Information Technology Reference
In-Depth Information
8.4
The Social Construction of Knowledge and Its
Consequences for the Discipline of Medicine
In the area of Medicine, the 'valid knowledge' model recognises that purely 'ob-
jective' data interact with other cognitive realities, such as the historical and social
contexts in which experts live and work. Thus, what is considered to be valid in the
development of knowledge in Medicine not only varies with new advances in 'ob-
jective' medical science but also as a consequence of the interaction of this objective
knowledge with other cognitive realities. This explains the existence of what Lorber
and Moore described as the social construction of illness [9] in their work reveal-
ing how what is considered normal and what is considered pathological is socially
constructed. Not considering medical knowledge as external from social values and
interests, etc., is not new in the debate surrounding the constitution of scientific
knowledge. Kuhn (already pointed out that all scientific knowledge is permeated by
what he denominates 'the cognitive expectations of the ruling paradigm' and, as ex-
pert knowledge, Medicine is no exception. In every society and historical moment
there are cognitive expectations that will determine how disease is conceived and its
consequent diagnostics and treatments.
“We have, thus far, pointed out the requirement that the physician listen to the
narrative of the particular patient and that she must have a database of reliable and
accessibly organized medical case stories. What must happen next is that the highly
subjective patient narrative must be heavily edited. Some features of the story will
be identified by the physician as medically important. On what grounds those deci-
sions are made are, to a significant extent, matters decided by the social construction
of medicine.” ([13], p. 223.)
One example of the social influence on how disease is defined can be found in the
symptoms associated with 'Multiple Chemical Sensitivity' (MCS). Individuals who
display certain kinds of dysfunctions are stimulating research on the existence of this
syndrome and the study of possible treatments. This pathology can be interpreted
as allergic reactions, toxic events or corrupted processes in the genetic, neurological
or psychological area [5]. The current lack of definition for this new illness can
be summed up in this 2010 study by the Spanish Ministry of Health, Social Policy
and Equality, in which the experts reviewing the available scientific documentation
conclude:
“The most methodologically rigorous research has found results that either put
in doubt the relation between causal factors and the illness, or conclude that the
relation cannot be demonstrated. In one line of research no relation was found
between chemical substances and the symptoms reported by patients, neither did
they find evidence of a possible initial exposure, nor any later exposures that could
have brought on the illness. In a double-blind, controlled provocation study in which
no differences between the groups was found, the authors concluded that it was
necessary to doubt the veracity of the MCS symptoms in the majority of cases and
instead consider other physical and psychiatric pathologies”.
