The end of the epidemiology wars? Epidemiological ‘ethics’ and the challenge of translation

Abstract

This article presents findings from a content analysis of the epidemiological literature from 1990 to 2007. We argue that the notion of multi-causality served as a boundary object that, on the surface, helped to defuse many of the conflicts raised by the so-called ‘epidemiology wars’ of the mid-1990s. But underneath this apparent consensus, we find that epidemiologists have forged two largely divergent ways of navigating their way through a thicket of questions about units and levels of analysis, the nature of disease causation, and the role of epidemiologists in public affairs. The inductive ethic delineates a data-driven enterprise, in which the mission of epidemiology is articulated as determining disease etiology, and it is frequently espoused by epidemiologists interested in the effects of genetic and behavioral risk factors. In contrast, the deductive stance argues for a theory-driven approach, reflecting a historical concern in epidemiology with population-level dynamics. These ethics encompass commitments to differing causal frameworks and views of scientific credibility and social responsibility. Based on these findings, we offer some reflections on the relationships among boundary objects, translation processes, and methods standardization, and how these highlight the challenges to interdisciplinarity in scientific work.