Centre for Biomedicine, Self and Society

Beyond Disease

Examining how new biomedical practices, including novel ways of accessing and interpreting data through data intensive research, challenge and define disease entities, diagnostic categories, treatment options and the processes of preventive, predictive and personalised care.

 

Introduction 

beyond disease

Contemporary developments in biomedicine not only challenge long-accepted ideas about the nature of particular diseases - they also raise more general questions about just what counts as disease. 

This has enormous implications also for the organisation and delivery of health care, and for the sociotechnical organisation of biomedical science. The potential impacts on individuals’ experiences of health and illness could be profound. 

For example, greater and more specific understanding of tumours in cancer research bring new treatment options - but they also disrupt conventional schemes of classification. At the same time, population research into biomarkers in cancer and other conditions is leading to new categories of pre-disease risk, bringing new classes of ‘patients-in-waiting’ under medical management. 

In psychiatry, the objectivity of established clinical tools for diagnosing mental disorders is being questioned by research funders, and there are calls for fundamental changes to existing diagnostic categories in the hope of driving therapeutic innovation for mental ill-health. Multi-dimensional approaches to population studies of psychiatric disorders are complicating understandings of the boundaries between normality and pathology. 

In society more widely, debates over disability, normality, ‘naturalness’ and enhancement further challenge concepts of disease and therapy. This is happening across a range of contexts spanning mental, physical and reproductive health and biomedicine.

Meanwhile increasing costs, earlier preventive interventions and an ever-increasing range of ways in which individuals seek to access biomedical technologies only add to the uncertainties about what counts as health, illness, and disease - and who benefits or suffers from those labels.

Together, these developments raise fundamental questions about the nature of disease, about who has the authority to label it as such, and about the subjective significance of disease itself. 

Biomedical research alone cannot answer these questions. Indeed, as the relationship between research and clinical practice becomes increasingly blurred, the issues only become more complex. 

Close engagement with humanities and social science research, as well as patients and their families, will help us all to navigate the increasingly blurred boundaries between health, illness, and disease in ways that best address the needs of individuals and populations.

People 

Researchers working in the theme include:

Sarah Chan

Giulia De Togni

Sonja Erikainen

Angela Marques Filipe

Andrea Ford (theme research fellow)

Esther Gonzalez Hernando

Chase Ledin

Ago Ganguli Mitra

Martyn Pickersgill (theme co-lead)

Steve Sturdy (theme co-lead)

Julia Swallow

Ingrid Young

 

Research

Position Paper 

 

The Beyond Disease team is currently writing a position paper about how vulnerability and disease intersect. It is using a cross-disciplinary lens and takes COVID-19 as a case study whilst drawing from the perspectives of over ten CBSS affiliates.

womb illustration

Endometriosis

Beyond Disease fellow Andrea Ford is conducting research on endometriosis, a poorly-understood disease that is difficult to categorize, diagnose, and treat. Part of the project examines how environmental toxicity influences disease, particularly endocrine disruption where chemicals mimic and alter hormone function. This raises questions about the social, cultural, and ecological aspects of disease. As part of investigating these questions, the strand organised an interdisciplinary event on 'Hormones and the shifting frontiers of disease' with colleagues in the medical sciences (January 2021). 

Immunity

Andrea and Wellcome Trust Senior Fellow Julia Swallow have recently organized a workshop (February 2021) and special journal issue investigating the contemporary manifestations of immunity and the immune system in biomedicine. Contributors are social scientists drawn from around the world, who are conducting research on topics as diverse as antibiotic resistance, the placenta, cancer, dementia, and inflammation. They look forward to hosting a follow-up workshop this autumn. 

Psychiatry

Martyn Pickersgill is exploring through Wellcome Trust research how diagnosis within psychiatry and psychiatric disorders themselves are being reimagined through biomedical research and clinical practice. In MRC research with psychiatrists themselves, Martyn is exploring everyday idioms of distress and how these can shape population studies.