School of Social and Cultural Studies, University of Western Australia, Australia.
Sociol Health Illn. 2010 Nov;32(7):1026-40. doi: 10.1111/j.1467-9566.2010.01255.x. Epub 2010 Oct 11.
More than 20years after it was first identified, the anomalous condition, multiple chemical sensitivities (MCS), remains immersed in controversy, with a continuing debate over its causation being played out in the medico-scientific community and in the courts. This article examines why sceptical and supportive experts disagree over the condition's legitimacy as an organic condition. Drawing on ethnographic research conducted in Perth, Western Australia, the author scrutinises the decision-making practices of 16 experts (eight sceptical and eight supportive of a chemical explanation). Both groups were found to use evidence-based, inductive reasoning. However, sceptical experts tended to use a different set of evidence requirements, exhibited more faith in the efficiency of the current biomedical paradigm regarding toxicity and were less likely to acknowledge uncertainty in their field. All the experts recognised a spectrum of beliefs about the causal mechanisms of MCS. However, when they were engaged in litigation as expert witnesses due to their supportive or sceptical tendency, the oppositional legal system polarised their opinions and exacerbated the perceived divide between them. Ultimately, the adversarial medico-legal process inhibits genuine dialogue between some of the key players in the MCS debate, thus impeding understanding and consensus about the condition.
在首次被确认 20 多年后，多种化学敏感性（MCS）这种异常状况仍然存在争议，医学科学界和法庭上持续争论其病因。本文探讨了为什么怀疑论者和支持者专家对该病症是否为有机病症存在分歧。本文作者通过在西澳大利亚州珀斯进行的民族志研究，仔细审查了 16 名专家（8 名怀疑论者和 8 名支持化学解释者）的决策实践。这两组专家都发现使用了基于证据的归纳推理。然而，怀疑论者专家往往使用不同的证据要求，对当前生物医学毒性范式的效率更有信心，并且不太可能承认其领域的不确定性。所有专家都认识到 MCS 的因果机制存在一系列信念。然而，当他们因支持或怀疑的倾向而作为专家证人参与诉讼时，对立的法律制度使他们的观点两极化，并加剧了他们之间的分歧。最终，对抗性的医学法律程序抑制了 MCS 辩论中的一些关键参与者之间的真正对话，从而阻碍了对该病症的理解和共识。
