Ingår i: Sociology of Health & Illness. - : Wiley. - 1467-9566 .- 0141-9889. ; 35:5, s. 761-777
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Tidskriftsartikel (refereegranskat)abstract
- Informed by recent sociological debates on pharmaceuticalisation, this article examines the evolution of the current EU legal proposal on prescription drug information to patients, as well as the surrounding controversies. In 2008 the European Commission proposed the relaxation of the existing rules governing drug information provision to patients by the pharmaceutical industry. Critics of the industry's influence over health policy and markets, including consumer organisations, industry-independent patient organisations and health professionals, rejected the Commission's proposal, claiming that the industry cannot be considered a reliable source of patient information due to inherent financial conflicts of interest. Since these critics were at least partially successful in rallying opinion against the Commission proposal, they functioned as countervailing forces to promotion-driven pharmaceuticalisation. Even so, as a watered-down version of the proposal moved through the European Parliament it was further modified to ultimately resemble the Swedish system that was held up as a high-quality example of industry-based information provision. Yet this article contends that the Swedish system displays evidence of corporate bias. Significantly, basing EU policy on a drug information system not resistant to corporate bias risks creating practices that violate the legally mandated mission of EU drug regulation, which is to 'promote and protect public health'.
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| 3. |
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| 4. |
- Liu, Rui
(författare)
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Capturing Quicksilver
- 2020
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Ingår i: Sociology of Health & Illness. - : Wiley. - 1467-9566 .- 0141-9889. ; 42:3, s. 680-681
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Recension (refereegranskat)
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| 5. |
- MacArtney, John I., et al.
(författare)
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The convivial and the pastoral in patient–doctor relationships : a multi-country study of patient stories of care, choice and medical authority in cancer diagnostic processes
- 2020
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Ingår i: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 42:4, s. 844-861
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Tidskriftsartikel (refereegranskat)abstract
- Experiences of cancer diagnosis are changing in light of both the increasingly technological-clinical diagnostic processes and the socio-political context in which interpersonal relations take place. This has raised questions about how we might understand patient–doctor relationship marked by asymmetries of knowledge and social capital, but that emphasise patients’ empowered choices and individualised care. As part of an interview study of 155 participants with bowel or lung cancer across Denmark, England and Sweden, we explored participants’ stories of the decisions made during their cancer diagnostic process. By focusing on the intersections of care, choice and medical authority – a convivial pastoral dynamic – we provide a conceptual analysis of the normative ambivalences in people's stories of their cancer diagnosis. We found that participants drew from care, choice and medical authority to emphasise their relationality and interdependence with their doctors in their stories of their diagnosis. Importantly negotiations of an asymmetrical patient–doctor relationship were part of an on-going realisation of the healthcare processes as a human endeavour. We were therefore able to draw attention to the limitations of dichotomising emancipatory-empowerment discourses and argue for a theorisation of the patient–doctor relationship as a contextually bounded and relationally ambivalent humanity.
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| 6. |
- Mulinari, Shai, et al.
(författare)
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Race in clinical trials in Sweden: How regulatory and medical standards in clinical research trump the post-racial discourse
- 2024
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Ingår i: Sociology of Health and Illness. - : WILEY. - 0141-9889 .- 1467-9566. ; 46:2, s. 315-332
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Tidskriftsartikel (refereegranskat)abstract
- The post-racial discourse that permeates many Western European countries depicts society as having moved beyond race concepts and classifications. This article focuses on Sweden, a country that, in line with the post-racial thinking, declares race to be an offensive and unscientific concept. The article investigates what happens when this post-racial discourse meets clinical research standards that encourage, if not demand, the collection of data on patient race. Through an analysis of the reporting of patient race in 76 multinational trials with at least one study site in Sweden, and a review of the regulatory and medical standards and trial documents that direct the collection of patient race in trials, we show how race classification is kept intact in trials despite conflicting with post-racial norms and conventions. Notably, our findings diverge from the way racialisation is typically assumed to work in Sweden and related countries. We argue this is possible because the two incompatible understandings of race are distributed (Mol, 2002, The body multiple: Ontology in medical practice, Duke University Press) among different social worlds. The distribution, we propose, is upheld through the paucity of major debate on why and how race classification should be carried out in clinical trials in Europe as this allows contradictions to remain unspoken.
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| 7. |
- Mulinari, Shai, et al.
(författare)
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Revisiting the pharmaceuticalisation of pandemic influenza using Lukes’ framework of power
- 2020
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Ingår i: Sociology of Health & Illness. - : Wiley. - 1467-9566 .- 0141-9889. ; 42:2, s. 327-341
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Tidskriftsartikel (refereegranskat)abstract
- The power of social actors to drive or block pharmaceutical uptake has been a concern in sociological debates on pharmaceuticalisation, including in the case of pandemic vaccination. We build on Steven Lukes’ three-dimensional view of power to explore the 2009 H1N1 pandemic vaccination in Sweden and Denmark – two similar countries that arrived at conflicting vaccination strategies. Drawing on interviews with members of each country’s pandemic steering group and on document analysis, we explore three consecutive stages of pandemic vaccination response: planning, vaccine procurement, and the vaccination campaign. The paper makes two contributions to studies of pharmaceuticalisation and pandemics. Conceptually, we advocate the suitability of Lukes’ framework over the ‘countervailing powers’ framework repeatedly used to model power in the pharmaceutical field. Empirically, our study confirms that government-appointed experts steered pandemic planning in both countries, but we show that the state, industry, and the WHO also exerted power by enabling and constraining experts’ decision-making, including by keeping some information secret. Furthermore, we argue that mass vaccination in Sweden was a pervasive expression of state power, in Lukes’ sense, since it rested on keeping latent the tension between many individuals’ health interests and the state’s interests in protecting social and economic functioning.
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| 9. |
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| 10. |
- Bergman, Karolin, 1979-, et al.
(författare)
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‘A holistic approach’ : incorporating sustainability into biopedagogies of healthy eating in Sweden’s dietary guidelines
- 2020
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Ingår i: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 42:8, s. 1785-1800
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Tidskriftsartikel (refereegranskat)abstract
- Dietary guidelines can be considered a pedagogical tool, designed to promotehealthy eating at the population level. In this study, we critically examine thebiopedagogies implicated in Sweden’s official dietary guidelines. Published in2015, these guidelines take a potentially innovative ‘holistic approach’ to food andeating, addressing the challenge of formulating dietary advice that considers bothhuman health and environmental concerns. Applying Bacchi´s ‘What’s theproblem represented to be?’ approach, we interrogate how the guidelines frame theinterplay of public health concerns and environmental concerns in making foodchoices. We find that the biopedagogies of sustainable eating, as presented in theseguidelines, implicate the subject position of the ideal eater. The ideal eater valuessustainability, has high cultural capital, and draws on both taste and nutritionalknowledge to make good food choices. However, while the ideal eater is expectedto be aware of environmental issues, these are incorporated into the ideal eater’schoices only in addition to the primary concern of health. Thus, although theguidelines frame a ‘holistic approach’ as the solution to both health andenvironmental concerns, in cases where health and environmental prioritiesconflict, the guidelines’ biopedagogies of sustainable eating align with earlierbiopedagogies of healthy eating.
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