I. Present Concepts of the Meaning and Limitations of Medical Diagnosis

Engle, Ralph L.; Davis, Betsy

doi:10.1001/archinte.1963.03860040108009

Cited by 47 publications

(2 citation statements)

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“…According to one authority, clinical diagnosis represents a conclusion about an abnormal state of health based on the assessment of a patient's history, physical findings, and laboratory studies. 21 Although clinical misinterpretation probably occurs often in practice, outbreaks due to misdiagnosis rarely have been reported. 10 In this particular outbreak, the consequences of misdiagnosis were not minor.…”

Section: Discussionmentioning

confidence: 99%

A Pseudoepidemic of Postoperative Scleritis Due to Misdiagnosis

Burwen

Margo²,

McNeil³

et al. 1999

Infect. Control Hosp. Epidemiol.

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Section: Discussionmentioning

confidence: 99%

A Pseudoepidemic of Postoperative Scleritis Due to Misdiagnosis

Burwen

Margo²,

McNeil³

et al. 1999

Infect. Control Hosp. Epidemiol.

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“…Engle and Davis (1963) describe medical diagnoses as being at different 'orders of certainty' reflecting the different characteristics of the patterns they are based on and how 'certain' a clinician can be that a patient's presenting problems 'match' any particular general pattern. The first order of certainty includes presentations where the causes are usually very clear and specific and where there is very little variation from person to person or environment to environment.…”

Section: What Is a Pattern?mentioning

confidence: 99%

The Road Ahead

Gaither¹,

Wood²

2022

Recovering the US Mental Healthcare System

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It is this philosophical basis, not just psychiatric diagnosis and medicalisation as such, which needs to be fundamentally re-thought if we are not to end up with variations on the same unsatisfactory system. Modified versions such as the 'vulnerability-stress' or 'biopsychosocial' models still position social and relational factors as secondary to underlying biological causal malfunctions, and thus do not fully theorise distress as a meaningful, functional and understandable response to life circumstances.Drawing on relevant theoretical approaches, principles and practices are presented which allow us to see humans as active, purposeful agents, creating meaning and making choices in their lives, while at the same time subject to very real enabling and limiting factors, bodily, material, social and ideological. This has implications for service user/survivor and carer voices and views, for culturally appropriate perspectives on manifestations of distress, and more widely, for ethics, values and social justice. In relation to the aims of the project, the implication is that patterns underpinning individual and group experiences of distress will be inseparable from their material, environmental, socio-economic and cultural contexts, and that alternatives to diagnosis need to recognise the centrality of meaning, narrative, agency and subjective experience.Chapter 3 picks up these themes by examining meaning and narrative in more detail. Personal meanings are shaped by social and cultural discourses, which themselves arise within wider social structures and socioeconomic contexts. These in turn are based on particular assumptions about human nature and behaviour. Judgements about who is deemed to be 'mad' are inevitably, to some extent, based on implicit norms about what are acceptable ways of thinking, feeling and behaving in a given society. This includes norms about gender roles, class and 'race', such that those whose behaviour and experiences do not fit the implicit parameters -either by falling short of expectations, or by over-fulfilling them -are more likely to attract a diagnosis. Further, it is suggested that lived experiences of distress, particularly in industrialised societies, are shaped by the more deep-rooted assumptions we have outlined above. Most profound of all are our core assumptions about personhood -what we mean by the 'self', and the relationship between self, others and the material and natural world. One implication is that, as cross cultural studies show, there are not, and cannot be, universal categories of emotional distress.

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Elements of the Medical Process

Elsom¹

1971

JAMA

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I. Present Concepts of the Meaning and Limitations of Medical Diagnosis

Cited by 47 publications

References 4 publications

A Pseudoepidemic of Postoperative Scleritis Due to Misdiagnosis

A Pseudoepidemic of Postoperative Scleritis Due to Misdiagnosis

The Road Ahead

Elements of the Medical Process

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