A division of labor exists between nurses and doctors in a surgical intensive care unit. Nurses perform a culturally identified feminine expressive role, caring about patients as well as for them. Doctors perform a culturally identified masculine instrumental role, concerned with curing patients’ bodies. The nurses are interested in the patients’ stories; the doctors attempt to ignore the stories to concentrate on returning patients to function. Based on the patient’s story, however, the nurses make severe judgments as to moral worth. Such judgments can impair medical care. Must doctors, then, disregard patients’ stories? In other words, must they limit themselves to caring for patients’ bodies, attempting to ignore the individuals, situated in a web of social relationships, who inhabit those bodies?
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References
1.
Benner, P. (1984). From novice to expert: Promoting excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley.
2.
Benner, P. (1994). Caring as a way of knowing and not knowing. In S. S. Phillips& P. Benner (Eds.), The crisis of care: Affirming and restoring caring practices in the health professions (pp. 42-62). Washington, DC: Georgetown University Press.
3.
Bosk, C. L. (1979). Forgive and remember: Managing medical failure. Chicago: University of Chicago Press.
4.
Buchman, T. G., Cassell, J., Ray, S. E.,& Wax, M. L. (2002). Whoshould manage the dying patient? Rescue, shame, and the surgical ICU dilemma. Journal of the American College of Surgeons, 194(5), 665-673.
5.
Buchman, T. G., Ray, S., Wax, M. L., Cassell, J., Rich, D.,& Niemczycki, M. A. (2003). Families’ perceptions of surgical intensive care. Journal of the American College of Surgeons, 196(6), 977-983.
6.
Burrell, D.,& Hauerwas, S. (1977). Fromsystem to story: Analternative pattern for rationality in ethics. In H. T. Engelhardt, Jr., & D. Callahan (Eds.), The foundations of ethics and its relationship to science (pp. 111-152). Hastings-on-Hudson, NY: Hastings Center.
7.
Cassell, E. J. (1991). The nature of suffering and the goals of medicine. New York: Oxford University Press.
8.
Cassell, J. (1989). Agroup called women: Sisterhood and symbolism in the feminist movement. Prospect Heights, IL: Waveland. (Original work published 1977)
9.
Cassell, J. (1991). Expected miracles: Surgeons at work. Philadelphia: Temple University Press.
10.
Cassell, J. (1998). The woman in the surgeon’s body. Cambridge, MA: Harvard University Press.
11.
Cassell, J. (2002). Perturbing the system: “Hard science,” “soft science” and social science. HumanOrganization, 61(2), 177-185.
12.
Cassell, J. (2003). State of the art: Life and death in intensive care. Unpublished manuscript.
13.
Cassell, J., Buchman, T. G., Streat, S., & Stewart, R. M. (2003). Surgeons, intensivists and the covenant of care: Administrative models and values affecting care at the end of life. Critical Care Medicine, 31(5), 1551-1559.
14.
Coles, R. (1989). The call of stories: Teaching and the moral imagination. Boston: Houghton Mifflin.
15.
Fabrega, H.,& Silver, D. (1973). Illness and shamanistic curing in Zinacantan: An ethnomedical analysis. Stanford, CT: Stanford University Press.
16.
Frank, A. (1995). The wounded storyteller: Body, illness, and ethics. Chicago: University of Chicago Press.
17.
Garro, L. C.,& Mattingly, C. (2000). Narrative as construct and construction. In C. Mattingly& L. C. Garro (Eds.), Narrative and the cultural construction of illness and healing (pp. 1-49). Berkeley: University of California Press.
18.
Glaser, B. G.,& Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.
19.
Good, B. J. (1994). Medicine, rationality, and experience: Ananthropological perspective. Cambridge, UK: Cambridge University Press.
20.
Good, B. J.,& Good, M.-J. D. V. (2000). “Fiction” and “historicity” in doctors’ stories: Social and narrative dimensions of learning medicine. In C. Mattingly& L. C. Garro (Eds.), Narrative and the cultural construction of illness and healing (pp. 50-69). Berkeley: University of California Press.
21.
Gordon, D. (1988). Tenacious assumptions in Western medicine. In M. Lock & D. Gordon (Eds.), Biomedicine examined (pp. 19-56). Dordrecht, the Netherlands: Kluwer.
22.
Hunter, K. M. (1991). Doctors’ stories: The narrative structure of medical knowledge. Princeton, NJ: Princeton University Press.
23.
Johnson, N., Cook, D., Giacomini, M., & Willms, D. (2000). Towards a “good” death: End-of-life narratives constructed in an intensive care unit. Culture, Medicine and Psychiatry, 24, 275-295.
24.
Jonsen, A. R. (1991). Casuistry as methodology in clinical ethics. Theoretical Medicine, 12, 295-308.
25.
Jonsen, A. R., & Toulmin, S. (1988). The abuses of casuistry. Berkeley: University of California Press.
26.
Kirmayer, L. J. (1988). Mind and body as metaphors: Hidden values in biomedicine. In M. Lock & D. Gordon (Eds.), Biomedicine examined (pp. 57-94). Dordrecht, the Netherlands: Kluwer.
27.
Kleinman, A. (1988). The illness narratives: Suffering, healing and the human condition. New York: Basic Books.
28.
Mattingly, C. (1998). Healing dramas and clinical plots: The narrative structure of experience. Cambridge, UK: Cambridge University Press.
29.
Moerman, D. E. (1983). Physiology and symbols: The anthropological implications of the placebo effect. In L. Romanucci-Ross, D. E. Moerman,& L. R. Tancredi (Eds.), The anthropology of medicine: From culture to method (pp. 156-167). South Hadley, MA: Bergin & Garvey.
30.
Montgomery, C. (1991). Caring v. curing. Common Boundary, 9(6), 37-40.
31.
Murray, J. F. (2000). Intensive care: A doctor’s journal. Berkeley: University of California Press.
32.
Shaeffer, R. (1992). Retelling a life: Narration and dialogue in psychoanalysis. New York: Basic Books.
33.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
34.
Watson, J. (Ed.). (1994). Applying the art and science of human caring. New York: National League for Nursing.
35.
Young, K. (1997). Presence in the flesh: The body in medicine. Cambridge, MA: Harvard University Press.
36.
Zussman, R. (1992). Intensive care: Medical ethics and the medical profession. Chicago: University of Chicago Press.
