Undisciplinary
Undisciplinary
Standpoint theory and bioethics: An Interdisciplinary Exploration with Supriya Subramani
**The below is AI generated**
Have you ever navigated the intricate dance of power and humility within the walls of a healthcare institution? Our latest episode features Dr. Supriya Subramani, shedding light on the ethical ballet between patients and doctors, infused with moral emotions and identity politics. As we weave through her interdisciplinary insights, Jane's battle with COVID offers a raw, firsthand perspective on these health research themes, grounding our discussion in the reality of patient experiences.
Tackling the heavy lifting in academia, this episode isn't afraid to question the pillars of knowledge creation and the researcher's place within it. We cast a critical eye on reflexivity, dissecting how our backgrounds and biases shape our understanding. The creases of feminist scholarship and standpoint epistemology unfold in our dialogue, as we probe the intricate relationship between authority and the diverse voices that strive to be heard within scholarly circles.
We round off our journey with a step into the quagmire of bioethics, informed consent, and the architecture of healthcare systems. Dr. Subramani's reflections from Indian hospitals pave the path for our exploration, examining how respect, privacy, and privilege are dispensed in medical care. As we tie up the threads of our conversation, we leave you with an invitation to continue these essential discussions, challenging the norms and shaping an informed, ethical landscape in health research and beyond.
- Audio excerpt of Helen Pluckrose from ABC RN Grievance studies, thought and debate
- Subramani, S. (2019). Practising reflexivity: Ethics, methodology and theory construction. Methodological Innovations, 12(2). https://doi.org/10.1177/2059799119863276
Undisciplinary - a podcast that talks across the boundaries of history, ethics, and the politics of health.
Follow us on Twitter @undisciplinary_ or email questions for "mailbag episodes" undisciplinarypod@gmail.com
Undisciplinary is recorded on the unceded lands of the Watarong peoples of the Kulin Nation in Geelong and the Gadigal peoples of the Iroha Nation in Sydney. Welcome to Undisciplinary, a podcast where we're talking across the boundaries of history, ethics and politics of health, co-hosted by Chris Mays and Jane Williams. Okay, so welcome to another episode of Undisciplinary. Today we are going to be talking about something that we have skirted around at different points. Jane and welcome, jane. Welcome to the podcast, thank you very much, Chris.
Speaker 1:Thank you for battling through for the dear listener. Jane has been experiencing COVID the full trajectory.
Speaker 2:I was going to say I have COVID.
Speaker 1:Yes, jane has COVID and she's battling on through, I feel that this podcast, if one were interested enough to go back to the beginning. You know you came on as our first guest, jane, when we were all concerned about what COVID was going to be.
Speaker 2:And now you know bookend, and here you are with it, Living and breathing with COVID.
Speaker 1:But no, seriously, I hope things go well for you. So yeah, we're going to be talking about something that we have skirted around in different ways and has different ideas attached to it Standpoint, theory, standpoint of histamology, reflexivity, maybe some characterizations. So I think we did have a discussion once about as a mother and whether as a mother gives you some kind of particular license.
Speaker 1:So you know, as someone with COVID, perhaps Jane you might have a particular perspective you want to give to this conversation. But more seriously and fortunately more importantly for the listeners, we've got somebody who's thought about this a bit more deeply than us. He's going to help us through, and we've had Supriya on here very briefly during our excursion into live recording at Arble. But, jane, would you like to introduce Supriya?
Speaker 2:Yes, delighted to have Supriya with us today. Dr Supriya Subramani explores morality, behavior and attitudes, and healthcare contexts. She uses social research and phenomenological frameworks I always do worry that I'm not going to be able to say that word and an interdisciplinary approach to studying moral emotions, so humiliation and shame and rage, and also ethical concepts such as disrespect and belonging. Her ongoing projects concern how emotions, moral epistemology and everyday interactions influence one's moral self, and how power is negotiated and challenged by individuals, such as patients and immigrants, in interpersonal interactions and institutions, particularly in healthcare settings. So I want to say first, a massive welcome to Supriya. It's lovely to have you here.
Speaker 3:Thank you so much, jane, and thanks Chris for having me here and second, a little bit of a disclaimer.
Speaker 2:I do have COVID. I am remarkably stupid today. So just a bit of grace everybody, a bit of slack, thank you.
Speaker 1:Okay, jane, yeah, we won't hold anything against you.
Speaker 3:I don't have any questions to your Jane, but I've got some insights though.
Speaker 1:So yeah, supriya, thanks a lot for coming on, and part of, I guess, what we'd like to do on in these conversations is to start with hearing a little bit about your own sort of trajectory into the kinds of research that you do, reflecting the show's title and disciplinary that. You know, not all of us have sort of clear, comfortable disciplinary boundaries and perhaps didn't arrive in the disciplinary disciplines that we now work in through a straight, linear path. So it would be great to hear a little bit about your journey to this area of research that you're doing.
Speaker 3:Yeah, thanks, chris. I mean thinking about disciplinary like. I have so diverse disciplinary background. For instance, even to start with my bachelors, I did my business management and I did a marketing research and that's how I started. I mean, I always found interesting to talk, even at my family gossiping, you know the idea of gossip. It's something which fascinated me with my family, but also the relationships and the way the kind of family dynamics played out within my family, but also the larger family which I was, that always drawn towards people, so I just like to just sit and talk, basically, and that's what happened during my bachelors too. And then that led me to and my dad basically said oh, you need to, you can't because after my business management I the reason I did this because I was working in a chemical industry. So after my it's called 12 standard.
Speaker 3:After my college level, I worked for some time in a chemical industry as a chemist kind of position, and that CEO basically said hey, what do you want to be once you grow, as you're growing up, or once you want to grow up? I want to be like you because I wanted money. I mean I needed to take care of my family, so I was like I need to earn money and be like you and then you should be doing business management. That's the you know, sometimes very strange ways you end up with even a just a suggestion. And then he actually funded my studies and that's how I started my bachelors. My parents did not have much money to take care of my education and that led to. After that I got a position in Mumbai for marketing representative and my dad said Don't go to Mumbai because it's all to do with red light area. I mean, basically it's about it's women are not supposed to go out of the city, especially to Mumbai, seen as something very dedicated and then having stereotypes. So then I'm like Okay, what do you want me to do? I wasn't a sports. So my dad said oh, you write an all-interference exam. So it's a very strange way I just wrote just to please my dad.
Speaker 3:And then I got into a specialization called youth empowerment. So I did my masters in youth empowerment. I assumed it's about sports but it's more to do with youth work. So, very strange way, I landed into the masters. But anyway, overall, after doing youth work I was doing a lot of activity based training and facilitating programs for young people, like on sexual reproductive rights, on skill development. So I have a very huge orientation towards activity based learning to and that's the training which I had and I, as I told, like I was enjoying doing meeting people and part of my master's program was around qualitative research. I'm part of community projects and that led me to a welcome trust project on bioethics After I had no idea what is bioethics in India I have never heard about bioethics because it was something to do with qualitative research.
Speaker 3:This project had a component. I joined through some social capital because my mentor was working with another person in one of the Indian Institute is elite Institute in India. It's called Indians to technology. All my life I've never I mean I've been exposed to people within the privileged backgrounds, but as an educational institute, super elite was the first time and I entered into this project level position and then one of my mentor there I would not call now as a mentor, but a supervisor there he basically said, oh, why don't you do a PhD? Because it was one of the checklist for a welcome trust project funding. There's a lot of politics there which we can talk later. But yeah, so, and then like, okay, fine, and then I started googling what is bioethics? That's how my entrance to bioethics, but I still enjoyed meeting people and then started questioning what is autonomy? Started questioning that taken for granted notions of concepts of autonomy in form, concern and where is these things? Because I never had experience earlier in my life and that's how I started critically questioning, as with years past, in my PhD. Took me almost five years to get there and yeah, and then moved to Switzerland to do my postdoc, again questioning around the concepts of.
Speaker 3:Because most of my life I experienced discrimination, more from caste discrimination. I come from in India called Bahujan community, so my dad is a politically contested community from Hill tribe, so on one hand you can see it as indigenous Adivasis, but then the communities question that I didn't, he's question, so I am seen as an outsider always and my mom is from other community, which is a middle caste, so I'm an outsider everywhere. My dad was excommunicated, so there's a history of this kind of getting kicked out or being an outsider in different positions in institutions, family, bureaucratic institutions in every ways. So that made me curious what these experience of disrespect is an everyday reality, how it become, how it makes you as a person or how it creates a sense of yourself and also your relationship with others, and so that continues in my work Even now. And when I moved to Switzerland to do my postdoc another layer of experience I was never a brown. I became a brown. I was a black in India because I was called as Kage Kage means crow in India, so my name was that. So it's so. I was seen as a black person in India, but then immediately when I went to you I mean Switzerland, zurich I became a brown person. So that was an interesting experiences a lot of public to public hate crimes, but a lot of other experiences.
Speaker 3:Let me to do research more on belonging, because one of my interests is on micro inequities. So so most of my works revolves around disrespect, disrespect experiences and also the emotions of humiliation, shame, and slowly I'm getting to a point of looking at a rage, because I either is an aspect within myself, but also people who experienced this have that but also creating a space of community. So there is a positive emotions to with when you experience negative self conscious emotions. It also leads to some ways of positive relationships and trying to explore that in my current and future projects. I think I did a long story there, but yeah, that's something which I can share.
Speaker 1:No, that's fantastic. Thank you for sharing that, your story and and yeah, there's so many different things I would like to sort of pursue a particularly that notion of rage at the end that you were talking about and, yeah, the way that you were bringing in sort of or questioning the everyday experiences of things through, you know feeling and being put in and sort of outside of status.
Speaker 1:So two of your papers, which we will link to because we'll link to one of them at least, because the other is under review that we will discuss now. I mean it's it's you're hearing your story and then, having read your papers, you can really see where these different points of connection come in. So, yeah, what we're talking about today, and drawing on Supriya's work and talking about it, is this idea of reflexivity, and we can talk later about whether there are sort of a kinship of terms that relate to that. But I'd be interested just first up as a as a kind of traditional conversation or just mapping out the sort of conceptual terrain of what. What do you mean by reflexivity? And you know why is this sort of an important concept that you're bringing into your work?
Speaker 3:So thanks for asking me much more of how I map or how do I understand reflexivity. It's because definitional understanding is so much. So many scholars have done undone, read on this concept in different ways and unpacked. So, before sharing how I understand, I think I should share that the way I see the world, or the way I want to know the world. You know that aspect of knowing the world around, that social and moral reality which we live in and how do we represent that is what. So the moment we think about the knowledge which we create, or the co construction process, or the production of knowledge around us, especially the social world, immediately, we say it as a socially situated and historically situated, the knowledge construction process. Then it is not a question that we ask us or demands us to think that it's not value, free and it's not innocent. So that means always knowledge is partial and that demands us to think through that, at least the ones who embrace this perspective. Right is demands. And then, if it is a partial, you know the reality or the partial understanding of the knowledge is what you look at. That means one needs to also acknowledge and take responsibility for that and that's where the flexibility plays in.
Speaker 3:So I understand the history around, whatever the situated knowledge history which played out, of course, from feminist scholarship with standpoint, epistemology is one of, as you mentioned. So most of the scholarship covers this aspect at different phases of course, and for me, reflexivity is a way, it is methodological, it's an epistemological and political practice, and what I mean by that is reflexivity as a methodological, as a researcher, as an academic. You look at a different methods, like, for example, as you think of your research question, to ask the data collection, you as your analysis, but also as a representation, because it's a performative act. We do language, the way we use right. So that's how I would see that, as a methodological practice, whereas when it comes to epistemological, of course, it overlaps with the methodological. You know the analysis or the perspective we take, but also questions the larger, the way you know the world, right. I mean that's where the epistemic practice of acknowledging the self and other, that's where the practice comes in at different stages.
Speaker 3:And the third, which I mentioned, is political practice. So most at least in the current, in the latest work, which I'm thinking is that so the moment, you want to also take responsibility for the knowledge which you create, a co construct. That also means it's you already have a value in the moment. So there is that. That means you are doing politics right, I mean. So the politics is part of knowledge, construction and production. So that's so. Reflectivity for me is a practice of a methodological, epistemological and political practice overall.
Speaker 1:Yeah, I like that the way that you. So, in the article that we'll be discussing, practicing reflexivity ethics, methodology and theory construction, which was published in Methodological Innovations 2019. Yeah, just the use of that, or framing that idea as a practice so it's reflexivity is something that is done and done in these particular ways, rather than, I guess you know, an abstract set of knowledges or an abstract theory of epistemology. But it's something that we are doing, and so I thought it was interesting the way, yeah, you described in that article, you know, towards the beginning, you sort of frame this idea of reflexivity or use the example, perhaps, of positionality statements that are becoming more and more common, and you talk about them as a ritual. And I'd just be interested I know that you know the article is not about these positionality statements as such, but as a way, sort of into some of these conversations, and I think this idea of ritual is quite interesting. So, you know, what do you think is the role of these rituals?
Speaker 1:And who perhaps do they who? Or what do they allow to happen in particular spaces, or prohibit or guard against or what do you see going on there with some of these? And maybe just to back up, I'm assuming most people listening know what is meant by positionality statement, but you know, for example, it would be. You know, I am a white settler whose family came to Australia through the 10 pound POM immigration scheme among other things.
Speaker 2:Great, yeah, thanks, christopher. Sorry, I'm just going to throw in a follow up question for Chris After Supriya answers. Chris, I'd really love you to reflect on whether or not this is different from conflict of interest statements.
Speaker 1:Okay, great question.
Speaker 3:That's another which is kind of fascinating, especially the biotheist scholarship. Right now, it's all around conflict of interest as a conversation. Of course, there is some reflexivity statements and positionality statements, but again, so, to go back to Chris's question and also thinking through, as even Jane was asking this question, I think I need to step back a little bit. And I wrote this in 2019, this paper on the, you know, practicing reflexivity. I see this as practicing reflexively one, part one, and the next one, if it gets published, part two because over the time, I have been rethinking and reworking around those and making it strengthen in certain aspects. And the reason why I wrote this first paper is because my supervisor was a philosopher. I have two supervisors one is an economist, I mean, when I was doing my PhD, one is an economist professor and the other is philosopher. And when I started telling that, hey, I mean I think I need to think about my stories and the way I claim my research questions and they're like you don't exist, they said. One person said you can't use I in your, when you're writing, you should use we are the study. You know those aspects. And then I started looking at because I was still as I was learning right, I'm still. I was learning so it's still my during my PhD and I was getting much more crisis kind of existential crisis in a way, when I started what's happening, why I feel I want to resist. So there was a resistance already for me with those conversations which I used to have. And then I realized, as I started reading the larger scholarship, especially within qualitative health research, which I was exposed to much more in the beginning, and also Kathy Chamas works on constructive is grounded theory around that, making me think that, oh, that's you as a researcher plays a big role. So that's how I started, you know, thinking through. So, going back to your question on ritual, so the way I started with that, you know, in that paper in the beginning it's like some of the positional statements are seen as a ritual is much more like some most of the scholarship and even the conversations which I had with my committee members also. For why is this like, oh, you want to talk about you. You just write a paragraph when you come from, where it is, I'm like, no, that's not what I mean. So that's where I had to write the whole paper. But then, of course, I did not add this in my thesis because it was so then not every journal also accepted, because I was not a researcher. Of course this paper was in the beginning. Still, I'm thinking through, I'm writing as a scholar, as an early career scholar. So then finally I reached out to Kathy Chamas, send out my draft. Hey, I need help much more here. And then I started revising reading and then finally I mean submitted.
Speaker 3:So the question of what is the purpose of the ritualistic?
Speaker 3:So, of course, rituals are great, right, I mean, rituals are important. It shows some familiarity with concepts and also leads us to think of the common ground or that. Oh, I'm signaling you that we practice this because you align with me ideologically or with the practice, the methodologically to in a qualitative health community. But at the same time, if you're doing it as a tokenistic, that the statements which become so superficial, then it demands one, all of us, to do any rituals, right, I mean, even if I'm in India, like you know, any kind of prayers have rituals and the moment you, when it becomes a very, you know, unreflexive part of your life, it's a habit, but at the same time, when that moment becomes so that you don't know why you do anymore, and then you tokenistic, then I think it's a moment to ask more why? And then unpack much more, and I think that's so reflexively in a way demands as much more. But also it's an opportunity for us to critically look through what we are doing as this community of scholars. I feel yeah.
Speaker 1:Yeah, no, that's. That's a good answer. And, and it's reminds me, there's a. There's a paper by a colleague anthropologist here, emma Kaval, who has talked about the acknowledgments of country in a sort of similar way. It's a bit of an uncomfortable paper to read but it's an interesting paper. And, jane, to answer your question, a question that was not planted, I guess, I have a paper called After Complex of Interest which I'd say addresses this question and in summary I would say that the difference is between the positionality statement I think it is getting more towards one's you know, history situated us sort of a more ontological claim about the sort of place of belonging that one has in a system of knowledge perhaps, whereas conflicts of interest statements tend to be talking about a specific and I would say this is where they need to have a financial rather than an on financial.
Speaker 1:But that sort of kicks, a certain hotness nest for a niche group of people, that the interest is a language of finance and that there's some kind of specific stake that you have in the outcome of some knowledge. Now, there is obviously a blend and an overlap between that, but I think this, these positionality statements, are related to knowledge, but in a very different way, and that's why, in this article and another where with some colleagues talk about conflicts of interest as an ethical political shortcut, is when those conflicts of interest statements are attempting to get to those broader ontological, political, epistemological questions, by getting people to declare whether what their religious affiliations are, what their positions on feminism are, what their political leanings are, which basically identify anything that is different from atheistic, secular, white, male.
Speaker 2:But exactly that. That was so, excuse me, that was what I was thinking. I really liked what you said about the ritual superior and and I thought about how, what is it? What do you? What do you talk about in a positionality statement, like what's important? What do you like? What are you saying is different from the norm, I guess, and thereby creating a norm. So I guess, which is what you just said, chris.
Speaker 1:So Related or developing further on this conversation about reflexivity, another thing that I really liked in the way you framed your sort of approach in this is talking about reflexivity as a practice of doing research and not as a this is quite you an academic virtue or a source of authority over knowledge. I think I thought that was really an interesting phrase and again, I guess also wanting to put this in the context of maybe your thought has shifted and developed since your writing this in 2019. But I'd be interested to expand, if you could sort of talk a little more about this idea of or or or or, trying to create a separation between position, reflexivity and this source of authority over knowledge, right, I?
Speaker 3:mean.
Speaker 3:So I think when I was writing this article, which I still now, sometimes question the idea of virtue for different set of reasons altogether. But going back to reflexivity, why it shouldn't be always a scene, as I know, academic virtue at least, let's say. First let me take virtue. Question here Is that have you thought of Michael Lynch, I think I'm not sure whether I'm pronouncing right he wrote an article called Against Reflexivity and one of the unpacking is against reflexivity as a source of virtue and source of knowledge and academic virtue. And then I'm like yes, but I don't agree with generally, with what he unpacks in his paper, but I do agree with these two stands, at least when I wrote then, and now I am still questioning, but I still hold on to a few aspects of this. So what I mean by that is. So I think I feel I need to resist the temptation that the moment when it becomes a virtue, when I say I am also embracing some kind of epistemic superiority and also prescribing that one of the moral value. But again, I might be wrong, I don't know how virtue ethicists would see this position, but when I think of reflexivity I feel like reflexivity is part of in my recent work. I think of humility though, but it's not of practicing. Reflexivity is a virtue, but it's more of a demands one to have humility. So I think I still see the disconnect, but there is an overlapping demand, moral demandness to be having humility, because when you're practicing reflexivity you're acknowledging that self, other knowledge, right. And also there is this whole discourse around center, periphery, and also it's not necessarily that it's a clear dichotomy, right, like center and periphery move across. Sometimes it's so mobile that we shift around. I mean having my own experiences. Who am I as a person, like? What kind of a person? Who I am Like? Can I be an Indian? What kind of an Indian I am? Many times you know that question of identity, which goes back to the larger questions around how do we unpack the question of self and the identity around us? But also it is identity, as many post-colonial scholars of Poseidon, it's evolving, right, it's not stagnant, so we keep changing with time and period. So if I use this lens to understand reflexivity so I don't want to come across, I'm at least resisting the temptation. That is a source, you know, it's an academic virtue One. The second is also the source of authority. That's a very interesting question.
Speaker 3:I mean, you know, think through, because lived experience, just because I'm a woman of color, should all my experience be a source of authority to say this is the way it should be the case, or should it be just a start of a conversation, right? I mean, so that's the later point where many of the scholars, especially the post-structuralist or even the post-colonial scholars, have been discussing, as the feminist scholarship also is evolving within the standpoint of epistemology too. Right that it's not a rigid, that women's experience are the only source of authority. I mean because I mean we know the story. What happened in this narrative of women's?
Speaker 3:You know the significance of women's lived experience. It became much more a white you know Anglo-Sphere is dominant experience than black feminist scholars have taught us and much of indigenous scholarship have taught us, like how the intersectionality plays an important role. That means. So when we think of source of authority, we need to also acknowledge that the mobility which happens in the center periphery and that means it was only a starting conversation. So I would see that as an authority, or rather it's just let's have a conversation and let's have this part of humility is what I would see that way to have a knowledge discussion. Maybe here I'm also critically strongly thinking of the idea of authority. Maybe that's the reason, maybe, of my feeling of resistance, but yeah.
Speaker 2:Can I jump in? Sorry, crocally, that was really interesting, Supriya. I wonder if I can kind of throw in a little thing of my own that really struck me while I was reading this. So, like, like Chris, like all of the guests that come on here, I had a very meandering path to where I am now, and I feel slightly ashamed to admit this because it's like the ultimate sort of colonialist project. But in the 1990s I did a masters of development studies. Supriya just laughed, she laughed very quietly and politely. It was taught by really, really terrific people and one of the first compulsory readings that I had to do was about situated knowledges and we had to read a lot of Donna Haraway and so on, and so for me this was always my normal. You know, it was like it wasn't. It wasn't. The idea of sort of positive thinking was bizarre to me and I had to kind of learn it when I later went back and did an MPH.
Speaker 2:But one of the things sorry, but one of the things that was interesting so you were talking about the mapping and the center and the periphery and so on One thing that we had to do fairly early on in the piece was the people. We had quite small classes. The people in the class had to each had to draw a map from where we were to a landmark that we all knew in the city in New Zealand where I was, and we of course all drew different maps, you know, because different things were important. You know, different landmarks made sense, or different, different bits, you know. So there was even with a very comparatively homogenous group. We all had different ways of looking at the same thing, and so that was sort of such an obvious introduction to the fact that different things are important to different people. We carry that information with us in the way that we talk to other people.
Speaker 2:And then, not too long after that, I was in Cambodia and I got on the back of a motor. I needed to go somewhere. I just arrived and I gave the motor driver a map and pointed to where I wanted to go and he just looked at me and said where's it near? And I'm like I don't know because I've never been there and he was like you know, of course, that so he couldn't read a map he didn't like. This to him was just like a bit of paper with like random stuff on it. It had no meaning to him as a person who knew his city inside out, you know.
Speaker 2:And so that for me was another really interesting sort of centiprary thing, because I've been like oh yeah, we can all write different maps and we can all read maps differently and so on, and then it was like, huh, or maps aren't even a thing that make any sense at all in this situation, like as a kind of further disruption where all of my situated careful knowledge was completely meaningless outside of my context. And I think that's why I struggle with people arguing against reflexivity, because I'm kind of like have you never done anything or gone anywhere where people don't understand you? I guess, excuse me, now I have to cough. Probably didn't make. I don't know what they mean. Stop.
Speaker 3:I think, supriya, I mean that's a question, right? I mean it's great that you know the way you were sharing and also being vulnerable with sharing this and acknowledging this is part of how we share and learn from each other, right? And many times it scares people. I mean, having talked to a few people my colleagues, my scholar, I mean my other friends, my peers who from different disciplinary backgrounds, they resist the idea of reflexivity because it scares them at least few of them who said I don't want to talk about myself because it puts me in a spot I don't want to draw attention to myself.
Speaker 3:But there's other huge, you know the different narratives of why not, and the one key thing which still I need to, I don't know the answer is talking about I don't want to be vulnerable and I don't want to be. Yeah, I don't want to be vulnerable. Why are you asking me to be vulnerable? And that's a different conversation. Definitely, but and that's where it scares me, and I can go back to the question of if I say that reflexivity as a virtue, it's almost to an extent of I'm demanding from people, but then, at the same time, is it anyway?
Speaker 3:That's something which I'm still working with, the idea of vulnerability and with the way we think about reflexivity, does it demand you always to be? And then that means all biotics scholars should be vulnerable. And I, yeah, yeah, that's something which not necessarily as a positionality I'm talking about as a deep, you know, embodied, sometimes intimate experiences demands you to really reflect and share your part of yourself with others. Sometimes it's to the whole world, right, I mean, for example, the spot cause I mean I have some weird stories and I end up telling things and I don't mind actually telling that. Some other thing is when I do tell them.
Speaker 1:Yeah, yeah, I mean, I think that's true, that idea of vulnerability and its relationship to reflexivity as a potential virtue. I wonder and now you know, speaking for the white men, I wonder as well whether the authority is a real big concern for people. And maybe you know the flip side of you know, potential particular positionality gives some people authority to talk about a particular situation or circumstance, but then also my lack of that experience or positionality diminishes my authority, and so there's a sort of anxiety around that and a like why should you know? I shouldn't be judged on the fact that I'm or not judged, but I shouldn't be. The fact that I'm a white cisgendered male shouldn't come into bear. Just read my words, just read my sort of ethical analysis of X, y or Z problematic or complicated issue in bioethics or public health, and just leave me out of it.
Speaker 1:Thank you very much, because I've studied my philosophy and I've got my logical arguments and I've read the literature and you don't need to bring me into this, my words will stand on their own.
Speaker 3:It seems to be a reaction and, I guess, a yeah, a concern that some people yeah no, I see that question and I just have sensed it with you know, especially people in privileged positions, and that's because giving up power not necessarily means the idea that when I, for example, a woman of color who wants to share a particular sense, as just a partial knowledge, right, it's not the whole truth. The whole conversation, we at least the whole standpoint, epistemologies or situated knowledge which they started, is like, hey, just let us hear from marginalized or people like margins, right, so it's not to take over the whole world and then say this is we are and just listen to us At least that's how the conversation went. And I think you are right with the question of authority is like giving up power and not wanting to be, to engage with people at margins are the problem, especially when there's resistance. Because, as you said, I think one of the key thing which I do see at journals having lived through all this, from since I started my PhD and talking to different people in both the global not very last seven, eight years and then having lived all in time in my India with when I'm working on my papers is that there is this key narrative of who are the gatekeepers, and not just within global, north and south as a dichotomy. Even within global, within India, there is gatekeepers. Who is who can do what kind of research and who is not? For example, one of the person when I did during my PhD, they said that you are only fit to do a be a project associate. You can't, you don't have, you're not fit to be openly. It's a. You know, it's like the categorization and the gatekeeping happens even within global. So so global so not necessarily means that periphery always right. I mean, I promise. So there is this. So we need to blur and that's the whole point of it these situated knowledge is to blur the deconstruction aspect of the power as symmetries, but also opening up the conversations to this whole, how power plays a role in this whole knowledge production.
Speaker 3:I think. I think that's the charm and I enjoy this. It gives us to think through this, not following the dichotomous way of looking at the world. Yeah, but. But I see the point with authority, definitely, and I'm curious to what extent so far biotics, scholarship have, with all the six cent tribes which I'm now thinking of, our super specialization is happening and who are the gatekeepers of all. This demands as much more and, I think, reflexively demands us to look at these politics of knowledge practices. Who gets to get what kind of funding again? Yeah, anyway, that's a longer conversation, definitely.
Speaker 1:Yeah, yeah, no, and I think as well the the opening the door to this epistemological shift. Even if people know that practically speaking it is not possible to have impartial knowledge, I think theoretically and ideally, some people still hold on to that as a possibility and I can have impartial knowledge and there can be no margin. There's the possibility of having no margins to my knowledge, that my knowledge can be omniscient and take over and or a whole area. Where is this reflexive turn or standpoint theory? And it exposes the lie of that.
Speaker 1:But moving on with your article, I thought what you know, jane brought up conflicts of interest. I thought really, your, your focus is on informed consent, which is a, I'd say you know, a twin to this idea of conflicts of interest. Like you know, consent is this other kind of ritual that plays out in medical spaces and bioethicists sort of see it as this sort of gold stamp of approval for some kind of ethical relationship between a patient at a doctor I'm sorry, patient, yeah, patient and doctor or a participant and a researcher. Yeah, be interested, you know, for you to talk a little bit about how bringing reflexivity into your research about informed consent played out in this way and how has this approach been perhaps received among other people working on informed consent? Because that's it seems to me that some of these stakes of impartiality, objectivity, transparency, of knowledge, power you know the quality, those sorts of things.
Speaker 1:Yeah very strong in informed consent.
Speaker 3:I mean. So, as I said earlier, like the way I started doing informed consent, like even to do as a PhD student, when I thought about this oh, I'm going to do about it. I'm concerned. I look at the law because I was doing medical negligence cases, how Supreme Court analysis, so I was looking at rhetoric within Indian law and I'm writing a book right now called the passive patient. I just finished today one section of my book with the after the death of sick patient heard what is the welcoming of active patient and that that narrative of moral construction around who is a patient and what kind of patient type plays out in bioethics generally right and much of the moral is an ethical arguments revolve in form. Consent is one of the solid principle there which uses the key archetype of a patient is active, right, active agent who needs to be informed about, who is supposed to be well competent and needs to be. You know that we need to have a disclosure. So all the values which demands an active patient archetype and of course we have a history. I mean looking at sociological lens, we know that how they are for the after the enlightenment period in a way that with industrialization and privatization, with consumers model and the patient centered movements, which plays a huge role in this active patient narrative building and that made me question much more.
Speaker 3:In India, when I started interviewing patients and being part of, I did ethnographic research in two hospitals one public and another is private hospital it was really difficult to get access to. But anyway, when I, after I got the access to the hospital, I started doing research and I never used informed consent very rarely I use because in government hospital as a researcher, I'll talk about the concept in theory in the bioethics scholarship, but in theory, in practice as a researcher. When I started interviewing them or like observing them, you know the fetishization of the consent process was very, very, very strong but at the same time, so checkbox not necessarily as a practice, so it became bureaucratic, so it actually was much more of a hurdle and at the same time the doctors did not. Doctors and patients never even they just trusted means different ways. It's not like by default trust, you need to gain trust. It takes some time right to go back and forth with the hospital settings, especially in the postoperative care. I was. I was looking at elective surgery, so it was just after three days of the surgery. I was interviewing some of them.
Speaker 3:So anyway, to go back to the question of that process or the practice of getting consent as a researcher, it made me think through much more, like what kind of research I'm doing on informed consent and what is this concept of bioethics? It doesn't play out the way I assumed. You know the theory of bioethics reading as a young I mean now I'm young too, but you know that as a scholar. When I started thinking through the chairman children, this is a book which my professor gave. This is what you should read and you finish this book and then start your fieldwork, I'm like I don't know. I need to settle really thinking everything which I have read now. So that made me question. I mean the usual. We know the idea of East versus West or the global south versus global north. I didn't want to look through that lens but also ask that institutionally, at structural level, at the doctor patient relationship level.
Speaker 3:In India, where there's huge patriarchy, hierarchy, caste, gender, all kind of hierarchies playing out at the hospital as one of the institutions, not just one right, one part of the institutions, which reproduces inequities in the face, what is? How can a doctor get informed concern from patient, especially in a government hospital. So most of my analysis revolved around is as a patient, if you ask questions to doctors, you are a troublemaker, you're a deviant. As a person who is in the government hospital, who is usually poor and socially, socio economically and cast not privileged patients, they are assumed by default as incompetent. That means by seeing the social markers, that is, you know the way you trust, the way you talk, all these perceptions and, by default, the way you talk about the social functions. Right in itself, you are never given the opportunity, so you're already assumed as passive and incompetent and actually done so in one of the Supreme Court judgment in India, which is a precedent case which we still follow, is that Indian patients who are these Indian patients? And Indian patients is passive patients, and all the cases which went to the Supreme Court judgment are all rich patients and many times are the ones for doctors to. So it's not about education, it's not about necessarily about class to, but there is this ideology of passivity you expected in from the Indian, so called Indian patient.
Speaker 3:Now that makes me again question, you know, go back to the larger global discourses around the active patient. How do you say the infant consent works well when this model is there. But I'm not saying that we shouldn't have in front concern, but the practice of the relationship, building the trust, and what are the institutional conditions demands so that the ethical practice becomes a practice which is an authentic practice? So I don't know. So I started for almost losing hope on infant consent.
Speaker 3:I looked at embodied discrimination and that's where my work around micro inequities played out and the idea of social construction, of incompetency. You know, because I was influenced by the work of social construction in everyday practices. The incompetency narrative was building because not of legal competency argument or capacity based argument or in the way in bioethics we talk about capacity or decision making, right in in everyday position of my ethnographic research, it was more about these patients, the idea of these patients are just dumb, so by default, as that relationship itself, you ignore the person. A patient as a person is not even valued. So then how do I even talk about capacity? How do I even talk about autonomy? So that's where I moved away from the whole autonomy and moved towards the social power dynamics and understanding of disrespect, because the need for respect is very significant, but not in the way, at least not the way autonomy based because it's important, but it's not the start for me.
Speaker 3:So I wanted this let's talk about first experiential aspect of respect, respecting a person, I mean. So I mean, of course, sociological theories and medical, so you know the target persons when he talks about sick patients, right, I mean we have, of course, done with sick patient, but still now we are struggling with the idea of the patienthood who is a patient and how? Not just in India, right, even I mean when I did my field work in Zurich, the idea of immigrants are also seen as the same thing. So then it makes us the questions much more of who is a patient here? What kind of social categories makes a person passive archetype of a patient and not an active patient? But yeah, going back to reflexivity question, I think I never started linking reflexivity and inform-consent, but I moved away from it because I was practicing reflexivity, I think.
Speaker 1:Yeah, just a final discussion point on from this paper before we move on to your other one.
Speaker 1:You do provide an anecdote or a situation where I related to a part of this, where you talk about being in the dentist chair and I guess this question of respect as well, this sense of whether respect was not being given to you in that moment, and then a sense of anger in response to that. But then you have this reflexive moment and I'm paraphrasing this bit where the problem was perhaps your exposure to bioethics literature had altered your expectations of what a good medical encounter was and made me think about whether, in studying bioethics, does it make us become bad patients, because I certainly have had some medical encounters as well. As soon as you start telling them that you're in bioethics, and then they usually ask what's that? And then you have to Google it to tell them, and then it does alter that medical encounter. But yeah, I guess both. There's the less serious question, but then it does seem to tie in with that question about respect in the medical encounter as well.
Speaker 3:No, I totally agree, but at the same time, yeah, I don't mean the idea of, I mean I don't want to invoke the concept that just because you're exposed to bioethics we are bad patients. You know the bad feminist thing, yeah, but anyway, but it's not. That's not what I was referring to. I think it's much more my own crisis because most of my bringing you know, because of my experience in a way, that the moment when you go to the government hospital, which I was usually going to, not necessarily private, not many times, because we couldn't afford my parents so they used to take me to my aunt who was a nurse, and she used to secretly, you know, take me into the another nurse chamber and so I was getting kind of the similar with you know that the nurse who walks in with another child, right, but I had an experience back, but then I did not ever think that of, of course I was a child, maybe, but I never process in a way that I'm not thinking of patients rights or the dignity aspect in that particular clinical encounter, right, I mean, as I was growing up later I was thinking this is a part and parcel. People get you know what the privilege in certain ways and you know the mechanism of relationship changes, with what power dynamics in what situations. But reading this biotics literature is that thing, the language which I got the language to hold on to. Of course in India we have respect I was dignity concepts are there as some of my. In my mother tongue it's Canada. So in Canada we do have I think I was talking to Jane earlier sometime before respect we have. But many times when I use a word or my parents use a word, the language of respect in my mother tongue it's more to do with being your place, don't move away. I mean the sense of the hierarchy that is, you know, sometimes that is the right word difference. So it's much more that listen to elders, listen to authority and also don't move away from your expected role. So as a person, what is your social release? You know, do and practice. But at the same time there's a huge Dalit, you know, in India the kind of anti-cast movements and the concept of dignity and respect is also very central. But there the concept is not of difference or the way, the position. It's more to do with inherent value, right, and that's what the larger conversations which we also keep talking and as Axel Hornet's work talks about respect in a larger social dynamics and power asymmetries when it exists too.
Speaker 3:So to going back to that incident I mean I was reading again that incident of you know, just sitting there and experiencing this as a patient, but then as a student, I was still in an elite institute who was accessing this medical institute. So there I already feel entitled to that. So there is a switch happened for me. That's the reason I started questioning the switches institutionally, but also my role and the entitlement. I felt that wait, this is an elite institute, I am supposed to be getting the time here and then I need to learn. And now I have a vocabulary which is the language of rights and the language of the ethical concepts, which perfectly went well. And then it made me start questioning everything which I learned. So it was a more of a crisis phase to reflect on what I practice and how I have changed and moved in different institutions.
Speaker 3:And then I also interview patients and I think in my other, I think in this paper also, I talk about how the spaces changes, like the architecture of hospitals. You know move, for example, in government hospital it was a rectangular ward, like in a huge, just a room of 20, 25 or like, depends which ward it is. 15 people are there in the arm length, there's a bed and I just started interviewing. I went in, got the permission from the director, the nurses, always in the right in middle. She gave me permission, then I started interviewing and then walked around the ward last time, you know, with the power of privilege is there as a researcher, right.
Speaker 3:And then when I went to the private hospital, it is individual rooms and I had to knock each door and then I need to wait and I need to make sure the nurse gives me permission and the patients were usually super rich people. So it's a different dynamics played out for me. And then I'm like, oh, privacy, what is this concept? How? Why did I not think through in this way as a researcher? So, yeah, so these are the moments which made me think through and I think this is what reflects the moments which I also talk in. I mean, I borrow and learn from other scholars who have used this, but the personal stories and the flex moments, or imagination sometimes makes you think through concepts differently same concept but you feel it differently when you start looking through in different situations.
Speaker 1:Yeah, yeah, I really thought the discussion of space and architecture was really interesting. I have a paper that's written with Angie Sasano, a colleague, that is under review. We'll probably get rejected, but hopefully it comes out soon. But, yeah, looking at, yeah, I think that this is something that we need to think of more as bioethicists. But before it'd be good to move on to the next paper. But let's check in with Jane. Haven't heard from Jane for a while.
Speaker 2:How are you Not coughing? I think it's just that I can't talk very much, like a few times, but if I just talk for too long I start coughing.
Speaker 1:Okay, well, feel free to jump in as you'd like.
Speaker 1:Not dead Not dead, but my own thing. So this other paper is under review. We have discussed under review papers before and then they've been published short after, so hopefully we'll give you the undisciplinary bump. So any potential reviewers of a paper that's talking about practicing reflexivity, just no, it's a great one. Yeah, I really enjoyed reading this and this perhaps correct me if I'm wrong like you, were involved with this panel discussion with Jane at Arbel and there seems to touch on some of those themes that were also discussed there. So maybe as a sort of general kind of conversation point. And you know we've danced around this in different ways, but you know this reflexive turn that's goes on has been going on for a while. It's a turn that keeps on turning, but I think, as you said as well, like it's newer to different communities. So for some feminist groups it's old hat. The arc of the universe is learning Very slow.
Speaker 1:But in bioethics, it does seem to have this sort of a newness to it for some people, and so I'd just be interested yeah, for you, from your perspective, mapping out some of these normative implications of reflexivity that you see.
Speaker 3:Great. I see, I think one of my observation reading the literature on within bioethics specifically, and having read some works and also being influenced by Black feminist scholarship and situated knowledge is I mean, I've been reading here and there and still learning new, new things about the situated knowledge is I think it's an ongoing process because the post structuralism has led to, and post colonial scholarship has led to much more crisis, if I some people think it is crisis, but I see it as an opportunity to learn more. But so anyway, but having read different scholarship around this and when I see bioethics scholarship, when they use the term reflexive turn with, as you said, like so many turns, we have empirical turn, we have a reflexive turn now and I think it's not a surprising thing. I feel like the shift of empirical turn and reflexive turn are not shift the moment of discovery within bioethics as the turns. Because, on one hand, I think bioethics is in a moment of of course, I think it has always been in the moment of crisis, as because it's a multi disciplinary community and then you bring different perspectives, but at the same time, there is a huge assumption, the normative assumption, when we say that we are, when we make ethical arguments or like this is what ex normative frameworks are, or this is what an ethical argument of a particular scholar, let's say, but many times when scholars who do, especially quantitative. So the idea of empirical turn which I want to pick is that empirical turn in bioethics is what I mean. So my understanding is it's a quantitative, qualitative methods is employed to understand certain ethical concepts or even moral concepts, not necessarily always just ethical arguments or because it's not necessarily always a quandary right.
Speaker 3:So so in this scholarship people we use different methods, but then, rather than saying I mean this, maybe here I'm a bit critical I think here we're, rather than saying that we are borrowing and learning from sociological or anthropological or different disciplinary, why are we as bioethics or in the discipline is that? Oh, we have a empirical bioethics, sorry, we have empirical biotics methodologies, and I'm really that's where, for me, the question of reflexive turn also fits in like so what are we doing here then when we say this is empirical bioethics, empirical biotics methodologies, and then we again say it, as we have a reflexive turn in empirical biotics methodologies and we need to integrate these things. So, having discussed, of course, with you know, with many scholars, and even Jonathan Ise was here, and then Michael Dunn was here and then Julie, like we even had the panel discussion at Arbol. So it was an interesting way of learning from me, from listening from different and John and Mikey is in a way a proponent I would say, tell me if I'm wrong I mean learning of empirical biotics. They have been using the scholarship right. I mean using this was very strongly. Of course there are many scholars too, but the ones which I'm at least thinking there's a huge influence and now that makes me question how they're using it and why are they using it and what kind of frameworks and what are the normative and methodological assumptions they are using.
Speaker 3:When the scholars who invoke the word reflexive or invoke the word empirical turn. And that made me think through the question of then I started thinking of my own position, because whenever we start making any is, you know, at least in social research papers, which, wherever I publish, I make sure my methodology is clear. I mean you unpack and you share where you're coming from. Right, you do this. But there are moments I feel like I'm a bit lost when I read biotics scholars. So for me, the aspect of loss at what is underlying methodological assumptions, where are these? So if you do use, let's say, reflexive, or if you do use the concepts of intersubjectivity, let's say, and then use systematic review or, you know, a scoping review or the certain objective way of telling the truth of ethical thing, for me that's the loss, like I'm unable to understand now what so? What do I do with this scholarship? Because methodologically it's disconnected from the larger framework and the languages which we use. So that's where I started observing and in this paper I'm trying at least I'm not sure I have done a good job of unpacking it because I'm still learning.
Speaker 3:I'm sure I'm not read the whole breadth of biotics scholarship around here, but when I'm picking few, at least few spots of observational layers, of the reflexivity or reflexive terms, at least the ones who you're using explicitly reflexive or reflexivity I feel it's a thin conception. We need to go deeper. And once we go deeper, the way the biotics is done, especially in the so-called empirical term, or even actually the way we do biotics generally, even in so-called philosophical leaning, bioethics, right, we need. I mean, at least that's where the politics plays out for me. So that's a responsibility of a researcher. Is that? Tell me where you're coming from and why do you say and clearly tell me what is a value commitment? And then let's talk about what value commitments we need to engage in. See the knowledge practices. What we are doing Because right now that goes and connects back for me is that there is a certain kind of works which gets funded, that certain kinds of papers get published.
Speaker 3:So we are going with the flow of this current neoliberal ways of functioning in academia and we are just going along with this, not stopping by thinking through, and then we are calling ourselves reflexive. That's my kind of observation, but also a crisis and a little lost. Maybe I'm not able to fully understand what's happening, but this is my genuine curiosity and a little bit of undress. That's the reason I'm thinking through those questions.
Speaker 2:Yeah, I kind of want to give that a round of applause, but I don't know if the recording will pick it up.
Speaker 1:Yeah, or that's the one.
Speaker 2:I imagine oh.
Speaker 1:Yeah, I like this.
Speaker 1:So in the paper you make this distinction between thick and thin reflexivity and do you think?
Speaker 1:And then you talk about this a little bit in the language of bias as a sort of concern for, and it seems to me and through reading your paper so I'm not wanting to sort of repackage your thoughts as my own thoughts but it seems to me that this the thick and thin distinction, rests on the relationship, to an extent, to the idea of value neutrality. Value neutrality that the thin one, the thin reflexivity, still want to hold on to some sense of, oh, if I sort of you know, or if we have some kind of, maybe a positional statement, or if we have some you refer to, yeah, the ticker box, you have some kind of yes, we have been reflexive about the questions we're asking these people and now we're going to we've had that moment, we're going to analyze our data and here are our value neutral responses, whereas the thick one takes more seriously the ontological, political, epistemological depth of reflexivity, such, and then questions even, not so much even the possibility of value neutrality, but whether that would be a good thing to pursue in and of itself.
Speaker 3:To know to Chris. I think that's because the language, on one hand, yes, there is this thick concept of reflexivity, at least here and there, and the moment when it becomes bias and conflict of interest, and sometimes even the idea of generalizability could plays in, and sometimes credibility plays in. Now the question for me is like for whom it is credible? For who are we talking about the bias? Because the moment when situated knowledge is coming, it's not a problem, it's, it's. There is no reason why I need to say it as like, oh, I'm done with my identity, and then I want to just say this my where I come from, who I am, and then I'm like not taking ownership of what I'm creating. Right, and that's where the responsibility aspect of this is, because the whole larger, the positive spring of which I think, much of qualitative scholarship have done, and then there is huge black, feminist scholarship and again, the situated knowledge is. They keep going back to this conversation of you know, the universalism versus relativism, or the all the dichotomies of fact, value distinction. So on one hand, biotics wants to move away from it, but then we still want to hold on to it, and then that's where I I see that the thicker, I mean the thinner version of using reflexivity is a problem. That means we are not letting go and move forward with the way, what kind of knowledge, what kind of what these ethical theories are meant for. So are we just going to publish more and more about again, maybe me leaning towards my own? I certainly have my own existential crisis. Doing the research which I do, all I do usually is I unpack. Hey, this is a problem, this is taken for granted notion, I'm doing nothing about it. So it just makes me feel like little restless. And then there are moments I break down literally, especially with the current situation in the world, with Middle East, you know, with with Palestine situation, and and also puts back to the question of everyday realities, of myself in academia, being in some editorial committees, being in one of the, you know some positions where the diversity check is just a, you know, a tick box, or I fit in just because of diversity, which you thought our diversity is, you know, and the reason why I'm talking about this, these are the manifestation of the thinner version of doing just for the sake of doing it. So the moment when we go beyond it, the value commitments, I think that means reorientation of the whole way we do academia to maybe not necessarily just the whole way of practices which we do. Right, I mean including myself. So in what ways?
Speaker 3:As a person who comes, who is sitting here because I didn't get a job in India, I mean literally I apply for positions in India and there the caste dynamics and gender dynamics played out to an extent, and also the hierarchy of academia. I applied for philosophy, the only departments which I applied, and then then few of them never responded, and the ones who I went to the interview, they said biotics is not even a field. You know the. You know that hierarchy in academia, rather than learning that, learning from different disciplines, different concepts, and seeing how to bring social change, especially as social researchers I mean that's where the question back to the justice, equity, these are the concepts we want in bioethics or in any scholarship in social research Then where is this hierarchy playing out?
Speaker 3:And again, this is where the space of reflexivity deep. I mean, I'm not saying again, it's a virtue base or that I'm doing moral superior work, but at least it leaves us the discomfort that we have to think through more and go deeper and look at our value commitments. And then of course, this doesn't serve the current neoliberal academy. And now what do we do? But yeah, yeah.
Speaker 1:Um, yeah, a lot of fantastic points that I'd like to go on from. But yeah, I mean you finish with the neoliberal academy and I hope this doesn't sound any more pointed than it should be. But I think while you were talking it sort of occurred to me that perhaps another reason for the discomfort around a thicker reflexivity compared to a thin one, and especially, you know if we're going to, you know the narrative of the empirical turn, and reflexivity is part of that empirical turn. In a different way, I think that's sort of an ethical motivator for the empirical turn. Oh, sorry, there are ethical motivators for the empirical turn, which is me as a researcher sitting in my office.
Speaker 1:I don't know everything, so I should go out and ask some people what they sort of, I guess, the democratic side of the empirical turn. But there is also related to that, the making impact for policy development and the policy relevance of research, and so the empirical turn gives that greater purchase because it's like, well, this is what people in your constituency or this is what people who are concerned by this policy think. But then perhaps if you throw in then a thicker reflexivity, it has the potential to undo the policy relevance of some of the empirical work. I don't know, that's just a question like I do some people with the concern.
Speaker 1:But yeah, that undermines or not undermines, but maybe muddies the water of a clearer policy relevance. Empirical ethics.
Speaker 3:So so just correct me, if I get it, write your question. Yeah, are you suggesting or you're thinking that if we do empirical turn I mean that is a, let's say without having a thicker concept of reflexivity, then no wait, let me just rephrase that. So the thicker concept of reflexive would not allow to do the way they right now. The empirical turn is helping the policy development, is that?
Speaker 1:it could. Yeah, I guess it could trouble that.
Speaker 3:Right. So if that is a case, I disagree because the way I see empirical turn, I mean at least the way the usage of in bioethics, I'm not saying just the empirical scholarship. So I would definitely see the difference. For example, researchers who want to learn about homelessness in Australia right, they definitely have to do rather than sitting in the armchair. Of course it's a good thing to even think and talk about the homelessness can be fixed by sitting in, theoretically thinking. Because if it is giving a paradigm shifting work which gives us a different perspective to the way we engage with homelessness and the issue, or that the institutional level, that's not what I would see it as. But let's say let's listen to lived experience. I think that's where the empirical methods play a role. Right, we need to listen to people's stories, narrative beliefs, values. Let's go and meet them, let's sit and talk to them and so basically putting back the lived experience into the main center of empirical scholarship. So that's not what I mean when I use the word empirical turn in bioethics. So here, maybe much more. Maybe that's again, maybe I am misunderstanding sometimes. So I think the empirical turn I am talking about within the largest bio scholarship as a way of telling that, oh, we are doing something new, without acknowledging that we are learning from other. You know already existing scholarship, like sociology, anthropology. We are borrowing a lot, we are learning and also we are sometimes taking these concepts without the context. That historical context, for example, if I just say content analysis, is a famous thing for me. That's like you know.
Speaker 3:You go, you go to the field, you interview, let's say, 10 to 15 people. Now, when you ask a scholar who is doing I'm not I'm not being too cynical here, but I'm genuinely asking you interview, but saying it's a for a policy relevance. Right, you need to get some lived experience. I want to do the policy relevance. But then who do you choose? For example, if your question is to talk about, oh, I would like to understand that homelessness from the perspective of, let's say, homelessness in Australia generally, and you go and interview all the policymakers and you write a report or or even make a lot of it, but having not even thought of interviewing one person who is having real, lived reality of homelessness.
Speaker 3:You know that disconnect is what I'm thinking, the way you approach the research, the way you think about and also which scholarship influences right, I mean different paradigms, also sees homelessness in different. I'm giving an example because I read article two days back on homelessness, right, I mean that's the reason. But generally with any scholarship, right, I mean this again with you know, queer community, what kind of a research question is framed if you don't even account the lived experiences of them? But not just for the sake of interview, I'd only at the final stage of you go and collect the data. But thinking through the perspective and using their narratives, the marginality, you know that the whole conversation of situated knowledge is bringing the marginalist lived experiences and there's life experiences at the center, right, and what does it demand us is not just using it.
Speaker 3:Maybe now I'm being strong, superficially, to just say it's an empirical method. We got our data done, that's an evidence. So it goes back to again a conversation of evidence, what is considered evidence? And in the name of a short term quick solutions, sometimes we are losing and at least that's what I'm hoping that a thicker concept of reflexivity demands us to look at the all across stages of methodological, epistemological and political. You know the practices which we do, which would make it actually a solid reason why it should be part of the policy change.
Speaker 3:So it did actually not make it very good reason. For example, when we look at, I think in UK there was a recent report right where they only looked at the class perspective of the health outcomes, again after so many years of Black River. But again they looked at but they only thought of. They never used racism as a part of the analysis. So so that makes me again question why not If you had used from the start when you go and do the survey or whatever, because that perception or that construction of knowledge is seen as something dismissing and at least the reflexivity which is used in a thicker understanding would not allow that to happen, because your value commitment is very clear from the start, or at least I'm hoping that will be the case. Yeah, I don't know whether did I answer.
Speaker 1:No, no, that's perfect. That's, that's good. Yeah, so I guess I Hinda was probably the wrong word for me to use. I mean, it sort of makes it harder, so it's, it's better. It's better and more like an ideal. Yes, exactly as you sort of spelled out. It makes a better policy. It makes a policy that sort of captures and reflects and engages with the communities of concern. But if you want a quicker, dirtier, cheaper, maybe even more impactful because it speaks to the policy paradigm and itches the politicians ears, involving all of that other stuff and involving all those people can be more difficult.
Speaker 3:Oh, just a quick note, I mean, as I was talking about policy and I remember this. This is a clear example within global health too. Or you know the health promotions and interventions, right, it's a quick way of getting the banged programs out done very quickly. I mean, breastfeeding for me is like very. I mean I've been reading around this. The breastfeeding interventions are so interesting. The number of interventions are super high in Africa and South Asia and Asian countries, but the breastfeeding rate is generally low in global, not like, let's say, us and UK or even in Australia right Now.
Speaker 3:The question for me is like why? And the answer is obviously is that? Oh, because in the countries and global South, usually the developing countries, are low income countries, they are up with hygiene and there's poverty. I am like, good, go and do interventions, but not in a very banded way of fixing the you know the poverty, because you need to do reorientation of the whole geopolitics in many ways for that, but you need to go and fund only our cities then. So so for me, that's where the political commitment comes in and critically questioning why we do, why, what? Yeah, for what kind of interventions? I mean, this is another example which I keep getting trouble for last few years because I was involved in breastfeeding project.
Speaker 1:But yeah, we are going to have to sort of wrap it up shortly, but I did want to get to this and perhaps you know, from this rich and meaningful conversation, to maybe some of the more trivialization and media slander against some of these ideas. So, you know, as sort of alluded to throughout this sort of connection between standpoint theory or standpoint epistemology and reflexivity, some people you know there is a sort of similarity or overlap between some of these and I wanted to sort of get your opinion contribution to this. I guess, seeing two different kinds and perhaps two different ways that these, that these ideas have been misconstrued and even weaponized, I guess, for different political ends, and one of them I think it was from, I think, 2016. So you know these people, you don't?
Speaker 1:Son, your Kruger is a media person, but it was in response to a terrorist attack. I think that had happened in France. And then in the morning talk shows segment, she sort of says as a mother, you know, I think we should cut immigration to these sorts of Muslims and Muslim countries, which rightly attracted a lot of criticism of that comment. But it also drew attention to the the use of this idea. I think there was a trending hashtag as a mother, and so it created these sort of conversations about you know, is this use of identity position or you know standpoint? Is this a valid use of that? Because I think she explained, you know or tried to justify her calls for restrictive immigration based on that perspective.
Speaker 2:So I guess, maybe just firstly, and Jane you know, jump in with another one as a mother. As a mother, I would like to add something here. No, but I feel like the as a mother thing is interesting because it's it's pulled out of the bag very frequently, but slightly differently to, you know, as a father. So as a mother does work that as a father doesn't. As a father is the sort of thing that's used to denounce things like sexual violence, that men get to denounce only when they've got a daughter or something like that, you know and only realize is a bad thing.
Speaker 2:Yeah, oh you mean, oh yes, it would be terrible if that happened to my daughter. Now I understand that I shouldn't, yeah, exactly, but I but I'm kind of interested in the, in the, in the difference of those positions as well, as a mother and as a father and as an anything. Really, is this a useful card? To be able to play? Probably not.
Speaker 3:I mean at least having learned from all the scholarship, at least growing scholarship, around standpoint and epistemology is against. Situated knowledge is and any critical social theories right, which acknowledges that identity, you know, the position, the location which you are. It's as a mother, the role you play, or as a daughter, as a father, or as a brown, as a black, or that essentialist understanding actually is not what the larger scholarship is aiming for. The aim of these situated knowledges any situated knowledges right is aiming for moving away from it. Actually it's a, it's a starter for, especially for people who are marginalized. And now it's an interesting thing. I mean when I was looking at this to be honest I have no clue what happened in that as a mother, the hashtag thing, but I was just quickly browsing and I'm like that's an interesting way of using identity as discriminating for another identity right. So the identity politics is clearly at play there, but then it's not politics in a way I usually associate with. It's more of othering for me, using the essentialist understanding of particular identity to alienate or to other marginalized communities already.
Speaker 3:And all the situated knowledges are the scholars who talk about. You know, like up I R, homie Baba or postcolonial scholars. Start how, like all of them, they engage with hybridity notion. And so it's not just about just because you are X category necessarily means a source of authority to other.
Speaker 3:So the idea of going back to the first statement with Shetty side of callers, if a knowledge is socially and historically situated, that means listening to one perspective is important, but that's not the sole authority. Then comes the next layer and that's where the spokesperson or the, you know the theorizing plays a role. I feel like you know what kind of theorizing, where the value commitment plays, and how do you make sense of this scholarship, right, or the, these kind of situations and context? And then comes the next layer of responsibility and that's where, again, going back to the politics of practice, you know the. So the way I would understand is, as a mother or as an, any identity would not so that the essentialist notion is not what situated knowledge is about. So I think that's a misrepresentation of this whole situation.
Speaker 2:Now, yeah, and I think it's interesting, the ones that people get to pick right. So, as a mother, is very much imbued with a sort of moral superiority. That because clearly, motherhood had absolutely nothing to do with the situation at hand that she was presumably trying to say as a mother, I am caring and thinking and I have got no idea. I mean, who knows what's on your mind? Who is?
Speaker 3:the one who is saying this right and who the one who is falling for that kind of identity? What kind of power and privilege they are making use of 100%. So that's something is what actually situated knowledge is questioning. So putting back the power and knowledge and raising the critical consciousness and I mean, if I want to use that word, of the whole scholarship of Blacks, feminist thoughts of consciousness or double consciousness plays out. So we need to think through all this, I feel yeah.
Speaker 1:So the final example, and sorry to subject you to Helen Pluckrose and mortal enemy Grievance studies. Grievance studies folks, and this is from an interview on ABC from a few years ago. I distinctly remember being in the front yard gardening when I listened to this excerpt, which I will play now. Anyway, I'll read it. Did you read it Like yeah?
Speaker 3:I listened to it too.
Speaker 1:Okay, Okay, you listen to it too. Yeah, so I mean, having heard that, what you know, I mean that's just to me seems like such a overreach and a greedy, egregious misrepresentation of what standpoint epistemology is about. But I guess, yeah, what are your?
Speaker 3:I mean, it was so fascinating to listen to the whole podcast, the way there is a huge superficially simplifying these concepts and fitting into the clean categorization of dichotomous view of objective knowledge versus experiential knowledge. For me, it was interesting to see the other and other things that you know, the so called scandal, the similar way the you know this this person was experimenting with the trust based system of academia, which is so, and again, the underlying theme is how. For me is like, how did dismiss the experiential knowledge? But looking from the point of giving an example of childbirth, right, that is very fascinating for me because it's like you're disconnecting the idea of so called objective, science based or evidence based knowledge versus that experiential knowledge is something which is seen as it's a social dimension. I mean, if I want to know a person's like how breastfeeding feels, let's say, right, how childbirth experiences, partial, partially. You get some understanding from listening to women's studies and, of course, which women. It again depends on your question, right? I mean, if you're looking at women experiences, now, who are these women? Again, that's a question which demands much more of. Let's unpack the intersectional practice, right, and that's what situated knowledge demands us to do.
Speaker 3:But as far as I have read the scholarship, let's say Sandra Harding or Bell Hooks or Patricia Collins, all of the scholarship, whichever I'm of, air of no one dismisses the larger understanding of evidence based knowledge. But what do they question is the idea of objectivity? How do we achieve objective? It is a different conversations, let's say, with Donna Harvey or Sandra Harding right, I mean, actually I think Harding is the one and even Donna Harvey things to an extent of not to get to a stronger, stronger objective or drop us. Reflexivity is required To get objectivity. You completely, you know, subvert the whole idea of objectivity not in the need category of positives framework and that means you need to value the lived experience. But it's not just the essentialist understanding of that.
Speaker 3:Going back to Helen's, as I was listening it was interesting the way she positioned herself as economic liberal, you know the feminist right. I mean I'm like, yeah, there's an answer. Let's move away, let's progress. Acknowledge the ongoing process of the whole unpacking of intersectional factors, how identity is, hybridity is part of it and identity is you learn and unlearn, and how it influences the larger idea of knowledge. So yeah, I think that's yes, it is a misrepresentation of how this whole knowledge process is developed and I feel sad that there is a lot of misrepresentation. I've never heard about this, but yeah, where I see where it is coming from.
Speaker 1:Well, I'm sorry to bring it to your attention, but thank you very much for your answers and responses. It was very generous and it was great to have this conversation with you. Thanks a lot, Supriya.
Speaker 2:Yeah, thanks, Heaps, for me as well. Supriya, Sorry for my yeah, Thank you so much. It's a crossing fit. One of these is trying to engage.
Speaker 1:Yes, and you can like share and contact. I'm disciplinary through various social media channels Twitter, instagram and our email. Undisciplinary underscore pod at gmailcom. Thanks a lot.