In contemporary society there are now many different systems of medical knowledge that either complement, or are competing with, traditional medical science. The knowledge systems differ in the ways that the knowledge is constructed, how it is assimilated and the authority that scientific, academic and governmental institutions put on it (p37). Medical knowledge can be both common sense knowledge and scientific knowledge depending on the authority of the source. Childbirth and midwifery used to be the preserve of experienced older women and was based on common sense knowledge that was passed down from generation to generation. In contemporary society childbirth and midwifery is considered to be scientific medical knowledge, but is based on passed down common sense knowledge. While common sense medical knowledge is still socially accepted, it generally does not have the same status as the other systems of medical knowledge. But, as seen in the example of childbirth and midwifery, common sense knowledge can be the basis for other medical knowledge. For example putting babies to sleep on their backs was common sense knowledge that, following scientific research into sudden infant cot death, became scientific knowledge. Our society is becoming increasingly more open to alternative medicine systems, such as those of homeopathy, herbal medicine and acupuncture. The increase in diverse sources of, sometimes contradictory, medical knowledge has led to more uncertainty about which medical expert or what medical knowledge to believe. As while access to different types of medical knowledge creates choice it also creates anxiety.
German sociologist Ulrich Beck characterises contemporary societies as, ‘risk societies,’ because of their increased knowledge of threats and danger (p144). The proliferation of available medical knowledge and medical ‘experts’ means that people now know more about the human body, health and sickness than ever before. However, an increase in the knowledge we have can bring with it an increase in the awareness of health risks and this awareness of risk creates anxiety. The increased anxiety about health risks can lead people to look to medical experts for further information and assurance. However, there are now many types of experts giving opinions on all medical matters, from specialised medically trained practitioners to government spin doctors. The resulting, and often conflicting, medical knowledge regarding health risks, further increases anxiety and creates uncertainty, as when making decisions most people are not easily able to ascertain which of the different sources of knowledge is valid, or if indeed any are.
The anxiety and uncertainty caused by so many conflicting views on medical matters leads people in contemporary society to question the medical expert’s opinions and advice, whereas previously medical experts were sources of certainty and their opinions and advice were undoubted. This doubting of the medical experts ‘truths’ means that making a decision based on those ‘truths’ can be very difficult. One area of current medical knowledge where medical opinion is divided, leaving the public uncertain, is that of childhood immunisation, in particular, the MMR vaccination. While the government and many institutional medical practitioners advocate the MMR vaccine, there are frequently reports in the media, supposedly endorsed by experts, of new knowledge outlining its risks. In a risk society this increased access to knowledge about potential dangers of the vaccine adds to the uncertainty of whether to give the vaccine or not. Further the amount of differing information available to the public on the subject is vast, making the decision-making process even more strenuous. The uncertainty for the public comes from the fact that both the advocates and those offering contradictory opinions are considered ‘experts’ on the subject. One of the sources of information against the MMR vaccine is pressure groups, such as ‘JABS’ (TV05) set up by parents who believe that their children became ill due to having the vaccination. This type of source, an example of structure versus agency, directly contradicts the medical experts and by doing so increases the publics’ feelings of risk and uncertainty, while raising the issues of who to believe and whose knowledge is most relevant.
According to the theory of risk society, now that specialised medical knowledge can be easily accessed and is no longer the preserve of an authorised few, the claims of the government and of the medical authority are increasingly going to be questioned, and risk being undermined. This can be seen in the social change that has occurred as the public no longer has confidence in the states claims and assurances regarding medical matters, such as the MMR vaccine. As the amounts of contradictory medical knowledge increases, the trust and confidence in medical experts’ opinions decreases, and lay people go on their own fact finding missions. But as the risk theory speculates, rather than reassure, the acquisition of new knowledge that a fact finding mission would bring can further increase the perception of risk and therefore make decision-making more difficult. This can be seen on the TV programme where Lisa Parkinson found the knowledge about the MMR vaccine that she unearthed, to be, ‘confusing information, conflicting information, which is making me feel quite undecided’ (TV05).
Access to the knowledge about the MMR vaccine gave Lisa Parkinson greater participation and agency in the decision-making process; such that she disregarded the government and institutional medical knowledge and assurances about the risks and went on to decide against the triple vaccine, deciding instead to travel to France to have the vaccines administered separately. As the risk theory suggests access to specialised knowledge did not allay her fears, but instead was a source of anxiety and uncertainty.
An increase in access to diverse sources of specialised medical knowledge has led to a shift in society, away from where medical knowledge belonged predominantly to members of medical institutions, to where it is now available to all. But, while this has given the public choice and the opportunity to question medical opinion, it has taken away the trust, confidence and certainty that the public had in the medical experts, thus reducing the expert’s authority and leaving the public anxious and uncertain. This anxiety and uncertainty makes decision-making in medical matters more difficult in contemporary society.
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References
Goldblatt D, Mcfall L and Woodward K, (2004) Changing times, changing knowledge, in Goldblatt. D, (2004) knowledge and the social sciences: theory, method, practice, London: Routledge, Taylor and Francis in association with The Open University
Watt. S and Woodward. K, (2004) Science and society: knowledge in medicine, in Goldblatt. D, (2004) knowledge and the social sciences: theory, method, practice, London: Routledge, Taylor and Francis in association with The Open University
TV05 Knowledge and knowing, DVD0050 (2005), Mother Knows Best, Milton Keynes, The Open University
