Impure Science: AIDS, Activism, and the Politics of Knowledge
Steven Epstein is a sociologist whose expertise lies in health care inequalities and research on human subjects. Published in 1995, Impure Science: AIDS, Activism, and the Politics of Knowledge is a study of the politicized production of knowledge in the AIDS epidemic in the United States. This work shows Epstein’s interest in how expertise is constructed, the ways in which those who are considered “outsiders” can influence medicine, and how credibility is gained and lost. Epstein focuses on the question of how knowledge is produced through complex interactions among government agencies, pharmaceutical companies, scientists, medical people, and “treatment activists” to discover how knowledge about AIDS emerges out of what he calls "credibility struggles."
Epstein follows the “principle of symmetry”, a methodology for analyzing both mainstream and dissenting views in the same way; this differs from the usual approach which tends to accept a mainstream worldview as true, and then tries to explain other opinions as various kinds of errors. The principle of symmetry reads that the same types of conceptual tools ought to be used to explain both true and false beliefs.
For sources Epstein used medical journal articles, mass media news reports, articles in gay and lesbian press, activist documents, and government documents as well as extensive interviews with more than thirty researchers, activists, and government officials. He also attended many conferences, meetings, forums, demonstration, and other public events. He writes that his “fundamental analytical strategy has been to bring into critical juxtaposition contemporaneous records from different “social worlds”” (page 355). Epstein also explains that he would attend demonstrations and such because he felt that published sources can only tell part of the story and can sometimes conceal parts of the story.
The first part of Impure Science is titled The Politics of Causation and deals with the “consolidation of certainty” surrounding the AIDS hypothesis. Many nonscientists are unaware of and often hold misconceptions about the degree of certainty behind the knowledge that science generates. Through the descriptions of the discourse between the American scientist Robert Gallo and the French Scientist Luc Montagnier, along with the denial by Peter Duesberg of HIV’s role in the disease, we are able to see the social relations, assertions, and assessments that can direct scientific knowledge production.
The second longer section of the book is titled The Politics of Treatment and the primary concern here is the process by which knowledge producers gain credibility, the “credibility struggles”. The scientists in this were deemed the most credible source of knowledge on AIDS due to pre-existing notions and the legitimacy given to them by society. In contrast, the AIDS activists only...