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Disease prestige and the hierarchy of suffering

Louise Stone
Med J Aust 2018; 208 (2): 60-62. || doi: 10.5694/mja17.00503
Published online: 5 February 2018

Suffering should not be hierarchical, and care should not be predicated on the prestige that a disease attracts

Symptoms may herald illness, but it is the diagnosis that announces the presence of disease. While the experience of illness is subjective, disease is authorised by a health professional through diagnosis (Box 1).1 A good diagnosis explains pathology, suggests prognosis, enables access to services, grounds evidence-based therapies and provides an explanation that makes sense of a patient’s suffering. Beyond this, a diagnosis justifies sickness, providing the patient with a rationale for their disabilities — for friends, family, employees, but most importantly for patients themselves.2 To be left without a diagnosis is to be left without a story, with no way of making sense of suffering or communicating distress to others. Diagnosis, then, is often a relief, even when the diagnosis suggests a bleak future (“thank goodness, I knew there was something wrong”).3

  • Louise Stone

  • Australian National University, Canberra, ACT

Correspondence: louise.stone@anu.edu.au

Competing interests:

No relevant disclosures.

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