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Set, Setting, and Clinical Trials: Colonial Technologies and Psychedelics

Experiment

Abstract

This chapter brings together ethnographic work on technologies of healing, pharmaceutical and psychedelic clinical trials, and ceremonial uses of the Amazonian herbal brew ayahuasca. Building on a review of anthropological work on clinical trials, we argue that randomised controlled trials (RCTs), even psychedelic ones, have been captured by the pharmaceutical industry in its quest to grow profits rather than reduce illness. We track the role that the category of technology plays in continued industrialised, colonial, genocidal, and dispossessive violence. This includes institutions of intellectual property, evidence-based medicine, RCTs, pharmaceuticals, drugs, active ingredients, industrial medicine, diagnostic standards, investment capital, and treatment sovereignty. Using the idea of container technologies, we discuss how psychedelic clinical trials attempt to expand the magic bullet experimentally, to reveal set and setting. We contrast this with arguments by Indigenous scholars that ayahuasca is not a psychedelic, and that ceremonial work cannot be separated from ongoing colonial violence. Holding space for ceremonial work means refusing to know what the problem is ahead of the encounter with the plant spirit. Such settings are explicitly anti-causal, unpredictable, and deeply paradoxical, allowing something to happen that is not reducible to action, intention, or the act of containing.

Keywords

  • Ayahuasca
  • Capitalism
  • Colonial technologies
  • Holding space
  • Untranslatability

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Notes

  1. 1.

    Arguing for a better definition of technology does not change the ongoing effect of the category of the standard view of technology. Collaborations between Indigenous actors and colonial states or pharmaceutical companies are important in their successes and failures (Wahlberg 2008a), but they do not change the ongoing effects of state, colonial, and capitalist violence on communities conducted under the banner of medical and technological development.

  2. 2.

    COVID-19 has brought some (but only some) of these structural inequalities in medicine to the fore, but not essentially changed them (Metzl et al. 2020).

  3. 3.

    Medical historian Oram argues that Savage’s experiments with LSD to treat depressed and psychotic patients were not only the first to make use of a control group in LSD research, but one of the earliest examples of controlled experimentality in psychiatry (Oram 2018, p. 29).

  4. 4.

    These are summary notes taken by the authors attending a virtual conference. Speakers have been anonymised as per the IRB.

  5. 5.

    An English version of the text is available here: https://chacruna.net/declaration-of-the-3rd-brazilian-indigenous-conference-on-ayahuasca/. Accessed 3 November 2020.

  6. 6.

    On ‘healers, but not only’, see de la Cadena (2015).

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Acknowledgements

This research was made possible by generous support from the ERC Starting Grant n°757589 ‘Healing Encounters: reinventing an indigenous medicine in the clinic and beyond’ based at CERMES3 (Université de Paris, EHESS, CNRS). The authors acknowledge invaluable feedback from the Oxidate Writing Group, as well as by the editors and anonymous reviewers of this Handbook.

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Dumit, J., Sanabria, E. (2022). Set, Setting, and Clinical Trials: Colonial Technologies and Psychedelics. In: , et al. The Palgrave Handbook of the Anthropology of Technology. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-16-7084-8_15

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  • DOI: https://doi.org/10.1007/978-981-16-7084-8_15

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