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Lost along the way? : Searching for the inclusion-and-difference paradigm in pharmaceutical research and regulation in Sweden

Bredström, Anna and Mulinari, Shai LU (2025) In Behemoth 18. p.28-28
Abstract
This article examines how the U.S. ‘inclusion-and-difference paradigm’
translates to the Swedish context. According to Steven Epstein (2007), this
paradigm combines health equity arguments for racialised minorities and
women with a biological understanding of racial and gender differences in
medicine. Drawing on interviews with experts, policymakers, and clini-
cians involved in international clinical trials in Sweden, we argue that crit-
ical elements of the U.S. paradigm – notably the ‘categorical alignment’ of
race-and-ethnicity taxonomies between the social worlds of medicine, gov-
ernment bureaucracy, and political discourse – are absent in Sweden and,
more generally, Europe. Consequently, there is... (More)
This article examines how the U.S. ‘inclusion-and-difference paradigm’
translates to the Swedish context. According to Steven Epstein (2007), this
paradigm combines health equity arguments for racialised minorities and
women with a biological understanding of racial and gender differences in
medicine. Drawing on interviews with experts, policymakers, and clini-
cians involved in international clinical trials in Sweden, we argue that crit-
ical elements of the U.S. paradigm – notably the ‘categorical alignment’ of
race-and-ethnicity taxonomies between the social worlds of medicine, gov-
ernment bureaucracy, and political discourse – are absent in Sweden and,
more generally, Europe. Consequently, there is no coherent framework for
interpreting the existing ‘niche standardisation’ of certain medicines based
on race and ethnicity, such as racialised treatment recommendations. In
conclusion, we discuss possible future scenarios and highlight a recent col-
laboration between the pharmaceutical industry and EU institutions. Des-
pite the challenging context, this collaboration aims to establish a
European standard for race and ethnicity data in clinical trials. However,
we argue that such attempts warrant caution: with racism being so wide-
spread in contemporary Europe, emphasising racial differences in medi-
cine may unintentionally reinscribe harmful notions of race. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Behemoth
volume
18
pages
38 pages
DOI
10.6094/behemoth.2025.18.1.1118
project
A New Biologism? How Medical Research, Policy and Clinical Practice Approach Ethnic Differences in Health
language
English
LU publication?
yes
id
e48579b8-fa0a-4a44-a259-96a4bcd109ba
alternative location
https://freidok.uni-freiburg.de/data/271750
date added to LUP
2025-10-02 09:59:30
date last changed
2025-10-03 09:15:00
@article{e48579b8-fa0a-4a44-a259-96a4bcd109ba,
  abstract     = {{This article examines how the U.S. ‘inclusion-and-difference paradigm’<br/>translates to the Swedish context. According to Steven Epstein (2007), this<br/>paradigm combines health equity arguments for racialised minorities and<br/>women with a biological understanding of racial and gender differences in<br/>medicine. Drawing on interviews with experts, policymakers, and clini-<br/>cians involved in international clinical trials in Sweden, we argue that crit-<br/>ical elements of the U.S. paradigm – notably the ‘categorical alignment’ of<br/>race-and-ethnicity taxonomies between the social worlds of medicine, gov-<br/>ernment bureaucracy, and political discourse – are absent in Sweden and,<br/>more generally, Europe. Consequently, there is no coherent framework for<br/>interpreting the existing ‘niche standardisation’ of certain medicines based<br/>on race and ethnicity, such as racialised treatment recommendations. In<br/>conclusion, we discuss possible future scenarios and highlight a recent col-<br/>laboration between the pharmaceutical industry and EU institutions. Des-<br/>pite the challenging context, this collaboration aims to establish a<br/>European standard for race and ethnicity data in clinical trials. However,<br/>we argue that such attempts warrant caution: with racism being so wide-<br/>spread in contemporary Europe, emphasising racial differences in medi-<br/>cine may unintentionally reinscribe harmful notions of race.}},
  author       = {{Bredström, Anna and Mulinari, Shai}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{28--28}},
  series       = {{Behemoth}},
  title        = {{Lost along the way? : Searching for the inclusion-and-difference paradigm in pharmaceutical research and regulation in Sweden}},
  url          = {{https://lup.lub.lu.se/search/files/228887340/Lost_Along_the_Way.pdf}},
  doi          = {{10.6094/behemoth.2025.18.1.1118}},
  volume       = {{18}},
  year         = {{2025}},
}