Produire l'objectivité médicale : un système expérimental réplicatif de standardisation

As seen through studies in medical sociology and though the concerns expressed by health-care professionals, standardizing medical practices is the key to the theoretical and practical thought devoted to the production of scientific objectivity. Till present, analyses have given a special place to the conditions for establishing innovative systems of medical coordination on a large scale. Recent studies have focused on constructing standards and concretely applying them to the coordination of medical practices. Under this paradigm however, maintaining standardized practices over time is taken for granted. Attention has mainly turned toward the visible aspects of standardization in a narrowly defined medical setting with, as a result, models that are based on the degree of standardization obtained instead of on the process of attaining it. Two empirical studies are used to raise questions about how to make the nascent medical/administrative objectivity last. This presentation of a “style of standardization” pleads for a pragmatic approach to the producing of standards so as to describe the various innovative forms of standardized practices without necessarily making presuppositions about the context of discovery or the properties inherent in what is to be standardized.     

À la recherche d’une politique biomédicale en France : chronique d’une réforme inaboutie en cancérologie

This article proposes to explore research administration practices in the analysis of the spread of biomedicine in France. This approach, combined with an analytical positioning inspired by the sociology of organisations, brings an additional element to conventional approaches to biomedicine, since it helps to identify constraints other than those associated with the scientific and clinical practices themselves. Drawing on empirical observation of the development of contemporary policy on cancer research, we will show the crucial influence of the distribution of power between the different stakeholders involved in developing public processes for promoting biomedical practices.     

Construction d'un problème public autour du dopage et reconnaissance d'une spécialité médicale

The formation of a professional specialty — sports medicine — is described with emphasis on how drug abuse has become a public issue. This notion's itinerary is traced between 1955 and 1999 so as to show how doctors with different profiles and activities successively raised the issue of “doping”. The objectives of medicine, as it was being applied to sports, gradually changed. At the start, the intention was to cure, a view that celebrated the virtues of practicing a sport and it condemned using drugs. A new field of medical competence was opened with the “biological preparation of performances”, which, though presented as an alternative to using drugs, blurred the boundaries with doping. Medical positions became polarized: on the one side, a science of training took shape around the physiology of physical efforts, which made it possible to intensify activities while optimizing them thanks to rest periods; and on the other side, clinicians who, in closer contact with the everyday life of players, both understood the requirements ensuing from a continuous renewal of performances and tended to favor taking “products” for “curative” purposes. Sports medicine was legitimated as a medical specialty on two grounds: the one, obvious, sets doping at odds with health; and the other, aberrant from the viewpoint of health but nonetheless accepted, associates intensive sports with health.