Jaco van der Merwe BA. (University of Groningen)
Medicine: A social construction?
Homeopathy has been cited as an example of what constitutes unscientific
practice. One of the arguments is that it is necessary to demonstrate that
the empirical observations are reproducible before an explanatory theory
can be formulated and the results applied in practice (Kuipers, 1995).
Where this is not done, it is not possible to formulate test criteria
whereby a theory can be refuted. Scientific practices, on the other hand,
can be demarcated by examining the core of the methodology followed and
taking a critical stance regarding the content of the discipline. Such an
internal demarcation does not take account of what non-scientists
and persons external to the discipline might consider relevant. The chemical
industry is an example of an internal demarcation. The challenges confronting
the chemical engineer are defined by technological problems. The final
product must meet predetermined specifications and to achieve this as
efficiently as possible, requires the application of scientific knowledge.
Products are sold on a market where the main criterion is the chemical
composition, in short, the purity of the compound.
Engineers and scientists in the chemical and pharmaceutical industries are
applying the same laws of physics and chemistry. Whether calculating the
required reaction rate or designing a heat exchanger to cool the process
liquid - the principles to be applied are common to both sectors. However,
the pharmaceutical industry is a completely different world to the chemical
industry. The most significant difference is the way in which the quality
of the final product is defined. Quality in the pharmaceutical industry is
an institutional construct encompassing much more than confirmation that
the product meets the predetermined specifications. What will be argued is
that the GMP (Good Manufacturing Practice) guidelines applicable in the
pharmaceutical industry, demarcate the boundaries of science and technology
during the manufacture of medicinal products. It is a quality assurance
system wherein the GMP guidelines itself becomes constitutive of what can,
or can not, be defined as medicinal products. In the end, medicines are for
the greater part defined as substances possessing, or reputed to possess,
curative or remedial properties by a framework of institutions regulating
the pharmaceutical industry. Not the absolute facts about the chemical
composition of a drug ultimately define it, but an institutional construction
which determines the allowable factual content of pharmacology as science.
The presentation is divided into four sections:
- A summary of the key concepts of institutional facts;
- Secondly the framework of GMP will be explained;
- Thirdly, it will be shown that a) GMP is a social construct and b) that medicines can not be defined outside of the GMP framework.
- The consequences for scienctists due to this socially constructed demarcation of the discipline.
Kuipers, T.A.F. (1995-6). Wetenschappelijk en pseudo-wetenschappelijk dogmatisch gedrag. Wijsgerig perspectief, 36, 92-97. Amsterdam: Meulenhof educatief. ISSN: 00435414.
Searle, J.R. The Construction of Social Reality, The Free Press, New York, 1995.
Jaco van der Merwe obtained his Bachelor degree in Chemical Engineering
from the University of Potchefstroom, in South Africa, in 1989. After
graduating, he joined the Foods Division of the National Chemical Products
Company in South Africa, working mainly in the field of ethanol, bakers'
yeast and citric acid production. In 1994 he attended the Massachusetts
Institute of Technology Summer Program in Biotechnology, followed by the
Advanced course in Microbial Physiology and Fermentation Technology at
the T U Delft during January 1995.
Further pursuing his interest in biotechnology, he obtained his M.Sc. in
Chemical Engineering in 1996 at the Slovak Technical University, in
Bratislava. The topic of his thesis was "A study of heat and mass transfer
aspects in fungal fermentations on an industrial scale".
Jaco emigrated to the Netherlands in 1998. He enrolled for a Bachelor in
Philosophy of a specific scientific discipline at the Groningen University
in 2005. His current employer is DSM Biologics, a pharmaceutical contract
manufacturing organisation in Groningen.