1 00:00:04,880 --> 00:00:12,920 Welcome everybody. I am maternally, Lummi Research Fellow at the Queens College, University of Oxford. 2 00:00:12,920 --> 00:00:23,330 This fourth episode of Translating COVID 19 features a very special guest, Arvind Engebretsen, who is joining me from Norway. 3 00:00:23,330 --> 00:00:26,690 Welcome, David. Thanks. 4 00:00:26,690 --> 00:00:36,590 I mean, Bank of Britain is professor of Interdisciplinary Health Sciences at the Institute of Health and Society, University of Oslo. 5 00:00:36,590 --> 00:00:43,340 I mean, there's recently been elected by Moscow Studies Oslo Faculty of Medicine, 6 00:00:43,340 --> 00:00:48,980 and he's the co-founder of Norway's first Centre for Sustainable Health Care Education. 7 00:00:48,980 --> 00:00:52,130 I mean, these are truly interdisciplinary scholar. 8 00:00:52,130 --> 00:01:01,880 And his expertise covers fields such as medical philosophy, evidence based medicine, knowledge, translation and the history of knowledge. 9 00:01:01,880 --> 00:01:12,200 Since 2017, I think there's been a leader for the Oslo based project The Body in Translation, a transdisciplinary and international day here, 10 00:01:12,200 --> 00:01:19,730 which has established a new field of research at the intersection between translation studies and the medical sciences. 11 00:01:19,730 --> 00:01:30,800 I really cannot underline enough the importance and innovation of Vivian's research for the development of an integrated science humanities medicine. 12 00:01:30,800 --> 00:01:39,570 I feel very honoured to discuss with you today. Possible past passive translation India in the age of COVID. 13 00:01:39,570 --> 00:01:45,900 And would you like to align for us what the budding translation project is and what aspects 14 00:01:45,900 --> 00:01:53,250 of these translation oriented project could help us better understand coronavirus disease? 15 00:01:53,250 --> 00:02:00,000 Yes. First of all, thank you so much for inviting me to this conversation and for your kind introduction. 16 00:02:00,000 --> 00:02:00,570 Well, 17 00:02:00,570 --> 00:02:12,720 the basic idea behind the body in Translation Project is to try and bridge the gap between concepts of translation in the humanities and in medicine. 18 00:02:12,720 --> 00:02:21,560 And of course, you know that translation is a very significant concept in the humanities and also in the social sciences. 19 00:02:21,560 --> 00:02:28,920 But during the last 20 years or so, it has also become a very, very powerful trope in medicine, 20 00:02:28,920 --> 00:02:36,300 leading to practises such as translational research and also knowledge translation. 21 00:02:36,300 --> 00:02:41,610 But while Constellation in the Social Sciences and Humanities has become a Toklas 22 00:02:41,610 --> 00:02:49,140 for challenging and theorising complex entanglements between material bodies, 23 00:02:49,140 --> 00:03:01,740 culture, language, there's very little reflection about the processes of translation and meaning making involved in medical knowledge translation. 24 00:03:01,740 --> 00:03:02,640 In the latter case, 25 00:03:02,640 --> 00:03:14,670 translation refers to the practise of carrying knowledge across the classical boundary of medicine as a science and medicine as an art. 26 00:03:14,670 --> 00:03:24,450 And this process is structured by very standardised procedures and also specific text shoulders. 27 00:03:24,450 --> 00:03:35,730 The gold standard for medical knowledge translation is the so-called randomised controlled trial or the RC t three intervention. 28 00:03:35,730 --> 00:03:45,900 For instance, a drug previously tested in a laboratory context is tested on patients by comparing a group 29 00:03:45,900 --> 00:03:52,960 that is exposed to the drug and another group with another group that is not exposed to it. 30 00:03:52,960 --> 00:04:03,160 And based on systematic reviews of such activities, clinical guidelines are developed, 31 00:04:03,160 --> 00:04:10,120 which provide doctors with so-called evidence based treatment recommendations. 32 00:04:10,120 --> 00:04:18,760 And although this is supposed to be a dynamic exchange between research, development and clinical needs, 33 00:04:18,760 --> 00:04:28,870 the translational process ourselves is very linear in the sense that it presupposes that the evidence is first developed through 34 00:04:28,870 --> 00:04:40,930 one kind of standardised procedures like the our cities need them to be translated into the second kind of standardised procedure, 35 00:04:40,930 --> 00:04:47,440 which are the reviews or guidelines. So this was standardised. 36 00:04:47,440 --> 00:04:55,930 Conception of translation also undermines the very important aspects of creativity and 37 00:04:55,930 --> 00:05:03,790 and interpretation which aren't necessarily involved in all the translational processes. 38 00:05:03,790 --> 00:05:05,380 So in the bottom translation project, 39 00:05:05,380 --> 00:05:16,330 we wish to challenge these underlying dispositions through translate translation theories from the humanities and social sciences. 40 00:05:16,330 --> 00:05:22,000 And we believe that notions of translation from the humanities can help both tease 41 00:05:22,000 --> 00:05:28,390 out and also articulate the complexities involved in medical knowledge translation. 42 00:05:28,390 --> 00:05:39,910 And in the case of COVID 19, the problem of this linear concept of knowledge translation becomes obvious because it is simply impossible to 43 00:05:39,910 --> 00:05:47,620 separate knowledge production from knowledge translation simply because we do not have any produced knowledge. 44 00:05:47,620 --> 00:05:51,910 Still, we are confronted with an imperative to to act. 45 00:05:51,910 --> 00:05:59,800 We need to translate. Thank you, event your rigorous and yes, in a sense, 46 00:05:59,800 --> 00:06:08,170 revolutionary answer raises a series of questions about the status and the nature of knowledge translation as an 47 00:06:08,170 --> 00:06:16,240 exclusively scientific concept and in an article that has recently appeared on the Journal of Medical Humanities. 48 00:06:16,240 --> 00:06:24,850 You and your colleagues stated that knowledge translation that is the translation between the laboratory and society is a translation, 49 00:06:24,850 --> 00:06:35,800 and I quote between different cultural places, not between universally valid science and the local prejudice or culture, unquote. 50 00:06:35,800 --> 00:06:41,590 So what do you think are the limits of this dominant way of thinking and operating? 51 00:06:41,590 --> 00:06:45,070 The privilege is the scientific of the cultural? 52 00:06:45,070 --> 00:06:55,120 And how does these medical model impact and affect global health policy at the time of the coronavirus crisis? 53 00:06:55,120 --> 00:07:02,020 Well, one obvious limitation is that knowledge is considered non cultural. 54 00:07:02,020 --> 00:07:11,770 While culture is considered non knowledge and I mean this and this assumption has already been been fundamentally questioned within, 55 00:07:11,770 --> 00:07:16,420 for instance, the sociology of knowledge or science and technology studies. 56 00:07:16,420 --> 00:07:29,620 But I think that an equally important and perhaps less acknowledged problem with the medical model is its implicit temporality. 57 00:07:29,620 --> 00:07:40,730 Because translation in the medical sense implies a clear distinction between evidence has passed and its translation as present. 58 00:07:40,730 --> 00:07:54,770 And at the same time, so to speak. Evidence, when correctly produced, has regained an outside time status by claiming to be universal, 59 00:07:54,770 --> 00:08:00,110 but it's also bought into time through the act of translation. 60 00:08:00,110 --> 00:08:13,340 And this temporal structure fundamentally undermines, I would say, the fix this time involved both in production of knowledge, 61 00:08:13,340 --> 00:08:19,160 translation or knowledge, and also the energy dependence of these two modes. 62 00:08:19,160 --> 00:08:30,350 Oh no. And it also undermines that both as both the production of the translation or knowledge are open towards the future. 63 00:08:30,350 --> 00:08:43,760 Both the production on the translation on knowledge are haunted by the uncertainty of the times to come on the COVID 19 crisis demonstrates, 64 00:08:43,760 --> 00:08:52,210 I think, this temporal paradox of evidence very clearly because. 65 00:08:52,210 --> 00:09:06,060 The evidence in that case is not the path. It is not that produced, at least not in terms of a finalised body of knowledge and evidence base. 66 00:09:06,060 --> 00:09:14,310 Yes, we are, as I said, required to act to translate and evidence is produced through this act of translation. 67 00:09:14,310 --> 00:09:24,030 So the distinction between the moment of production and the moment of translation or knowledge is fundamentally blurred. 68 00:09:24,030 --> 00:09:36,980 But still, the health authorities seem very eager to define the evidence base outside time, although this, in my opinion, is not. 69 00:09:36,980 --> 00:09:45,050 Possible, not productive. Yes, I think that you touching here a very fundamental point. 70 00:09:45,050 --> 00:09:53,930 The Dominion of time and science, which is evidence based on the space and translation which is culturally constructed at the pandemic, 71 00:09:53,930 --> 00:09:59,360 has in many ways challenged, if not reversed, this pyramid of power. 72 00:09:59,360 --> 00:10:06,620 To give an example, the ongoing debate around the use of face masks in order to limit contagion has this clause 73 00:10:06,620 --> 00:10:12,980 that yet another crisis precisely the crisis of this model of evidence based medicine, 74 00:10:12,980 --> 00:10:23,270 which has been accompanied on top by a sense of scepticism and perhaps even distrust towards the so-called objectivity of science. 75 00:10:23,270 --> 00:10:28,160 So I guess my question is what is medical evidence? 76 00:10:28,160 --> 00:10:36,410 To what extent are we allowed to incorporate the subjectivity of culture into the body of medical knowledge? 77 00:10:36,410 --> 00:10:43,570 And can culture be a form of medical intervention and eat the right? 78 00:10:43,570 --> 00:10:55,600 Well, I think that most pandemic measures such as lockdowns, face masks, as you mentioned and social distancing are fundamentally cultural, 79 00:10:55,600 --> 00:11:04,600 and their implementation and success depends, of course, strongly on cultural contexts and practises. 80 00:11:04,600 --> 00:11:12,160 But as, for instance, Trish Greenhouse has shown in her recent studies of face masks, 81 00:11:12,160 --> 00:11:19,480 when we look for evidence, we tend to look beyond culture, especially to our cities. 82 00:11:19,480 --> 00:11:29,630 As I talked about earlier. Although these are cities might be completely irrelevant to the problem we intend to solve. 83 00:11:29,630 --> 00:11:40,390 For instance, when studies of whether face masks protect the wearer are used as evidence that they do not protect the community. 84 00:11:40,390 --> 00:11:44,280 Fisher So. So I think that instead, 85 00:11:44,280 --> 00:11:54,270 we should acknowledge that public health interventions are helpful and but situated 86 00:11:54,270 --> 00:12:02,370 knowledge translation is evidence rather than merely different statements of evidence. 87 00:12:02,370 --> 00:12:11,700 Yes. Thank you. And perhaps we could even conclude in a sense by saying that the most relativistic and subjective 88 00:12:11,700 --> 00:12:18,510 translation can indeed provide a formal medical evidence that is evidence of the change, 89 00:12:18,510 --> 00:12:25,290 adaptability and non-dominant see with which I think we should address the mystery of our body. 90 00:12:25,290 --> 00:12:35,940 So thank you so much, Eileen, for revealing to us a new fundamental way to conceive of and use translation both culturally and medically. 91 00:12:35,940 --> 00:12:37,590 And thank you for doing this. 92 00:12:37,590 --> 00:12:48,630 As a scientist and from a scientific standpoint, but at the same time, in a way that celebrates rather than exploits the humanities. 93 00:12:48,630 --> 00:12:55,080 And as a medical humanities scholar interested in translation and a former student of medicine myself, 94 00:12:55,080 --> 00:13:00,150 I could not be more honoured and inspired by your contribution today. 95 00:13:00,150 --> 00:13:06,780 So last but not least, the animals thank you guys to our listeners who have been accompanying a supporting 96 00:13:06,780 --> 00:13:13,890 us during the difficult months in which this programme has been created, when evidence indeed was a possibility. 97 00:13:13,890 --> 00:13:22,112 So thank you, everyone. Thank you so much.