Ambiguity and the search for meaning: Childhood leukaemia in the modern clinical context

Abstract

The case of childhood leukaemia in the modern clinical context is a graphic instance of the social implications of advances on the margins of medical knowledge. Developments in the treatment of this condition have significantly altered rates of survival among sufferers. But knowledge has advanced unevenly and individual prognosis remains distressingly uncertain. A study of the families of 60 leukaemic children revealed how such technical shifts shape the experience of life-threatening illness and how apparent clinical gains serve to highlight remaining uncertainties. For such advance in medical knowledge complicates the search for meaning and predictability in the wake of threatening illness, and sharpens contradictions inherent in medicine itself and in its relationship to its wider social context. Observation of the impact of the disease revealed how medicine can be seen as ambiguous in a double sense: the more it appears to control, the more threatening is the domain where knowledge is still lacking; and the more it controls, the more alienated the layman himself from control over its effects.