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Disease, knowledge and society
  1. A Molarius
  1. Centre for Public Health Research, Karlstad University, Sweden

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    D E Gannik, L Launsø, editors. (Pp 264; DKK 220.00.) Frederiksberg: Samfundslitteratur, 2000. ISBN 87-593-0814-1.

    The purpose of this book is to provide critical analyses of disease, treatment and care as socially structured practices. The authors are Danish and Norwegian social scientists and sociologists—and occasional historians, psychologists and biologists—who belong to Disease and Society Network. The book consists of papers presented at the seminars of this network.

    The papers have a wide scope, ranging from highly theoretical (for example, social construction of diagnosis, philosophy of science critique of the randomised clinical trial) to highly empirical approaches (for example, user participation in employees' strain disorders intervention programme, observations on the role of food in hospitals). They also cover a wide variety of disciplines ranging from a historical overview of public health impacts of medicine to psychoneuroimmunology, which studies the relations between behaviour, the hormone system, the nervous system and the immune system in the human body. One of the starting points is the medical science's inability to deal with patients instead of diseases. Critique of the randomised clinical trial as the gold standard in medical science is also one of the key issues. Somewhat surprisingly the book does not take up such topics as health inequalities, empowerment or disease prevention/health promotion.

    I found Hans Wadskjær's analysis of the modern institutionalised medicine as a disease system particularly interesting. The success of this system in society, its self referent nature and the power, prestige and status associated with it has led it to cooperate with another powerful system, the economic system in order to avoid the constraints put upon it by the political system. Even though there are exceptions to the rule, modern medicine seems to be engaged in providing incredibly sophisticated services to small, mainly affluent groups. The impact this development in the society should be of interest both for health researchers and social scientists. It is in this discourse this book finds its place.