Regimes of Patienthood: Developing an Intersectional Concept to Theorize Illness Experiences

Abstract

In this paper, we develop the concept regimes of patienthood . Regimes of patienthood highlights the micro and macro dimensions of illness, paying close attention to how the interplay between the two creates expectations and points of intervention for people when they are ill. Such expectations may vary across time, place, and social position (e.g., age, class, ethnicity, gender, race, sexuality). Regimes of patienthood are always regimes of power and resistance, where the forms of resistance may vary based on individuals’ intersectional positions. We draw on two cases—a study of 45 mostly white, middle class adults living with autoimmune illnesses and a study of 20 Black women living with advanced cancer—to examine one dimension of regimes of patienthood—control. Although a number of social positions, such as age and race, co-produce illness experiences, we focus on three—class, insurance status, and gender—that are particularly salient in our data in relation to control. Such a move illustrates the theoretical power of regimes of patienthood for science and technology studies (STS).