The Politics of Diagnosis in Medically Unexplained Symptoms

Medically Unexplained Symptoms 　ニミル　シンダン　ノ　ポリティクス

ノジマ, ナツコ

Nojima, Natsuko

オオサカ ダイガク ダイガクイン ニンゲン カガク ケンキュウカ シャカイガク ニンゲンガク ジンルイガク ケンキュウシツ

Sociology, Anthropology and Philosophy, Graduate School of Human Sciences, Osaka University

診断

慢性疾患

病人役割

病の経験

diagnosis

chronic illness

sick role

experiences of illness

This paper reviews the dominant trends in the focus of medical sociology, shifting from the analysis of the “sick role” in acute disease patients towards the analysis of the “experience” of chronic illness and discusses the limits and the blind spots of the latter approach. The author summarizes these limits and blind spots in the following two points. 1) The chronic illness study approach takes the acquiring the sick role for granted, and hence cannot explain the experience of people unable to acquire the sick role while obviously suffering illness. 2) The chronic illness study approach stresses the importance of “lived experience” of illness and tends to downplay the process and the conditions in which the experience of suffering becomes “disease.” These limits and blind spots of the chronic illness study become obvious when we deal with the issues surrounding the MUS (medically unexplained symptoms). Considering the issues related to MUS, the author insists on the following points that would bene t future study of medical sociology. 1) Society does not recognize any suffering as such without any “diagnosis.” 2) Hence, any “diagnosis” has a political aspect in which specific sufferings receive social recognition. The author stresses the importance of sociology of “diagnosis” for future study.