This chapter has begun with an acknowledgement of the limitations of multiple choice questionnaires in assessing and raising public awareness of genetic disorders. The limitations are not only of language and meaning, not even just of culture, but of the incommensurate nature of different discourses. Giving a voice to communities of interest has been said to constitute a challenge to the hierarchy of credibility (Becker, 1967) such knowledge assessment questionnaires impose.
Yet merely giving a voice to communities of interest is problematic within critical realism for it raises the potential of an extension of social control. In such cases to challenge the basis of oppressions requires clarity about how an oppression is constituted. Such decisions are not always easy to make. In gender terms it may be that genetic knowledge simultaneously increases the choices of (some) individual women whilst simultaneously foreclosing debates about the values and nature of children and child rearing. In terms of ethnicity it is not clear whether prenatal diagnosis and selective termination is an unwelcome curtailment of fertility or whether such techniques are disproportionately denied to black families by health workers who make racist assumptions that Moslem groups, for example, will find such techniques unacceptable (Petrou et al, 1990). Indeed an anti-essentialist view of ethnicities renders the very link between haemoglobin disorders and particular ethnic groups problematic (Dyson, 1998). Moreover, the blurring of genetic information by community members (Hill, 1994) suggests a problem for disability rights authors (Oliver, 1992) for an invitation to change the social relations of research may itself be experienced as an imposition (Hammersley, 1995) in that what may be desired is no research at all.
Postmodernist commentators are variously concerned to question the essentialist fallacies of genetic discourses. In Foucauldian terms the ante-natal clinic creates not only the genetic subject but also simultaneously the ethical affronts to that subject. If professions are key resources in the process of governmentality, in which populations learn to exercise control over themselves (Johnson, 1995), then public awareness through genetic information is one medium through which governmentality is enacted.
Other authors have emphasised the previously underestimated centrality of the body to social relations. Genetic information is not passively learned but becomes a resource in the active construction of social identities. Such postmodern sociologies can offer the promise of channelling communication between competing discourses in the hope of promoting the démocratisation of science (Kerr et al, 1997).
In summary, subjectivisms can teach us how to listen. Critical theories may alert us, albeit sometimes too programmatically, to what communities of interest experience as 'wrong'. Postmodernisms may help us mutually reveal our standpoints. For all the contradictions in their respective resolutions to the dilemmas of knowing, these sociologies do, collectively, caution against certainty. They caution against certainty in the conception of genetic knowledge, in the action of health professionals and in the implementation of genetic policy.
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