Biomedical scientists' perception of the social sciences in health research

Abstract

The growing interest in interdisciplinary research within the Canadian health sciences sector has been manifested by initiatives aimed at increasing the involvement of the social sciences in this sector. Drawing on Bourdieu's concept of field and Knorr-Cetina's concept of epistemic culture, this study explores the extent to which it is possible for the social sciences to integrate into, and thrive in, a field in which the experimental paradigm occupies a hegemonic position. Thirty-one semi-structured interviews were conducted to explore biomedical scientists' receptiveness toward the social sciences in general and to qualitative research in particular. We found that these respondents exhibited a predominantly negative posture toward the social sciences; however, we also found considerable variation in their judgments and explanations. Eight biomedical scientists tended to be receptive to the social sciences, 7 ambivalent, and 16 unreceptive. The main rationale expressed by receptive respondents is that the legitimacy of a method depends on its capacity to adequately respond to a research question and not on its conformity to the experimental canon. Unreceptive respondents maintained that the social sciences cannot generate valid and reliable results because they are not conducive to the experimental design as a methodological approach. Ambivalent respondents were characterized by their cautiously accepting posture toward the social sciences and, especially, by their reservations about qualitative methods. Based on the biomedical scientists' limited receptiveness, we can anticipate that the growth of the social sciences will continue to meet obstacles within the health research field in the near future in Canada.

Introduction

Although health care professionals and policy-makers have long recognized the importance of the social dimensions of health and health care, this recognition has not traditionally been matched by a robust commitment to the social sciences in the health research domain. In recent years, there have been signs that this disparity is beginning to change. A growing interest in interdisciplinary research has prompted more concerted efforts by health research funding agencies to incorporate the social sciences and humanities into their agendas. For example, the Canadian Institutes of Health Research (CIHR) was established in 2000 with an express mandate to encourage interdisciplinary health research including the social sciences (Government of Canada, 2000); similarly, in 2001, the National Institutes of Health took steps to enhance the social sciences' contribution to health research (Bachrach & Abeles, 2004). Although these are promising signs for the growth of the social sciences in health research, mandating change is not sufficient for effecting change. Editorials and commentaries of social scientists who have conducted research within the health domain suggest that current attempts to integrate the social sciences into this domain are encountering significant difficulties and resistance (Bernier, 2005, De Villiers, 2005, Morse, 2006, Williams et al., 2002). These difficulties seem to arise in part because the social sciences must integrate themselves into a domain where the dominant research paradigm is experimental (Clarke, 2001, Daly and McDonald, 1992). Moreover, the medical sciences primarily conceive health as a physiological and individual phenomenon, with social factors given only secondary consideration (Clair et al., 2007, Fremont and Bird, 1999, Freund and McGuire, 1991, Turner, 2000). Different conceptions of health may constitute another source of contention between biomedical and social scientists and hinder the integration of the social sciences in the health domain. This paper reports on a research project that aimed to explore the potential epistemological and cultural ‘clash’ between the biomedical sciences (mostly experimental and favoring a biological view of health) and the social sciences (mostly non-experimental and favoring a more holistic view of health).

Using the Canadian context as a case study, the research reported here, which is part of a larger project on interdisciplinarity in the health research field, focuses on one group involved in this potential clash, namely biomedical scientists (more precisely, laboratory or bench scientists). The core research question is: do biomedical scientists think that the social sciences can generate genuine scientific knowledge and, consequently, truly participate in knowledge advancement in public health? More broadly, our study explores whether and to what extent biomedical scientists' perceptions of social science research might constitute a symbolic or cultural boundary to the integration of the social sciences in the health domain.

In order to explore these questions, we investigated the perceptions and judgments of biomedical scientists regarding some epistemological features and methodologies characteristic of the social sciences, in particular, their views on qualitative approaches. Understanding the perception of biomedical scientists with regard to the social sciences is critical because of the high status typically held by these scientists in the health research field (Clarke, 2001, Clarke et al., 2003, Gordon, 1988) and the potential impact that their favourable or unfavourable judgments may have on the integration of the social sciences in this field. For instance, insofar as these scientists inform policies and peer reviews at universities, funding agencies, and journals, their unfavourable judgments may impede social scientists' ability to access financial resources, network with other health scientists, promote a more holistic view of health and, ultimately, influence public health policy-makers. Conversely, favourable judgments may facilitate social scientists in gaining a higher status in the field, accessing more resources, and, possibly, exerting a stronger influence on health policies.

Little is currently known about how biomedical scientists perceive and evaluate the social sciences. One relevant and active debate has concerned the role and status of medical anthropology in the conduct of epidemiological and medical research in developing countries. This body of work has been produced largely by anthropologists reflecting on how their own scientific practice is affected by their growing collaboration with epidemiologists and physicians. Predominantly in the form of essays (rather than empirical research), these authors describe their experiences of interdisciplinary research. The work addresses three key areas of concern: Why are anthropologists often confined to subordinate roles in public health interdisciplinary research teams (Barrett, 1997, Foster, 1987, Lambert and McKevitt, 2002, Napolitano and Jones, 2006)? Why are results from anthropological studies attributed a lower scientific value than epidemiological and medical “evidence” (Foster, 1987, Kendall, 1989)? Is it possible to reconcile the current dominant scientific culture in public health (primarily atheoretical, quantitative and hypothesis-driven) with the scientific culture of anthropology (primarily theoretical, qualitative and interpretive) in a way that encourages cross-fertilization between these two domains (Barrett, 1997, Inhorn, 1995, Trostle and Sommerfeld, 1996, Van der Geest, 1995)?

Drawing on this body of work, Napolitano and Jones (2006) explored how medical anthropologists see themselves within the field of tropical public health, and how they are perceived by public health professionals. Respondents maintained that anthropology, despite improvements in recent years, still holds a lower scientific status than other disciplines in public health. The authors report that many still view anthropology as “a practical field tool or method to get an intervention implemented acceptably, rather than a basic research component” (2006, p. 1271).

While our study shares Napolitano and Jones' concern for cross disciplinary relationships, it departs from theirs in that it focuses on biomedical scientists' perception of the social sciences in the context of interdisciplinary research in the health domain and not only within the context of a research team. Furthermore, we present a novel exploration of the judgments and perceptions of a dominant group (biomedical scientists) with regard to the scientific value of the knowledge production of a relatively non-dominant group (social scientists).