PostDoctoral Research Fellowship

Fullwiley, Duana, New York NY

Investigators

Abstract

This post-doctoral research and training grant queries the emergence of "tailored medicine" as rationales of population-specific biological differences are varyingly taken up by professionals in the medical sciences, researchers in biotechnology, strategists in pharmaceutical planning and lay publics. The persistent confusion over the place of "race" in the sciences as well as its social, biological, genetic, and epidemiological validity, or invalidity, will be explored. Taking the example of African-American hypertension and heart failure, the research component of this postdoctoral grant will consist of an ethnographic, multi-sited study on the appearance of, and justification for, the first ethnically marked pharmaceutical drug called BiDil. This "African-American drug" is currently in its first year of a two-year medical trial at over 100 clinical sites in the U.S. and is produced by Bedford, MA based NitroMed, Inc. Relying on methods of multi-sited fieldwork (Heath et al. 1999; Rapp 1999), I will conduct participant observation at one or more trial sites in the New York area to learn how both doctors and patients understand "African-American hypertension" as a different disease than that of its "Caucasian" counterpart. This aspect of the fieldwork will be complemented by participant observation and interviews with geneticists researching SNPs (single nucleotide polymorphisms) as markers of biological difference crucial to pharmacogenomics. The controversy over whether or not phenotypic traits can scientifically belie one' genetic constitution regarding drug metabolizing enzymes has recently brought the usage of race in science to the fore in The New England Journal of Medicine (Exner et al. 2001; Yancy et al. 2001) where many of those working on BiDil have published key papers justifying their all Black study, The African-American Heart Failure Trial (Dries et al. 1999; Exner et al. 2001). Geneticists publishing in Nature Genetics have upped their criticism of race as a surrogate marker for genetic difference due to the NEJM debates (Editorial 2001). By interviewing spokespeople for biotechnology companies working on SNP mapping for pharmacogenomics purposes, scientific advisors on NitroMed, Inc.'s BiDil trial, cardiologists, hypertension specialists, members of the Association of Black Cardiologists (ABC), patients, and patient advocate group members, I will chronicle the deployment of race and other markers (such as SNPs) as each potentially inflect new social understandings of difference, identity, and health in the post-genomic age. This Postdoctoral Research and Training Fellowship, to be carried out at New York University under the sponsorship of senior Professor of Anthropology Rayna Rapp for 18 months, and at the University of London, Goldsmith College with Professor of Sociology Nikolas Rose for 6 months, is both timely and pertinent. The field of pharmacogenomics is just emerging, while questions on the responsible use of the concept of race --selectively resisted in both the life and social sciences--demand more detailed interdisciplinary scholarship. This project will build upon the work of researchers in medical anthropology and sociology interested in the intersection of various social and biological markers of difference, such as ethnicity and disease genes. It will furthermore contribute to research in the social studies of science concerned with the co-production of disease, identity, technology, and market.