Decision-making in Practice: Surgical Actionability and Consent in Pelvic Floor Medicine
Date
2014-05-27
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Abstract
In this thesis I explore how patients’ problems are made surgically actionable so that decisions regarding and consent to surgery may be produced. I employ ethnographic observations of the material and semiotic practices in which surgeons and patients are engaged. Surgical actionability arises in a cascade of practices that produce diseases such that they meet conditions of actionability. Disagreement between realities of a problem, or uncertainty regarding surgical outcomes, may produce disruptive turbulence in these cascades. Surgeons manage turbulence by shifting sites of decision onto ‘patient choice’ – if a patient decides she is bothered enough to justify the risks, surgery may go forward. However, patients’ decisions rarely take on this ‘rational’ character; instead, they appear to be non-formal and centre on issues other than risks and benefits. I question the value of ‘respect for autonomy’ and propose that policy based in care, with a focus on the particularities of disease and decision production, may serve patients better.
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Education--Sociology of, Sociology, Health Sciences
Citation
Nikoo, S. W. (2014). Decision-making in Practice: Surgical Actionability and Consent in Pelvic Floor Medicine (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25528