Uncertain and under Quarantine: Toward a Sociology of Medical Ignorance

Abstract

At the center of the COVID-19 pandemic lies a ubiquitous feature of medicine. Medicine is permeated with ignorance. Seizing this moment to assess the current state of medical sociology, this article articulates a sociology of medical ignorance. We join insights from earlier medical sociological scholarship on uncertainty with emerging research in the sociology of ignorance to help make sense of the omnipresent but sometimes invisible dynamics related to the unknowns in medicine. Then we examine two streams of inquiry with a focus on uncertainty and ignorance—(1) research on the interconnections between technology, medical authority, and ignorance and (2) research on lay expertise within the context of ever-present uncertainties. For decades, and to good effect, medical sociologists have asked, “What does medicine know, and what are the consequences of such knowing?” Going forward, we encourage medical sociologists to examine the unknown in medicine and the consequences of not knowing.

Non-knowledge in Medical Practices

“…Consequently, healthcare professionals are increasingly guided "to new horizons of what is unknown" (Gross and McGoey 2015, p. 1). Epistemology encompasses this unknown under the concept of medical ignorance (hereafter, non-knowledge) (Whooley and Barker 2021).…”

“…As Whooley and Barker (2021) explained, non-knowledge can adopt different forms. To name a few, in medicine there can be known unknowns (unknowns that we are conscious of their existence); unknown unknowns (unknowns that we are not conscious of their existence); tacit knowing (unknowns that we do not know that we are conscious of their existence); errors (unknowns that we think we are conscious of their existence but that are erroneous); taboos (unknowns that we are not supposed to be conscious of their existence but that may be useful); and denials (unknowns that we refuse to be conscious of their existence) (Kerwin 1993).…”

“…To name a few, in medicine there can be known unknowns (unknowns that we are conscious of their existence); unknown unknowns (unknowns that we are not conscious of their existence); tacit knowing (unknowns that we do not know that we are conscious of their existence); errors (unknowns that we think we are conscious of their existence but that are erroneous); taboos (unknowns that we are not supposed to be conscious of their existence but that may be useful); and denials (unknowns that we refuse to be conscious of their existence) (Kerwin 1993). The bottom line of these categorisations is to highlight that knowledge in medicine is limited, where those things that we do not know are intertwined with those things that we do know (Kerwin 1993;Whooley and Barker 2021). As a result, "ignorance saturates all of medicine, from the biomedical laboratory to the design of medical technologies, from the clinical encounter to collective politics of health and illness" (Whooley and Barker 2021, p. 280).…”

‘Don’t think that we die from AIDS’: Invisibilised uncertainty and global transgender health

“…Comprehensive global transgender health research is a form of ‘undone science’ (Frickel et al., 2010 ; see also Hanssmann, 2020 , p. 3), in which research topics go ‘unfunded or are ignored’ (Whooley & Barker, 2021 , p. 279). As global funders, agencies and researchers have focussed on HIV often to the exclusion of other issues (Vijayakumar, 2021 ), many transgender health issues are deprioritised or disregarded.…”

“…settings, demonstrating the ‘distinct interconnections and global processes that reshape health and health care in various parts of the world’ (Farber & Harris, 2022 , p. 17; see also Bell & Figert, 2012 ). The article thus answers calls to ‘pars[e] distinct types of medical unknowns’, advancing a sociology of medical ignorance, of which medical uncertainty is a subcategory (Whooley & Barker, 2021 , p. 280). It advances relational theories of gender and health by illuminating the ‘social processes that shape bodies’ (Connell, 2012 , p. 1678), as omissions in health research and data collection become embodied on a world scale.…”