Premium
Formats of responsibility: elective surgery in the era of evidence‐based medicine
Author(s) -
Ducey Ariel,
Nikoo Shoghi
Publication year - 2018
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/1467-9566.12659
Subject(s) - action (physics) , contingency , ethnography , elective surgery , health care , medicine , psychology , surgery , sociology , epistemology , law , political science , philosophy , physics , quantum mechanics , anthropology
This article illustrates what pragmatic sociology refers to as investments in form, by examining the formats created and used by a group of surgeons to determine when elective surgery for pelvic floor disorders could be responsibly undertaken. Drawing upon ethnographic observations of surgical consultations at an academic medical centre in Canada, we show how two specific formats – that the patient is sufficiently bothered and the patient accepts the risks of surgery – allow for justifiable action in conditions of uncertainty and contingency and in light of the demands of dominant imperatives in medicine and health care, especially evidence‐based medicine ( EBM ). We argue that an analytic of justification is necessary for understanding when and how surgery is offered and elected for, and for considering how surgical consultations might be improved.