Preliminary Programme

Sham surgery as a placebo-control for experimental trials of surgery reemerged in the US after a long hiatus in the 1990s and found expanding use. Sham surgical trials draw public attention in part for their deflationary results and generate lengthy debate among medical ethicists. The rationale behind their use has also gone through an important, unacknowledged transition in recent decades.
Renewed interest in sham surgery began with tests of novel neurosurgical operations to implant brain tissue to treat Parkinson’s disease. The advocates justified non-therapeutic drill-holes in the skulls of subjects in the control group on the basis of the powerful placebo effect of surgery in a subjectively assessed condition like Parkinson’s -- to avoid invalid promotion of an innovative surgery for this difficult disease. The null result in these trials seemed to confirm sham surgery as a valuable control. By 2002, the use of sham surgical trials had migrated to the reassessment of established techniques widely in use. Placebo surgery was applied to test surgery for chronic conditions such as degenerative knee disease, low back pain, and recurrent migraine headaches where placebo effects were thought to be significant. Sham surgery shifted from a role testing novel interventions to an innovative test to winnow through existing interventions.
Recent debates over placebo surgery expose underlying anxieties about the relationship of the validation of surgical technique to questions about healthcare use and health. (Show less)

Since 1997, when the World Health Organization (WHO) declared the “global obesity epidemic”, “overweight” and “obesity” are treated as serious public health risks. Subsequently, numerous studies explored the “weighty” role of the Body-Mass-Index (BMI) as the most important indicator of body fatness and predictor of morbidity and mortality. Today, the BMI is the most accepted biomedical instrument to measure body weight and its implications for health. But is the BMI a valid biomedical instrument? Based on an analysis of selected historical European and US-American documents (medical and statistical textbooks and articles), self-help-books and advertisements, I claim that our definition of obesity, is a biopolitical, global construction with a long historical background. Our prevailing understanding of overweight and obesity, linked with the BMI, relies on “technologies of power” (Foucault) that were once planned to rule people and populations. It shall be argued that these technologies of power started as political efforts to measure soldiers and children in institutions. The protection against the risk of being abnormal (e.g. “overweight”) and the medicalization of obesity seem to be the logical consequence nowadays. For example, in Germany, BMI metrics have become the obligatory standard: People are not given the civil-servant status if they have a BMI over 25 (overweight). BMI categories like “underweight”, “normal weight” and “overweight” group people, categorize health and lead to three different “body identities”. In my presentation, I will show the connection between underlying “technologies of power” and their implication in the way people deal with these different “body identities”. Special emphasis will be placed on how today we are – willingly and unwillingly – forced to measure and reduce our body weight for preventive medical purposes. (Show less)

In 2011, a new drug, pitivastatin, was introduced to the US market as the eighth entry into the crowded class of cholesterol lowering drugs known as the statins. It was promptly derided by the medical press as just another "me-too" drug. Why did the world need another, more expensive statin, critics asked, when so many other similar drugs were already generically available? This complaint is quite familiar: by the early 21st century the me-too drug had become a stock character in critiques of the increasingly trivial innovation of the pharmaceutical sector. This paper will narrate the origins and development of the me-too drug from the early 1960s to the early 21st century as an inverted history of biomedical innovation. In a biomedical marketplace that values innovation, the me-too drug represented a form of minor fraud: a new product which claimed to be a significant innovation but in practice was only trivially different from its competitors. In the American context, public and professional critique of me-too drugs first became visible in a series of Congressional inquiries into the pharmaceutical industry under the Democratic Senators Estes Kefauver and Gaylord Nelson in the 1960s and 1970s. But the me-too drug had its defenders as well, from industry, the medical profession, and even consumer groups. Using manuscripts from institutional and personal archives, government documents, and readings from professional, policy, popular, and trade literatures, I trace the history of the me-too drug as a contested litmus test for distinguishing significant from trivial innovation in the biomedical field. (Show less)

Cancer is engrained in public imagination as the “emperor of all maladies” (Mukherjee 2012). Its existence is fraught by narratives of unease (Shapin 2010), and it remains a reminder that life is fragile, inherently unknowable, and subject to sudden change. As a range of literary, sociological, and historical studies have forcefully illustrated, cancer remains a matter of enormous individual and collective concern. That multiplicity has come to the fore through public health programmes that single out cancers such as abdominal, prostate, lung, or breast cancer. Early cancer detection tests have become a commonplace these days, one can choose from a range of biomedical tests to find undetected cancer growth in one’s body. Achieving social acceptance (and/or use of) of these technologies, however, remains a continuous struggle for the medical profession and for health politics alike as they are caught up in economic, social and ethical controversies about the application, for example of mammography and PSA-tests (cf. Leibing and Kampf, 2013).

This paper will offer a historical contextualization of this dilemma by looking at earlier struggles about the introduction and applications of biomedical technologies for detecting cancer early on. Informed by the history of science, the history of cultures of knowledge, and cultural anthropology (cf. Pickstone 2011), the paper aims at demonstrating the extent to which the current vexed issue of social acceptance of biomedical innovation has deeper historical roots. Drawing on recent attention given by historians to the modern history of cancer in the French and Anglo-American realm the paper will exemplify this idea in the German context, in which empirical historical cases in the public realm in the second half of the twentieth century are rare and fragmented. As part of a larger historical study on cancer as a scientific and public concept, the paper covers a time period in which the newly introduced German Cancer Aid foundation, the rise of biomedical research technologies on cancer, the challenges posed by alternative medical strands, and health policy initiatives all were caught up in intense media coverage about the meanings of growing cancer morbidity statistics and collective public concern. “Public” in the paper is understood as a dynamic process built by medical, socio-cultural, political, and media practices and various actors.

The paper will draw from a range of sources, including two ministries of health (BRD and GDR), public health educational material, cancer aid material, medical dissertations on cancer and prevention medical writings and textbooks on cancer and press coverage.

Leibing, A. and Kampf, A. (2013) Neither Body nor Brain: Comparing Preventive Attitudes Towards Prostate Cancer and Alzheimer’s Disease, Body & Society.
Mukherjee, S. (2010) The Emperor of All Maladies: A Biography of Cancer. New York: Scribner.
Pickstone, J. V. (2011) A Brief Introduction to Ways of Knowing and Ways of Working. History of Science 49: 235-245.
Shapin, S. (2010). Cancer World. The making of a modern disease. The New Yorker ( 8 November). (Show less)