Jutel Annemarie
School of Midwifery, Otago Polytechnic, New Zealand.
Sociol Health Illn. 2009 Mar;31(2):278-99. doi: 10.1111/j.1467-9566.2008.01152.x. Epub 2009 Feb 11.
Diagnoses are the classification tools of medicine, and are pivotal in the ways medicine exerts its role in society. Their sociological study is commonly subsumed under the rubrics of medicalisation, history of medicine and theory of disease. Diagnosis is, however, a powerful social tool, with unique features and impacts which deserve their own specific analysis. The process of diagnosis provides the framework within which medicine operates, punctuates the values which medicine espouses, and underlines the authoritative role of both medicine and the doctor. Diagnosis takes place at a salient juncture between illness and disease, patient and doctor, complaint and explanation. Despite calls for its establishment, almost two decades ago (Brown 1990), there is not yet a clear sociology of diagnosis. This paper argues that there should be, and, as a first step, draws together a number of threads of medical sociology that potentially contribute to this proposed sociology of diagnosis, including the place of diagnosis in the institution of medicine, the social framing of disease definitions, the means by which diagnosis confers authority to medicine, and how that authority is challenged. Through this preliminary review, I encourage sociology to consider the specific role of diagnosis in view of establishing a specific sub-disciplinary field.
诊断是医学的分类工具，在医学发挥其社会作用的方式中起着关键作用。对诊断的社会学研究通常归入医学化、医学史和疾病理论等范畴。然而，诊断是一种强大的社会工具，具有独特的特征和影响，值得进行专门的分析。诊断过程为医学运作提供了框架，体现了医学所秉持的价值观，并凸显了医学和医生的权威角色。诊断发生在疾病与病症、患者与医生、主诉与解释之间的关键节点。尽管近二十年前就有人呼吁建立诊断社会学（布朗，1990年），但目前仍没有清晰的诊断社会学。本文认为应该建立诊断社会学，并且作为第一步，梳理医学社会学的一些线索，这些线索可能有助于构建这一拟议中的诊断社会学，包括诊断在医学体系中的地位、疾病定义的社会框架、诊断赋予医学权威的方式以及这种权威是如何受到挑战的。通过这一初步综述，我鼓励社会学界鉴于建立一个特定的子学科领域来考虑诊断的具体作用。
