Kairos as indeterminate risk management: The pharmaceutical industry's response to bioterrorism

Quarterly Journal of Speech

Volumn 92, Issue 2, 2006, Pages 115-143

  Blake Scott, J ^a,b  

^a UNIVERSITY OF CENTRAL FLORIDA   (United States)

^b NONE   (United States)

Author keywords

Bioterrorism; Globalization; Kairos; Pharmaceutical; Risk

Indexed keywords

EID: 33746144523     PISSN: 00335630     EISSN: 14795779     Source Type: Journal    
DOI: 10.1080/00335630600816938     Document Type: Review

References (128)

1. The Associated Press, "Bush Signs Vaccine Stockpile Legislation," July 21, 2004, http://www.msnbc.msn.com/id/5472564.
2. Carolyn R. Miller, "Opportunity, Opportunism, and Progress: Kairos in the Rhetoric of Technology," Argumentation 8 (1994): 81-96.
3. Miller, "Opportunity, Opportunism, and Progress," 93.
4. Of course, this could also be argued of the Bush administration, which seized the moment of signing BioShield into law - in the middle of the presidential campaign - to counter waning support for the war in Iraq and on terror.
5. Scott Consigny, "Rhetoric and Its Situations," Philosophy and Rhetoric 7 (1974): 175-86, 177;
6. Debra Hawhee, Bodily Arts: Rhetoric and Athletics in Ancient Greece (Austin: University of Texas Press, 2005), 77.
7. Miller, "Opportunity, Opportunism, and Progress," 83.
8. Quoted in Amélie Frost Benedikt, "On Doing the Right Thing at the Right Time: Toward an Ethics of Kairos" in Rhetoric and Kairos; Essays in History, Theory, and Praxis, ed. Philip Sipiora and James S. Baumlin, 226-235 (Albany, NY: SUNY Press, 2002), 228.
9. See Benedikt, "On Doing the Right Thing," 229, where she also discusses Plato's concern with what he saw as Gorgias's overemphasis on invention. See also Hawhee, Bodily Arts, on the importance of bodily training to the sophistic and larger classical teaching of kairos.
10. Erwin Panofsky, Studies in Iconology: Humanistic Themes in the Art of the Renaissance (Bolder, CO: Westview Press, 1972), 71-2;
11. Hawhee, Bodily Arts, 71-6.
12. Hawhee, Bodily Arts, 75.
13. Hawhee, Bodily Arts, 68. In the accommodation model of kairos, deployed by James Kinneavy and others, the rhetor must "consider and adapt to the tones and moods of the situation at hand," explains Hawhee. In the creation model, the "rhetor-in-charge creates his or her own openings."
14. John E. Smith, "Time and Qualitative Time," in Rhetoric and Kairos: Essays in History, Theory, and Praxis, edited Philip Sipiora and James S. Baumlin, 46-57 (Albany, NY: SUNY Press, 2002), 47-8.
15. Hawhee, Bodily Arts, 68.
16. Miller, "Opportunity, Opportunism, and Progress," 83-4.
17. Mary Garrett and Xiaosui Xiao, '"The Rhetorical Situation' Revisited," Rhetoric Society Quarterly 23, no. 2 (Spring 1993): 30-40, 14.
18. Eric Charles White, Kaironomia: On the Will-to-Invent (Ithaca, NY: Cornell University Press, 1987), 14.
19. Hawhee, Bodily Arts, 70.
20. Smith, "Time and Qualitative Time," 50.
21. Smith, "Time and Qualitative Time," 48.
22. Miller, "Opportunity, Opportunism, and Progress," 89.
23. Miller, "Opportunity, Opportunism, and Progress," 90.
24. Miller, "Opportunity, Opportunism, and Progress," 92.
25. Steven B. Katz and Carolyn R. Miller, "The Low-Level Radioactive Waste Siting Controversy in North Carolina," in Green Culture: Environmental Rhetoric in Contemporary America, ed. Carl G. Herndl and Stuart C. Brown, 111-40 (Madison: University of Wisconsin Press, 1996), 132.
26. On the "technocratic" model, see Craig Waddell, "Saving the Great Lakes: Public Participation in Environmental Policy," in Green Culture.
27. Jeffrey T. Grabill and W. Michele Simmons, "Toward a Critical Rhetoric of Risk Communication: Producing Citizens and the Role of Technical Communicators," Technical Communication Quarterly 7, no. 4 (1998): 415-41.
28. Beverly Sauer, The Rhetoric of Risk: Technical Documentation in Hazardous Environments (Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2003), 15.
29. Deborah Lupton, Risk (New York: Routledge, 1999), 33.
30. Mitchell Dean, "Risk, Calculable and Uncalculable," in Risk and Sociocultural Theory: New Directions and Perspective, ed. Deborah Lupton, 131-59 (Cambridge: Cambridge University Press, 1999), 142.
31. Jenny Edbauer. "Unframing Models of Public Distribution: From Rhetorical Situation to Rhetorical Ecologies," Rhetoric Society Quarterly 35, no. 4 (2005): 5-24, 20.
32. One of Beck's main examples of risk is that of environmental destruction and the host of health and other effects that it can enable.
33. Beck more specifically describes the shift to a second modernity as involving the weakening of states and corresponding strengthening of transnational corporations, economic deregulation, the flexibilization of labor, and the growth of unemployment and under-employment; see Ulrich Beck, World Risk Society (Cambridge, UK: Polity Press, 1999), 3.
34. Ulrich Beck and Johannes Willms, Conversations with Ulrich Beck, trans. Michael Pollak (Cambridge, UK: Polity Press, 2004), 111.
35. Mitchell Dean, "Risk, Calculable and Uncalculable," in Risk and Sociocultural Theory: New Directions and Perspective, 135.
36. Francois Ewald, "Insurance and Risk," in The Foucault Effect: Studies in Governmentality, ed. Graham Burchell, Colin Gordon, and Peter Miller, 197-210 (Chicago: University of Chicago Press, 1991), 199.
37. Beck, World Risk Society, 140.
38. See also John Tulloch and Deborah Lupton, Risk and Everyday Life (London: Sage, 2003), 3. Beck offers advances in genetic knowledge and technology as an example of this phenomenon.
39. See Ewald, "Insurance and Risk";
40. Lupton, Risk;
41. Nick J. Fox, "Postmodern Reflections on 'Risk,' 'Hazards,' and Life Choices," in Risk and Sociocultural Theory, 12-33.
42. Even in his earlier published Risk Society, Beck states that risks "only exist in terms of the (scientific or anti-scientific) knowledge about them. They can be changed, magnified, dramatized, or minimized within knowledge and to that extent they are particularly open to social definition and construction"; see Ulrich Beck, Risk Society: Towards a New Modernity, trans. Mark Ritter (London: Sage, 1992), 23.
43. Beck and Willms, Conversations with Ulrich Beck, 120.
44. Ulrich Beck, "Risk Society Revisited: Theory, Politics, and Research Programmes," in The Risk Society and Beyond, ed. B. Adam, U. Beck, and J. Van Loon, 211-19 (London: Sage, 2000), 213. In his widely cited essay "Insurance and Risk," Ewald offers an even more clearly constructionist view that some critics align with Foucault but not Beck: "Nothing is a risk in itself; there is no risk in reality. But on the other hand, anything can be a risk; it all depends on how one analyzes the danger, considers the event," 199.
45. Stephen Hilgartner, "The Social Construction of Risk Objects: Or, How to Pry Open Networks of Risk," in Organizations, Uncertainties, and Risk, ed. J. Short and L. Clark, 39-53 (Boulder, CO: Westview Press, 1992).
46. Ulrich Beck, What is Globalization? (Cambridge, UK: Polity Press, 2000), 120.
47. Beck, What is Globalization?, 122.
48. Lupton, Risk, 31.
49. For a similar argument about the concept of risk in the institutional processes of insurance, see Elizabeth Britt, "The Rhetorical Work of Institutions," in Critical Power Tools: Technical Communication and Cultural Studies, ed. J. Blake Scott, Bernadette Long, and Katherine V. Wills (Albany: SUNY Press, 2006).
50. Beck, World Risk Society, 143.
51. See Public Citizen, America's Other Drug Problem: A Briefing Book on the Rx Drug Debate, http://www.citizen.org/documents/drugbriefingbk.pdf;
52. Families USA Foundation, Profiting from Pain: Where Prescription Drug Dollars Go (July 2002), http://www.familiesusa.org/site/docserver/ppreport.pdf? docid = 249;
53. Families USA Foundation, Out of Bounds: Risking Prescription Drug Prices for Seniors (July 2003), http://www.familiesusa.org/site/docserver/ out_of_bounds.pdf?docid = 1522.
54. America's Other Drug Problem, 65.
55. America's Other Drug Problem, 34.
56. John Tomlinson, Globalization and Culture (Chicago: University of Chicago Press, 1999);
57. Michael Hardt and Antonio Negri, Empire (Cambridge, MA: Harvard University Press, 2000).
58. Beck and Roland Robertson also write about the simultaneous diffusion and fragmentation of power on the one hand and intensification of transnational interdependence on the other; Beck, What is Globalization?, 47-9.
59. Arjun Appadurai, Modernity at Large: Cultural Dimensions of Globalization (Minneapolis: University of Minnesota Press, 1996).
60. Beck, What is Globalization?, 65;
61. William K. Tabb, Unequal Partners: A Primer on Globalization (New York: The New Press, 2002), 2.
62. See Beck, What is Globalization?, on NGOs as a growing "third force" (between markets and states) that comprise "the first outlines of a 'global citizenship'" (38).
63. See Appadurai, Modernity at Large, on how globalization has led to new forms of transnational political linkage and delocalized political communications (196).
64. Brook K. Baker, African AIDS: Impacts of Globalization, Pharmaceutical Apartheid, and Treatment Activism (January 9, 2002), Health Global Access Project, http://www.healthgaporg/press_releases/01/040301_bbaker_ppr_sa.pdf, 22.
65. For examples of such programs, see the PhRMA publication Global Partnerships, on the Web at http://world.phrma.org/global.partnership.2003.pdf, and websites of individual pharmaceutical companies (including Bristol_Myers Squibb, Abbott, GlaxoSmithKline, Merck, and Pfizer).
66. For a critique of the industry's philanthropic efforts, see Beyond Philanthropy, a joint report by Oxfam, Save the Children, and VSO, on the Web at http://www.oxfam.org.uk/what_we_do/issues/health/downloads/beyondphilanthropy. pdf.
67. Justin Gillis, "Scientists Race for Vaccines: Drug Companies Called Key to Bioterror Fight," The Washington Post, November 8, 2001, El, emphasis mine.
68. Miller, "Opportunity, Opportunism, and Progress," 93.
69. Playing off big pharma's offer to increase the National Pharmaceutical Stockpile after the anthrax attacks, two New York Times reporters characterized the industry's motive as "stockpiling goodwill" for future crises (Leslie Wayne and Melody Petersen, "A Muscular Lobby Rolls Up Its Sleeves," November 4, 2001, 3:1).
70. Linda D. Kozaryn, Bush Signs Health Security, Bioterrorism Act, American Forces Press Service, press release, June 13, 2002, http://www.defenselink.mil/ news/Jun2002/n06132002_200206133.html.
71. Wayne and Petersen, "A Muscular Lobby."
72. Gillis, "Scientists Race for Vaccines."
73. PhRMA, Former Head of FDA and Veteran of the Public Health Service, Dr. Michael Friedman, to Lead PhRMA's Task Force for Biomedical Preparedness, press release, October 30, 2001, http://www.phrma.org/mediaroom/press/releases/30.10. 2001.303.cfm.
74. Pfizer, Pfizer Enlists in the War on Terror, press release, October 24, 2001, http://www.pfizer.com/are/news_releases/mn_2001_1024b.html.
75. In Gillis, "Scientists Race for Vaccines."
76. See Pfizer, Pfizer Enlists.
77. Gillis, "Scientists Race for Vaccines."
78. Cited in Tulloch and Lupton, Risk and Everyday Life, 6.
79. Justin Gillis, "Drugmakers Step Forward in Bioterror Fight; Free, Discounted Pills Offered," The Washington Post, October 31, 2001, A18.
80. PhRMA, America's Pharmaceutical Companies Create Task Force on Emergency Preparedness, press release, October 17, 2001, http://www.phrma.org/mediaroom/ press/releases///17.10.2001.299.cfm.
81. Pfizer, Pfizer Enlists.
82. See, for example, the following websites: http://www.merck.com, http://www.bayer.com, www.bms.com/landing/data/index.html, and http://www.pfizer.com/pfizer/main.jsp.
83. PhRMA, Former Head of FDA.
84. Gillis, "Scientists Race for Vaccines."
85. Wayne and Petersen, "A Muscular Lobby.".
86. In Gardiner Harris, "Questions of Security: Bayer is Accused of Profiteering on Cipro," The Wall Street Journal, October 26, 2001, A6.
87. PhRMA, America's Pharmaceutical Companies Partner with Federal Government to Launch Educational Programs on Bioterrorist Threats, press release, April 11, 2002, http://www.phrma.org/mediaroom/press/releases/11.04.2002.384.cfm. The Homeland Health website was on the Web at http://homelandhealth.com but has since been removed.
88. In Andrew Pollack, "A Nation Challenged: The Drug Makers; Antibiotics Business is Again Popular," The New York Times, November 13, 2001, B6.
89. See Keith Bradsher, "A Nation Challenged: The Drug Makers; Industry Seeks U.S. Contracts to Develop Antibiotics," The New York Times, October 31, 2001, B1.
90. In testimony before a U.S. House committee meeting on Project Bioshield, the head of the Biotechnology Industry Organization (BIO) suggested that the government's investment in anti-bioterror technology should be comparable to its investment in fighting the nuclear threat (see J. Leighton Read, BIO Testimony on Project Bioshield, Biotechnology Industry Organization, March 27, 2003, http://www.bio.org/healthcare/biodefense/20030327.asp?p=yes&).
91. Actually, the FDA had approved other antibiotics for anthrax but did not specify whether they could be used to treat the inhalation form.
92. Keith Bradsher and Melody Petersen, "A Nation Challenged: The Drug Makers; Offers of Free and Discounted Medicine May Help Industry Prevent New Regulations," The New York Times, October 27, 2001, B8.
93. Wayne and Petersen, "A Muscular Lobby."
94. John E. Calfee, Biotenorism and Pharmaceuticals: The Influence of Secretary Thompson's Cipro Negotiations (November 1, 2001), American Enterprise Institute for Public Policy Research, 4, http://www.aei.org/publications/pubID. 14863/pub_detail.asp.
95. Harris, "Questions of Security."
96. Calfee, Bioterrorism and Pharmaceuticals, 14.
97. Wayne and Petersen, "A Muscular Lobby."
98. Harris, "Questions of Security."
99. PhRMA, Statement by Shannon Herzfeld, Senior Vice President for International Affairs at PhRMA, press release, October 18, 2001, http://www.phrma.org/mediaroom/press/releases/18.10.2001.300.cfm.
100. Bayer, Bayer Expert Assures Congress that Company Will Continue to Meet Nation's Needs for Cipro, press release, October 23, 2001, http://www.ciprousa. com/news/press_releases_ agreement.asp.
101. Bradsher, "A Nation Challenged: The Drug Makers; Industry Seeks U.S. Contracts." [85] Bayer, Bayer Expert Assures Congress.
102. Bayer, You Can Count on Us, press release, 2001, http://www.ciprousa.com/ news/press_ releases_count_ad.asp.
103. Bayer, Bayer Expert Assures Congress.
104. Bayer, "You Can Count on Us."
105. Bayer, Our Commitment to You, press release, 2001, http://www.ciprousa. com/news/press_releases_message.asp.
106. Harris, "Questions of Security."
107. USA Today, "Cipro Saga Exposes How Drugmakers Protect Profits," October 29, 2001, A14.
108. Beck, Risk Society, 37.
109. Wayne and Petersen, "A Muscular Lobby."
110. In Bradsher and Petersen, "A Nation Challenged: The Drug Makers; Offers of Free and Discounted Medicine."
111. Alan F. Holmer, "Patent Protection is Key," USA Today, October 29, 2001, A14.
112. Although we might be tempted to call such drugs lower-risk, the recent safety alerts and litigation around the arthritis painkiller Vioxx and similar drugs would suggest otherwise.
113. Ironically, such arguments about the efficiency of "free" market approaches usually depend on the assumption that the government will continue to intervene in and regulate this market to the advantage of big pharma.
114. Calfee, Bioterrorism and Pharmaceuticals, 33.
115. See, for example, Kelly Hearn, "Activists: Poor Countries Need AIDS Meds," AEGIS/United Press International, November 1, 2001, http://www.aegis.com/news/upi/2001/UP011108.html.
116. Beck, What is Globalization?, 113.
117. Sabin Russell, "U.S. Push for Cheap Cipro Haunts AIDS Drug Dispute," The San Francisco Chronicle, November 8, 2001, A13.
118. Geoff Winestock and Helene Cooper, "Activists Outmaneuver Drug Makers at WTO," The Wall Street Journal, November 14, 2001, A2.
119. Beck, "Risk Society Revisited," 3.
120. Doyle, On Beyond Living: Rhetorical Transformations of the Life Sciences (Stanford: Stanford University Press, 1997), 3-5.
121. Edbauer, "Unframing Models of Public Distribution," 13.
122. Hardt and Negri, Empire, 136.
123. Although global power moves through diffuse networks of cultural relations, we can still identify concentrated nodes of power such as the U.S. federal government and transnational industry alliances. On this point I depart from the argument of Michael Hardt and Antonio Negri in Empire.
124. Beck and Willms, Conversations with Ulrich Beck, 52.
125. Edbauer, "Unframing Models of Public Distribution" 20.
126. Beck and Willms, Conversations with Ulrich Beck, 34.
127. Miller, "Opportunity, Opportunism, and Progress," 91.
128. For a different but complementary example of this project, see Britt's "The Rhetorical Work of Institutions," in which she uses theories of risk by Mary Douglas and Francois Ewald to show how insurance institutions are both discursive formations, engaged in and constituted by rhetoric, and cultural agents, "entangled with other institutions." In doing so, Britt brings institutions under the purview of rhetorical and cultural critique.