What is Normal in Medicine and Society?

Normal. Disordered. Diagnosis of Autism. These terms have definitions we generally accept enough to use (without wikipedia links for clarification) in common dialogue. But these terms also have a history, someone or something that generated them, a context in society. These terms are also fluid, always evolving, changing based on perspective, culture, individual bias.

The paper Competing Narratives in the Construction of a Category of Diagnosis presented by sociologist William Rocque at the annual meeting of the American Sociological Association looks at autism definition and diagnosis through the lens of sociology, examining how definitions of normal and disordered, autistic and not autistic have evolved to their present meanings. After an overview of the shifting definition of, and social response to, "disability," Rocque focuses how medicine and medical professionals have caused change in the way society defines and behaves toward "normalcy," using autism and the definitions of autism given by Kanner, Asperger, Bettelheim, and Rimland as examples.

In his conclusion, Rocque writes:

Exercising the institutional power of medicine through their authorial positioning in the text, the seminal authors discussed above make ontological claims about autism, assuming it to be and describing it as pathological in contrast to some "natural" normality. In doing so, they participate in the creation of a particular version of the world, and what is possible in it, from a position of peculiar power.

An article this morning from the Philippine Enquirer Mistaken ideas deter progress on autism includes quotes from the mother of a 26-year-old on the spectrum.

"I have seen him grow up and become the person he is today, and it gives me unending joy and a sense of fulfillment to know that this artistic, talented and sensitive young man is my own son.

"I, therefore, defy anyone to refer to my son, or to anyone with ASD for that matter, as being less than normal or as autistic or as disabled, or as being afflicted with a disease," she said.

De Lima said that while families' fears that their loved one with autism would be ostracized by society "are not unfounded," secrecy or self-denial "perpetuates the problem, and hinders the progress toward understanding and acceptance."

"By being obsessed with trying to blend in with the socially typical, the real needs of the most important person in the equation tend to be neglected..."

Is it the values of society that define the diagnostic criteria of medicine, or does medicine define the values of society? Or are both happening, society and medicine feeding back into each other, each shaping the other like Escher's hands that draw each other?

And how much does the fluidly shifting, "squishy," not really defined, concept of what is normal and what is autism play in the intense controversies that currently surround autism and disability?