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PerspectiveCase Studies in Social Medicine

Contingent Knowledge and Looping Effects — A 66-Year-Old Man with PSA-Detected Prostate Cancer and Regrets

List of authors.
  • Robert Aronowitz, M.D.,
  • and Jeremy A. Greene, M.D., Ph.D.

A 66-year-old man with PSA-detected prostate cancer undergoes prostatectomy that leaves him impotent — a decision he regrets when new evidence becomes available. How can the largely social processes by which we identify diseases transform diseases themselves?

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Funding and Disclosures

Disclosure forms provided by the authors are available at

The patient’s initial and identifying characteristics have been changed to protect his privacy.

The editors of the Case Studies in Social Medicine are Scott D. Stonington, M.D., Ph.D., Seth M. Holmes, Ph.D., M.D., Michelle Morse, M.D., M.P.H., Angela Jenks, Ph.D., Helena Hansen, M.D., Ph.D., Jeremy A. Greene, M.D., Ph.D., Keith A. Wailoo, Ph.D., Debra Malina, Ph.D., Stephen Morrissey, Ph.D., Paul E. Farmer, M.D., Ph.D., and Michael G. Marmot, M.B., B.S., Ph.D.

Author Affiliations

From the University of Pennsylvania, Philadelphia (R.A.); and Johns Hopkins University, Baltimore (J.A.G.).

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