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Race’ As a Variable in Biomedical Research

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Race’ As a Variable in Biomedical Research UNIVERSITY OF CALIFORNIA, SAN DIEGO The Use of ‘Race’ as a Variable in Biomedical Research A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Philosophy (Science Studies) by Sophia Efstathiou Committee in charge: Professor Nancy Cartwright, Chair Professor Craig Callender Professor Gerald Doppelt Professor Steven Epstein Professor Arnold Gass Professor Michael Hardimon Copyright Sophia Efstathiou, 2009 All rights reserved. The Dissertation of Sophia Efstathiou is approved, and it is acceptable in quality and form for publication on microfilm and electronically: Chair University of California, San Diego 2009 iii DEDICATION This dissertation is dedicated to Costas, Bookie and Jeannie. iv EPIGRAPH The pedigree of honey Does not concern the bee; A clover, any time, to him Is aristocracy. By Emily Dickinson v TABLE OF CONTENTS Signature Page ………………………………………………………………………….. iii Dedication……………………………………………………………………………….. iv Epigraph…………………………………………………………………………………. v Table of Contents………………………………………………………………………... vi List of Figures…………………………………………………………………………… xi Acknowledgements……………………………………………………………………… xii Vita……………………………………………………………………………………… xiv Abstract of the Dissertation …………............………………………………………….. xv Introduction ……………………………………………………………………………. 1 The Timeliness of this Discussion………………………………………………………. 4 The Perspective of This Discussion……………………………………………………... 7 An Alternative to Nominalism and Realism about Measurement………………………. 8 The Structure of this Dissertation And Its Argument…………………………………… 12 Chapter 1 TOOLS Tools for Analyzing the Use of ‘Race’ as a Variable in Biomedical Research…………. 15 1.1. Manifest, Operative and Target Concepts………………………………………... 15 1.1.1 How This Use of the “Manifest” v “Operative” v “Target” Distinction Diverges from Sally Haslanger’s………………………………………………………………….. 16 1.1.1.1 Sally Haslanger’s Distinction between “Manifest” v “Operative” v “Target” Concepts………………………………………………………………………………… 17 1.1.1.2 How Distinctions between “Manifest” v “Operative” v “Target” Concepts Work in This Dissertation……………………………………………………………….. 18 1.1.1.3 Divergences Between “Manifest” v “Operative” Concepts Need Not Indicate Illegitimate Oppression………………………………………………………………….. 20 1.2 Hardimon on Concepts of Race……………………………………………………... 23 1.2.1 The Ordinary, the Racialist and the Populationist Concepts of Race……………... 24 1.2.2 Hardimon on Socialrace…………………………………………………………... 27 1.2.3 Why Less Can Be More………...………………………………………………… 29 1.3 Biorace and Sociorace Race Concepts........................................................................ 31 1.3.1 Sociorace Concepts................................................................................................... 32 1.3.1.1 Sociorace Concepts Need not Pick Out Races...................................................... 33 1.3.1.2 Some Sociorace Race Concepts: Hardimon’s ‘Socialrace’ and Haslanger’s ‘Race’................................................................................................................................. 36 vi 1.3.2 Biorace Concepts...................................................................................................... 39 1.3.2.1 Biorace Concepts Need not Pick Out Races.......................................................... 40 1.4 Found Concepts and Founded Concepts...................................................................... 43 1.4.1 Finding and Founding............................................................................................... 44 1.4.1.1 Take A Pen-Cap..................................................................................................... 44 1.4.1.2 A Founded Concept............................................................................................... 47 1.4.1.3. Take A Race Concept........................................................................................... 48 1.4.1.4 The Risks of Using Founded Concepts................................................................. 50 1.5 Distinctions Between Race Terms, Concepts of Race and Race Concept.................. 54 Chapter 2 SYMPTOMS Some Positions on the Use of Race in Biomedical Research with Special Attention to its Use in Biomedical Genetics.......................................................................................... 56 2.1 Michael Root on the Usefulness of ‘Race’ for Epidemiological Research and the Usefulness of ‘Ancestry’ for Biomedical Genetics Research............................................ 57 2.1.1 Race Can Be Used in Biomedicine: It is a Real Social Category............................. 58 2.1.1.1 Root’s Operative Race Concept: Socialrace.......................................................... 59 2.1.1.2 Race: a Real Social Category................................................................................ 61 2.1.1.3 Some Worries About Root’s Distinctions............................................................. 64 Conclusion......................................................................................................................... 65 2.1.2 The Usefulness of Race in Epidemiology................................................................ 66 2.1.2.1 Root’s Manifest Target Concept: Sociorace.......................................................... 66 2.1.2.1 Root’s Operative Target Concepts......................................................................... 67 2.1.2.3 Operative Race Concepts: Sociorace and Biorace ................................................. 70 Conclusion......................................................................................................................... 70 2.1.3 ‘Race’ Should not Be Used to Approximate Genetic Variation.............................. 71 2.1.3.1 Three Theses, Three Concepts: ‘Race’, ‘Proxy’, ‘Ancestry’................................. 72 2.1.3.2 What Race Is: Understanding ‘Race’ as ‘Socialrace’............................................ 73 2.1.3.3 Root’s “Methodological” Concern........................................................................ 76 2.1.3.3.1 Root’s Manifest Concept of a ‘Proxy’................................................................ 76 2.1.3.3.2 Root’s Operative Notion of a Proxy................................................................... 78 2.1.3.4 The Final Solution: ‘Ancestry’.............................................................................. 79 2.1.3.5 The Need to Keep Thinking................................................................................. 81 Conclusion......................................................................................................................... 84 2.1.4 Using ‘Socialrace’ as a Proxy for Social Causes of Health Outcomes..................... 87 Conclusion to Section 1 on Root....................................................................................... 91 vii 2.2 Abdallah Daar and Peter Singer on the Use of ‘Race’ for Pursuing Population- Specific Pharmacogenetics................................................................................................ 93 2.2.1 The Targets of ‘Population’-Specific Pharmacogenetics Research......................... 94 2.2.1.1 ‘Populations’ or ‘Races’? Bioraces....................................................................... 95 2.2.1.2 Why Use ‘Race’ in ‘Pharmacogenetics’?.............................................................. 97 2.2.1.3 Broader Benefits of ‘Population’-specific Pharmacogenetics............................... 98 2.2.1.4 Financial Incentives for Population-Specific Pharmacogenomics........................ 100 2.2.1.5 The ‘Race’ Liability: The Case of BiDil............................................................... 102 2.2.1.5.1 A Brief Story for BiDil....................................................................................... 102 2.2.1.5.2 What Works And What Doesn’t........................................................................ 103 2.2.1.5.3 Failure................................................................................................................. 105 Conclusions to Section 2.2 on Daar and Singer................................................................ 106 2.3 Ian Hacking on the Use of ‘Race’ for Biomedical Practice......................................... 108 2.3.1 Hacking on Mill’s Distinction Between Real and Superficial Kinds....................... 109 2.3.1.1 A Real Class Need not be Useful and A Superficial Class Might......................... 111 2.3.1.2 Mill’s Naturalism Compared to Root’s Realism................................................... 116 2.3.1.3 Hacking’s Updates to Mill’s Naturalism............................................................... 120 2.3.1.3.1 Hacking’s Statistical Concepts........................................................................... 123 2.3.1.3.2 What is Updated?................................................................................................ 128 2.3.1.4 Hacking’s Updates Applied to ‘Race’................................................................... 132 2.3.2 Should ‘race’ categories be used to approximate medically interesting human genetic variation?............................................................................................................... 139 Conclusions to Chapter 2................................................................................................... 141 Chapter 3 DIAGNOSIS Found Science: Founding ‘Race’ in Biomedical
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