Making the invisible body visible. Bone scans, osteoporosis and women's bodily experiences
Introduction
The body's interior is objectified and made visible through its subjection to an increasing array of technology leading to the identification of health risks and diseases when they are still unacknowledged by the individual. (Featherstone & Burrows, 1995; Lock, 1993; Turner, 1995). Osteoporosis is an example of a risk condition (a corporal risk), located in the body of the person (Kavanagh & Broom, 1998), which can be unveiled by an examination (a bone scan) of the bone mass (Lock, 1993; Reventlow, Hvas, & Tulinius, 2001; van Wingerden, 1996). Osteoporosis and low bone mass remain invisible in the body and give no symptoms until the time when a fracture may occur. Osteoporosis, however, does not necessarily imply that a fracture will occur, and many people without osteoporosis still risk having a fracture.
The present study raises the question of what happens when medical technology, for the sake of prevention, makes otherwise hidden bodily processes visible. The authors’ background in general practice and medical anthropology creates an interdisciplinary space raising our awareness of the effect of medical technology on healthy women.
The aim of the study was to explore women's bodily experiences after a bone scan and to analyse how a bone scan affects women's self-awareness, and sense of bodily identity and bodily integrity.
Section snippets
Medical technology and osteoporosis
From a biomedical viewpoint, osteoporosis is described as a progressive systemic disease characterized by low bone density and micro-architectural deterioration of the bone tissue, with a consequent increase in bone fragility and susceptibility to fracture (WHO Study Group, 1994). Most frequent are fractures in the wrist, the hip and the backbone, with hip fractures as the most important, because of the association with medical complications and disability and the costs of hospitalisation.
Theoretical framework
The introduction of new technology into biomedicine launches new standard structures for diagnostic and treatment practices. New demands and new issues of acceptability concerning health are developed both in the health care system and among lay people (Koch & Stemerding, 1994). Preventive medicine and people's relationship with medical technology can be approached from a Foucauldian perspective on the disciplining of bodies and lives through an exertion of biopower (Foucault, 1977). Foucault
Methods
A qualitative interview study was chosen to explore women's experience of osteoporosis (Miller & Crabtree, 1999). The study focused on the informants’ experiences and does not address what doctors and the health personnel actually said to the women.
The informants were recruited from the sample of a representative, Danish population-based, age-specific cohort study conducted in the county of Copenhagen. The aims of the cohort study were to describe health and use of health services and of
Findings and interpretations
The women's reasons for being scanned varied (involvement in a research project, referral by their doctor, or personal request for an examination). However, no matter who requested the bone scan, they were all affected by the examination. The experience was exceptional and all gave an unprompted, detailed account of the situation. All the women had great faith in the bone scan technology. Most of them considered the bone scan an opportunity to have their bodies checked for osteoporosis and
Embodiment of the bone scan—theoretical analysis
We found that the participants articulated a change of their bodily experience after their encounter with the medical technology of the bone scan. This concerned issues like their consciousness of their body and bodily signs, and issues concerning bodily identity and bodily integrity.
Women's encounters with the medical technology of the bone scan
This study was in line with other studies demonstrating people's satisfaction with health examinations (Anderssen, 1998). A study from the United States found that most adults believe routine cancer screening is almost always a good idea (Schwartz, Woloshin, Fowler Jr, & Welch, 2004). The women had faith in the results of the bone examinations and most of them in the proposed prevention strategies too, which may also be attributed to their positive attitude to participation in a population
References (56)
- et al.
Fears of disease and disability in elderly primary health care patients
Patient Education and Counseling
(1998) - et al.
Embodied risk: My body, myself?
Social Science & Medicine
(1998) - et al.
The sociology of entrenchment: A cystic fibrosis test for everyone?
Social Science & Medicine
(1994) - et al.
The power of the visible: The meaning of diagnostic tests in chronic back pain
Social Science & Medicine
(1999) - et al.
The ‘limits’ of medicalization?: Modern medicine and the lay populace in ‘late’ modernity
Social Science & Medicine
(1996) A grounded hermeneutic editing approach
- Anderssen, J. (1998). No går det på helsa laus. Helse, sykdom og risiko for sykdom i to nord-norske kystsamfunn [“Now...
Health, stress, and coping. New perspectives on mental and physical well-being
(1979)Political anatomy of the body: Medical knowledge in Britain in the Twentieth Century
(1983)- et al.
‘I’ll worry about that when it comes along’: Osteoporosis, a meaningful issue for women at mid-life?
Health Education Research
(2000)
Unbearable weight. Feminism, Western culture and the body
New medical technologies and society. Rendering life
Body techniques, agency and intercorporeality: On Goffman's ‘relations in public’
Sociology
Embodiment as a paradigm for anthropology
Ethos
Words from the holy people: A case study in cultural phenomenology
New reproductive technologies: The views of women undergoing treatment
Increasing prevalence of diabetes mellitus and impaired glucose tolerance among 60-year-old Danes
Diabetic Medicine
Cultures of technological embodiment: An introduction
Body & Society
The birth of the clinic: An archaeology of medical perception
Discipline and punish: The birth of the prison
The wounded storyteller. Body, illness, and ethics
Interim report and recommendations of the World Health Organization task-force for osteoporosis
Osteoporosis International
The meaning of lumps: A case study of the ambiguities of risk
Sketch of a psychological phenomenological method
Medicine, rationality, and experience. An anthropological perspective
Narratives of risk: Women at midlife, medical ‘experts’ and health technologies
Health, Risk & Society
Women's control and choice regarding HRT
Social Science & Medicine
The health structure of 40-year-old men and women in the Glostrup area, Denmark—an epidemiological survey
Danish Medical Bulletin
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