Health Sciences
Resources
Basic InformationMore InformationLatest NewsQuestions and AnswersLinksBook Reviews
A Companion to GenethicsA Mind So RareA Mood ApartAcquiring GenomesAdaptive DynamicsAlterations of ConsciousnessAltered EgosAn Introduction to the Philosophy of MindAre We Hardwired?Being HumanBelief's Own EthicsBeyond GeneticsBiological Complexity and Integrative PluralismBody BazaarBrain Evolution and CognitionCloningCoherence in Thought and ActionConsciousness and the NovelConsciousness EmergingConsciousness EvolvingConsciousness in ActionConsciousness RecoveredConsciousness, Color, and ContentCreating Mental IllnessDarwinizing CultureDecoding DarknessDescriptions and PrescriptionsDynamics in ActionEmotionEmpathy and AgencyEvolutionEvolution and the Human MindEvolution's RainbowEvolutionary Origins of MoralityExploding the Gene MythFinding Consciousness in the BrainFrom Certainty to UncertaintyFurnishing the MindGenomeGetting HookedHeroes, Rogues, and LoversHeuristics and BiasesHow to Solve the Mind-Body ProblemHuman Nature and the Limits of ScienceHuman TrialsI of the VortexImproving Nature?In Our Own ImageIndividual Differences in Conscious ExperienceInformation ArtsIntelligence, Race, and GeneticsIntentions and IntentionalityMatters of the MindMind and MechanismModels of the SelfMy Double UnveiledNarrative and IdentityNaturalism and the Human ConditionNeurons and NetworksNorms of NatureOrigins of Human NatureOrigins of PsychopathologyOxford Guide to the MindPassionate EnginesPhilosophy and the NeurosciencesPhysicalism and Its DiscontentsPlaying God?PromiscuityProzac BacklashPsychiatry in the New MilleniumPsychological Concepts and Biological PsychiatryPsychological Dimensions of the SelfPsychologyRational Choice in an Uncertain WorldReclaiming CognitionRedesigning HumansSociological Perspectives on the New GeneticsSorting Things OutStrong FeelingsSurprise, Uncertainty, and Mental StructuresSynesthesia : A Union of the SensesThe Barmaid's BrainThe Birth of the MindThe Book of LifeThe Caldron of ConsciousnessThe Century of the GeneThe Cognitive Basis of ScienceThe Cognitive Neuroscience of ConsciousnessThe Conscious MindThe Debated MindThe Developing MindThe Dream DrugstoreThe Dynamic NeuronThe Empirical StanceThe Evolution of MindThe Illusion of Conscious WillThe Limits of Autobiography The Madness of Adam and EveThe Maladapted MindThe Mind's PastThe Misunderstood GeneThe Nature of ConsciousnessThe Nature of IntelligenceThe New PhrenologyThe Presence of MindThe Problem of the SoulThe Race for ConsciousnessThe Shattered SelfThe Significance of ConsciousnessThe Social Construction of What?The Terrible GiftThe Theory of OptionsThe Triumph of SociobiologyThe View from WithinThinks...Understanding CloningUnderstanding EmotionsUnderstanding the GenomeUp From DragonsWhat Genes Can't DoWhat It Means to Be 98 Percent ChimpanzeeWhere the Action IsWho Rules in ScienceWhy Smart People Can Be So StupidWhy We Lie
Related Topics

Medical Disorders
Mental Disorders
Mental Health Professions

by Geoffrey C. Bowker and Susan Leigh Star
MIT Press, 1999
Review by Patricia Ross, Ph.D. on Jun 12th 2000

Sorting Things OutThis book should be read not only by anybody who has ever thought about classification systems but also by anybody whose life has been touched by such systems. The approach taken by these authors in exploring and analyzing classification might be labeled social constructivism, but this would be to provide only a rough guide of what to expect. While the emphasis clearly is on the social aspects of categorizing - for example, how people interact with categories and in so doing change them, how said categories change the individuals both labeled by and employing the categories - the final product reaches well beyond such academic pigeon-holing and is, itself, an example of the very phenomenon it seeks to describe.

In the opening chapter of the book we learn that classification is an inescapable feature of human culture. As such, the authors of the text argue that classification warrants a systematic study of its own - a science of classification. Through an in-depth examination of several diverse examples of classification, and with an eye towards the many social and cultural roles that classification plays, this book begins to establish the character of this new science. The three main features of classification systems examined in detail include classifications as large-scale infrastructures, the consequences of applying classifications to particular individuals and the interplay between classification systems and work practice. Each of these features is explored through case studies.

Part I examines classification and large-scale information infrastructures by focusing on The International Classification of Diseases (ICD). Here we find a compelling explanation for why medical classification systems, while naturally prototypical (prototype systems employ exemplars and classify entities by way of extending the exemplar to the entity through metaphor and analogy) are, for bureaucratic reasons, made to look like Aristotelian categories (natural kinds). Moreover, we are given insights into how this is actually done.

A look at the historical development of the ICD, as presented in this Part I, makes a compelling case for the importance of history in understanding classification systems. As the authors argue, to look at the history of the ICD as one internal to the history of medicine would be to overlook most of the important influences on this classification system. The role of public health concerns as well as the development of information technology figure prominently in this history and it would be terribly difficult, if not impossible, to understand the ICD without these features as well. Through an examination of such features, one comes to see the ICD as not merely a passive list of categories but as a classification system that is a "fundamental tool for communication and control." [p. 132]

Part II looks at how classification systems affect the experiences of the classifier and those classified. Here, two particular cases are examined. The first case is the complex classification system developed by sufferers of tuberculosis and their doctors. What we find here is an analysis of the tensions that arise between a static, formal system of knowledge representation, such as a classification system, and informal, situated experiences that have significant duration and change in important ways over time. The authors show that the representation of time presents a problem for classification systems yet time (duration) and change over time is an essential feature of many of the things we seek to categorize.

The second case examined in Part II is the classification and reclassification of race under apartheid in South Africa. While the general conclusion of this chapter -- that systems of classification are used to justify racism -- should surprise nobody, the details of this case highlight just how difficult and, at times absurd, maintaining such a classification system can be. Moreover, this chapter explores the reasons for why such difficulties arise. Many individuals did not fit neatly into the rigid racial classification system that had developed as an attempt to ensure "separate development". As a result, classifying individuals was often done on the basis of who they associated with, where they lived and what language they spoke. Moreover, such classification, and reclassification, was most often done for economic and political gain. Thus we learn that, given a classification system incapable of making the categories and the individuals being categorized converge, the process of fitting individuals into categories can easily become a political battle.

Part III provides us with a look at the product of an effort of nursing scientists to produce a classification of activities carried out by nurses. The Nursing Intervention Classification (NIC) presents a system that includes numerous activities from `Airway Management' to `Humor'. One of the more interesting phenomena that we encounter here is the way in which the acts of classifying, while highlighting certain features or properties, at the same time obscures other properties. What is emphasized and what is ignored is a matter for negotiation and is continually being re-examined.

Only a few of the many lessons for a science of classification have been highlighted here. Numerous other implications for such a science are found throughout the book. So many implications, in fact, that one might easily become worried that the project is far too large and sweeping to produce any solid conclusions that might be of practical use in future classification projects. In fact, the book comes at a time when such general projects have been largely abandoned in favor of smaller, more discipline-based projects. So, for example, the search for an account of explanation in science has been replaced with smaller-scale accounts of how explanations work in biology or in the social sciences. Thus, finding a book that takes on classification writ large is reason to be wary.

The authors, however, manage to wrestle from this ambitious project many important lessons. Not least among these is the lesson that for too long people have thought about classification systems as objective, abstract, idealized systems of categories that, in some way, capture the essence of that which is categorized. As this book convincingly demonstrates, in order to begin to seriously understand such systems, one needs to look carefully at the actual work of attaching things to categories, the organization of categories into systems and the social and political dimensions of such systems. From this perspective, a more complete understanding of this inescapable fact of human life can be obtained.

Patricia Ross, Ph.D., is an Assistant Professor of Philosophy at the University of Minnesota as well as a Resident Fellow at the Minnesota Center for Philosophy of Science. Her main areas of research include Philosophy of Psychiatry, Philosophy of Psychology (especially developmental psychology) and Philosophy of Medicine.