Dr Stephanie Short

School of Health Services Management University of NSW Sydney, AUSTRALIA

Re Ideology and Aetiology: RSI, an Epidemic of Craft Palsy

This is a fascinating iconoclastic thesis. The first chapter provides a very good overview and analysis of the relevant literature in the social studies of science, and of key developments and insights in medical sociology. It draws in particular on insights from labelling theory, and from the work of Parsons, Freidson and Navarro, with emphasis on the role of physicians as moral entrepreneurs. The thesis draws also on the work of the libertarian/anarchist, Ivan Illich.

In my view this thesis makes an original contribution to our academic understanding of the social construction of medical knowledge, through analysis of the case study of RSI. The case study reveals how certain trade union officials, Federal government agencies and a handful of doctors constructed, albeit unwittingly, the epidemic of repetitive strain injury in Australia in the l980s. The insights about the political and social context within which the occupational health and safety movement developed are particularly fascinating and convincing..

The thesis reveals a more than respectable knowledge of the injury and somatization paradigms in occupational health and safety, and makes a convincing case for an alternative explanatory perspective which posits that RSI can be understood as a socially constructed epidemic, or as an example of cultural iatrogenesis. The implications of this thesis for ethical medical practice and for the funding and organisation of health care are immense. This has clearly been a very costly epidemic for many involved, both in human and financial terms. And professional and other empires have been built on it.

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