A child's "terminal illness" : an analysis of text mediated knowing

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2001

Authors

Bell, Nancy Marie

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Abstract

Several years ago a ten year child with a disability died from "severe malnutrition" according to a Coroners Service inquest jury. The inquest evidence shows that approximately one week prior to this child ' s death three health care providers conducted individual assessments of the child. Using institutional ethnography as a theoretical and methodological framework, the author conducts a textual analysis of the health care providers' documents generated during their provision of service to this child . Obtained as public documents from the Coroners Service, this data includes: the hospital form, the hospice society records and home care nursing records. In this inquiry, the author argues that health care providers' texts, as constituents of individual and collective action, mediated the health care providers' actions in relation to their professional and organizational agendas. The inquiry shows how this mediated textual activity led to an official and authoritative view of this child as dying from a "terminal illness". It also demonstrates how this official view subordinated alternative views about this child that might have directed professional intervention in a different way.

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