By David Silverman
David Silverman offers a comprehensively researched and analytically delicate account of the way medical professionals and sufferers relate. Drawing on quite a lot of unique fieldwork from either the united kingdom and in other places and from quite a few clinic settings, either privately and publicly funded, he demonstrates the complexity of clinical interactions and the significance in their context.
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Extra info for Communication and Medical Practice: Social Relations in the Clinic
First, they do not initiate the consultation by bringing a problem to the doctor's attention, and second, doctors may invoke the specialist character of the clinic to exclude discussion of concerns raised by the parents. 2. The treatment is centrally located in a London teaching hospital. This implies that there is no continuing relationship between the family and the hospital and its personnel over a range of routine and nonroutine medical contingencies. There is no close contact between the hospital and other agencies dealing with the child's care: clinics, GPs etc.
Objections and Limits We have almost reached the data. Before finally doing so, I must respond to some possible objections to the analytic framework already established. Thereby, I will present some of the limits that I perceive to arise in the present research enterprise. I will briefly list four points. 1. One possible objection to the analytic framework employed above is that it already presumes medical dominance. Instead of beginning on a tabula rasa of discursive symmetry, it begins from medical definitions of conditions and treatments.
D: Right. So he's feeding well? 2. M: Well, feeding often. 3. D: Feeding often. I There's 4. M: /( ) 5. D: There's no need to be too rigid about it 6. M: No, it just kills me that's all, every two hours in the night. Is it more difficult to feed them with a hole in the heart? These brief extracts suggest that, at least in the early stages of the career of a child with congenital heart disease, participation in decisionmaking is not at issue. Nonetheless, parents do want to play a part in the consultation, particularly by raising issues connected with the homenursing of their child in the context of the information they receive about the medical diagnosis and management-plan.
Communication and Medical Practice: Social Relations in the Clinic by David Silverman