Nettleton Sarah, Kitzinger Jenny, Kitzinger Celia
Department of Sociology, University of York, Heslington, York, YO10 5DD, UK.
School of Journalism, Media and Cultural Studies, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, CF10 3NB, UK.
Soc Sci Med. 2014 Sep;116(100):134-41. doi: 10.1016/j.socscimed.2014.06.036. Epub 2014 Jun 27.
Throughout affluent societies there are growing numbers of people who survive severe brain injuries only to be left with long-term chronic disorders of consciousness. This patient group who exist betwixt and between life and death are variously diagnosed as in 'comatose', 'vegetative', and, more recently, 'minimally conscious' states. Drawing on a nascent body of sociological work in this field and developments in the sociology of diagnosis in concert with Bauman's thesis of 'ambivalence' and Turner's work on 'liminality', this article proposes a concept we label as diagnostic illusory in order to capture the ambiguities, nuanced complexities and tensions that the biomedical imperative to name and classify these patients give rise to. Our concept emerged through a reading of debates within medical journals alongside an analysis of qualitative data generated by way of a study of accounts of those close to patients: primarily relatives (N = 51); neurologists (N = 4); lawyers (N = 2); and others (N = 5) involved in their health care in the UK.
在富裕社会中，越来越多的人在严重脑损伤后幸存下来，却留下了长期的慢性意识障碍。这群处于生死之间的患者，被诊断为处于“昏迷”“植物人”状态，最近又被诊断为“微意识”状态。本文借鉴了该领域新兴的社会学研究成果以及诊断社会学的发展，并结合鲍曼的“矛盾心理”理论和特纳关于“阈限性”的研究，提出了一个我们称之为“诊断幻觉”的概念，以捕捉生物医学对这些患者进行命名和分类时所产生的模糊性、细微的复杂性和紧张关系。我们的概念是通过阅读医学期刊上的辩论文章，并分析对患者身边的人（主要是亲属（N = 51）、神经科医生（N = 4）、律师（N = 2）以及英国参与其医疗护理的其他人（N = 5））的描述所产生的定性数据而形成的。
