Dangerous Diagnostics:
Shannon, Thomas A.
DANGEROUS DIAGNOSTICS The Social Power of Biological Information Dorothy Nelkin and Laurence Tancredi Basic Books, $18.95, 207 pp. Thomas A. Shannon Testing is one of the main experiences that...
...After providing an introduction and discussion of the concept of diagnosis, the authors look at testing, and the social implications of both diagnosis and testing in health care, the work place, and the schools...
...The authors expand the model of the company doctor to schools, hospitals, insurance companies, and the courtroom...
...When we entered the work world, we found other sorts of tests: Job evaluations, competition, promotions, raises...
...Nonetheless, the concerns and fears the authors raise are legitimate...
...The assumption of the book seems to be that as soon as a diagnostic technology or method is developed, it will be put to the service of the state or its officials...
...The concluding chapter, "Social Control Through Biological Tests," focuses on the themes of institutional conformity, the use of professionals to define, measure, and implement standards of normality, and the disenfranchisement of people through biological discrimination...
...Despite an unfortunate history of company doctors facing "conflicts of interest," the authors' conspiratorial tone leads me to be somewhat suspicious of their far-reaching claims...
...The authors also examine the role of the professional as institutional agent, one facing an increasing number of conflicts of interest between the well-being of patients or employees and the interests of the company...
...In 1980, the American Cyanamid plant barred females of childbearing age from working with certain toxic substances, unless they could prove they were sterilized...
...Such labeling could make work difficult to obtain, keep individuals from being insured, and create a genetic underclass...
...This is the major weakness of the book...
...While these issues are important, the discussion has not been advanced much beyond the sixties...
...This book raises the test ante considerably higher by describing a new dimension of testing: testing as social control...
...the reader is left with only very general nostrums for remedy and without a clear sense of how to develop a strategy to respond to the issues raised...
...The American eugenics movement, the past legalization of the sterilization of the mentally infirm and criminals, and the labeling of and discrimination against those with certain diseases-or who carry them-provide an unhappy context in which the concerns of the authors should be heard...
...Nelkin--on the faculty of New York University and quite distingushed as a sociologist of science-and Tancredi-who teaches medicine and law at the University of Texas Health Science Center-are utterly clear in their mistrust and suspicion of the technologies they discuss and the use to which they assume these will be put...
...Thomas A. Shannon Testing is one of the main experiences that unites us all...
...Individuals have claimed being barred from employment because of hyper-susceptibility to chemicals...
...Rather than building an argument of their own and critiquing the premises of their adversaries, the authors present a series of compelling and troubling images and articulate a conspiracy of testing...
...The public would better be served by a thorough analysis of the premise of such arguments...
...But then they take revenge by sending us to school and beginning what seems to be an eternity of testing...
...I think the authors implicitly buy into many of the exaggerated claims being made on behalf of the genetic structure of an individual, claims that have yet to be subjected to rigorous testing...
...The assumption was that workers, not employers, are responsible for their health and safety...
...The concluding chapters examine the legal implications of testing and examine how biological tests, in particular, can be used to effect social control...
...Pre-employment medical testing is being extended to evaluate fitness for work...
...As evidence for their perspective, they put forward a sampling of quotes from officials, journals,.and a series of case studies...
...Other companies have tested blacks for sickle cell anemia...
...We spend a fair amount of time as children testing our parents...
...Nelkin and Tancredi rehearse several critical case studies to reinforce their main points...
...These highlight the negative applications of various testing technologies...
...Many of the fears expressed about genetic or medical testing raised by the authors give unintended and uncritical support to these claims...
Vol. 117 • February 1990 • No. 3
