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Accomplishing the case in paediatrics and child health: medicine and morality in interprofessional talk.

White, Sue J. (2002) Accomplishing the case in paediatrics and child health: medicine and morality in interprofessional talk. Sociology of Health and Illness, 24 (4). pp. 409-435. ISSN 0141-9889

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Abstract

This paper presents data from a recently completed ESRC funded ethnography of social relations and case formulation in an integrated child health service, comprising paediatric inpatient and outpatient, child and adolescent mental health and child development services. Children present to the services with symptoms or troubles for which there are often competing biological, neurological, genetic and/or psychosocial models of causation. As a consequence, clinicians’ talk is oriented to deciding between three main potential types of case formulation – medical, psychosocial and not just medical. These three formulations are not static ideal-types. They are highly contestable and require complex practical and rhetorical work, through which facts and evidence are selectively invoked and different parties to the case are granted attributes which construct and reconstruct past events to render ambiguous symptoms or events understandable. In particular, moral judgements and complex characterizations about the child’s parents, or significant others, often form an indispensable warrant for these formulations. By analysing professional narratives about cases, this paper develops previous ethnographic work on the classification in medical work of children and adults as good or bad, appropriate or inappropriate, culpable or blameless, and renders visible a repertoire of moral formulations about childhood and child care. In particular, judgements about the adequacy of parental love are central to clinical reasoning.

Item Type: Article
Journal or Publication Title: Sociology of Health and Illness
Additional Information: RAE_import_type : Journal article RAE_uoa_type : Social Work and Social Policy & Administration
Uncontrolled Keywords: paediatrics • ethnography • professional talk • case formulation • moral judgement
Subjects: H Social Sciences > H Social Sciences (General)
Departments:
ID Code: 3286
Deposited By: ep_importer
Deposited On: 25 Mar 2008 09:18
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 17:17
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/3286

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