Abstract

Background: Access to the means of knowledge production is severely limited for many individuals who are socially, politically, and economically disadvantaged. Of particular concern, largely overlooked in bioethics discourse, is the manner by which surveillance, identification, and classification contribute to the creation of particular populations based on harmful social identities, and the subsequent stigmatization of the individuals subject to analysis. 
 Methods: Drawing from a range of philosophical and sociological literature, including Hans-Georg Gadamer, Charles Taylor, Bruno Latour, and Deborah Lupton, as well as public health discourse, this paper gives an analysis of a challenging metaphysical and ethical problem related to research practices and public health interventions in vulnerable communities. The themes of objectivism and stigmatization are illuminated by focusing on research related to HIV infection among survival sex workers in Vancouver’s downtown eastside. 
 Results: Reductionist models of human behaviour presuppose a clear distinction between description and evaluation, contributing to an understanding of social reality as structured by objective, base level data, and misconstruing modes of social relations as individual action. In the context of HIV risk, an ethical problem emerges: describing individual actions as “data,” or “fact,” serves to construct and reinforce transgressive social identities. Given that stigmatization is itself part of the context of adverse health outcomes and HIV infection, practices relying on methods that presume representational authority and fail to critically interpret human action are ethically problematic. Resolving difficulties within the methodological underpinnings of public health and HIV behavioural research requires an understanding of many social science methods as hermeneutical, while enabling the contribution of disparate standpoints to the production of scientific knowledge. 
 Conclusions: The implications of presumed objectivity and representational authority demand a reconsideration of how research in vulnerable communities might be conducted, such that it produces results that are scientifically rigorous and socially responsible.

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