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The Shifting Sands of Uncertainty: Risk Construction and BSE/v. CJD – Making The Case The Shifting Sands of Uncertainty: Risk Construction and BSE/v. CJD – Making The Case for a Socio-Linguistic Paradigm in Risk Analysis Research Paradigms of Risk Assessment and Uncertainty in Policy Research, UCSD, May 14 th -15 th, 2010 By Dr. Beth Kewell and Professor Matthias Beck, The York Management School, The University of York, United Kingdom.

Overview The socio-linguistic foundations of risk analysis: A research agenda The ‘linguistic framing’ of Overview The socio-linguistic foundations of risk analysis: A research agenda The ‘linguistic framing’ of BSE / v. CJD science Synergistic narrative junctures: The Southwood series and the 2001 v. CJD symposia Modality and ‘uncertainty sandwiching’ Key findings from ‘Shifting Sands’ Recent work: The Bristol Inquiry and epistemic modality; scientific narratives and Regenerative Medicine Conceptual and policy relevance

Socio-Linguistic Risk Analysis: A Research Agenda Contemporary risk historiographies and theoretical treatise tend to Socio-Linguistic Risk Analysis: A Research Agenda Contemporary risk historiographies and theoretical treatise tend to account, in different ways, for the heteroglossic epistemological heritage of the field; offering biographies of the ‘rational action’ methodology, or ‘risk society’ standpoint, for example; or the contributions made by various branches of the mathematical and natural sciences (Rosa 1998: 15 -24; Lupton 1999; Jaeger et al. 2001; Mc. Daniels and Mitchell 2003; Zinn 2008). Dentith (2001, emphasis altered), writing in The Literary Encyclopaedia refers to ‘heteroglossia’ as a: “Term [that] alludes to the multiplicity of languages within the apparent unity of any national language. However, it should not be confused with a simple celebration of linguistic diversity, for the term alludes not only to the co-existence of “languages” within a language, but their co-existence in a state of tension and competition”.

 This succinct definition could describe the world of risk analysis: a field unified This succinct definition could describe the world of risk analysis: a field unified by the portmanteau of ‘normal risk science’ (aka the “standard scientific model of investigation” – Rosa 1998: 16) and yet it hosts ontologically diverse language games within which we talk about risk / make sense of / define / frame / construct our meaning in very different ways… Risk? What is it? Answer: knowledge of opportunity or hazard produced within dialogic language game encounters, predicated on reputationally augmented information, held between social actants who are institutionally embedded within Bourdieusian habitus and field relations (Bourdieu 2004). Significantly, what they choose to discuss will involve real problems and prospects (either socially constructed via discursive means – literally talked into existence – or in response to a physical reality… for instance concerns about an impending Tsunami or earthquake or nuclear incident or ash clouds or mad cows…)

The Linguistic –Reflexive Approach To Understanding Risk Composition: Begins either explicitly or implicitly with The Linguistic –Reflexive Approach To Understanding Risk Composition: Begins either explicitly or implicitly with a Bourdieusian frame of reference (for instance: Bourdieu 2004), Knowledge and information are viewed primarily as reputationally founded (Bromley 1993); Sees texts as mirroring the social and cognitive contexts in which they were produced (i. e. no text is ‘unauthored’) (from the classic discourse literature: Potter 1996, Wood and Kroger 2000, Wetherell et al. 2001, Locke 2004, Fairclough 2003, Wooffitt 2005). The next working assumption is that social actants (e. g. scientists or risk analysts) contribute to language games which produce texts about risk. Language games are dialogically driven (Deetz 1996 – based on Wittgenstein 1953); their primary motors are competitive and associated with distinction seeking behaviours - for example the identification of a stock market busting algorithm; new scientific discovery or solution to a risk based problem (Bourdieu 2004).

 It is within the texts produced by language game actants that the ontological It is within the texts produced by language game actants that the ontological assumptions (associated with definitional activities and antagonisms see: Rosa 1998: 15 -23), epistemic practices and pedagogy of particularly risk stakeholders becomes evident. Significantly: Rosa (1998: 18 -19, 20 & 22, emphasis altered) asserts that both the “positivistic paradigm” “social constructivism and cultural theory” conflate ontology and epistemology (if in different ways): one “fuse[s] the ontology of risk with the epistemology of risk identification and risk estimation”, whilst the other “Fail[s] to make a clear distinction between the process and process of socially constructed knowledge”.

Socio-Linguistic Risk Analysis: A Research Agenda The narrativisation, portrayal, framing, grammatical and semiotic representation Socio-Linguistic Risk Analysis: A Research Agenda The narrativisation, portrayal, framing, grammatical and semiotic representation of risk and uncertainty are indicative of a given language game’s ‘zeitgeist’ at a particular moment in its history… This zeitgeist may reflect particular tastes, anxieties, trends, fashions of the moment or isomorphically replicate time honoured practices and institutions (Abrahamson 1991). The construal of risk and uncertainty in textual form may show the field sees the relationship between ontology and epistemology (and pedagogy) at the point of publication or communication– are they myopically merging them as Rosa (1998) suggests?

Risk Construction and BSE / v. CJD New variant Creutzfeldt-Jakob Disease (v. CJD): A Risk Construction and BSE / v. CJD New variant Creutzfeldt-Jakob Disease (v. CJD): A late 20 th century pathology with 21 st century repercussions: http: //findarticles. com/p/articles/mi_qn 4156 /is_20041212/ai_n 12592838/

Risk Construction and BSE / v. CJD Our paper (Kewell and Beck 2008) examines: Risk Construction and BSE / v. CJD Our paper (Kewell and Beck 2008) examines: ◦ The changing treatment of Bovine Spongiform Encephalopathy (BSE) as a zoonosis risk – as emboldened in two science-policy narrative borne of contrasting language games – the ‘Southwood series’ (c. 1989 -1994); and the proceedings of a scientific symposium, abridged within a special issue of the Journal of the Foundation for Science and Technology (FST Journal) published in 2001 in the aftermath of the Phillips Inquiry (Phillips 2001, also: Phillips 2000). ◦ Our key observations are that these narratives construct BSE/v. CJD risks according to contextual language game precepts, which in this case were highly politicised – one seeking to deamplify uncertainty; whilst the other (later) conversation overtly sought to illuminate uncertainties. ◦ Grammar, and the use of epistemic modality, were constituent utilities in the making of representations of risk and uncertainty (Mushin 2001, Fairclough 2003)

Risk Construction and BSE / v. CJD BSE and v. CJD: a short biography: Risk Construction and BSE / v. CJD BSE and v. CJD: a short biography: ◦ A genetic match was discovered between the two diseases in 1996 (Scott et al. 1999, Gill 2001, Trevitt and Sing 2003). ◦ 168 v. CJD deaths occurred between 1995 and April 2010 in the United Kingdom, from an estimate 172 diagnosed cases. See: - The National Creutzfeldt-Jakob Disease Surveillance Unit (NCJDSU) : http: //www. cjd. ed. ac. uk/figures. htm ◦ The gestation period of the two diseases is consistent at between 5 -10 years. ◦ The aetiology of Transmissible Spongiform Encephalopathies (TSEs), incurs severe neurological degeneration, ataxia and terminal illness involving loss of limb and brain function (Wells et al. 1987, Wilesmith et al. 1988). ◦ The disease attacks central nervous tissue and typically alters the molecular structure of brain stem cells so that they take on a spongiform appearance (Trevitt and Singh 2003). ◦ v. CJD has tended to affect younger people with valine homozygous genetic susceptibility to a gene prion mutation called Pr. PSc (Caughey 2000, Gill 2001: 9, Dormont 2001, Anderson 2001, Ironside et al. 2006). ◦ This view has been revised recently, however, in light of vulnerability within the “methionine homozygous population subgroup” (Ironside et al. 2006: 1186). More significantly perhaps, v. CJD may have an undetected presence amongst groups of older people (Gill 2001).

Risk Construction and BSE / v. CJD The discovery of BSE c. 1986 and Risk Construction and BSE / v. CJD The discovery of BSE c. 1986 and the ‘low zoonosis risk’ thesis (see for instance: Winter 1996, Powell and Leiss 1998, Seguin 2000, Millstone and van Zwanenberg 2001, Abell 2002). The scale of the infection – spread by the consumption of 750, 000 suspected bovine carcases prior to 1989 (Anderson 2001) – lead to intensive epidemiological investigations thereafter. Wells et al (1987) marks the beginning of the construction of BSE/v. CJD as a problematisation of risk and uncertainty and as a challenge to comparative science (i. e. the veterinary sciences and medicine).

Risk Construction and BSE / v. CJD Methods: ◦ An intertextual approach, which focused Risk Construction and BSE / v. CJD Methods: ◦ An intertextual approach, which focused upon an examination of discourse organisation between different texts (Locke 2004 citing Gee 1996 also Fairclough 2003), including, in this instance, the ‘Southwood Series’ and excerpts from the proceedings of a scientific meeting organised by Foundation for Science and Technology (FTS) after the Phillips Inquiry (Phillips Inquiry 2000). ◦ The initial research objective was to examine intertextuality between documents in the ‘Southwood Series’ - The Southwood Report 1989, The Tyrell Report 1989, The SEAC Report for 1992, and The SEAC Report for 1994. ◦ A simple method of coding, denoted by U for uncertainty and C for certainty, was applied to all documents to help illuminate an intertextual pattern of uncertainty handling (Fairclough 2003). A statement of certainty or uncertainty was defined as a collection of words underpinned either by an uncertainty related modality or series of modalities; and by taken for granted assumptions (Fairclough 2003) that existed either to establish, repeat, reinforce, explain or compound a certainty or uncertainty.

Risk Construction and BSE / v. CJD ◦ Finding the FST Journal (via a Risk Construction and BSE / v. CJD ◦ Finding the FST Journal (via a search for up to date epidemiology research) identified a second ‘story’ / language game for intertextual research ◦ Extracts of this research are illustrated in the paper/ this presentation. Linguistic markers of certainty appear with double underlining, whilst markers of hesitancy appear with a dotted line beneath, and markers of uncertainty appear in the text using bold and single underlining. ◦ In acknowledging the limitations of the research, it is recognised that our choice of texts is restricted to vignettes taken from a much broader heteroglossia of BSE/v. CJD science and policy debate. Our background as social scientists also means that we have had to broach the subject of study from a position of methodological relativism (Potter 1996, Fairclough 2003).

Risk Construction and BSE / v. CJD Extract 1: Southwood Report, 1989: “We have Risk Construction and BSE / v. CJD Extract 1: Southwood Report, 1989: “We have concluded (C 1) that Bovine Spongiform Encephalopathy (BSE) is one of the transmissible Encephalopathies caused by (C 2) an unconventional infectious agent with a prolonged incubation period” (Department of Health and Ministry of Agriculture, Fisheries and Food 1989: 22). Extract 2: SEAC 1994: “The transmission of scrapie-like agents is generally (C 1) more difficult between species than within species, and is most difficult (C 2) of all by the oral route” (Department of Health 1994). In the representation as a question or hypothesis, note the way certainty markers are used to help underpin postulation in Extract 3: Tyrell Report 1989: “Direct comparison of the neuropathological lesions with those found (C 1) in the other spongiform encephalopathies, particularly scrapie, provides support for (C 2) the hypothesis that these diseases are produced by similar, and perhaps even identical (C 3), agents. Detection of pathological abnormalities in peripheral tissues in BSE could (C 4) provide leads to new diagnostic methods” (Ministry of Agriculture, Fisheries and Food and Department of Health 1989: 12).

Risk Construction and BSE / v. CJD Extract 10: Southwood Report 1989: A certainty Risk Construction and BSE / v. CJD Extract 10: Southwood Report 1989: A certainty is stated: “There a number of transmissible spongiform encephalopathies affecting animals and man which are caused by unconventional infections agents” (C 1) (Department of Health and Ministry of Agriculture, Fisheries and Food 1989: 5). A major uncertainty then is presented in relation to a second certainty: “The agents responsible have not been completely characterised (U 1), although their composition appears to be very similar, with a peptide as a major component (C 2) (Department of Health and Ministry of Agriculture, Fisheries and Food 1989: 5). A controversial grey area is described in the next sentence using a third marker of certainty, shown in parallel to a second and third uncertainty (U 2 þ U 3): There are (C 3) three conflicting interpretations (U 2) of existing knowledge, the agent being termed either (U 3) a prion, a virino, or a filamentous virus. . . (Department of Health and Ministry of Agriculture, Fisheries and Food 1989: 5). In this example, and Extract 11 illustrated next, certainty is open to varying degrees of interpretation. The phrases ‘completely confident’ and ‘must point’ relay a sense of urgency in efforts to overcome imperfect knowledge of the disease. Note, moreover, the use, in Extract 12, of ‘appears that’ at the end of an otherwise certain statement:

Risk Construction and BSE / v. CJD Extract 11: Southwood Report 1989: “ The Risk Construction and BSE / v. CJD Extract 11: Southwood Report 1989: “ The Working Party wishes to emphasise the need to be completely confident (C 1) that the agent has been destroyed and must point (C 2) to the difficulties of demonstrating this (U 1) in view of the nature of the agent (U 2) and the time taken (U 3) for the symptoms to manifest themselves. . . (Department of Health and Ministry of Agriculture, Fisheries and Food 1989: 17). Extract 12: SEAC 1992: “Further studies of milk by oral exposure have been planned (C 1) and are soon to commence (C 2). Of all these tissues, only brain has so far proven positive (C 3). Other tissues from cattle including semen, spleen, buffy coat, placenta, bone marrow and skeletal muscle have all produced no disease (C 4). Thus it appears that (C 5) detectable infectivity in clinical cases of BSE is found (C 6) in the CNS but not in the peripheral tissues assayed (Department of Health 1992).

Risk Construction and BSE / v. CJD Extract 15: Professor Dominic Dormont: “On the Risk Construction and BSE / v. CJD Extract 15: Professor Dominic Dormont: “On the majority view (C 1) that the agent consists only of protein, the infectious Pr. P is(C 2) distinguished by an abnormal tertiary structure (C 1). That could arise by one of two pathways. Either the protein is produced in its normal form and then converted, within the cell, into the abnormal structure or the Pr. P misfolded as it is produced. What really happens remains an open question (U 1)” (Dormont 2001: 11– 12). He then addresses the broader uncertainties this has raised. Note the use of negative inference and uninhibited language in Extract 16: “It is puzzling that (sic. ) nobody has yet succeeded (U 1) in reconstituting infectious material after denaturing natural abnormal Pr. P, and that it has not been possible (U 2) to propagate infectivity from recombinant protein. That has led some people to suggest (U 3) that the prion thesis might be wrong (U 4) (Dormont 2001: 12).

Risk Construction and BSE / v. CJD Extract 16: Professor Roy Anderson: “The agent Risk Construction and BSE / v. CJD Extract 16: Professor Roy Anderson: “The agent can (C 1) move around the body from gut to brain for example, by various routes (C 2), but little is understood (U 1) about the detail. Studies of scrapie in mice have shown (C 3) the presence of the infectious agent both in the spleen (part of the immune system) and the brain, but over time, the concentration in the brain increases exponentially culminating in clinical symptoms and mortality. That is the basis for believing that (C 4), in cattle with BSE, animals in the late stage of incubation are likely (C 5) to be more infectious to humans than in the early stage due to (C 6) very high concentrations of the abnormal prion” (Anderson 2001: 13). Anderson then reveals that: “Along with knowledge of the life expectancy of the cattle host, the BSE incubation period in cattle tells us one very important thing (C 1)—the cases of overt disease that we see (C 2) in cattle are the tip of an iceberg (U 1). The average incubation period of BSE in dairy cattle is (C 3) approximately 5 years. The average life expectancy of a dairy animal is (C 4) between two and a half years. If (U 1) the incubation period of disease is five years and the life two years, the implication is that a great many diseased animals have entered the food chain without clinical disease being recognised (Anderson 2001: 13– 14).

Risk Construction and BSE / v. CJD Conclusions: ◦ The representation of risk and Risk Construction and BSE / v. CJD Conclusions: ◦ The representation of risk and uncertainty in the early part of the Southwood series was partly influenced by pressures leaning toward the deamplification of concerns about hazard (Bufton 2001, Millstone and van Zwanenberg 2001, Abell 2002, Frewer and Salter 2002, Cummings 2005). ◦ Grey areas, grammatical counterbalancing, and ‘uncertainty sandwiches’ represent demonstrative epistemic devices for expressing position (Mushin 2001) – they also ‘rule in’ and rule out’ possibility, plausibility and particular ways of thinking and acting (Hall 1997 in Wetherell et al. 2001). ◦ Both narratives examined here represent hegemonies of risk – one seeking to deamplify, the other to embolden…

Other Work: The Bristol Inquiry (and Epistemic Modality): A study of expert witness testimony Other Work: The Bristol Inquiry (and Epistemic Modality): A study of expert witness testimony among paediatric cardiothoracic surgeons and cardiologists (a quartet of leading experts in their fields). The paper examines the relationship between reputation, story, epistemic modality and risk / uncertainty construal within the context of a broader legal narrative about a harrowing iatrogenic incident… REMEDIE (EU FP 7) – Regenerative Medicine and ‘Risk Narratology Paper for SRA Europe, about the use of narrative in scientific reporting on RM innovations, involves looking at epistemic modality and its placement within ‘rational action stories’…

Conceptual and Policy Relevance Encourages recognition that risk and uncertainty are not purely decipherable Conceptual and Policy Relevance Encourages recognition that risk and uncertainty are not purely decipherable via the ‘standard science model’ upon which policy makers often rely– as illustrated in Risk Analysis: An International Journal! Highlights the extent to which representations of risk are grammatically framed and hegemonic – ruling in and out particular ways of viewing hazard, uncertainty and the unknown…. . Offers a rejoinder to Rosa’s (1998: 22) claim that constructivist research all too often “purees” object, method, theory and outcome – linguistic and discursive forms are an antidote to this problem.

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