Advocating for Comparative Effectiveness Research

Comparative Effectiveness Research is guided by the goal of creating information capacities regarding the best comparative evidence base on treatment effectiveness, side effects, and benefits of different treatment options. The CER process is one that attempts to de-center the shroud of secrecy and scientific legitimacy that the medical industry (pharmaceuticals, physicians etc.) rely on. What is most important about the CER process is the implicit acknowledgement that is built into it: that the culture of medicine operates often under a great deal of uncertainty, misinformation, and lack of solid information. The CER process therefore seeks to a) foster a scientific evidence base for comparing different treatments, and b) de-center the blindfolded legitimacy patients put in physicians by seeking to put information in the hands of patients.

It is precisely in this backdrop that I have witnessed resistance from physicians about CER in one-on-one interactions with them. That the transparency of information in CER threatens the privilege that many physicians enjoy in the status quo (based on the fundamentalism of science) does not come as a surprise. What however does come as a surprise is the argument that is being used by physicians and several lobbies funded by physicians: that patients don't know what is good for them, and medical decisions are best left in the hands of physicians.

Consider the hypocrisy of the argument that uses the language of science to make the very processes of science invisible to local communities. Part of the medical establishment is up in arms about CER precisely because physicians are scared about what this means for their practices and profts.

Personally, I am excited about what the CER processes promise to bring into medicine in the US, perhaps an opportunity for culture change, one that moves medicine from this hollow relic of sacredness that it occupies to a practice that is constituted in relationships, through struggles, and through the practices of healing and curing that work in the intimate spaces of phsyician-patient relationships, working together to heal the marks of disease and illness.

Whiteness, NCA, and Distinguished Scholars

In a post made in response to the changes to how my discipline operates made by the Executive Committee of the largest organization of the discipline, the National Communication Association (NCA), one of the editors of a disciplinary journal Rhetoric and Public Affairs (RPA), Professor Martin J. Medhurst, a Distinguished Scholar of the discipline, calls out what he sees as the threat of identity (see below for his full piece published in the journal that he has edited for 20+ years, with 2019 SJR score of 0.27). In what he notes is a threat to the "scholarly merit" of the discipline, Professor Medhurst sets up a caricature of what he calls "identity." In his rhetorical construction of the struggles the NCA has faced over the years to find Distinguished Scholars of colour, he shares with us the facts. So let's look at the facts presented by this rhetor. It turns out, as a member of the Distinguished Scholar community of the NCA, Mr. Medhurst has problems wit...

Upper caste Indian women in the diaspora, DEI, and the politics of hate

Figure 1: Trump, Vance and their partners responding to the remarks by Mariann Edgar Budde Emergent from the struggles of the civil rights movement , led by African Americans , organized against the oppressive history of settler colonialism and slavery that forms the backbone of US society, structures around diversity, equity, and inclusion (DEI) formed an integral role in forging spaces for diverse recognition and representation. These struggles around affirmative action, diversity, equity and inclusion were at the heart of the changes to white only immigration policies, building pathways for migration of diverse peoples from the Global South. The changes to the immigration policies created opportunities for Indians to migrate to the US, with a rise of Indian immigration into the US since the 1970s into educational institutions, research and development infrastructures, and technology-finance infrastructures. These migratory structures into the US were leveraged by l...

The Projection Machine: Epstein's Intellectual Network and the War on Trans People

The anti-transgender activist Posie Parker in Aotearoa NZ An Industry Built on Inversion Anti-transgender hate is an industry. Not a movement, not a moral concern, not an organic uprising of worried parents — an industry, deliberately constructed, lavishly funded, and strategically deployed to protect the interests of the powerful men who finance it. And like most industries built on fear, it requires a credible monster. Transgender people — a community representing roughly one percent of the population, facing disproportionate rates of poverty, violence, suicide, and discrimination — have been selected for that role with remarkable precision. The 2025–2026 release of the Jeffrey Epstein files has made something newly visible that was always structurally present: the men who built the ideological infrastructure of anti-trans politics are, in many cases, the same men — or the direct intellectual descendants of the same men — who moved through the social world of a convicted child sex tr...

Mohan Dutta: Culture-Centered Approach

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