Diagnosis, narrative identity, and asymptomatic disease

Mary Jean Walker*, Wendy A. Rogers

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)
8 Downloads (Pure)

Abstract

An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve ‘mismatches’ between one’s beliefs about one’s health status on the one hand, and bodily sensations or past experience on the other. Patients’ attempts to integrate these diagnoses into their self-narratives often involve either forming inaccurate beliefs about bodily sensations and/or past experience, or coming to believe that feelings and experience do not necessarily track or predict health status, leading to an ongoing sense of vulnerability to ill health. These resulting alterations in self-understanding can sometimes be considered harmful, in view of their implications for ascriptions of responsibility and ongoing anxiety.

Original languageEnglish
Pages (from-to)307-321
Number of pages15
JournalTheoretical Medicine and Bioethics
Volume38
Issue number4
Early online date5 Jul 2017
DOIs
Publication statusPublished - Aug 2017

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Bibliographical note

Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Diagnosis
  • Disease
  • Illness
  • Labelling
  • Narrative
  • Overdiagnosis
  • Personal identity

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