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In this paper, Christian Morgner provides a critical reading of Niklas Luhmann's thinking as ignoring human beings or even as antihumanist. Here, he presents an alternative view that centers on Luhmann's idea of the child or human being as a medium. To explain Luhmann's use of these ideas to conceptualize the child and the consequences for research, Morgner refers to the translation of Luhmann's paper "The Child as the Medium of Education" and to as yet unpublished material from his famous card‐box reference system. Drawing on these materials, Morgner can more clearly illuminate Luhmann's novel perspective and how it could inform further theoretical development, supported by new analysis of existing research in other fields, including developmental psychology, education, philosophy, and sociology. He concludes that, far from neglecting the human, Luhmann's theory takes human being very seriously and acknowledges its key role as a form‐giving medium in addressing the challenges faced by contemporary society. This renewed perspective should be of particular interest to educational theorists, enabling them to more freely apply his ideas in various settings. [ABSTRACT FROM AUTHOR]

This paper explores modes of expectation among care‐experienced young people when navigating educational success. Luhmann's theoretical framework is used to conceptualise experiences of educational success and the role of uncertainty. We identify three modes of expectation: trust, risk and danger. To illustrate these modes, we draw on selected examples from an interview study with 28 care‐experienced young people focusing on their experiences of support and aftercare while transitioning out of care. The trust mode of expectation is based in a confidence that the future entails a positive outcome—in the case of this study, regarding educational success. This expectation is characterised by the young person's feelings of belonging, underpinned by a safety net of unconditionally supportive caregivers. The risk mode of expectation is characterised by the young person's feeling of being overwhelmed and burdened by the complexity of the educational system in combination with unknown future circumstances when leaving care. The battle against child welfare services to keep supportive measures increases levels of uncertainty. The danger mode of expectation emerges when educational success is disrupted by the interference of child welfare services. The system is seen as unpredictable and powerful, making the young person withdraw from formal support. We conclude that educational success for care‐experienced young people is closely linked to their mode of expectation with regard to managing the uncertainty of the future and that their mode is highly dependent on their social, institutional and biographical contexts. [ABSTRACT FROM AUTHOR]

This article draws on 2 years' worth of ethnographic observation of team meetings to explore decision‐making in an NHS clinical genomics service. The focus of discussions was on ambiguous genomic results known as VUS or Variants of Uncertain Significance, which may be pathogenic but which also may turn out to be benign. In examining decision‐making around such results, we note how, in contrast to much policy and promotional material in this area, clinicians in these meetings (clinical geneticists and genetic counsellors) place great emphasis on parental phenotypes and whether the parents of a patient share the symptoms and signs of the suspected condition. This information is then combined with the result of genomic tests to decide whether the variant a patient has is responsible for their condition. This article explores the way in which clinicians attempt to flexibly enrol parents into genomic explanations through informal diagnosis of their possible phenotypes and the way in which actually meeting parents allows some clinicians to trump explanations based on documentary or photographic data. The paper sheds light on the way that earlier scholarly understandings of such decisions (around, say dysmorphology) remain relevant and explores claims that laboratory tests overrule clinical decision‐making. [ABSTRACT FROM AUTHOR]

The article discusses information about the 27th Sociology of Health and Illness Monograph. Topics covered include the emergence of the construct of overdiagnosis, the impact of diagnostic, prognostic, and treatment uncertainty on the lay-professional interface, and organisational and health system level responses to uncertainty.

In this collection we revisit the enduring phenomenon of uncertainty in health care, and demonstrate how it still offers coherence and significance as an analytic concept. Through empirical studies of contemporary examples of health care related uncertainties and their management, our collection explores the different ways in which uncertainty may be articulated, enacted and experienced. The papers address a diverse range of healthcare contexts ‐ Alzheimer's disease, neonatal surgery, cardiovascular disease prevention, cancer, addiction (use of alcohol and other drugs during pregnancy), mental health/disorders and medical education – and many tackle issues of contemporary relevance, such as an ageing population, and novel medical interventions and their sequelae. These empirical papers are complemented by a further theoretical contribution, which considers the role of 'implicit normativity' in masking and containing potential ethical uncertainty. By mapping themes across the collection, in this introduction we present a number of core analytical strands: (1) conceptualising uncertainty; (2) intersections of uncertainty with aspects of care; (3) managing uncertainty; and (4) structural constraints, economic austerity and uncertainty work. We reflect on the methodological and theoretical stances used to think sociologically about uncertainty in health care, and the strengths, silences and gaps we observe in the collection. We conclude by considering the implications of the insights gained for 'synthesising certainty' in practice and for future research in this area. [ABSTRACT FROM AUTHOR]

Within western cultures, portrayals of dementia as 'a living death' are being challenged by people living with the diagnosis. Yet dementia remains one of the most feared conditions. The sociological lens of citizenship provides a conceptual framework for reviewing the role of society and culture in repositioning dementia away from deficit to a discourse of agency and interdependence. Awareness of cognitive change, and engaging with the diagnostic process, moves people into a transitional, or 'liminal' state of uncertainty. They are no longer able to return to their previous status, but may resist the unwanted status of 'person with dementia'. Drawing on qualitative studies on social participation by people with dementia, we suggest that whether people are able to move beyond the liminal phase depends on acceptance of the diagnosis, social capital, personal and cultural beliefs, the responses of others and comorbidities. Some people publicly embrace a new identity whereas others withdraw, or are withdrawn, from society to live in the shadow of the fourth age. We suggest narratives of deficit fail to reflect the agency people with dementia can enact to shape their social worlds in ways which enable them to establish post-liminal citizen roles. (A Virtual Abstract of this paper can be viewed at: ) [ABSTRACT FROM AUTHOR]

Some scholars contend that genetic medicine is transforming the experience of illness and the social category of the family - bringing future risks into the present, and potentially strengthening familial biological bonds in light of these shared genetic risks. However, research has shown that genetic information is interpreted and acted upon through a rich repertoire of adaptable social, cultural and familial factors which pre-exist and interact with biomedical knowledge. This paper reports research into families living with Neurofibromatosis Type 1 ( NF1), a highly uncertain condition the manifestation of which can vary considerably also within the same family and, for this reason, has been defined as a 'condition without parameters'. These characteristics make NF1 a particularly informative condition for the examination of family dynamics around genetic information. The study and the methodology are based on the exploration of family networks and allow us to investigate the interrelation of individual and familial constructions of the uncertainty of NF1. This also allows both theoretical and policy claims to be made about the danger of reductionist thinking about the transformative potential of genetic technologies. [ABSTRACT FROM AUTHOR]