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2. A Beneficent Healer and a Career-Minded Falsifier? Physician Researcher Role Conflict and the Janus-Faced Dr. Roger Poisson
- The University of Alabama Press
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2 A Beneficent Healer and a Career- Minded Falsifier? Physician Researcher Role Conflict and the Janus-Faced Dr. Roger Poisson In the fallout from the public disclosure that he had falsified North America’s landmark breast cancer data,Dr.Roger Poisson became a doctor in disgrace. He was summarily shamed by the medical community, disbarred from federal research funding, and forced from his academic job. Ten months after Datagate first made headlines, the January 1995 issue of Discover magazine admonished readers about “yet another wayward researcher,playing fast and loose with his data,” who “sullied the name of science.”1 Discover’s saga of Roger Poisson, alliteratively titled “Doctor Doctors Data,” cast the Montreal surgeon- cum- NSABP- investigator as a deviant whose decades- long duplicity undermined more than his own reputation. “By fabricating trial data,” journalist Denise Grady explained, “Roger Poisson brought down both himself and NSABP cancer trial head Bernard Fisher.”2 Although it is arguable whether it was Poisson’s misdeeds or public perceptions of Fisher’s reticence about them that angered patients and health- care advocates more, the discovery of Poisson’s deceptive data triggered condemnation. Headlines hinting at his misconduct,the horrifying idea that a doctor had messed with something as sacred as breast cancer treatment research, sent shockwaves through the medical community, alarming medical practitioners, patients ,and breast cancer advocacy groups and tipping off the hullabaloo that brought the backstage wrangling of biomedical research into public light. U.S. media attention would quickly center on Fisher, but in the meantime Roger Poisson spent an intense period in the limelight.3 The ensuing contest over Poisson’s character exposes underlying normative tensions in biomedical research. Science studies scholar Dorothy Nelkin once observed that “controversies over science and technology reveal tensions between individual autonomy and community needs” and “reflect the 46 Chapter 2 ambivalent relationship between science and other social institutions such as the media, the regulatory system, and the courts.”4 “L’Affaire Poisson,” as Datagate became known in the Canadian media, exposed fissures between scientific autonomy; breast cancer patients’ preferences; and the values of politicians, the press, and funding agencies. My analysis of Poisson’s characterization in U.S. and Canadian media and international medical journal articles therefore generates instructive lessons about how the rhetorically constituted characters of science- based controversies divulge cracks in communal understandings of appropriate scientific practice. Poisson suffered expulsion from the church of science, yet recurrent characterizations of his actions raise important considerations for contemporary scientific practice and its broader relation to public life. As this chapter details,dominant characterizations of Roger Poisson pivoted on two conflicting countenances: the personae of beneficent healer and that of an unscrupulous, career- minded research- scientist- turned- fraud. Like Janus,the two- faced god of Roman mythology associated with portals, passageways, and doorways, Poisson appeared caught between two worlds— the mythos of the ancient and humane art of healing and the contemporary rigors of clinical science. In his well- known Science in Action, philosopher of science Bruno Latour used a Janus analogy to differentiate between the black box of “science already made”and the open controversies of “science in the making.”5 One of Janus’s faces looked to the past and the other to the future .My analogy similarly invokes Janus’s bidirectional viewing: the beneficent healer peers into an idealized vision of the past where doctors’overriding concern was the individual patient, while the career- minded researcher watches the future of large- scale, bureaucratized research endeavors. Accordingly , Janus is an appropriate figure to signify competing characterizations of a man caught between disparate but interdependent worlds. My argument that Poisson’s two personae and the values they signify often collide in ways that can harm clinical trial participants is not the only lesson to be drawn from the controversy, however. These two personae, these masks onto which Poisson’s actions are projected, further highlight a tension that continues to haunt contemporary biomedicine, one that is further complicated by the politics driving big science: the tension between physician and researcher. In examining the personae of Roger Poisson, then, we witness how scientific characters animate and challenge randomized clinical trials, and we consider what is gained and lost in the present configuration with its stark division between science and its stakeholders,with its expectation that doctors who treat can simultaneously be doctors who study. This chapter thus tracks the battle over the Janus- faced representations of Beneficent Healer and Career- Minded Falsifier? 47 Poisson, the competition...