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Paper short abstract:

Building on realist theoretical frameworks in STS and drawing on fieldwork in Europe and the US spanning over a decade, this paper examines how political, economic and institutional interests have reshaped definitions of pharmaceutical carcinogens, and considers the implications for public health

Paper long abstract:

Building on realist theories of science, developed by Bhaskar (1975, 1979) within philosophy and brought to empirical fields of STS by Abraham (1995), this paper starts from the presupposition that the domains of 'the political' and of the 'natural world' are to some extent autonomous. From that starting point, it systematically investigates how politics has shaped the production of scientific knowledge in the field of pharmaceutical carcinogenic risk assessment. Drawing on years of fieldwork, including nearly 100 interviews and extensive documentary research in Europe and the US, involving pharmaceutical industry scientists, drug regulatory agencies, experts from key national and international scientific laboratories and committees, and relevant advocacy organizations, this paper explains how various economic, political and institutional interests have sought to change how pharmaceuticals are defined as carcinogens. This paper makes three principal points: one empirical; one policy-relevant; and one philosophical/methodological. Empirically, it is argued and demonstrated that the process of redefining what counts as pharmaceutical carcinogens over the last 30 years has been biased in favour of commercial interests with the blessing of drug regulators, violating scientific standards as it goes . Policy-wise, this has cemented a direction of assessment and decision-making against the interests of public health. Philosophically/methodologically, the research confirms the relative autonomy of the domains of 'politics', 'science', and 'nature' for it is precisely because the natural world is not entirely malleable by politics that the practices of particular scientists can be revealed as biased and inconsistent with scientific standards developed to accurately characterise that world.