Clinical Research as Social Practice

“For much of this book, I have been arguing that clinical research is intrinsically a social process. The most routine of clinical investigations involves seemingly endless negotiations: negotiations to persuade participating researchers to abide by a uniform protocol even when there are more interesting’ questions to pursue; negotiations with referring clinicians to send patients to the study; efforts to persuade patients to join such studies; negotiations with editors and coauthors about where to publish, how many tables to publish, and how many authors to credit. In all these activities, researchers have to persuade others – scientists, physicians, and patients – that their questions are worth asking; that their research plans (study design, treatment protocol, outcome measures) and their resources (clinical population, clinical staff, ancillary support) are adequate for the job; that their analyses are sound; and that what they have found should alter or affirm existing practice. All of these efforts entail the use of persuasion and power” (Marks, 240; cf. 243).