2_Tyranny of Diagnosis - Charles Rosenberg

2_Tyranny of Diagnosis - Charles Rosenberg - tightly to...

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The Tyranny of Diagnosis: Specific Entities and Individual Experience CHARLES E. ROSENBERG Harvard University _D -xIAGNOSIS HAS ALWAYS PLAYED A PIVOTAL ROLE IN medical practice, but in the past two centuries, that role has been reconfigured and has become more central as medicine-like Western society in general-has become increasingly technical, special- ized, and bureaucratized. Disease explanations and clinical practices have incorporated, paralleled, and, in some measure, constituted these larger structural changes. This modern history of diagnosis is inextricably related to disease specificity, to the notion that diseases can and should be thought of as entities existing outside the unique manifestations of illness in par- ticular men and women. During the past century especially, diagnosis, prognosis, and treatment have been linked ever more
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Unformatted text preview: tightly to specific, agreed-upon disease categories, in both concept and everyday practice. In fact, this essay might have been entitled "Diagnosis Mediates an In- visible Revolution: The Social and Intellectual Significance of Specific Disease Concepts." It would have been even more precise, if rather less arresting. This title also would have the virtue of emphasizing both the impor- tance and comparative novelty of 19th- and 20th-century conceptions of disease, ideas we have come to take so much for granted that they have become invisible. It would not be inappropriate, however, to compare The Milbank Quarterly, Vol. 80, No. 2, 2002 ? 2002 Milbank Memorial Fund. Published by Blackwell Publishing, 350 Main Street, Malden, MA 02148, USA, and 108 Cowley Road, Oxford OX4 1JF, UK. 237...
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This note was uploaded on 10/10/2010 for the course ENG 000121 taught by Professor Mcgrand during the Spring '10 term at Cornell University (Engineering School).

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