Good Patients and Problem Patients: Conformity and Deviance in a General Hospital

126

The paper examines the stereotypes of South Asian descent women held by midwives in a British hospital. The data are drawn from a small‐scale ethnographic study which investigated the women's maternity experiences. The midwives’ stereotype contained four main themes: the difficulty of communicating with the women; the women's lack of compliance with care and abuse of the service; their tendency to ‘make a fuss about nothing’; and their lack of ‘normal maternal instinct’. The creation, perpetuation and effects of this negative stereotyping are examined in the light of the wider sociological research on patient typification. Black and minority ethnic patients are particularly vulnerable to negative typification because of their visibility combined with the fact that crude racial stereotypes are common in wider society. Stereotyping reflected and reinforced the view that Asian women are ‘all the same’ but ‘not like us’. Midwives used stereotypes to help them to make judgements about the kind of care different women want, need and deserve. It is therefore argued that stereotyping is a factor in the creation of the inequality in health experiences of black and minority ethnic patients.

Section: Asian Women As 'Bad' Patientsmentioning

confidence: 99%

Section: Asian Women As 'Bad' Patientsmentioning

confidence: 99%

‘They're not the same as us’: midwives' stereotypes of South Asian descent maternity patients

Bowler

1993

126

“…Evaluations of patient behaviour in the immediate face-to-face situation can also result in delay or denial of care. Patients who were perceived as uncooperative or over-complaining received less attention in the surgical unit studied by Lorber (1975) and in the psychiatric ward studied by May and Kelly (1982).…”

Section: Introductionmentioning

confidence: 99%

Categorisation and micro‐rationing: access to care in a French emergency department

Vassy

2001

This paper describes how the categorisation of patients by staff in a French emergency department (ED) leads to the micro-rationing of care. Although ED staff are reluctant to acknowledge it, they refuse to treat many would-be patients at the reception stage, and advise them to go to other care settings (such as general practitioners' premises or social dispensaries).The study analyses the judgmental categories staff use to decide patients' eligibility for care, paying particular attention to their clinical, organisational, moral and social dimensions. Staff ration care at the point of service delivery but they soften the harshness of the rationing by making a positive discrimination in favour of those seen to be in real need. Data from observations and interviews are used to analyse the tensions between the different models of`local justice' employed by doctors.

“…Over several decades sociologists have provided numerous accounts of these social and biological processes. Thus the importance of the social construction and definition of illness experiences (Freidson 1970, Scheff 1966, the kinds of social structures which constrain human behaviour in the face of discomforts and disruptions (Locker 1983, Navarro 1978, the means and the mechanisms whereby the bearers of expert languages are able to define the situation in various and sometimes self-serving ways (Hollingshead and Redlich 1958, Mercer 1972, Scheff 1966, Scott 1969, the divergence between expert and lay languages (Friedson 1970), the nature of the power relationships between patients and professionals (Friedson 1970, Kelly and May 1982, Jeffery 1979, Lorber 1975, and the contingent nature of diagnosis (Dingwall 1976) have all been described sociologically. Some authorities have written their sociology in ways which eloquently express physical limitations and bodily difficulties (Strauss et al 1984) or directly address the interactions between physical and social aspects of human life and their consequences for illness (Freund, 1982;Freund andMcGuire 1991, Lawler 1991).…”

Section: Introductionmentioning

confidence: 99%

Medical sociology, chronic illness and the body

Kelly

Field

1996

277

157

The sociological conceptualisation of chronic illness requires a sociology which indicates the physicality of the body theoretically. The aim of this paper is to demonstrate how the body might be integrated into sociological accounts ofthe experience of chronic illness in a way that acknowledges biological and social facts. Central to our argument is the connection between bodily aspects of self and identity. Self and identity are core aspects of everyday experience and of the everyday experience of illness. With the onset of illness bodily functioning alters and self-conceptions and identity may also change. The body, which in many social situations is a taken for granted aspect of the person, ceases to be taken for granted once it malfunctions. The bodily basis of chronic illness has to be attended to because it limits or interferes with other physical and social activities. The connection between biological and social facts is explored using the concepts of self and identity.