June 7, 2021 | Reflections
Pia Vuolanto is Senior Research Fellow at the Tampere University Institute for Advanced Social Research and Project Coordinator in the EU-funded research project VAX-TRUST, which focuses on vaccine hesitancy. She also co-leads a research project on criticism of medicine, Health, Knowledge, and Expertise, with Dr. Johanna Nurmi. Renee Marie Shelby interviews Pia Vuolanto on the connections of her work with trust, gender, and the medical fringe.
How does your work contribute to current debates in STS? In what ways does it counter or reveal marginalization and exclusion in technoscience?
I research the boundaries of technoscience, the medical fringes. Technoscience is a tricky concept because it often sets the focus on the hard sciences, technologies, and biomedicine. These are impactful areas, and STS should study these fields. However, focusing on the hard sciences means many other knowledge-making fields—such as the social sciences—receive less attention. I have focused my research on nursing, social studies of health and illness, and the medical professionals’ experiential knowledge.
STS has much to offer in understanding the broad spectrum and impact of these health-related research fields within universities that are, of course, dominated by biomedicine. An example of this kind of marginalised field in the area of biomedicine is complementary and alternative medicine. Together with Caragh Brosnan and Jenny-Ann Brodin Danell, I edited a book on how STS approaches and methodologies could be used to study this controversial field, where there is a surprisingly rich body of work on knowledge production.
Nursing is another knowledge-making field where STS perspectives have proved beneficial. Early research on nursing within STS, for example, by Aant Elzinga and Thomas Brante on professionalisation back in the 1980s and 1990s, and the already quite broad area of ‘care studies,’ begun by Annemarie Mol, Ingunn Moser, and Jeannette Pols is insightful. But more could be done. Some of my work has explored nursing’s relation to the understudied fields of complementary and alternative medicine. I applied Thomas Gieryn’s boundary-work concept to show how medicine controls nursing as the ‘big brother.’ There are a lot of interesting power games going on in this corner of the research world.
The fruitfulness of focusing on fields marginalised in STS is that there too, as well as studies of ‘harder’ technoscience, can we find new aspects in boundaries and controversies over knowledge production, the public understanding of science, and the status of experts and expert knowledge in societies. And who knows, maybe STS mingling with these terrains could bring new ideas.
Key themes in your research are power and how power is negotiated within biomedicine. As you note in your co-authored article at Public Understanding of Science, fringe medical movements “both align with biomedical expertise and seek to transform it.” How do these insights shed light on the broader phenomenon of critique and contestation of the medical establishment?
The study in Public Understanding of Science with sociologists Harley Bergroth, Johanna Nurmi, and Suvi Salmenniemi draws attention to the important aspects of the publics of biomedicine and the relations of users of different ‘fringe medicine’ with expert and lay knowledges. Among others, Brian Wynne, Jaron Harambam, Stef Aupers, and Maya Goldenberg have pointed out conspiracy groups and critics of medicine are not stupid or ignorant of scientific knowledge. Their criticism stems from a lack of trust in biomedical knowledge production processes and how technoscience dominates the accepted forms of care and treatments and the recommended practices for taking care of health.
What was important in our study was it showed people want to be more engaged with science. They want opportunities to have a say in what science focuses on. Sounds like citizen science or public engagement of science, doesn’t it? There is more for STS to do. To make it explicit for the broader society that we need to think about publics in new ways: the publics of science should not just be considered a target of technoscientific products and recommendations. They are also potential collaborators in knowledge production, and they are, for sure, willing to be engaged in knowledge production.
Your article published at Science, Technology, and Human Values examines the Finnish skepticism movement to reveal the multiple ways boundary work is gendered. How do these forms of boundary work contribute to hierarchies of knowledge production? And, why is it so important to examine movements that have rarely been the object of critical inquiry within STS?
This article, co-authored with gender researcher Marjo Kolehmainen, is about the defence of science. In particular, the defence of technoscience by the skepticism movement. This is a productive angle to examine the defence of science because it reveals the hierarchical nature of knowledge production.
The skepticism movement is a powerful actor engaged in defining science in multiple ways. It is a science-based social movement with interest in defending science from humbug and non-science. In STS terms, the skepticism movement is engaged in boundary work between science and other spheres of knowledge. In Finland and elsewhere—and the movement is widespread and international—they are close to the scientific elite. Some of the movement’s central figures are esteemed academics. Thus, it is vital to dig deeply into this movement because when it’s defending science, the skepticism movement is shaping the public understanding of science, what is included in it, and what is excluded.
Our article makes visible the mundane, exclusionary tactics of the skepticism movement that are deeply gendered. We show how fields like gender research and social sciences get nullified and ridiculed in the Finnish skepticism movement’s magazine. We demonstrate the multiple ways women are excluded from science and women’s knowledge production is belittled. These exclusionary strategies have profound consequences regarding how attractive science is to women and the formation of boundaries between women and men as knowledge producers and legitimate intellectual actors.
We also found an attitude of “arrogance” towards people who use complementary and alternative medicine and use the knowledge that is not proven by scientific processes and evidence. It is interesting how in the skepticism movement’s social world, the social sciences and humanities should not be defended, but contested. I think it is surprising more focus has not been put on the skepticism movement in STS. Per Anders Forstorp is a pioneer in this area. In the early 2000s, he was investigating the patriarchal project of the skepticism movement.
You’re currently working on a project around trust and vaccine hesitancy. How does your work on gender and its intersections shape your research on trust, hesitancy, and medical controversies?
Regarding vaccine hesitancy, it is important to open eyes on whose knowledge gets marginalised and whose knowledge is valued, and how these processes are shaped by gender and the contradictory perceptions about science, expert knowledge, and recommendations by authorities. Adele Clarke has worked on ‘silent implicated actors’ in scientific controversies. In the public sphere and the media landscape, vaccine-critical groups are often silent or silenced. The debates around vaccines may wholly concern their issues and healthcare. Still, they get left out, and their views get marginalised even though these people’s compliance is the basis of the whole vaccine enterprise. But in the consultancy room, vaccine critics have agency. They can choose whether to take the end-products of the technoscientific development, vaccines, and other recommended treatments. Some choose not to take vaccines or give vaccines to their children, and that choice is deeply immersed in their thinking about science and its knowledge production mechanisms.
Moreover, some vaccine-hesitant people may hold healthcare professional degrees, so this issue is deeply internal to the medical establishment. It has to do with how the professional knowledge base is understood and maintained. The internal medical critique has long roots, which are intertwined with healthcare authority. I have two on-going projects to investigate internal and external criticism of medicine. One is Health, Knowledge, and Expertise jointly led by Johanna Nurmi and myself. The other is an EU Horizon 2020-funded project called Addressing Vaccine Hesitancy in Europe (VAX-TRUST) together with ten partners from seven countries where I am the Principal Investigator.
Are there any new projects or collaborations you’re working on?
Together with Caragh Brosnan and Jenny-Ann Brodin Danell, we are building an STS-CAM network and have organised several sessions at STS conferences. We bring STS perspectives, including boundary-work, actor-network theory, bibliometrics and Bourdieu, to study the margins of biomedicine. With Mathieu Albert, I have ongoing collaboration on interdisciplinarity. I am a member of the International Research Network for the Study of Science and Belief in Society, which was established a few years ago. I am connected with some really interesting work around vaccine hesitancy in the Canadian Indigenous communities with Sangita Sharma.
Renee M. Shelby is a postdoctoral researcher with the Sexualities Project at Northwestern University and a Visiting Fellow with the Justice and Technoscience Lab (JusTech) at the Australian National University. She holds a PhD in Sociology of Science & Technology from the Georgia Institute of Technology.
Published: 06/07/2021