Accomplishing 'the case' in paediatrics and child health

Medicine and Morality in Inter-Professional Talk

Bibliographic Data

ID2248644
AuthorsSusan White (0000-0003-1249-8603, University of Manchester, corresponding author)
Year2002
Volume24
Issue4
Pages409-435
Publication date2002-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.00302
OpenAlexW2028763664
LanguageEN
Citations received39
References cited20

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

Causation · Construct (python library) · Developmental psychology · Epistemology · Ethnography · Mental health · Narrative · Psychiatry · Psychosocial · Rhetorical question · Sociology · Warrant · Child and Adolescent Health · Children's Rights and Participation · Language, Discourse, Communication Strategies · Medicine · Psychology