ABSTRACT

Health care practitioners generally agree that a correct diagnosis—literally a “discerning knowledge”—of a sick person’s condition constitutes the essential clinical basis upon which a specific treatment programme can be implemented. Despite the fact that, on occasion, clinicians rely on interpretations of outcome causation to formulate a diagnosis—the patient suffers from bipolar disorder because he or she responds positively to lithium—in most cases the diagnosis provides a rationale for the treatment, and it ensures that the therapeutic intervention is adapted and adjusted to the clinical specificity of the patient’s symptoms. Straightforward as this may seem, the purpose of a diagnosis, which always epitomises a targeted process of knowledge-production against the background of established socio-cultural beliefs about health and disease, has nonetheless been questioned by medical sociologists and critical theorists working within a Foucaultian paradigm, on the grounds that diagnostic categories are often not at all indicative of clinical realities, but rather a clever means for medical and health authorities to exercise power, either with a view to pathologising and stigmatising those conditions which cannot be recuperated as “desirable” within existing configurations of ideological acceptability, or with a view to capitalising on the creation of new lucrative opportunities for the production, sale and consumption of drugs. Diagnosing persistent shame as social anxiety disorder endows the sufferer with a new label of pathology, and excludes him or her from the mentally healthy section of society, but it also allows pharmaceutical companies to profit from the administration of Seroxat/Paxil®, Zoloft®, and other psychotropic substances (Lane, 2007). In cases such as these, the psychiatrically sanctioned diagnosis also has the secondary benefit that it removes the patient’s accountability, so that sufferers no longer need to look for personal answers to the question as to what caused the condition.