The diffusion of diagnosis and its implications for the epistemology and ontology of disease.

Rather than confining the categories health and sickness to a biomedical conception of the biological organism, there is growing recognition of epistemological and ontological multiplicity in the realm of diagnosis and, indeed, in the very realm of disease itself. In short, the empirical manifestations of health and illness as well as the processes thought to cause them are now understood to assume a much wider variety of both biological and other forms. This essay considers the underlying epistemological and ontological opportunities and challenges of taking what we are calling this diffusion of diagnosis seriously.

The particularity of freedom and recovery from addiction in practice: On the therapeutic limitations of generalising addiction science.

Addiction science is very often cast as an indispensable source of political justification and clinical resources for engaging addicts therapeutically rather than punitively. It is said to promote an image of overcoming addictions as projects of recovery from disease or mental disorder rather than merely a repudiation of one's formerly troubled ways. Thusly, it is said to inform more compassionate and effective approaches to fostering constructive personal change than merely blaming and punishing addicts for their difficulties.

Psychosomatic subjects and the agencies of addiction.

Addiction science and public policy have for some time been articulated in conformity with a broader antinomy in Western thought between biological reductionism and liberal voluntarism. Hence, mainstream debates have concerned whether and how addiction might be understood as a disease in the biomedically orthodox sense of anatomical or physiological pathology or whether and how addiction might be understood as a voluntary choice of some kind. The fact that those who staff these debates have appeared either unable or unwilling to consider alternatives to this antinomy has resulted in a rather unhappy and intransigent set of intellectual anomalies both on the biomedical and the social scientific sides of this divide.

Post-humanism, addiction and the loss of self-control: reflections on the missing core in addiction science.

The core criterion of addiction is the loss of self control. Ironically enough, however, neither the social nor the biomedical sciences of addiction have so far made any measurable headway in linking drug use to a loss of self control. In this essay I begin by demonstrating the limitations in this regard suffered by the social and bio-medical sciences.

Learning disability and the limits of liberal citizenship: interactional impediments to political empowerment.

Recent policy initiatives have moved decisively toward empowering learning disabled citizens, recognising ability over disability, and promoting people's political empowerment and voice in the design of public services. While laudable and encouraging, these initiatives raise an important question: to what extent can a group of service users, whose very entitlement to state-sponsored assistance is justified by putative intellectual impairment, be empowered according to an exclusively liberal model of citizenship that presumes and requires, as its very defining features, intellectual ability and independence? In this paper we consider this question by means of an ethnographic analysis of an innovative advocacy group: the Parliament for People with Learning Disabilities (PPLD). We first document both an institutional and an interactional preference for clients to speak actively for themselves.

Concepts of social justice in community psychology: toward a social ecological epistemology.

In this paper we address the pervasive tendency in community psychology to treat values like social justice only as general objectives rather than contested theoretical concepts possessing identifiable empirical content. First we discuss how distinctive concepts of social justice have figured in three major intellectual traditions within community psychology: (1) the prevention and health promotion tradition, (2) the empowerment tradition, and most recently, (3) the critical tradition. We point out the epistemological gains and limitations of these respective concepts and argue for greater sensitivity to the context dependency of normative concepts like social justice.