Naming and Framing: The Social Construction of Diagnosis and Illness

TLDR

Medical sociology emphasizes the centrality of social construction and the pivotal role of diagnosis, underscoring the need for a dedicated sociology of diagnosis. The study investigates how diagnosis and illness are socially constructed, particularly through controversial and conflictual diagnoses, to advance a sociology of diagnosis. The author proposes a typology of social construction with four combinations of acceptance and biomedical definition, and outlines stages from initial social discovery (diagnosis) through treatment and outcomes that recursively shape social construction. The paper concludes that the social constructionist perspective has significant health policy implications.

Abstract

This paper examines the social construction of diagnosis and illness in several ways. First, I discuss the centrality of social construction in medical sociology. Next I discuss the major role of diagnosis in social construction, leading to the need for a sociology of diagnosis. I emphasize controversial and conflictual diagnoses, as a first step toward a more general sociology of diagnosis. Then I put forth a typology of social construction, involving four combinations based on whether a condition is generally accepted and whether a biomedical definition is applied. Next I detail a series of stages in the social construction of a condition. In that process, my primary concern is the initial social discovery, which is essentially a matter of diagnosis, with a secondary emphasis on illness experience. This is followed by stages of treatment and outcome, which recursively affect social construction. I conclude by noting the health policy implications of the social constructionist perspective.