Being Sick Online: Exchanges of Medical Knowledge on the Internet

This dissertation investigates how social connectivity facilitated by the internet influences the exchange of knowledge amongst ill people. Its primary data source is a large online illness community at which several thousand patients meet daily to share knowledge and support. The dissertation is organized into three empirical chapters designed for publication in academic journals that each deal with a distinct aspect of knowledge exchange at the community under study. The first chapter examines how patients in online illness communities train one another to exercise agency strategically in clinical encounters by honing specific interactional skills. The second chapter focuses on the dilemma that ill people in online communities face in assessing one another as sources of information about their health and isolates two heuristic strategies that patients have developed to accomplish this task. The third chapter analyzes the nature of authority exercised by moderators in online illness communities and builds on scholarship concerning how patterns of social authority shape the content and structure of knowledge. The dissertation concludes by reconsidering the main findings of the three chapters in light of the overarching neoliberal orientation of American healthcare, culminating in the problematization of a central moral theme woven into all three papers: that patient autonomy and choice are inherent goods.PhDSociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/140914/1/dmfoster_1.pd