Scientific Methods for Negotiating Medical Uncertainty
Author: Christa Teston
Publisher: University of Chicago Press
Category: Language Arts & Disciplines
Medical professionals, scientists, and patients have long grappled with the dubious nature of medical certainty regarding diagnosis, treatment, and prognosis of disease states. Modern Western medicine strives for certainty by monitoring symptoms, modeling risk, and controlling knowledge. In the 1990s, evidence-based medicine became coin of the realm for managing uncertainty. This turn toward evidence-based medicine has proved highly contentious, however. Considerable scholarship has emerged exploring the complex nature of evidence-based medical decision making. Many scholars have sought to account for affect, logic, intuition, persuasion, and experiential knowledge in medicine. But what of the pre-deliberative practices that render the grounds upon which decisions are made? What of the agentic capacity of evidence itself? Inspired by these questions, in Bodies in Flux: Scientific Methods for Negotiating Uncertainty, technical communication scholar Christa Teston explores the discursive and material methods by which medical evidence is designed and the pre-deliberative, rhetorical design work that affords grounds upon which uncertainty is identified and managed when medical decisions are made. She explores specific sites (pathology laboratories and FDA drug hearings) and methodological practices (statistical analysis and genetic sequencing) of medical decision making to reveal the real-time assemblages of people, bodies, practices, and objects that create evidences that are later used to make decisions about treatment. In doing so she reveals the complexity of this work and demonstrates ways in which medical evidence is not definitively objective. Rather than viewing construction of certainty as an exclusively human enterprise, she demonstrates how humans and nonhuman agents co-construct certainty in real-world medical settings where life-and-death decisions must be made.