Managing uncertainty in healthcare: Revisiting and advancing sociological contributions
27th Sociology of Health & Illness
Monograph Editors: Nicola Mackintosh and Natalie Armstrong
One of the most pervasive themes in the sociology of medical knowledge and its critiques is the role of uncertainty in clinical practice. This 27th Sociology of Health and Illness Monograph will revisit this enduring phenomenon in the context of changes over the recent past, notably the emergence of the construct of ‘overdiagnosis’, increasing public anxiety over health and risk of illness, shifting patient expectations on the benefits of scientific innovation and the reliability of clinical expertise, and the growth of organisational and technological ‘quick fix’ solutions to manage uncertainty. The Monograph will bring together papers which examine these contemporary developments across a range of clinical contexts to both revisit and advance the existing literature on uncertainty and to produce new sociological insights into ways of managing, coping with, and locating accountability for uncertainty in healthcare.
We invite papers which align with the following themes:
Handling uncertainty around diagnosis and/or risk work: we invite papers that consider the process of diagnosis, distinctions between under- and overdiagnosis, and use of rational classification schemes, screening programmes and diagnostic tools to construct order in relation to risk, prognostic and diagnostic work. We are also interested in the trade-offs and tensions between technical and experiential knowledge in the application of risk and diagnostic categorisation systems and decision aids.
The impact of diagnostic, prognostic and treatment uncertainty on the lay-professional interface: we invite papers that explore patients’ tolerance of uncertainty, and professionals’ experiences of providing care in the face of prognostic, diagnostic and treatment uncertainty. We are interested in the labelling and stigma associated with particular behaviours and moral categorisation around risk and decision making (e.g. in undergoing elective mastectomy, caesarean section) in the face of uncertainty.
Organisational and health system level responses to uncertainty: we invite papers that explore organisational tolerance of uncertainty and the ‘calculability’ of consequences of uncertainty at the system level, as well as organisational features that serve to locate accountability for uncertainty in healthcare.
Digitally mediated uncertainties: we invite papers considering the digital mediation of ambivalence, uncertainty or ambiguity about health, illness and treatment particularly in the light of public health concerns e.g. in relation to over-prescribing of antibiotics. Papers might consider how digital health technologies are reshaping networks, the distribution of power and public/professional/organisational relationships linked to managing uncertainties in healthcare.
Potential contributors should send an abstract of up to 600 words to firstname.lastname@example.org<mailto:email@example.com> and firstname.lastname@example.org<mailto:email@example.com> by 31st July 2018. Abstracts should clearly indicate the proposed paper’s sociological importance. Informal email enquiries prior to 2 submission are welcome (please address these to both editors). Name and institutional affiliation of author(s) should also be supplied, including full contact details. We encourage international contributions, which will allow for cross-cultural comparison across the collection, as well as contributions from authors at a range of career stages, from early career to more established writers. Proposals will be reviewed by the monograph team and potential authors notified by 30 September 2018. These short-listed authors will be invited to submit their work by 31 January 2019. Submissions will be refereed in the usual way and should follow the journal’s style guidelines (http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291467- 9566/homepage/ForAuthors.html).
The monograph will be published in the January issue of the journal in 2021 (online in December 2020). We will commission an artist to represent key overarching themes emerging from the papers to facilitate further dialogue and conceptual insights about the nature of uncertainty in healthcare, which will form part of a symposium event to mark the Monograph’s publication.