Uncertainty and contestation in the medico-legal field: an ethnography of dispute over the legitimacy of multiple chemical sensitivities

[Truncated abstract] More than twenty years after the condition multiple chemical sensitivities (MCS) was first labelled, a debate is still playing out in the medico-scientific community and in the courts over what causes the condition. While some contend it is a genuine and debilitating injury caused by toxic exposure, others argue it is a psychosomatic illness related to paranoia about chemicals. People with MCS in Australia, as in many other parts of the world, have thus far been denied the legitimacy of an official categorisation of illness. They often encounter disbelief and disregard from doctors, strong resistance to their claims in the political sphere, little recognition in the law and a lack of sympathy within the broader community. Potentially, MCS could one day be recognised as a valid disability in Australia, as it has in Germany, Austria and under some jurisdictions in the USA. An examination of other illnesses which were once individualised and subject to stigma - such as repetitive strain injury - reveals the potential for conditions to undergo ‘regime’ changes (Klawiter 2005). Through cultural shifts, social movements and changes in scientific discovery, those with environmental illness can receive increasing community support, legislative recognition and greater understanding from the health care sector. For such widespread changes to occur, a condition must undergo legitimisation, which is a social process in which the illness becomes accepted as authoritative and politically justified (Willis 1994, p.55). This thesis presents an ethnography of dispute in the medico-legal field, which is described as an important stage on which the battle over MCS legitimacy plays out. Drawing on qualitative research conducted over three years in Western Australia, I examine seven workers’ compensation lawsuits involving MCS, with a combination of participant observation in formal court hearings and at informal gatherings during legal proceedings;