The social application, transmission and production of medical knowledge : a framework for analysis

This thesis investigates theoretical and empirical developments in thesociology of medical knowledge in the period between 1951 and 1990.The problems addressed are twofold. First, how have medical sociologistsproblematised medical knowledge and secondly, what makes medicalknowledge impervious to sociological scrutiny? The theoretical perspectiveadopted in this study is a critical sociology of knowledge that draws insightsfrom feminist critical theory and from the ideas of Michel Foucault. The studydevelops an analytical framework based on a heuristic distinction betweensociological studies of medical practice, medical education and medicalresearch. The method of investigation comprises analysis of relevanttheoretical studies followed by in-depth analysis of five empirical case studiesof medical practice, education and research.The first conclusion reached is that sociological studies of medical practicetend to investigate the application of medical knowledge; that studies ofmedical education focus on examining the transmission of medical knowledge;and that studies of medical research examine the production of medicalknowledge. The study revealed that the content of medical scientificknowledge was excluded from sociological scrutiny in the studies of medicalpractice and education considered here, due to the positivist assumption thatmedical scientific knowledge of biophysical reality is universal and objectivein nature, and hence not suitable as a topic for sociological enquiry. Incontrast, sociological studies of medical research examine the limits andvalidity of medical scientific knowledge.The second conclusion reached is that there is a considerable degree ofinternal differentiation within the sociological studies of medical practice,education and research. Sociologists are interested in studying aspects ofmedical knowledge which are subject to medical disagreement. Also,sociologists are inclined to study aspects of medical knowledge in which thereis an apparent distance or disjuncture between the cultures of patients anddoctors. Government interest in scrutinising or regulating a medical problemalso focuses sociologists attention on some medical problems rather thanothers. Conversely, medical knowledge tends to remain impervious tosociological scrutiny if it is not subject to either medical disagreement, culturaldisjuncture or government scrutiny