Rebirthing the clinic: The interaction of clinical judgment and genetic technology in the production of medical science

Joanna Latimer; Katie Featherstone; Paul Atkinson; Angus Clarke; Daniela T. Pilz; Alison Shaw

doi:10.1177/0162243906289613

Rebirthing the clinic: The interaction of clinical judgment and genetic technology in the production of medical science

Joanna Latimer^*, Katie Featherstone, Paul Atkinson, Angus Clarke, Daniela T. Pilz, Alison Shaw

^*Corresponding author for this work

Sociology

Research output: Contribution to journal › Article › peer-review

Abstract

The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future.

Original language	English
Pages (from-to)	599-630
Number of pages	32
Journal	Science, Technology and Human Values
Volume	31
Issue number	5
DOIs	https://doi.org/10.1177/0162243906289613
Publication status	Published - Sept 2006

Keywords

Clinical classification
Dysmorphology
Genetic science
Medical knowledge
Molecular technology

Access to Document

10.1177/0162243906289613

Cite this

@article{59d2afc7795c440b863a65fc6ae554e6,

title = "Rebirthing the clinic: The interaction of clinical judgment and genetic technology in the production of medical science",

abstract = "The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future.",

keywords = "Clinical classification, Dysmorphology, Genetic science, Medical knowledge, Molecular technology",

author = "Joanna Latimer and Katie Featherstone and Paul Atkinson and Angus Clarke and Pilz, {Daniela T.} and Alison Shaw",

year = "2006",

month = sep,

doi = "10.1177/0162243906289613",

language = "English",

volume = "31",

pages = "599--630",

journal = "Science, Technology and Human Values",

issn = "0162-2439",

publisher = "SAGE",

number = "5",

}

TY - JOUR

T1 - Rebirthing the clinic

T2 - The interaction of clinical judgment and genetic technology in the production of medical science

AU - Latimer, Joanna

AU - Featherstone, Katie

AU - Atkinson, Paul

AU - Clarke, Angus

AU - Pilz, Daniela T.

AU - Shaw, Alison

PY - 2006/9

Y1 - 2006/9

N2 - The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future.

AB - The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future.

KW - Clinical classification

KW - Dysmorphology

KW - Genetic science

KW - Medical knowledge

KW - Molecular technology

UR - http://www.scopus.com/inward/record.url?scp=33747122587&partnerID=8YFLogxK

U2 - 10.1177/0162243906289613

DO - 10.1177/0162243906289613

M3 - Article

AN - SCOPUS:33747122587

SN - 0162-2439

VL - 31

SP - 599

EP - 630

JO - Science, Technology and Human Values

JF - Science, Technology and Human Values

IS - 5

ER -

Rebirthing the clinic: The interaction of clinical judgment and genetic technology in the production of medical science

Abstract

Keywords

Access to Document

Other files and links

Cite this