Medicine, Risk, Discourse and Power This book critically explores from a comparative international perspective the role medicine plays in constructing and managing natural and social risks, including those belonging to modern medical technology and exper- tise. Drawing together chapters written by professional practitioners and social scientists from the UK, South America, Australia and Europe, the book offers readers an insightful and thought-provoking analysis of how modern medicine has transformed our understanding of both ourselves and the world around us; but in so doing, it has arguably failed to fully recog- nize and account for its unintended and negative effects. This is an essential read for social scientists, practitioners and policy makers who want to better understand how they can develop new ways of thinking about how modern medicine can promote social goods and enhance public health. John Martyn Chamberlain is Associate Professor in Medical Criminology at the University of Southampton. Routledge Advances in Sociology For a full list of titles in this series, please visit www.routledge.com 136 Advances in Biographical 141 The Re-Use of Urban Ruins Methods Atmospheric Inquiries of the City Creative Applications Hanna Katharina Göbel Edited by Maggie O’Neill, Brian Roberts and Andrew 142 Reproductive Tourism in the Sparkes United States Creating Family in the Mother 137 Social Cohesion and Country Immigration in Europe and Lauren Jade Martin North America Mechanisms, Conditions and 143 The Bohemian Ethos Causality Questioning Work and Making a Edited by Ruud Koopmans, Scene on the Lower East Side Bram Lancee and Merlin Judith R. Halasz Schaeffer 144 Critical Theory and 138 Digital Publics Social Media Cultural Political Economy, Between Emancipation and Financialization and Creative Commodification Organizational Politics Thomas Allmer John Michael Roberts 145 Socio-Cultural Mobility and 139 Ideology and the Fight Against Mega-Events Human Trafficking Ethics and Aesthetics in Brazil’s Reyhan Atasü-Topcuoğlu 2014 World Cup Rodanthi Tzanelli 140 Rethinking Serial Murder, Spree Killing, and Atrocities 146 Seeing Religion Beyond the Usual Distinctions Toward a Visual Sociology of Robert Shanafelt and Nathan Religion W. Pino Edited by Roman Williams 147 European Citizenship and 156 The Geography of Nostalgia Social Integration in the EU Global and Local Perspectives on Jürgen Gerhards and Holger Modernity and Loss Lengfeld Alastair Bonnett 148 International Migration and 157 Transnational Students and Ethnic Relations Mobility Critical Perspectives Lived Experiences of Migration Edited by Magnus Dahlstedt and Hannah Soong Anders Neergaard 158 Aging in Contexts of Migration 149 Stigma and the Shaping of the Edited by Ute Karl and Sandra Pornography Industry Torres Georgina Voss 159 Twentieth Century Population 150 Religious Identity and Social Thinking Change A Critical Reader of Primary Explaining Christian conversion Sources in a Muslim world Edited by Population Knowledge David Radford Network 151 God, Politics, Economy 160 The Synchronization of Social Theory and the Paradoxes National Policies of Religion Ethnography of the Global Tribe Bülent Diken of Moderns Pertti Alasuutari 152 Lifestyles and Subcultures History and a New Perspective 161 Retail and the Artifice of Social Luigi Berzano and Carlo Change Genova Steven Miles 153 Comedy and Social Science 162 Theorizing Social Memories Towards a Methodology Concepts and Contexts of Funny Edited by Gerd Sebald and Cate Watson Jatin Wagle 154 Sociology of Economic 163 Addiction, Modernity, and Innovation the City Francesco Ramella A Users’ Guide to Urban Space Christopher B.R. Smith 155 Mobility, Modernity and the Slum 164 Medicine, Risk, Discourse The Real and Virtual Journeys of and Power ‘Slumdog Millionaire’ Edited by John Martyn Rodanthi Tzanelli Chamberlain This page intentionally left blank Medicine, Risk, Discourse and Power Edited by John Martyn Chamberlain First published 2016 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 Taylor & Francis The right of the editor to be identified as the author of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Medicine, risk, discourse and power / edited by John Martyn Chamberlain. p. ; cm. — (Routledge advances in sociology ; 164) Includes bibliographical references and index. I. Chamberlain, John Martyn, 1972– , editor. II. Series: Routledge advances in sociology ; 164. [DNLM: 1. Medicine. 2. Risk. 3. Sociological Factors. WB 100] R729.8 610—dc23 2015025795 ISBN: 978-0-415-50269-6 (hbk) ISBN: 978-1-315-65874-2 (ebk) Typeset in Sabon by Apex CoVantage, LLC Contents 1 An Introduction to Medicine, Risk, Discourse and Power 1 JOHN MARTYN CHAMBERLAIN 2 Sociology and Risk: A Link in Permanent (Re)Construction 25 FIORELLA MANCINI 3 Time, Risk and Health 52 ANDY ALASZEWSKI AND PATRICK BROWN 4 Using Medicines in the Face of Uncertainty: Developing a Habermasian Understanding of Medicines’ Lifeworlds 76 PATRICK BROWN 5 Performing Risk and Power: Predictive Technologies in Personalized Medicine 100 NADAV EVEN CHOREV 6 Balancing Risk and Recovery in Mental Health: An Analysis of the Way in Which Policy Objectives Around Risk and Recovery Affect Professional Practice in England 120 JEREMY DIXON 7 Moving From Gut Feeling to Evidence: The Case of Social Work 141 GEMMA MITCHELL 8 Regulating for Safer Doctors in the Risk Society 162 JOHN MARTYN CHAMBERLAIN 9 Health Experts Challenge the Safety of Pesticides in Argentina and Brazil 179 RENATA MOTTA AND FLORENCIA ARANCIBIA viii Contents 10 Changing Discourses of Risk and Health Risk: A Corpus Analysis of the Usage of Risk Language in the New York Times 207 JENS O. ZINN AND DANIEL MCDONALD Contributors 241 1 An Introduction to Medicine, Risk, Discourse and Power John Martyn Chamberlain INTRODUCTION The study of modern medicine and the high levels of public trust and social status afforded to it, along with the economic and cultural rewards associ- ated with this state of affairs, has long preoccupied social scientists. Over the last hundred years or so, sociologists have considered the causes and consequences of medical power within society, and more lately, they have considered its decline or, at the very least, just what new form it is trans- forming into. One particularly important element of this corpus of study has been the consideration of the rhetorical role played by medical knowl- edge and technology, alongside the diverse forms of clinical expertise which emerge as a result of its application in the health-care diagnosis and treat- ment context, in promoting risk identification and appraisal discourses that can serve to either promote or inhibit patient control over the medical encounter. Another body of literature linked to this considers the role played by medical discourse and power in enabling and legitimizing the greater sur- veillance and disciplinary control of populations, be they law abiding and healthy or otherwise. As this chapter will reinforce, both these viewpoints, along with the recognition of the practical value of medical knowledge and expertise for promoting public health and social welfare and community cohesion, are necessary for a fully developed understanding to emerge of the important social role medicine plays in enhancing our lives, both individu- ally and collectively. Although as we shall see, this has not always been the case; few sociolo- gists today would consider medicine’s role in transforming how we can live a healthy life to be beyond critique. It is the purpose of this book to con- tribute to the academic study of medicine through exploring the application of medical discourse and power through the lens of risk in various national contexts; including, Europe, the US and South America. In doing so, the authors collectively hope to elucidate the similarities and subtle differences which exist internationally in order to advance our understanding of the complex social role played by medicine internationally. In this chapter, I seek to set the scene for this by providing the reader with an introduction