Biomedical Engineering Reference
In-Depth Information
dissolved in an attempt to bring everyone within a network of visibility. The
individual body is placed in a fi eld that is not delineated by the absolute
categories of normality and abnormality, but by the characteristics of the
normal population. 'The new dimensionality of identity is to be found in
the shift from a three-dimensional body as the locus of illness to the four-
dimensional space of the time-community' (ibid.: 403). Illness is thus placed
in a new temporal context, where risk factors are pointers to a potential yet
unformed eventuality.
If we look at contemporary practice, the notions of normality,
abnormality and a potential abnormality seem to take on different
meanings in different contexts. In the
everyday practice of medicine
, health
professionals draw on scientifi c defi nitions of normality as well as clinical
experience and everyday knowledge. Notions of normality are shared with
the local clinical community and communicated in clinical encounters with
patients. Normality can be defi ned statistically or clinically, and is closely
linked to the concepts of health and illness. Hoedemaekers and ten Have
(1999) argue that in a non-scientifi c usage, health tends to be associated
with normality (as an absence of disease or apparent pathology). Health,
as adequate functioning and performance is also the state found in the
majority of cases, and therefore considered normal. Disease is found in
a smaller number of people, and tends to be connected with abnormality
(1999: 539). However, it is not always clear whether the normal represents
the state of the average person or an 'ideal type' in terms of optimal
functioning, appearance or performance (or minimal functioning). 'The
normal indicates how the organ or human body should function, it is the
function which is desirable for all' (ibid.: 540). Thus, the ways the concepts
of normality and abnormality are used in everyday clinical practice can be
described as complex and problematic.
Today, medical technology increasingly plays an important role when
abnormality is diagnosed and when potentially abnormal individuals are
'sorted out', as well as when efforts are made to enhance normality - and
new methods that open up new possibilities and more precise methods are
continuously introduced. Medical technology is used in clinical practice to
diagnose abnormality, for example in prenatal diagnostics to identify foetuses
with certain malformations or genes which will lead to future disease or
disability. Technology is used in screening to 'sort out' individuals at high risk
of having an abnormality, according to certain established criteria. However,
the process by which these methods are applied and integrated in clinical
practice are quite complex, and are in turn embedded in the local culture of
the clinic with its particular rules, norms and traditions. The task of using
medical technology, and interpreting and communicating the outcome in
encounters with patients, is thus something that medical professionals 'learn'
in the context of medical work. Of particular interest here is how these
rules, norms and traditions have to be 'learned' by new members in clinical
practice (Atkinson 1995).
