“I Never Wanted to Be a Quack!”

Abstract

When medical practitioners act as expert witnesses for the plaintiff in contested illness lawsuits, they can be stigmatized by their professional community. Drawing on ethnographic research surrounding the condition multiple chemical sensitivities (MCS) in Australia, this article focuses on: how plaintiff experts specialize; their rationale for deviance from the professional norm; and structural constraints to medical advocacy. By diagnosing and treating the condition as organic, these experts oppose the accepted disease paradigm of the medical community and therefore face professional isolation and peer pressure. They rationalize their continued advocacy within a moral discourse, which includes a professional aspiration toward altruism, an ethical commitment to "truth," and the explicit emphasis that financial gain is not a motivation. For their deviance the experts have been confronted with professional disillusionment and emotional drain. Ultimately, the medical profession is disenfranchising experts who may be vital characters in the quest for understanding about environmental illnesses.

From individual coping strategies to illness codification: the reflection of gender in social science research on Multiple Chemical Sensitivities (MCS)

“…Studies were primarily conducted in the United States, and some took place, at least partially, in Canada [23,38-45] and in Australia [22,25,45]. Most reviewed papers relied mainly on qualitative research methods, and size of sample varied greatly (N = 1-445).…”

“…Participants were generally persons with MCS, although some authors also interviewed or surveyed MCS patients’ family members [43,45], health and social service professionals [22,23,25,38,41,42,45,52], legal practioners [22,45], political representatives [22,45] and MCS advocates [22,45]. Women constituted between 0 and 100 p.cent of the research sample, but represented more generally 80 to 90 p.cent of it.…”

“…These papers however further addressed broader issues surrounding MCS, such as illness legitimation and diagnostic decision-making strategies [52], legal recognition and medical codification of MCS [22,25,45], dynamics of expertise and decision-making in workers’ compensation claims [22,25,45], legitimacy [22,25] and professional stigmatization of empathetic MCS experts [45]. Also discussed were the sense of place and illness experience associated with MCS local “outbreaks” [43], p. 87 and technology-related disability barriers [54].…”

“…Some interesting concepts, having repercussions for equity issues, were brought jointly to a discussion integrating gender, such as the historical psychologization and delegitimization of women’s health issues [14,19,24,38,41,44,47], the misunderstanding and vulnerabilities associated with hidden disabilities [45] and the sex bias in environmental and occupational health research [19,23,40,41]. Murphy [14], in her work on biochemical individuality with a gendered relationship to risk culture, was amongst those who more finely articulated sex/gender theorization with the actual issue of MCS.…”

“…Papers where sex and/or gender dimensions were absent generally presented a more specifically developed theoretical component, by proposing, for example, an epistemological discussion of power and biomedical uncertainty [45] or by addressing the strategies of diagnosis, codification and expertise of contested illnesses [21,45,52]. Critical impairment and disability studies were also mobilized [54].…”