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Repositioning the patient: the implications of being 'at risk'

Author

Listed:
  • Scott, S.
  • Prior, L.
  • Wood, F.
  • Gray, J.

Abstract

In the modern era of biomedical practice, genetic knowledge has redefined the idea of 'the patient' to include those who are 'at risk' of disease alongside those who are already sick. For such individuals, it is risk itself that constitutes the raison d'être of medical intervention. Using data from interviews with 58 users of a UK cancer genetics service together with data derived from clinical consultations, we consider the way such patients or clients make sense of a cancer genetic risk estimate and how they integrate genetic risk information into their lifeworld. In particular, we note that patient-clients who are 'at risk' tend to see themselves in a liminal position betwixt the healthy and the sick, and that such individuals consequently seek recourse to systems of medical surveillance that can continuously monitor their state of health. Our analysis also revealed the fact that many of those deemed by professionals to be at low risk of inheriting cancer-related mutations subsequently strove to be re-categorised as being at moderate or high risk of an adverse outcome. A number of explanations concerning lay health beliefs, lay 'representations' of health and the nature of the patient-client's lifeworld are examined and assessed in order to account for this apparent paradox.

Suggested Citation

  • Scott, S. & Prior, L. & Wood, F. & Gray, J., 2005. "Repositioning the patient: the implications of being 'at risk'," Social Science & Medicine, Elsevier, vol. 60(8), pages 1869-1879, April.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:8:p:1869-1879
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    References listed on IDEAS

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    1. Rees, G. & Fry, A. & Cull, A., 2001. "A family history of breast cancer: women's experiences from a theoretical perspective," Social Science & Medicine, Elsevier, vol. 52(9), pages 1433-1440, May.
    2. Skolbekken, John-Arne, 1995. "The risk epidemic in medical journals," Social Science & Medicine, Elsevier, vol. 40(3), pages 291-305, February.
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    Cited by:

    1. Jae-Mahn Shim, 2022. "Patient Agency: Manifestations of Individual Agency Among People With Health Problems," SAGE Open, , vol. 12(1), pages 21582440221, March.
    2. Will, Catherine M. & Armstrong, David & Marteau, Theresa M., 2010. "Genetic unexceptionalism: Clinician accounts of genetic testing for familial hypercholesterolaemia," Social Science & Medicine, Elsevier, vol. 71(5), pages 910-917, September.
    3. Salter, Charlotte Ingrid & Howe, Amanda & McDaid, Lisa & Blacklock, Jeanette & Lenaghan, Elizabeth & Shepstone, Lee, 2011. "Risk, significance and biomedicalisation of a new population: Older women's experience of osteoporosis screening," Social Science & Medicine, Elsevier, vol. 73(6), pages 808-815, September.
    4. Caiata-Zufferey, Maria, 2015. "Genetically at-risk status and individual agency. A qualitative study on asymptomatic women living with genetic risk of breast/ovarian cancer," Social Science & Medicine, Elsevier, vol. 132(C), pages 141-148.
    5. Sutton, E. & Martin, G. & Eborall, H. & Tarrant, C., 2023. "Undertaking risk and relational work to manage vulnerability: Acute medical patients’ involvement in patient safety in the NHS," Social Science & Medicine, Elsevier, vol. 320(C).
    6. Paul Stenner & Raffaele De Luca Picione, 2023. "A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology," IJERPH, MDPI, vol. 20(11), pages 1-21, May.
    7. Nettleton, Sarah, 2006. "'I just want permission to be ill': Towards a sociology of medically unexplained symptoms," Social Science & Medicine, Elsevier, vol. 62(5), pages 1167-1178, March.
    8. Skolbekken, John-Arne & Østerlie, Wenche & Forsmo, Siri, 2008. "Brittle bones, pain and fractures - Lay constructions of osteoporosis among Norwegian women attending the Nord-Trøndelag Health Study (HUNT)," Social Science & Medicine, Elsevier, vol. 66(12), pages 2562-2572, June.

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