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Open Access The Appropriateness of : Smuggling Values into Clinical Practice De la pertinence du terme approprié: la « contrebande » des valeurs en milieu clinique

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Abstract:

The word has become an institutional given, part of the clinical jargon used in discussions with and about patients and families. The authors unpack arguing that this seemingly innocuous word has implications for clinical practice. They begin with the theoretical and historical question What does "do" in clinical discourse? The answer is both grammatical and moral, rooted in the 19th-century distinction between and and the 20th-century medicalization of behaviour. The examination references rhetorical theory and the history of statistics and psychology, and it uses pediatric health care as an example. The authors argue that the use of the word facilitates the smuggling of values into clinical encounters, which can marginalize patients and compromise therapeutic relationships. In uncovering the discursive (moral) elements of they challenge readers to critically reflect on how they speak to and about patients and families.

French
Le terme approprié est devenu un élément clé du jargon employé en milieu clinique dans les échanges avec les patients et leurs familles et les discussions les concernant. Les auteures s'appliquent à décortiquer ce qualificatif en apparence anodin et ses implications pour la prestation des soins. Elles se questionnent d'abord sur le rôle du terme dans le discours clinique, d'un point de vue théorique et historique. Son origine serait de nature grammaticale et morale; il trouverait sa source à la fois dans la distinction qu'on a établie, au XIXe siècle, entre le normal et le pathologique et dans la médicalisation du comportement qui s'est ensuivi au XXe siècle. La réflexion proposée ici touche à la théorie rhétorique et à l'histoire des statistiques et de la psychologie, tout en prenant appui sur l'exemple des soins pédiatriques. Les auteures avancent que l'usage du terme approprié favorise une sorte de « contrebande » des valeurs dans les échanges en milieu clinique, susceptible de marginaliser les patients et de compromettre l'intégrité de la relation thérapeutique. Dévoilant les éléments discursifs (moraux) du terme, elles incitent les lecteurs et lectrices à réfléchir à leur façon de s'adresser aux patients et à leurs proches et de traiter des questions qui les concernent.

Keywords: DISCOURSE; FAMILY-CENTRED CARE; LANGUAGE; MORAL REASONING; NORMAL VS. PATHOLOGICAL

Document Type: Research Article

Publication date: 2007-12-01

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