Sociology of Health & Illness Vol. 26 No. 1 2004 ISSN 0141–9889, pp. 102–106
© Blackwell Publishing Ltd/Editorial Board 2003. Published by Blackwell Publishing, 9600 Garsington
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Blackwell Publishing Ltd Oxford, UK SHIL Sociology of Health & Illness 0141–9889 © Blackwell Publishing Ltd/Editorial Board 2004 January 2004 26 1 000 Original Article A comment on Hedgecoe’s ‘Expansion and uncertainty’ Anne Kerr
Giving up on geneticization: a comment on
Hedgecoe’s ‘Expansion and uncertainty:
cystic fibrosis, classification and genetics’
Anne Kerr
Department of Sociology, University of York
In his latest paper on the issue of geneticization, Adam Hedgecoe explores
the expansion of the cystic fibrosis (CF) continuum (Hedgecoe 2003),
drawing on my previous paper on the relationship between CF and a form
of male infertility called Congenital Bilateral Absence of the Vas Deferens
(CBAVD) (2000). He extends my story beyond the 1990s, noting some recent
disagreements about the expansion of CF to include CBAVD. He sug-
gests, however, that these debates have recently ‘died down’ (2003: 59) and he
reiterates the main argument in my earlier paper, stressing ‘the nosological
expansion of the disease to include a certain form of male infertility’
(Hedgecoe 2003: 50).
The bulk of his analysis is based upon a review of two articles concerning
CF (Davis, Drumm and Konstan 1996 and Stern 1997) and an outline of
several discursive strategies that make a link between CF and male infertility
in these papers. He supplements this with discussion of other more recent
articles on the classification of CF (such as Stuhrmann and Dörk 2000,
Rosenstein and Cutting 1998, Bush and Wallis 2000) and similar work on
the link between CF and pancreatitis (e.g. Cohn et al. 1998). Referring to
my earlier work, Hedgecoe also states that the fact that ‘we both reached
largely the same position regarding the expansion of CF classification sup-
ports both our individual approaches’ (2003: 53).
I beg to differ. Whilst I must thank Hedgecoe for his generous acknow-
ledgement of my 2000 paper, I am uneasy about the ways in which he
has interpreted and developed my work. Although we both focused upon
CF and CBAVD, my analysis stopped at 1999. I based my paper upon a
thorough analysis of 80 papers published during the 1990s. I argued that the
establishment of the CF clinical continuum involved dynamic processes of
expansion and contraction and significant levels of interpretative flexibility
and I noted in the conclusion of my paper that, in relation to CF overall,
the clinical continuum between CF and CBAVD was a minor theme. The
interviews that I have since conducted with CF clinicians and scientists, and
my on-going analysis of the history of CF
1
, have underscored my sense that