Abstract

Abby Lippman's geneticisation thesis, of the early 1990s, argued and anticipated that with the rise of genetics, increasing areas of social and health related activities would come to be understood and defined in genetic terms leading to major changes in society, medicine and health care. We review the considerable literature on geneticisation and consider how the concept stands both theoretically and empirically across scientific, clinical, popular and lay discourse and practice. Social science scholarship indicates that relatively little of the original claim of the geneticisation thesis has been realised, highlighting the development of more complex and dynamic accounts of disease in scientific discourse and the complexity of relationships between bioscientific, clinical and lay understandings. This scholarship represents a shift in social science understandings of the processes of sociotechnical change, which have moved from rather simplistic linear models to an appreciation of disease categories as multiply understood. Despite these shifts, we argue that a genetic imaginary persists, which plays a performative role in driving investments in new gene-based developments. Understanding the enduring power of this genetic imaginary and its consequences remains a key task for the social sciences, one which treats ongoing genetic expectations and predictions in a sceptical yet open way.

Highlights

  • Within the sociology of health and illness, the development and implications of contemporary genetics have been a major focus for both debate and research for the past 25 years (Conrad and Gabe 1999, Tutton and Hallowell 2009), and continue to be an important area of study

  • We present and analyse an in-depth review of the literature published since the early 1990s under a series of headings related to the main areas covered by the geneticisation thesis: scientific discourse and practice; clinical discourse and practice; popular culture and lay discourses and practices

  • It should be noted that there is a wider body of social science literature about genetics/ genomics that does not enrol the concept of geneticisation or cite Lippman’s papers, and instead uses alternative concepts, such as biomedicalisation or molecularisation

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Summary

Introduction

Within the sociology of health and illness, the development and implications of contemporary genetics have been a major focus for both debate and research for the past 25 years (Conrad and Gabe 1999, Tutton and Hallowell 2009), and continue to be an important area of study. Lippman reiterated and further developed her arguments about geneticisation (see for example Lippman 1993, 1998) Together, this body of work provided a wide-ranging critique of the role of genetics in health care and made a comprehensive set of claims about genetics and its uses. Lippman’s critique combined a constructionist understanding of health and illness and a commitment to health activism Her aim was both to highlight the social and cultural assumptions that underpin genetic ways of categorising and responding to health problems, and to prioritise alternative responses that foreground the social and structural determinants of health. Subsequent theorising about bio/medicalisation (Clarke et al 2010, Conrad, 2005) has continued to posit a dominant role for genetics/genomics, whilst rehearsing updated technoscientific visions of genomic enhancement and redesign

Methodology and scope of the review
The debate about geneticisation after Lippman
Analysing different dimensions of geneticisation
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