CERMES3 (Centre for research on medicine, science, health, mental health, and society) is a multidisciplinary research centre dedicated to the social analysis of transformations in the fields of the sciences, medicine and health, as well as their relationships with society. In its current programme, the choice was made to analyse these transformations in light of the notion of “crisis”, by focusing on the specific consequences brought about by the convergence of various kinds of crises. The research centre brings together sociologists, historians, anthropologists, political scientists, economists, psychologists and philosophers.
CERMES3 is a research unit of the CNRS (National Centre for Scientific Research, UMR 8211), Inserm (National Institute for Medical Research, U 988), the EHESS, (School of Advanced Studies in the Social Sciences), and the University of Paris. It is associated with two Labex (Laboratory of Excellence): Sites and Tepsis.
CERMES3 originated with the merging in 2010 of Cermes – a joint unit of the CNRS, Inserm and the EHESS founded in 1986 by Claudine Herzlich and directed from 1998 to 2009 by Martine Bungener – and the Cesame, a joint unit of the CNRS, Inserm and the University Paris-Descartes, created in 2004 and directed by Alain Ehrenberg.
Under the direction of Jean-Paul Gaudillière from 2010 to 2018, Cermes3 focused its work on the social analysis of contemporary transformations in the domains of science, medicine and health, and their relationships with society.
The Cermes3 scientific project today
In its new scientific programme, Cermes3 chose to continue its work on transformations in the areas of medicine and health by emphasizing the notion of crisis in order to study rising tensions within the domains of medicine and health likely to lead to disruption or radical change. This entails exploring the effects of these crises on health and social welfare policies in order to clarify disagreements and negotiations concerning the expansion of universal health coverage, the cost of medical innovations and the creation of new measures of solidarity and care of patients and populations. We are also interested in the consequences for the health domain of the crises similarly affecting therapeutic innovation, scientific expertise, environmental health and the managing of humanitarian emergencies. The objective is therefore to favour a social sciences approach in order to clarify the social and political dynamics of crises influencing the domains of health and medicine, but also to identify what is at stake concerning their political, economic, legal and ethical characteristics. More generally, our analyses contribute to an understanding of transformations in our globalised societies that requires an approach using perspectives from several different angles: the management of expertise, the work environment, and the creation, use and consequences of innovations.
In order to carry out this programme, which links crises and medical, health and social transformations, our research centre marshals expertise in four areas:
- specific skills regarding the production, diffusion and use of knowledge and techniques;
- a varied and multifaceted approach to innovation, at the crossroads of health needs, social welfare and markets;
- the observation of medical and care work and practices;
- a renewed approach to globalisation taking into account the effects of symmetry between Northern and Southern countries.
Our work continues the historical themes of Cermes3 (the relationship to scientific knowledge; the importance of technical tools in clinical practice; health policies…), while opening up new areas of investigation and more directly confronting issues affecting the field of health brought about by present crises.
To carry out this programme, Cermes3 deploys transdisciplinary approaches able to bring together sociologists, historians, anthropologists, political scientists, psychologists and economists to study subjects and projects they have in common, using complementary methods of investigation (archives, ethnographic studies, interviews, quantitative analyses). It carries out research projects in close cooperation with jurists and philosophers, but also with those doing research in biomedicine (clinicians, biologists) and in public health.
The research centre programme brings together three main multidisciplinary research themes:
1/ diversification of health care practices and settings
Our interest here is in the diversification of care practices as they are carried out in different social contexts: within medicine, but also at school, in the family, at work, etc… This research will continue previous work of the CERMES on medical practice, critically examining the effects of crises on care practices: deinstitutionalisation, a reconsideration of professionalism and the instrumentalisation of care. We will study formal and informal health care organisations, their transformations and the way they reallocate healthcare work among professional or lay actors. We will examine health care trajectories as well, by focusing simultaneously on two ways of gaining input: through individuals and through healthcare facilities.
2/ policies related to knowledge
Research in this thematic area concerns systems of (co)production of health knowledge, envisaged as three types of complementary configurations: biomedical research, interventions on behalf of populations, and procedures for defining expertise. Our principle objective consists in using several methods for analysing the stakes involved in policies underlying the production and diffusion of knowledge, in order to better understand the different kinds of “crises” and other partially interwoven “critical situations”: crisis of objectivity, crisis of therapeutic and technological innovation, crisis of models used in caring for target populations, crisis of expertise…. The underlying hypothesis for our research is that most of the increasingly sharp criticisms over the course of the past decades aimed at procedures for defining expertise – as well as at ways of producing and publicising scientific knowledge in the area of health – are based on a series of tensions created by references to the objectivity of the scientist, and by extension, of the expert. Neither the fact that many authors have highlighted the unattainability of this absolute imperative of distancing – which appeared in the nineteenth century – nor the more recent formulation of alternative epistemologies, has led to a questioning of this central but also problematic social norm. Our research aims in particular to explore the two complementary aspects of this "crisis of objectivity": conflicts of interest on the one hand, and the symmetrical inability of experts and scientists to give full consideration to the legitimate interests of patients and the different categories of users, on the other.
3/ innovation, markets and social welfare
Links between social welfare and healthcare markets have gone through remarkable changes for several decades. While the financing and profitability of health goods and services still depend on social coverage that ensures the solvency of the demands made on them, the understanding arrived at between innovation and social coverage may be about to break down because of a dizzying inflation in prices that are being called into question by public and social payers in the United States and Europe, especially concerning cancer and hepatitis. Prices of and accessibility to innovations in low and middle income countries in the South continue to be major issues in the context of still-quite tentative projects for universal coverage backed by WHO. At the same time, there are increasing health problems linked to the unbridled diffusion of chemical products or ingredients (pesticides, herbicides, household products), the harmfulness of which, when it is detected, may give rise to sometimes divergent national and/or international reactions. Nation states, the traditional places where health protection of populations is located, are thus overwhelmed by the development of often intertwined markets whose influence on public health is either harmful or at least difficult to ascertain. Our research programme has 4 themes: 1) tensions between social coverage and innovations; 2) the transnational logic of healthcare markets; 3) the impact of innovations on health risks and their management; 4) the globalisation of markets and the diffusion of social welfare models.
Partners and collaborators
While research contracts and international collaboration established by researchers at Cermes3 testify to the academic influence of their work, the latter is also largely disseminated to public health authorities through participation by the researchers on public health advisory bodies or scientific committees of health agencies. The involvement of the centre’s members in the supervision of several Masters programmes reflects their investment in teaching and in training for research.
Enrolment in two Labex with strongly complementary themes:
SITES – Science, Innovation and Technique in Society
Sites is sponsored by the PRES (Research and Higher Education Centre) at Paris-Est University (ESIEE, École des Ponts PartiTech, UPEM), the Pres Hesam (EHESS, Cnam), the CNRS, the INRA, the IRD and the University Paris 13. Sites brings together more than 150 researchers belonging to 7 research groups working on sciences and technology, the dynamics of their production, and their relationships to the economy and to aspects of policy.
TEPSIS – State transformation, politisation of sociétés, institution for social issues
Sponsored by the Pres Hesam (EHESS, Cnam), Tepsis brings together researchers and teams belonging to 13 Joint Research Units associated with the CNRS and the ENA research centre. The subject of their research is the diversity of modes in policy involvement in the urban environment and within social settings.
- Master of Health, populations, policies and social interventions – Focus Health, Populations and Social Policies, EHESS Pars;
- Master in Risk Management of Crises – Focus Social Sciences, University of Paris;
- Master in Social Sciences, emphasis on survey sociology, University of Paris;
- Master Research and Evaluation in the health and social sector (EVSAN), University of Paris;
- Master in Contemporary Societies, University of Paris.
- Doctoral Schools:
- Doctoral School Social Sciences – EHESS;
- Doctoral School Sciences, Knowledge, Education – University of Paris;
- Doctoral School Science of Societies – University of Paris.
A genuine multidisciplinary scientific coordination enriches and complements the work of thesis directors of doctoral students (more than 50 at present, all of them funded). This includes thesis committees, doctoral student seminars, workshops, doctoral student days.
This policy continues through the hosting of post-doctoral students, with the aim of completing their training and accompanying them in their professional development (teaching, research, or other).