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身体诊断工作与诊断空间:临床医生在诊断过程中对空间和身体的运用

Corporal diagnostic work and diagnostic spaces: clinicians' use of space and bodies during diagnosis.

作者信息

Gardner John, Williams Clare

机构信息

Science and Technology Studies Unit (SATSU), Department of Sociology, University of York, UK.

Department of Sociology and Communications, Brunel University, London, UK.

出版信息

Sociol Health Illn. 2015 Jun;37(5):765-81. doi: 10.1111/1467-9566.12233. Epub 2015 Feb 13.

Abstract

An emerging body of literature in sociology has demonstrated that diagnosis is a useful focal point for understanding the social dimensions of health and illness. This article contributes to this work by drawing attention to the relationship between diagnostic spaces and the way in which clinicians use their own bodies during the diagnostic process. As a case study, we draw upon fieldwork conducted with a multidisciplinary clinical team providing deep brain stimulation (DBS) to treat children with a movement disorder called dystonia. Interviews were conducted with team members and diagnostic examinations were observed. We illustrate that clinicians use communicative body work and verbal communication to transform a material terrain into diagnostic space, and we illustrate how this diagnostic space configures forms of embodied 'sensing-and-acting' within. We argue that a 'diagnosis' can be conceptualised as emerging from an interaction in which space, the clinician-body, and the patient-body (or body-part) mutually configure one another. By conceptualising diagnosis in this way, this article draws attention to the corporal bases of diagnostic power and counters Cartesian-like accounts of clinical work in which the patient-body is objectified by a disembodied medical discourse.

摘要

社会学领域中不断涌现的一批文献表明,诊断是理解健康与疾病社会维度的一个有用焦点。本文通过提请人们关注诊断空间与临床医生在诊断过程中运用自身身体的方式之间的关系,为这项工作做出了贡献。作为一个案例研究,我们借鉴了与一个多学科临床团队开展的实地调查,该团队通过深部脑刺激(DBS)疗法治疗患有肌张力障碍(一种运动障碍疾病)的儿童。我们对团队成员进行了访谈,并观察了诊断检查过程。我们阐明,临床医生通过运用具身化的沟通工作和言语交流,将物质领域转化为诊断空间,并且我们还阐明了这种诊断空间如何在其中构建具身化的“感知与行动”形式。我们认为,“诊断”可以被概念化为源自一种互动,在这种互动中,空间、临床医生的身体以及患者的身体(或身体部位)相互塑造。通过以这种方式对诊断进行概念化,本文提请人们关注诊断权力的身体基础,并反驳了那种笛卡尔式的临床工作描述,即在这种描述中,患者的身体被一种脱离身体的医学话语客观化。

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