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Vulnerability as practice in diagnosing multiple conditions
- Source :
- Medical Humanities, Medical humanities, 2019, Vol.45(3), pp.278-287 [Peer Reviewed Journal]
- Publication Year :
- 2018
- Publisher :
- BMJ Publishing Group, 2018.
-
Abstract
- The paper contributes to contemporary understandings of vulnerability by expanding their scope with an understanding of vulnerability as generated through institutionalised practices. The argument draws on experiential accounts of navigating the practices of diagnosis by people living with multiple conditions of ill-health and disability. Vulnerability as a concept is used widely across different domains and conveys a multitude of meanings. Contemporary biomedicine, and its associated health systems and services, understands vulnerability mostly as inherent to particular physical and mental bodily conditions that put people at risk of ill-health or emotionally fragility. This may combine with a more epidemiological understanding of vulnerability as the experience of certain population groups subject to entrenched structural inequalities. Philosophers and feminists have argued that vulnerability is a universal experience of being human while political commentators have explored its potential as a resource for resistance and action. Diagnosis within medicine and psychiatry has been the subject of extensive social analysis, critique and activism. The paper draws on first-hand experiential accounts collected through face-to-face interviews with people living with multiple conditions about their experiences of diagnosis, mostly at the primary care level. We identify five aspects to diagnostic practice that are harmful and exacerbate the experience of vulnerability: temporal sequencing; diagnostic authority; medical specialisation; strategic symptom selection; medical isolation. However, these diagnostic practices are not best understood only in terms of the power asymmetries inherent to the medical consultation, but are embedded into the very institution of diagnosis. The paper thus proposes a combined approach to vulnerability that recognises it as a universal condition of humanity but one that becomes animated or amplified for some bodies, through their own inherent incapacities or the external structures of inequality, and through the practices of medicine as situated in particular times and places.
- Subjects :
- Adult
Male
patient narratives
medical humanities
media_common.quotation_subject
Population
Vulnerability
Experiential learning
Vulnerable Populations
Pathology and Forensic Medicine
03 medical and health sciences
primary care
Humanities
0302 clinical medicine
Argument
social science
050602 political science & public administration
Institution
Humans
Medical humanities
030212 general & internal medicine
Sociology
Multiple Chronic Conditions
education
media_common
Original Research
education.field_of_study
05 social sciences
Multitude
Environmental ethics
Middle Aged
3. Good health
0506 political science
Philosophy
Action (philosophy)
Female
Subjects
Details
- Language :
- English
- ISSN :
- 14734265 and 1468215X
- Volume :
- 45
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Medical Humanities
- Accession number :
- edsair.doi.dedup.....0ff091bc4e9ca65359acf4b79b892cd3