This collection is dedicated to the diagnostic moment and its unrivaled influence on encompassment and exclusion in health care. Diagnosis is seen as both an expression and a vehicle of biomedical hegemony, yet it is also a necessary and speculative tool for the identification of and response to suffering in any healing system. Social scientific studies of medicalization and the production of medical knowledge have revealed tremendous controversy within, and factitiousness at the outer parameters of, diagnosable conditions. Yet the ethnographically rich and theoretically complex history of such studies has not yet congealed into a coherent structural critique of the process and broader implications of diagnosis. This volume meets that challenge, directing attention to three distinctive realms of diagnostic conflict: in the role of diagnosis to grant access to care, in processes of medicalization and resistance, and in the transforming and transformative position of diagnosis for 21st-century global health. Smith-Morris’s framework repositions diagnosis as central to critical global health inquiry. The collected authors question specific diagnoses (e.g., Lyme disease, Parkinson's, andropause, psychosis) as well as the structural and epistemological factors behind a disease’s naming and experience.
"Diagnostic Controversy provides a diverse and intriguing window into the 'diagnostic moment,' when clinicians provide and patients learn what disease they have. In the vein of Latour and Woolgar’s Laboratory Life, the authors provide an anthropology of knowledge about how diagnoses are constructed and how what is often presented as a medico-technical enterprise is suffused with cultural, social, political and economic influences. The broad set of case studies in this book, edited by Carolyn Smith-Morris, provide rich examples from a range of disease categories, not only psychiatric diagnoses that have been a major critical focus of medical anthropologists. The book interrogates a central question in medical anthropology about the boundaries between the normal and the abnormal, introduced to the field by Ruth Benedict in 1934. The book provides new directions in 'critical studies of biomedical praxis' that both informs the field in new ways about the process of diagnosis and provides a framework for on-going interrogation of medical diagnosis as a highly social and cultural practice, even as medical science further emphasizes the biological and genetic bases of disease."
- Peter J. Guarnaccia, Professor, Department of Human Ecology, Cook College and Investigator, Institute for Health, Health Care Policy and Aging Research, Rutgers University
"This groundbreaking book challenges the assumption central to global health efforts that prioritizes standardization of diagnoses, to impose uniformity and promote regulation across geographical and social boundaries. The authors explore the production and negotiation of diagnoses, and argue powerfully that diagnoses are not objective entities but rather are constituted and renegotiated by processes that are not value-neutral. Rich case studies demonstrate strategies of knowing, the emergence of new diagnoses in particular social contexts, and the personal, professional, epidemiological and financial interests that generate diagnostic controversies and contested power relations. This volume is compelling in its argument that diagnosis is less authoritative than uncertain, subject to resistance as well as accommodation. This is the most innovative work on diagnosis as a construct and its implications for healing praxis since the early 1980s and one that is destined to become a classic in medical anthropology."
-Carolyn Sargent, Professor, Sociocultural Anthropology and Women, Gender, and Sexuality Studies, Washington University in St. Louis
Introduction 1. Diagnosis as the Threshold to 21st-Century Health Carolyn Smith-Morris Part I: Diagnostic Access 2. Testing Pregnant Women for HIV: Contestations in the Global Effort to Reduce the Spread of AIDS Anita Hardon 3. Resisting Tuberculosis or TB Resistance: Enacting Diagnosis in Georgian Labs and Prisons Erin Koch Part II: Medicalization and Resistance to Diagnosis 4. Promotion of Andropause in Brazil: A Case of Male Medicalization Fabiola Rohden 5. Making Sense of Unmeasurable Suffering: The Recontextualization of Debut Stories to a Diagnosis of Chronic Fatigue Syndrome Lisbeth Sachs 6. Credibility and the Inexplicable: Parkinson's Disease and Assumed Diagnosis in Contemporary Australia Narelle Warren and Lenore Manderson 7. Defiance, Epistemologies of Ignorance, and Giving Uptake Properly Nancy Nyquist Potter Part III: Diagnosis in a Global Community 8. Supervirus: The Framing of a Doomsday Diagnosis Johanna Crane 9. Diagnosing Psychosis: Scientific Uncertainty, Locally and Globally Neely Myers 10. The Lyme Wars: The Effects of Biocommunicability, Gender, and Epistemic Politics on Health Activation and Lyme Science Georgia Davis and Mark Nichter Afterword Afterword: Diagnosis: To Tell Apart Atwood D. Gaines