Welcome everybody. I am maternally, Lummi Research Fellow at the Queens College, University of Oxford.
This fourth episode of Translating COVID 19 features a very special guest, Arvind Engebretsen, who is joining me from Norway.
Welcome, David. Thanks.
I mean, Bank of Britain is professor of Interdisciplinary Health Sciences at the Institute of Health and Society, University of Oslo.
I mean, there's recently been elected by Moscow Studies Oslo Faculty of Medicine,
and he's the co-founder of Norway's first Centre for Sustainable Health Care Education.
I mean, these are truly interdisciplinary scholar.
And his expertise covers fields such as medical philosophy, evidence based medicine, knowledge, translation and the history of knowledge.
Since 2017, I think there's been a leader for the Oslo based project The Body in Translation, a transdisciplinary and international day here,
which has established a new field of research at the intersection between translation studies and the medical sciences.
I really cannot underline enough the importance and innovation of Vivian's research for the development of an integrated science humanities medicine.
I feel very honoured to discuss with you today. Possible past passive translation India in the age of COVID.
And would you like to align for us what the budding translation project is and what aspects
of these translation oriented project could help us better understand coronavirus disease?
Yes. First of all, thank you so much for inviting me to this conversation and for your kind introduction.
Well,
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.
And of course, you know that translation is a very significant concept in the humanities and also in the social sciences.
But during the last 20 years or so, it has also become a very, very powerful trope in medicine,
leading to practises such as translational research and also knowledge translation.
But while Constellation in the Social Sciences and Humanities has become a Toklas
for challenging and theorising complex entanglements between material bodies,
culture, language, there's very little reflection about the processes of translation and meaning making involved in medical knowledge translation.
In the latter case,
translation refers to the practise of carrying knowledge across the classical boundary of medicine as a science and medicine as an art.
And this process is structured by very standardised procedures and also specific text shoulders.
The gold standard for medical knowledge translation is the so-called randomised controlled trial or the RC t three intervention.
For instance, a drug previously tested in a laboratory context is tested on patients by comparing a group
that is exposed to the drug and another group with another group that is not exposed to it.
And based on systematic reviews of such activities, clinical guidelines are developed,
which provide doctors with so-called evidence based treatment recommendations.
And although this is supposed to be a dynamic exchange between research, development and clinical needs,
the translational process ourselves is very linear in the sense that it presupposes that the evidence is first developed through
one kind of standardised procedures like the our cities need them to be translated into the second kind of standardised procedure,
which are the reviews or guidelines. So this was standardised.
Conception of translation also undermines the very important aspects of creativity and
and interpretation which aren't necessarily involved in all the translational processes.
So in the bottom translation project,
we wish to challenge these underlying dispositions through translate translation theories from the humanities and social sciences.
And we believe that notions of translation from the humanities can help both tease
out and also articulate the complexities involved in medical knowledge translation.
And in the case of COVID 19, the problem of this linear concept of knowledge translation becomes obvious because it is simply impossible to
separate knowledge production from knowledge translation simply because we do not have any produced knowledge.
Still, we are confronted with an imperative to to act.
We need to translate. Thank you, event your rigorous and yes, in a sense,
revolutionary answer raises a series of questions about the status and the nature of knowledge translation as an
exclusively scientific concept and in an article that has recently appeared on the Journal of Medical Humanities.
You and your colleagues stated that knowledge translation that is the translation between the laboratory and society is a translation,
and I quote between different cultural places, not between universally valid science and the local prejudice or culture, unquote.
So what do you think are the limits of this dominant way of thinking and operating?
The privilege is the scientific of the cultural?
And how does these medical model impact and affect global health policy at the time of the coronavirus crisis?
Well, one obvious limitation is that knowledge is considered non cultural.
While culture is considered non knowledge and I mean this and this assumption has already been been fundamentally questioned within,
for instance, the sociology of knowledge or science and technology studies.
But I think that an equally important and perhaps less acknowledged problem with the medical model is its implicit temporality.
Because translation in the medical sense implies a clear distinction between evidence has passed and its translation as present.
And at the same time, so to speak. Evidence, when correctly produced, has regained an outside time status by claiming to be universal,
but it's also bought into time through the act of translation.
And this temporal structure fundamentally undermines, I would say, the fix this time involved both in production of knowledge,
translation or knowledge, and also the energy dependence of these two modes.
Oh no. And it also undermines that both as both the production of the translation or knowledge are open towards the future.
Both the production on the translation on knowledge are haunted by the uncertainty of the times to come on the COVID 19 crisis demonstrates,
I think, this temporal paradox of evidence very clearly because.
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.
Yes, we are, as I said, required to act to translate and evidence is produced through this act of translation.
So the distinction between the moment of production and the moment of translation or knowledge is fundamentally blurred.
But still, the health authorities seem very eager to define the evidence base outside time, although this, in my opinion, is not.
Possible, not productive. Yes, I think that you touching here a very fundamental point.
The Dominion of time and science, which is evidence based on the space and translation which is culturally constructed at the pandemic,
has in many ways challenged, if not reversed, this pyramid of power.
To give an example, the ongoing debate around the use of face masks in order to limit contagion has this clause
that yet another crisis precisely the crisis of this model of evidence based medicine,
which has been accompanied on top by a sense of scepticism and perhaps even distrust towards the so-called objectivity of science.
So I guess my question is what is medical evidence?
To what extent are we allowed to incorporate the subjectivity of culture into the body of medical knowledge?
And can culture be a form of medical intervention and eat the right?
Well, I think that most pandemic measures such as lockdowns, face masks, as you mentioned and social distancing are fundamentally cultural,
and their implementation and success depends, of course, strongly on cultural contexts and practises.
But as, for instance, Trish Greenhouse has shown in her recent studies of face masks,
when we look for evidence, we tend to look beyond culture, especially to our cities.
As I talked about earlier. Although these are cities might be completely irrelevant to the problem we intend to solve.
For instance, when studies of whether face masks protect the wearer are used as evidence that they do not protect the community.
Fisher So. So I think that instead,
we should acknowledge that public health interventions are helpful and but situated
knowledge translation is evidence rather than merely different statements of evidence.
Yes. Thank you. And perhaps we could even conclude in a sense by saying that the most relativistic and subjective
translation can indeed provide a formal medical evidence that is evidence of the change,
adaptability and non-dominant see with which I think we should address the mystery of our body.
So thank you so much, Eileen, for revealing to us a new fundamental way to conceive of and use translation both culturally and medically.
And thank you for doing this.
As a scientist and from a scientific standpoint, but at the same time, in a way that celebrates rather than exploits the humanities.
And as a medical humanities scholar interested in translation and a former student of medicine myself,
I could not be more honoured and inspired by your contribution today.
So last but not least, the animals thank you guys to our listeners who have been accompanying a supporting
us during the difficult months in which this programme has been created, when evidence indeed was a possibility.
So thank you, everyone. Thank you so much.