A tale of two experts: Thalidomide and political engagement in the United States and West Germany
A tale of two experts: Thalidomide and political engagement in the United States and West Germany
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DOI：
10.1093/shm/15.1.137
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发表时间：
2002-04-01
影响因子：
0.7
通讯作者：
Daemmrich, A
中科院分区：
文献类型：
--
作者：
Daemmrich, A
这两位医生，Widukind伦茨和Frances凯尔西，在20世纪60年代早期的沙利度胺戏剧中扮演了关键角色。直到儿科医生伦茨（Lenz）公布了该药与近4,000名肢体发育异常儿童的出生有关后，该药在西德德国的广泛使用才停止。由于美国食品和药物管理局的医疗官员凯尔西一再推迟沙利度胺的上市批准，美国报告的病例很少。两国的专家都被期望公开展示医学的专业“客观性”和监管机构的制度“无私”。这些规范被寻求削弱两位专家的行业代表和希望加强监管控制的批评者援引。比较伦茨和凯尔西，可以看出制度结构如何塑造专家的社会和科学角色。虽然美国通过凯尔西在FDA的监管职位为她提供了免受外部压力的重要保护，但伦茨却容易受到尖锐的批评，特别是在漫长的法庭审判期间提供专家证词时。这两位专家受到政治动机攻击的程度不同;然而，当他们公开沙利度胺与出生缺陷之间的联系时，他们的专业信誉和个人诚信面临着类似的威胁。
The physicians, Widukind Lenz and Frances Kelsey, played crucial roles in the thalidomide drama of the early 1960s. Widespread use of the drug in West Germany was only halted when the paediatrician, Lenz, publicized its association with the birth of nearly 4,000 children exhibiting abnormal limb growth. Few cases were reported in the United States because Kelsey, a medical officer at the US Food and Drug Administration, repeatedly delayed thalidomide's marketing approval. Experts in both countries were expected to demonstrate publicly the professional 'objectivity' of medicine and the institutional 'disinterestedness' of regulatory bodies. These norms were invoked both by industry representatives seeking to undermine the two experts and by critics desiring stronger regulatory controls. Comparing Lenz with Kelsey demonstrates how institutional structures shape an expert's social and scientific roles. While the United States provided important protection from external pressure for Kelsey through her regulatory position at the FDA, Lenz was open to sharp criticism, especially when giving expert testimony during a lengthy court trial. The degree of exposure to politically motivated attacks differed for these two experts; they nevertheless faced similar threats to their professional credibility and personal integrity when they publicized links between thalidomide and birth defects.