Review

Exposing experts

MEDICINE, HEALTH AND RISK: sociological approaches
Jonathan Gabe (ed)
Blackwell, 1995

This monograph, the first in a planned series by the editorial board of the Sociology of Health and Illness, contains eight essays which bring a sociological perspective to bear on the matter of defining and assessing modern risks to health. Substantive topics addressed by contributors include HIV, childbirth, childhood immunisation, toxic waste, disease prevention and risk assessment.

While each chapter is of interest in its own right, all eight taken together begin to feel rather repetitive, with little variation of topic, argument or texture. The essays are generally discursive and literature-based with little in the way of primary evidence or detailed analysis of particular points.

There is a central message which comes over repeatedly: ‘expert’ risk assessors present only one version of risk. Of course, such a message can be interpreted in various ways. Although the crude reduction to ‘never trust an expert’ is not explicit, one feels that some authors would be sympathetic with such a view.

A more sophisticated recognition that multiple assessments of both safety and danger are possible, and that all are necessarily socially constrained – or constructed – is a point which many contributors never seem to reach. The result is a sense of frustration that we don’t often get past the ‘expert as alien’ version.

One notable exception is the essay by David Pilgrim and Anne Rogers which explores the views of four distinct groups – various ‘experts’ and parents – on childhood immunisation. This account is refreshing and illuminating precisely because it is sensitive to the tensions and contradictions withinthe understandings of each group, as well as between them.