Shai Mulinari
Associate Professor | Senior Lecturer
Lost along the way? : Searching for the inclusion-and-difference paradigm in pharmaceutical research and regulation in Sweden
Author
Summary, in English
This article examines how the U.S. ‘inclusion-and-difference paradigm’
translates to the Swedish context. According to Steven Epstein (2007), this
paradigm combines health equity arguments for racialised minorities and
women with a biological understanding of racial and gender differences in
medicine. Drawing on interviews with experts, policymakers, and clini-
cians involved in international clinical trials in Sweden, we argue that crit-
ical elements of the U.S. paradigm – notably the ‘categorical alignment’ of
race-and-ethnicity taxonomies between the social worlds of medicine, gov-
ernment bureaucracy, and political discourse – are absent in Sweden and,
more generally, Europe. Consequently, there is no coherent framework for
interpreting the existing ‘niche standardisation’ of certain medicines based
on race and ethnicity, such as racialised treatment recommendations. In
conclusion, we discuss possible future scenarios and highlight a recent col-
laboration between the pharmaceutical industry and EU institutions. Des-
pite the challenging context, this collaboration aims to establish a
European standard for race and ethnicity data in clinical trials. However,
we argue that such attempts warrant caution: with racism being so wide-
spread in contemporary Europe, emphasising racial differences in medi-
cine may unintentionally reinscribe harmful notions of race.
translates to the Swedish context. According to Steven Epstein (2007), this
paradigm combines health equity arguments for racialised minorities and
women with a biological understanding of racial and gender differences in
medicine. Drawing on interviews with experts, policymakers, and clini-
cians involved in international clinical trials in Sweden, we argue that crit-
ical elements of the U.S. paradigm – notably the ‘categorical alignment’ of
race-and-ethnicity taxonomies between the social worlds of medicine, gov-
ernment bureaucracy, and political discourse – are absent in Sweden and,
more generally, Europe. Consequently, there is no coherent framework for
interpreting the existing ‘niche standardisation’ of certain medicines based
on race and ethnicity, such as racialised treatment recommendations. In
conclusion, we discuss possible future scenarios and highlight a recent col-
laboration between the pharmaceutical industry and EU institutions. Des-
pite the challenging context, this collaboration aims to establish a
European standard for race and ethnicity data in clinical trials. However,
we argue that such attempts warrant caution: with racism being so wide-
spread in contemporary Europe, emphasising racial differences in medi-
cine may unintentionally reinscribe harmful notions of race.
Department/s
- Sociology
- Birgit Rausing Centre for Medical Humanities (BRCMH)
Publishing year
2025-10-01
Language
English
Pages
28-28
Publication/Series
Behemoth
Volume
18
Full text
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Links
Document type
Journal article
Topic
- Sociology (excluding Social Work, Social Anthropology, Demography and Criminology)
- Other Health Sciences
Status
Published
Project
- Are you Caucasian, Black, or Asian? A study of the current Swedish biopolitical paradigm of race and ethnicity in medicine