This article explores general practitioners' (GPs) persuasive efforts in cases where biomedical evidence is absent but expected. Health insurance in Western countries is based on the biomedical ideal ...that legitimate complaints should have objective causes detectable by medical examination. For GPs responsible for assessing sickness and incapacity for work, the demand for objective evidence can be problematic: what if they as experts deem that a patient is in fact sick and eligible for benefits, but are unable to provide objective evidence to that fact? How can they convince bureaucrats in the insurance system to accept their judgment? Taking ‘medically unexplained symptoms’ as my case, I draw on focus group and follow-up interviews with GPs in Norway to explore how GPs attempt to persuade bureaucrats to accept their professional judgment. Proposing the concept of ‘rhetorical work’, I reconstruct a typology of such work that doctors engage in to influence bureaucratic decision-making and provide long-term health benefits for patients. I then discuss the potential societal implications of GPs' rhetorical practices and the applications of the concept of rhetorical work in future research.
•Absent but expected biomedical evidence cause problems of trust and credibility.•General practitioners (GPs) face such problems as gatekeepers in health insurance.•The study explores GPs' work to construct convincing cases for insurance benefits.•Uses focus groups and follow-up interviews to unpack GPs' persuasive efforts.•Proposes rhetorical work and insurance trajectories as conceptual innovations.
This article explores the making and management of anomaly in scientific work, taking ‘medically unexplained symptoms’ (MUS) as its case. MUS is a category used to characterize health conditions that ...are widely held to be ambiguous, in terms of their nature, causes and treatment. It has been suggested that MUS is a ‘wastebasket diagnosis’. However, although a powerful metaphor, it does neither the category nor the profession justice: Unlike waste in a wastebasket, unexplained symptoms are not discarded but contained, not ejected but managed. Rather than a ‘wastebasket’, I propose that we instead think about it as a ‘junk drawer’. A junk drawer is an ordering device whose function is the containment of things we want to keep but have nowhere else to put. Based on a critical document analysis of the research literature on MUS (107 research articles from 10 medical journals, published 2001–2016), the article explores how the MUS category is constituted and managed as a junk drawer in medical science.
Anticipation is a fundamental aspect of social life and, following Weber, the hallmark of social action—it means trying to take others’ responses to our actions into account when acting. In this ...article, we propose and argue the relevance of anticipation to the sociological study of diagnosis. To that end, we introduce and elaborate on the concept of diagnosing by anticipation. To diagnose by anticipation is to consider diagnoses as cultural objects imbued with meaning, to anticipate how others will respond to their meaning in situ and to adapt the choice of diagnosis to secure a desired outcome. Unlike prognosis, which seeks to predict the development of a disease, diagnosing by anticipation entails seeking to predict the development of a case and the effect of different diagnostic categories on its trajectory. Analytically, diagnosing by anticipation therefore involves a shift in diagnostic footing, from trying to identify what the case is a case of, to trying to identify which diagnosis will yield the desired case trajectory. This shift also implies a stronger focus on the mundane organisational work of operating diagnostic systems and coordinating case trajectories within and across social systems, to the benefit of the sociology of diagnosis.
'Homebound' children are unable to attend school for illness-related reasons. To lessen their predicament, schools have begun experimenting with 'telepresence robots' that can enable remote ...participation. While promising, we know little about the use of telepresence robots in practice. To begin to redress this, we draw on 159 semi-structured interviews to explore the experiences of 37 child users of the robot 'AV1' in Norwegian schools. The children's experiences varied, with some benefitting greatly and others not getting any benefit from using the robot. To explain these variations, we reconstruct the robot's critical component structure - that is, the assembly of sociomaterial elements that determines whether and how the robot works in practice. We also explore the benefits of using the robot when these critical components align. In so doing, we provide in-depth knowledge about the potential and prerequisites of using telepresence robots in schools - to the benefit of users, producers and scholars of telepresence technology.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Varm teknologi mot ensomhet blant eldre? Børve Rasmussen, Erik; Askheim, Clemet; Oppedal, Bjarne ...
Tidsskrift for samfunnsforskning,
11/2021, Letnik:
62, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Sammendrag Artikkelen undersøker hvordan ensomhet blant eldre er forsøkt motvirket ved bruk av digital teknologi: Kommunikasjonsløsningen Komp er en skjerm med kun én knapp og en tilhørende app man ...kan bruke til å sende bilder, meldinger og opprette videosamtaler med skjermen. Den er utviklet spesielt for eldre brukere uten digital kompetanse og skal motvirke ensomhet gjennom økt digital sosial kontakt. Utviklerne kaller den en «varm teknologi» fordi de mener den knytter folk sammen. Vi bruker skriptteori til å undersøke samspillet mellom teknologiens utforming, brukernes erfaringer og sentrale normer i demokratiske samfunn. Analysen viser at Komp kommer med «innskrevne» forventninger om velfungerende familier med digitalt inkompetente eldre og kompetente pårørende. Når brukerne godtok forventningene, uten videre eller gjennom tilpasning, fikk Komp være en varm teknologi og skape digitalt mediert familienærvær. Men det kunne også oppstå friksjon, enten fordi brukerne avviste forventningene, eller fordi teknologien aktualiserte motsetningsfylte normer knyttet til medborgerskap og selvbestemmelse på den ene siden, og omsorg og myndighetsoverføring på den andre. Artikkelen bidrar til å forstå de sosiomaterielle forutsetningene for at digitale teknologier kan bringe folk sammen og derigjennom redusere ensomhet.
This article contributes to the sociology of education and technology by providing a cultural analysis of scepticism towards new technologies in school, using reactions to the telepresence robot ...'AV1' as its case. AV1 is designed to connect 'homebound' students with their 'school-based' teachers and classmates. Despite its idealistic purpose, the robot has been met with significant scepticism by Norwegian school workers. To understand why, the article proposes the novel concepts of 'educational purity' and 'technological danger' to highlight the shared beliefs that underlie school workers' concerns. We find that school workers see AV1 as threatening key ideals of schools being pedagogically oriented, physically copresent and bounded institutions - all concerns that reflect widespread ideas about how technologies tend to (not) function within educational contexts. In highlighting these symbolic tensions between new technologies and schools, the article sets a course for future studies into the cultural sociology of education and technology.
‘Theory’ is a seminal term in sociology. Sociologists tend to ask that articles, chapters and monographs are ‘theoretical’, ‘develop theory’ or ‘make a theoretical contribution’. Yet, as demonstrated ...in Gabriel Abend’s 2008 article ‘The Meaning of ‘Theory’, it is generally unclear what sociologists mean when they talk about theory. Abend distinguishes seven different meanings sociologists tend to impute to ‘theory’ and argues that no single definition can usefully capture these substantively different meanings. Counter to Abend, we propose and defend a minimal and versatile theory of theory, which does capture the important common denominators in sociologists' various uses of the term theory. The major strengths of our proposal are that it enables informed and synthetic discussion and fosters reflexivity about differences and similarities between different types of theory. Our minimal theory of theory thus serves as an invitation to a broader conversation about theory in sociology.
The recent inclusion of behavioural conditionality in health‐related benefit programmes raises questions about frontline workers' (FWs') discretionary use of sanctioning. Using an experimental ...vignette design in a survey of 824 FWs in the Norwegian Labour and Welfare Administration (NAV), we investigated whether FWs' perceptions of diagnosis and sick recipients' obligations affect their propensity to sanction for non‐compliance. We find that the recipients' diagnoses did not influence FWs' propensity to sanction for non‐compliance. Recipients with a symptom diagnosis (ME/CFS) were sanctioned to the same degree as those with a diagnosis based on objective medical evidence (Bekhterev's disease). However, FWs who generally found it difficult to impose activity requirements on recipients with health‐related problems were also less prone to enact sanctions. Our results support the notion of competing approaches to activating and sanctioning the sick. FWs who agree that it is difficult to activate the sick also tend to avoid sanctioning, whereas the propensity to sanction is more widespread among those who disagree that activating the sick is difficult.
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