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The convivial and the pastoral in patient-doctor relationships : a multi-country study of patient stories of care, choice and medical authority in cancer diagnostic processes
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MacArtney, John I., Andersen, R. S., Malmström, M., Rasmussen, B. and Ziebland, S. (2020) The convivial and the pastoral in patient-doctor relationships : a multi-country study of patient stories of care, choice and medical authority in cancer diagnostic processes. Sociology of Health and Illness . doi:10.1111/1467-9566.13067 (In Press)
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Official URL: https://doi.org/10.1111/1467-9566.13067
Abstract
Experiences of cancer diagnosis are changing in light of both the increasingly technological‐clinical diagnostic processes and the socio‐political context in which interpersonal relations take place. This has raised questions about how we might understand patient–doctor relationship marked by asymmetries of knowledge and social capital, but that emphasise patients’ empowered choices and individualised care. As part of an interview study of 155 participants with bowel or lung cancer across Denmark, England and Sweden, we explored participants’ stories of the decisions made during their cancer diagnostic process. By focusing on the intersections of care, choice and medical authority – a convivial pastoral dynamic – we provide a conceptual analysis of the normative ambivalences in people's stories of their cancer diagnosis. We found that participants drew from care, choice and medical authority to emphasise their relationality and interdependence with their doctors in their stories of their diagnosis. Importantly negotiations of an asymmetrical patient–doctor relationship were part of an on‐going realisation of the healthcare processes as a human endeavour. We were therefore able to draw attention to the limitations of dichotomising emancipatory‐empowerment discourses and argue for a theorisation of the patient–doctor relationship as a contextually bounded and relationally ambivalent humanity.
| Item Type: | Journal Article | |||||||||||||||||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Physician and patient , Cancer -- Patients -- Care | |||||||||||||||||||||
| Journal or Publication Title: | Sociology of Health and Illness | |||||||||||||||||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | |||||||||||||||||||||
| ISSN: | 0141-9889 | |||||||||||||||||||||
| Official Date: | 26 February 2020 | |||||||||||||||||||||
| Dates: |
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| Date of first compliant deposit: | 17 January 2020 | |||||||||||||||||||||
| DOI: | 10.1111/1467-9566.13067 | |||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||
| Publication Status: | In Press | |||||||||||||||||||||
| Publisher Statement: | "This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." | |||||||||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||||||||
| Copyright Holders: | © 2020 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL. | |||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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