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Vulnerability as practice in diagnosing multiple conditions.
Lindsay-Ann Coyle1, Sarah Atkinson1
1Institute for Medical Humanities, Durham University, Durham, UK.
Medical Humanities
|June 29, 2018
Summary
This study redefines vulnerability, showing how medical diagnosis practices amplify it for patients with multiple conditions. It highlights how institutionalized medicine can worsen patient vulnerability beyond inherent conditions or social inequalities.
Area of Science:
- Sociology of Health and Illness
- Medical Sociology
- Disability Studies
Background:
- Vulnerability is broadly understood in biomedicine as inherent to certain conditions or linked to structural inequalities.
- Philosophical and feminist perspectives view vulnerability as a universal human experience and a potential resource for resistance.
- Medical and psychiatric diagnosis has been a focus of social critique and activism.
Purpose of the Study:
- To expand contemporary understandings of vulnerability by examining its generation through institutionalized diagnostic practices.
- To explore how people with multiple conditions experience vulnerability within the diagnostic process.
- To propose a combined approach to vulnerability that integrates universal, structural, and practice-based dimensions.
Main Methods:
- Qualitative study employing face-to-face interviews with individuals living with multiple conditions.
- Analysis of experiential accounts of navigating diagnostic practices, primarily at the primary care level.
- Focus on identifying harmful aspects of diagnostic procedures that exacerbate vulnerability.
Main Results:
- Five harmful aspects of diagnostic practice were identified: temporal sequencing, diagnostic authority, medical specialization, strategic symptom selection, and medical isolation.
- These practices exacerbate patient vulnerability, extending beyond inherent conditions or structural inequalities.
- Diagnostic practices are embedded within the institution of diagnosis, not solely due to power asymmetries in consultations.
Conclusions:
- Vulnerability is a universal human condition amplified by institutionalized medical practices, particularly diagnosis.
- Diagnostic practices can significantly exacerbate vulnerability for individuals with multiple conditions.
- A comprehensive understanding of vulnerability requires considering its universal, structural, and practice-based dimensions within healthcare settings.
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