Leveraging Epistemic Authority: How Physicians and Parents Negotiate the Uncertainty of Genomic Test Results

• In Event: 372 - Section on Medical Sociology Paper Session. Technology, Health and Medicine

Abstract

Clinicians order next-generation genetic testing in order to address unsettling feelings of diagnostic uncertainty about the cause of symptoms. We use a combination of ethnographic and conversation analytic methods to examine geneticists returning exome sequencing results to families. We find that in genetic consultations, clinical geneticists exert epistemic authority by interpreting genomic findings in ways that go beyond the laboratory report while also offering parents insight into the basis of their judgment. This news delivery approach facilitates parents' involvement in the determination of genetic causality and allows physician and parent to collectively define the boundaries of uncertainty. We then show that through collectively managing the causal ambiguities of genomic findings, clinicians and parents enact a care relationship that works to assuage diagnostic uncertainty.

Authors

• Stefan Timmermans, UCLA

• Tanya Stivers, UCLA