The Early Works of Renée Fox: Linking Care and Uncertainty in Medical Practices
EDN: OQEHOO
Abstract
The article reinterprets the early works of Renée Fox—primarily her monograph Experiment Perilous (1959)—through the lens of the connectionand thebetween production the key of themesscientific of knowledge uncertainty. The and standard care in clinicalreception practice of Fox as a researcher of professional socialisation and role expectations in medical work reduces this subject matter, overlooking the epistemic and affective issues inherent in the practical processes of clinical and research work. Reconstructing Merton’s influence, evident in her methodological framework of role conflicts, the article demonstrates that even in her early works, Fox shifts the focus from the reproduction of norms to the mechanisms of emotional regulation arising under conditions of multi-layered uncertainty: the opacity of individual and collective medical knowledge, the ontological instability of the research objects, and the complex affective interactions between doctors and patients. Drawing on Parsons’ concepts of double contingency and the sick role, Fox examines illness as a moral process, where various forms of care and the patient’s behavior affect not only their condition but also the generation of new knowledge through scientific experiments. The aspects of care described by Fox are considered as an integral part of both physicians’ emotional regulation and the construction of scientific facts. The article situates Fox’s early work within the tradition of functionalism, highlighting those moments where her attention to uncertainty, care, and knowledge production transcends Merton’s project, opening avenues for further exploration of both affective issues in medicine and the processes of constructing medical facts.
Supporting agencies: The publication was prepared in the course of a study (project no. 2400-042, Russian Psychiatry in a Transnational Context: Transfers and Circulations of Scientific Theories and Everyday Practices (the second half of the 19th — 20th centuries)) within the framework of the Program “Scientific Foundation of the National Research University Higher School of Economics (HSE)”.
About the Author
K. I. Yakovlev
National Research University Higher School of Economics
Russian Federation
Russian Federation
Kirill I. Yakovlev — PhD student, Department of Sociology
St. Petersburg
References
1. Alexander J. C. (1978) Formal and Substantive Voluntarism in the Work of Talcott Parsons: A Theoretical and Ideological Reinterpretation. American Sociological Review, 43, рр. 177‒198.
2. Atkinson P. (1984) Training for certainty. Social science, medicine, 19(9), рр. 949‒956. https://doi.org/10.1016/0277-9536(84)90324-1
3. Becker H. S. (1961) Boys in white: Student culture in medical school. Transaction publishers.
4. Blair J., Adaway J., Keevil B., Ross R. (2017) Salivary cortisol and cortisone in the clinical setting. Current Opinion in Endocrinology, Diabetes and Obesity, 24(3), рр. 161‒168. https://doi.org/10.1097/MED.0000000000000328
5. Bochatay N., Bajwa N. M. (2020) Learning to manage uncertainty: supervision, trust and autonomy in residency training. Sociology of health, illness, 42, рр. 145‒159. https://doi.org/10.1111/1467-9566.13070
6. Braslow J. T., Marder S. R. (2019) History of psychopharmacology. Annual review of clinical psychology, 15(1), рр. 25‒50. https://doi.org/10.1146/annurev-clinpsy-050718-095514
7. Brooks J. V., Bosk C. L. (2012) Remaking surgical socialization: Work hour restrictions, rites of passage, and occupational identity. Social science, medicine, 75(9), рр. 1625‒1632. https://doi.org/10.1016/j.socscimed.2012.07.007
8. Cockerham W. C. (2019) Medicine and Health (pp. 250–266). In Ritzer G., Murphy W. W. (Eds.), The Wiley Blackwell Companion to Sociology Book. Wiley. https://doi.org/10.1002/9781119429333.ch15
9. Diefenbach G. J., Diefenbach D., Baumeister A., West M. (1999) Portrayal of lobotomy in the popular press: 1935‒1960. Journal of the History of the Neurosciences, 8(1), рр. 60‒69. https://doi.org/10.1076/jhin.8.1.60.1766
10. Fox R. G. (1957) Training for uncertainty (pp. 207‒242). In The student-physician: Introductory studies in the sociology of medical education. Harvard University Press. https://doi.org/10.4159/harvard.9780674366831.c13
11. Fox R. C. (2019) Experiment perilous: Physicians and patients facing the unknown (Original work published 1959). Routledge. https://doi.org/10.4324/9780429334092
12. Fox R. C. (1970) A sociological perspective on organ transplantation and hemodialysis. Annals of the New York Academy of Sciences, 169(2), рр. 406‒428. https://doi.org/10.1111/j.1749-6632.1970.tb54750.x
13. Fox R. C. (1980) The evolution of medical uncertainty. The Milbank Memorial Fund Quarterly. Health and Society, 58(1), рр. 1‒49. https://doi.org/10.2307/3349705
14. Fox R. C. (2002) Medical uncertainty revisited (pp. 236‒253). In Bendelow G., Carpenter M., Vautier C., Williams S. (Eds.), Gender, health and healing. Routlege.
15. Giddens A. (1977) Studies in Social and Political Theory. Hutchinson.
16. Haas J., Shaffir W. (1977) The professionalization of medical students: Developing competence and a cloak of competence. Symbolic Interaction, 1, рр. 71‒88. https://doi.org/10.1525/si.1977.1.1.71
17. Haas J., Shaffir W. (1982) Taking on the role of doctor: A dramaturgical analysis of professional socialization. Symbolic Interaction, 5(2), рр. 187‒203. https://doi.org/10.1525/si.1982.5.2.187
18. Hacking I. (2000) The Social Construction of What? Harvard University Press.
19. Heidarnia M. A., Heidarnia A. (2016) Sick Role and a Critical Evaluation of its Application to our Understanding of the Relationship between Physician and Patients. Novelty in Biomedicine, 4(3), рр. 126‒134. https://doi.org/10.22037/nbm.v4i3.10648
20. Lief H. I., Fox R. C. (1963) Training for “detached concern” in medical students (pp. 12‒35). In Lief H. I., Lief V. F., Lief N. R. (Eds.), The psychological basis of medical practice. Harper, Row. https://doi.org/10.2307/3349705
21. Light Jr D. (1979) Uncertainty and control in professional training. Journal of Health and Social Behavior, 20(4), рр. 310‒322. https://doi.org/10.2307/2955407
22. Loveys B. (1990) Transitions in chronic illness: The at-risk role. Holistic nursing practice, 4(3), рр. 6‒64.
23. Mol A., Law J. (1994) Regions, networks and fluids: Anaemia and social topology. Social studies of science, 24(4), рр. 641‒671. https://doi.org/10.1080/03085149800000020
24. Mol A. (1998) Lived reality and the multiplicity of norms: A critical tribute to George Canguilhem. Economy and Society, 27(2‒3), рр. 274‒284. https://doi.org/10.1177/030631279402400402
25. Mol A. (2000) What diagnostic devices do: the case of blood sugar measurement. Theoretical medicine and bioethics, 21(1), рр. 9‒22 https://doi.org/10.1023/A:1009999119586
26. Mol A. (2008) The Logic of Care: Health and the Problem of Patient Choice (1st ed.) Routledge. https://doi.org/10.4324/9780203927076
27. Mol A. (2011) Tasting food: Tasting between the laboratory and the clinic (pp. 467‒480). In Mascia-Lees F. E. (Ed.), A Companion to the Anthropology of the Body and Embodiment. Blackwell Publishing Ltd. https://doi.org/10.1002/9781444340488
28. Majerus B. (2016) Making Sense of the “Chemical Revolution”. Patients’ Voices on the 196 Introduction of Neuroleptics in the 1950s. Medical History, 60(1), рр. 54‒66. https://doi.org/10.1017/mdh.2015.68
29. Merton R. K. (1938) “Social Structure and Anomie”. American Sociological Review, 3(5), рр. 672‒82 (41). https://doi.org/10.2307/2084686
30. Merton R. K. (1957) Some Preliminaries to a Sociology of Medical Education (pp. 3‒81). In The student-physician: Introductory studies in the sociology of medical education. Harvard University Press.
31. Merton R. K., Reader G. G., Kendall P. (1957) The student-physician: Introductory studies in the sociology of medical education. Harvard University Press.
32. Olsen L. D., Gebremariam H. (2022) Disciplining empathy: Differences in empathy with US medical students by college major. Health, 26(4), рр. 475‒494. https://doi.org/10.1177/1363459320967055
33. Paradis E., Webster F., Kuper A. (2013) Medical education and its context in society (pp. 136‒147). In Walsh K. (Ed.), Oxford Textbook of Medical Education. Oxford University Press.
34. Parsons T. (1937) The Structure of Social Action. McGraw-Hill.
35. Parsons T., Shils E. A. (1951) Toward a General Theory of Action. Harvard University Press.
36. Parsons T. (1951a) Chapter X (pp. 428‒479). In The social system. The Free Press.
37. Parsons T. (1951b) The social system. New York: The Free Press.
38. Parsons T. (1951с) “Illness and the Role of the Physician: A Sociological Perspective.” American Journal of Orthopsychiatry, 21(3), рр. 452‒60. https://doi.org/10.1111/j.1939-0025.1951.tb00003.x
39. Parsons T., Fox R. (1952) Illness, therapy and the modern urban American family. Journal of social issues, 8(4), рр. 31‒44. https://doi.org/10.1111/j.1540-4560.1952.tb01861.x
40. Parsons T., Bales R. F., Shils E. A. (1953) Working Papers in The Theory of Action. The Free Press.
41. Parsons T. (1963) Social Structure and the Development of Personality: Freud’s Contribution to the Integration of Psychology and Sociology. Psychiatry. Nov; 21(4), рр. 321‒340. https://doi.org/10.1080/00332747.1958.11023143
42. Parsons T. (1967) Sociological Theory and Modern Society. The Free Press.
43. Parsons T., Platt G. M. (1973) The American University. Harvard University Press.
44. Parsons T. (1978) Action Theory and the Human Condition. The Free Press.
45. Parsons T. (1979) “Definitions of Health and Illness in the Light of the American Values and Social Structure.” In Patients, Physicians and Illness: A Resource Book in Behavioral Science and Health, edited by E. Gartly Jaco, 165‒187. London: Collier-Macmillan.
46. Russel S. M., Geraghty J. R., Renaldy H., Thompson T. M., Hirshfield L. E. (2021) Training for professional uncertainty: Socialization of medical students through the residency application process. Academic Medicine, 96(11S), S144‒S150. https://doi.org/10.1097/ACM.0000000000004303
47. Schipke T. (2019) The Chronic Sick Role: Its Time Has Come. OMEGA — Journal of Death and Dying, 83(3), рр. 470‒486. https://doi.org/10.1177/0030222819852848
48. Seeman M. V. (2021) History of the dopamine hypothesis of antipsychotic action. World Journal of Psychiatry, 11(7), р. 355. https://doi.org/10.1007/s00702-019-01987-0
49. Tretter M., Ott T., Dabrock P. (2025) AI-produced certainties in health care: current and future challenges. AI and Ethics, 5(1), рр. 497‒506. https://doi.org/10.1007/s43681023-00374-6
50. Vinson A. H., Underman K. (2020) Clinical Empathy as Emotional Labor in Medical Work. Social Science, Medicine, (251). https://doi.org/10.1016/j.socscimed.2020.112904
51. Underman K., Hirshfield L. E. (2016) Detached concern?: Emotional socialization in twenty-first century medical education. Social Science, Medicine, (160), рр. 94‒101. https://doi.org/10.1016/j.socscimed.2016.05.027
52. Vinson A. H., Underman K. (2020) Clinical Empathy as Emotional Labor in Medical Work. Social Science, Medicine (251). https://doi.org/10.1016/j.socscimed.2020.112904
53. Vinson A. H. (2023) Articulating the canon: The sociology of medical education from 1980 to 2000. Health, 27(2), рр. 169‒185. https://doi.org/10.1177/13634593211013886
54. Weindling P. (2016) Nazi Human Experiments: The Victims’ Perspective and the Post-Second World War Discourse. Clio Medica, 95(1). https://doi.org/10.1163/9789004286719_011
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Yakovlev K.I. The Early Works of Renée Fox: Linking Care and Uncertainty in Medical Practices. Sociology of Power. 2026;38(1):175-198. (In Russ.) EDN: OQEHOO
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