Constructing Realities

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  • Constructing Realities

    1. 1. Constructing Realities
    2. 2. The Problem of Reality
    3. 3. The Problem of Reality • Reality is dependent on social reasoning and social practices
    4. 4. The Problem of Reality • Reality is dependent on social reasoning and social practices • Medical knowledge sets out to create diseases by constructing classification criteria which are socially derived
    5. 5. The Problem of Reality • Reality is dependent on social reasoning and social practices • Medical knowledge sets out to create diseases by constructing classification criteria which are socially derived • Medical theorising reflects social theorising
    6. 6. The Problem of Reality • Reality is dependent on social reasoning and social practices • Medical knowledge sets out to create diseases by constructing classification criteria which are socially derived • Medical theorising reflects social theorising • Perceptions of the body and disease change over time
    7. 7. Medicalisation
    8. 8. Medicalisation • Medicine has increasingly deposed competing knowledge bases
    9. 9. Medicalisation • Medicine has increasingly deposed competing knowledge bases • Sex
    10. 10. Medicalisation • Medicine has increasingly deposed competing knowledge bases • Sex • Interpersonal relationships
    11. 11. Medicalisation • Medicine has increasingly deposed competing knowledge bases • Sex • Interpersonal relationships • Childbirth
    12. 12. Hierarchy of Scientific Research
    13. 13. Hierarchy of Scientific Research Case Study
    14. 14. Hierarchy of Scientific Research Cohort Study Case Study
    15. 15. Hierarchy of Scientific Research Randomised Control Study Cohort Study Case Study
    16. 16. Hierarchy of Scientific Research Reliability Randomised Control Study Cohort Study Case Study
    17. 17. Hierarchy of Scientific Research Reliability Randomised Control Study Cohort Study Case Study Authenticity
    18. 18. Thomas Kuhn: Paradigms
    19. 19. What is observed Thomas Kuhn: Paradigms
    20. 20. What is observed Questions to be asked Thomas Kuhn: Paradigms
    21. 21. What is observed Questions to be asked Structure of Inquiry Thomas Kuhn: Paradigms
    22. 22. What is observed Questions to be asked Structure of Inquiry Form of Interpretation Thomas Kuhn: Paradigms
    23. 23. Science Measureable What is observed Questions to be asked Observable Structure of Inquiry Controllable Form of Interpretation Testable Thomas Kuhn: Paradigms
    24. 24. Science Measureable What is observed Questions to be asked Observable Structure of Inquiry Controllable Form of Interpretation Testable Thomas Kuhn: Paradigms
    25. 25. Science Measureable What is observed Questions to be asked Felt Observable Structure of Inquiry Controllable Form of Interpretation Testable Thomas Kuhn: Paradigms
    26. 26. Science Measureable What is observed Questions to be asked Felt Observable Structure of Inquiry Controllable Form of Interpretation Testable Thought Thomas Kuhn: Paradigms
    27. 27. Science Measureable What is observed Questions to be asked Felt Observable Implied Structure of Inquiry Controllable Form of Interpretation Testable Thought Thomas Kuhn: Paradigms
    28. 28. Constructed Science Measureable What is observed Questions to be asked Felt Observable Implied Structure of Inquiry Controllable Form of Interpretation Testable Thought Thomas Kuhn: Paradigms
    29. 29. Medical Evidence: Paradigm Shift
    30. 30. Medical Evidence: Paradigm Shift
    31. 31. Medical Evidence: Paradigm Shift Pathophysiology
    32. 32. Medical Evidence: Paradigm Shift Medical training + common sense evaluation Pathophysiology
    33. 33. Medical Evidence: Paradigm Shift Medical training + common sense evaluation Pathophysiology Clinical experience
    34. 34. Medical Evidence: Paradigm Shift Individual expertise Medical training + common sense evaluation Pathophysiology Clinical experience
    35. 35. Medical Evidence: Paradigm Shift Individual expertise Rules of evidence Medical training + Pathophysiology necessary common sense evaluation but not sufficient Pathophysiology Reproducible Clinical experience Systematic
    36. 36. Medical Knowledge and Social Relations
    37. 37. Medical Knowledge and Social Relations • Disease categories may reinforce social relations
    38. 38. Medical Knowledge and Social Relations • Disease categories may reinforce social relations • Anorexia Nervosa and sexual development
    39. 39. Medical Knowledge and Social Relations • Disease categories may reinforce social relations • Anorexia Nervosa and sexual development • Attention Deficit Disorder
    40. 40. Counting the Dead “We are still unable to count the dead in the vast majority of the world’s poorest countries” (Evans and Stansfield 2003) Less than 10 Sub Saharan African Countries can produce ‘useable mortality data’ (Evans and Stansfield 2003) 9

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