PMID: 18717363Aug 23, 2008Paper

The coproduction of moral discourse in U.S. community psychiatry

Medical Anthropology Quarterly
Paul Brodwin

Abstract

Anthropologists often criticize the discipline of bioethics because its remote, abstract theories fail to capture how front-line clinicians experience and resolve moral uncertainty. The critique overlooks, however, the ways that everyday, emergent moral discourse is influenced--over time and through several mediations--by formal ethical notions. High-order ethical pronouncements become sedimented into the conditions of work, illustrated in this article by a two-year ethnographic study of Assertive Community Treatment (ACT), a popular mode of outpatient psychiatric services. ACT clinicians' moral unease when they break the confidentiality of patients is connected to high-order debates, dating back 35 years, about ensuring patients' autonomy without abandoning them. These debates originally spurred the invention of ACT, and they get braided into today's moral discourse through several mediations: regulatory paperwork, the mandates and micropolitics of staff-patient interactions, and the idealized self-image of front-line staff. This article shows how everyday moral talk is coproduced by both the immediate contexts of clinical work and the categories of formal bioethics.

References

Feb 1, 1978·Scientific American·E L Bassuk, S Gerson
Dec 1, 1992·Social Science & Medicine·B Hoffmaster
Jan 1, 1991·Psychotherapy and Psychosomatics·M RigatelliA R Morritti
Nov 1, 1990·The American Journal of Psychiatry·L R MarcosJ Brittain
Jun 1, 1985·New Directions for Mental Health Services·L I Stein, M A Test
Jun 1, 1985·New Directions for Mental Health Services·R J Diamond, D I Wikler
Jan 1, 1974·Psychotherapy and Psychosomatics·T S Szasz
Jan 1, 1984·Perspectives in Biology and Medicine·R C Fox, J P Swazey
Apr 1, 1994·Social Science & Medicine·J H Fujimura, D Y Chou
May 20, 1998·The American Journal of Orthopsychiatry·G B TeagueR E Drake
May 29, 2000·Psychiatric Services : a Journal of the American Psychiatric Association·L Dixon
Mar 10, 2001·Journal of Medical Ethics·A B Shaw
Aug 29, 2001·International Anesthesiology Clinics·G S Belkin, A M Brandt
Oct 20, 2001·Christian Bioethics·Julian Anitei
Mar 1, 1992·Medical Anthropology Quarterly·Patricia A Marshall
Oct 27, 2005·Culture, Medicine and Psychiatry·Paul Brodwin

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Citations

Sep 6, 2012·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Martyn D Pickersgill
Jun 24, 2010·Culture, Medicine and Psychiatry·Neely Laurenzo Myers
Dec 12, 2012·Social Theory & Health : STH·Martyn Pickersgill
Aug 20, 2010·Anthropology & Medicine·Paul Brodwin
Jun 26, 2008·The American Journal of Bioethics : AJOB·Paul Brodwin
Aug 13, 2011·Medical Anthropology Quarterly·Paul Brodwin
Aug 1, 2013·Anthropology & Medicine·David Parkin
Apr 26, 2014·Annals of the American Thoracic Society·Elizabeth L Daugherty BiddisonEric S Toner
Oct 26, 2014·The New Bioethics : a Multidisciplinary Journal of Biotechnology and the Body·Nathan Emmerich
Jun 7, 2018·BMC Medical Ethics·Nathan Emmerich
Sep 17, 2014·Culture, Medicine and Psychiatry·Paul Brodwin

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