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Iscensättanden av halsfluss: Relationella göranden av en sjukdom i medicinska praktiker
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
2016 (Swedish)In: Sociologisk forskning, ISSN 0038-0342, Vol. 53, no 3, p. 247-270Article in journal (Refereed) Published
Abstract [en]

In this paper the diagnostic process of bacterial tonsillitis at two Swedish health centres is described and analysed as to how this disease comes into being, or how it is enacted. The concept of enactment implies that disease is constituted in, and through, relational practises involving human and non-human elements. The study is based on interviews with nurses and doctors as well as field observations from the health centres. In the analysis it becomes apparent that different and sometimes conflicting enactments of tonsillitis appear in medical practices, depending on the organization of relations between different elements. It is concluded that diagnostic agency is created in relations between both humans and non-humans, and who and what is given diagnostic agency is changeable depending on the relations at hand. The diagnostic process of tonsillitis shows how the most mundane medical diagnoses involves a number of complex relations, that stretches beyond categories such as social and medical.

Place, publisher, year, edition, pages
2016. Vol. 53, no 3, p. 247-270
Keywords [en]
enactment, the clinical gaze, medical sociology, medical technologies, science and technology studies (STS)
National Category
Sociology
Identifiers
URN: urn:nbn:se:uu:diva-308067ISI: 000385336700003OAI: oai:DiVA.org:uu-308067DiVA, id: diva2:1050881
Available from: 2016-11-30 Created: 2016-11-23 Last updated: 2018-08-31
In thesis
1. Unpacking Rational Use of Antibiotics: Policy in Medical Practice and the Medical Debate
Open this publication in new window or tab >>Unpacking Rational Use of Antibiotics: Policy in Medical Practice and the Medical Debate
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Rational use of antibiotics–using antibiotics only when needed and in the right way–is a prioritized goal in policy aimed at preventing antimicrobial resistance. A vast body of research is devoted to understanding why unnecessary antibiotics are prescribed. However, this research tends to treat the definition of rational prescribing as an unproblematic fact, which is given by evidence.

The thesis aims to sociologically unpack rational use of antibiotics as medical knowledge and a policy goal. One study examines how rational use of antibiotics in health care was established as a crucial part of AMR prevention in Sweden, and three studies, drawing on different materials, look at how rational antibiotic use for everyday infections is negotiated and performed in medical practice and the medical debate in Sweden. The thesis makes theoretic use of material semiotics and critical policy studies, which enables examination of how medical knowledge, medical objects and policy are performed in webs of relations between human and non-human actors.

The studies show that rational use of antibiotics for everyday infections is characterized by uncertainties and tensions. These cannot be reduced to medical professionals’ ignorance, or to how non-medical factors influence medical practice. This implies that social factors are not enough to explain why medical professionals dismiss specific policy definitions of medically appropriate prescribing. Instead, the uncertainties and tensions characterizing rational antibiotic prescribing can be traced to the complex and contingent nature of medical knowledge and medical objects, as well as to the potentially conflicting risks that antibiotic prescribing involves. As a consequence, deviance from, or critique of, a specific definition of rational use of antibiotics may constitute a performance of rational use of antibiotics as a policy goal. In medical practice and the medical debate, rational use of antibiotics as a policy goal can draw on and work with mutable medical knowledge and objects, as well as conflicting medical risks. It is concluded that sociologists need to continue entering the seemingly pure medical sphere to critically investigate policy and policy goals that draw on medical knowledge and that, as such, appear to be neutral and undisputable.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 72
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 158
Keywords
Antibiotics, Policy, Medical Sociology, Actor-Network Theory, Human-microbial relations, Antimicrobial Resistance, Everyday Infections, Material semiotics, Medical sociology, Medical objects, Medical technologies, Medical knowledge
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:uu:diva-358022 (URN)978-91-513-0421-2 (ISBN)
Public defence
2018-10-12, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-09-20 Created: 2018-08-23 Last updated: 2018-09-20

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