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the absence of clinical evidence as ‘hysterical’, as I demonstrated in Chapter 3 and Chapter 5 . In Chapter 2 I introduced the concept of ‘mechanical epistemic injustice’ to better elucidate this specific kind of instrument-based discrimination. This, as might be anticipated, is paralleled in illnesses that do not clearly map onto signs of physiological function, a phenomenon associated with conditions like chronic fatigue or MUS (medically unexplained symptoms). As the discussion about what decibel threshold level ‘counts’ as deafness demonstrated, diagnostic
perpetuate them. One of the ways that we can start to recognise and deal with the categorisations that lead to data discrimination is through examining the historical classification and categorisation of relevant groups. This is particularly relevant within healthcare classification systems, which often split up the world into useful categories. Classification systems section the world and allow us to put things or people into neat sets of boxes, which then work in the promotion of knowledge production. 47 My argument here is not just that the variable use of reference
reassurance. Such a challenge assumed individualised and public forms, as an alliance of patients and practitioners sought to challenge discrimination and negative perceptions of diabetes. Offering self-care advice, idealising ‘the diabetic life’, and celebrating achievements of public figures with diabetes were key strategies designed to promote emotional and psychological balance and well-being. 4 In discussing the plurality of balances involved in diabetes
time, tactile and visual discrimination, auditory discrimination, transfer of training skills, generalisation of information and the psychological ‘coding’ of information using different modes or senses. They employed techniques such as galvanic skin conductance, electroencephalogram (EEG) recordings, heart-rate measures and systematic observation and recording methods in order
thesis of this book is that health measurements are given artificial authority if they are particularly amenable to calculability and easy measurement. Furthermore, the selection of people we have chosen to measure as standard is subject to discrimination and bias as we prioritise the measurement of easily recognisable groups. This, I contend, has led to biased data sets that have conflicted with individual perceptions of health, especially in cases of invisible but experiential disability. The real-world consequences of this are highlighted in cases of invisible
managing such illnesses were believed to encounter psychological challenges, discrimination, and often painful long-term complications. For these problems, it was argued, early diagnosis and treatment by a multi-disciplinary team of medical, nursing, and technical staff offered the best solutions. Unfortunately for visionaries like Reid, the tripartite division of the NHS into general practice, hospital, and local government provision made multi-disciplinary and cross-institutional disease management difficult to realise. Reid had, for instance
As Edith Sheffer has shown in persuasive detail, Asperger's example demonstrates how categorising children – even with the most humane intentions – creates opportunities for systematic pathologising and discrimination of the kind discussed by Steven Taylor in the previous chapter. 97 Asperger's clinic grew out of the progressive and interventionist medical policies of socialist Vienna in the 1920s. But in the 1930s, Austrofascism and then the Nazi Anschluss saw Asperger's clinic move to the far right and participate
9 Changes in nursing and mission in post-colonial Nigeria Barbra Mann Wall Introduction In 1914, Britain created the country of Nigeria by joining northern and southern protectorates together. In a colonisation process that lasted more than forty years, the British employed treaties, battles, threats of deportation and collaboration with compliant local rulers as they established a policy of ‘indirect rule’. Yet racial discrimination and other forms of alienation led to anti-colonial protests and nationalist resistance movements. After the Second World War
managerial frameworks to refocus professional attention on specified groups. If certain structures (of employment or discrimination) are simultaneously subjecting populations to increased risks and excluding them from mainstream institutions, then they will not come under the care of health services in the first place. 85 Undoubtedly the connections between marginality and morbidity are complex, but they will probably require fundamental changes in income distribution, social organisation, physical environments, and embedded cultural practices to produce more equitable
procedures were put in place specifically to prevent violence and abusive behaviour towards these individuals. At a European level, they argued that a Europe-wide constituency should be arranged regarding the guardianship, legal capacity and criminal responsibility of autistic people and that the European Commission should extend anti-discrimination and racial harassment laws to those