Globalization and ideology: ethics committees and global clinical trials in South Africa and Brazil

This study aims to explore the ideological implications of globalization, asking whether the global diffusion of guidelines and economic schemes leads to a parallel diffusion of interpretations, hopes and ideologies. I focus on the globalization of clinical trials sponsored by pharmaceutical companies to assess the efficacy and safety of new therapeutic compounds. I analyze the ways in
which this globalization has been framed by the members of ethics committees, which are bodies responsible for assessing clinical research proposals submitted by both multinational companies and local researchers. I focus on the situations of South Africa and Brazil, two countries that have witnessed an important expansion in the number of global clinical studies conducted in their
territories.

My theoretical framework is the theory of communicative action proposed by German sociologist Jürgen Habermas. According to this theory, social actors can be either self-oriented and frame the social context as an instrument (instrumental rationality), or take other actors into account and search for intercomprehension (communicational rationality).

Even though the presence of these two rationalities was detected in my study, it was seen that rationalities are composed by sub-groups, specks of rationalities, which I propose to name mentalities. The description and interpretation of the seven mentalities identified in my study (pragmatic, bioethical, technical, healing, communitarian, analytical and critical) is the main task undertaken in this thesis.

Interpreting mentalities is important to understand the political debates taking place in South Africa and Brazil (and, potentially, other countries). To engage in debates, social actors frequently mobilize claims and ideas gleaned from different mentalities. Over the last decades, the bioethical, technical and healing mentalities have acquired an important force and legitimacy. However, discordant discourses continue to be voiced, drawing on the ideological tools provided by the analytical and critical mentalities. Thus, ethics committees can be seen as a political arena, reproducing broad social debates.