Abstract

This dissertation constitutes a first step in the development of what I am calling the consultative approach to understanding health, illness and disease. Its primary concern is to outline a rationale for, and delineate the theoretical tools to help think about, the relativity of the social construction of disease. Particular emphasis is placed on the medical construction of disease, and how medicine constructs some diseases more than it does others. To this end, a preliminary typology is suggested for "mapping" the degree to which different diseases are constructed. This has implications for the social constructionist position, and what is referred to more broadly as horizontalism, because it suggests that medicine, while certainly constructing diseases, may also be getting at certain diseases for more or less what they are. It also has consequences for verticalism--an epistemological and ontological orientation informing much of current biomedicine--because it challenges, along with social constructionism, the idea that medicine, or any paradigmatic orientation for that matter, has special access to the "real" workings of the body. Finally, various philosophical implications that follow from the relativity of the social construction of disease are discussed. ;As I see it, developing the consultative approach involves two major projects. The first is to demonstrate the utility of meaningful interparadigmatic collaboration for achieving better understanding of disease . The second is to establish the power of a particular communicative process termed "consultation" for achieving such collaboration. While, for the most part, I leave these two projects for subsequent study, this dissertation lays the theoretical foundation for the first. I say this because, if different paradigms can see and penetrate into reality , then there is utility, theoretically speaking, in fostering meaningful interparadigmatic collaboration. And as discussed, different paradigms , can indeed , see and penetrate. This is confirmed by the relativity of the social construction of reality