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Item Diagnosis as a social and political practice(Massey University, 2025-07-16) Morison T; Sarah RIn this chapter, we examine diagnosis not just as a process of labelling diseases, but as a practice that establishes a shared understanding of what constitutes sickness—an understanding shaped by values, norms, and biology, and imbued with significant social consequences (Jutel, 2024). We begin by asking, “What is diagnosis?”—exploring how naming and framing create diagnostic systems that often struggle with ambiguity. Next, we examine diagnosis as a social tool. In medical interactions, healthcare providers wield the “power to name,” raising questions: Who benefits from specific diagnoses? What role do they play in maintaining the status quo and, hence, social inequity? We also consider diagnosis in the context of medicalisation, whereby everyday experiences are reframed as medical issues through diagnostic classifications. We discuss the benefits, such as validation and care, and drawbacks, including stigma and oversimplification, associated with this practice.Item Diagnostic processes and disclosure: A survey of practitioners diagnosing cognitive impairment(New Zealand Psychological Society, 2014-07) McKinlay A; Leathem J; Merrick PThe literature reports widespread variation in practitioners’ disclosure of a dementia diagnosis, though it is currently unclear what factors influence this difference in practice. 57 New Zealand based practitioners completed an online questionnaire relating to how they reach a diagnosis of cognitive impairment and under what circumstances (if any) a diagnosis might be withheld from a client. The findings indicate that a diagnosis of cognitive impairment is never completely withheld by practitioners. All qualitative responses were analysed using conventional content analysis. Practitioners noted more positive consequences associated with disclosing a diagnosis to their clients, suggesting that providing a diagnosis is perceived by practitioners as helpful for people experiencing cognitive impairment. This study adds to the field of ethics and diagnostic disclosure in that it highlights what specific factors are considered when a practitioner chooses how to relay a cognitive impairment diagnosis to their client. Such considerations include when disclosure conflicts with the clients wishes, lack of insight, and the presence of other illnesses. Ongoing research on the subject of disclosure is needed as the number of adults who will experience cognitive impairment is predicted to rise.
