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The sexual health consultation as a moral occasion
Author(s) -
Cook Catherine
Publication year - 2014
Publication title -
nursing inquiry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.66
H-Index - 49
eISSN - 1440-1800
pISSN - 1320-7881
DOI - 10.1111/nin.12018
Subject(s) - confessional , reproductive health , morality , sexual health clinic , psychology , medicine , social psychology , family medicine , epistemology , politics , population , philosophy , environmental health , men who have sex with men , syphilis , human immunodeficiency virus (hiv) , political science , law
Sexually transmitted infections (STIs) are socially constructed as more ‘dirty’ than other gynaecological conditions. This article analyses women’s accounts of interactions with clinicians, subsequent to a diagnosis of genital herpes simplex virus or human papilloma virus. Women conceptualised consultations as a ‘moral event,’ different from other consultations. This moral component is highlighted drawing on Foucault’s notion of ‘the confessional.’ Additionally, Douglas’ anthropological construction of ‘dirt’ is used to consider why these consultations are ‘confessional’ experiences. Email interviews were conducted with 26 women diagnosed with a viral STI and 12 sexual health clinicians. Data were analysed thematically using a feminist, poststructuralist approach. Findings indicated that discourses of morality shape sexual health consultations. Five themes were identified in relation to the moral ‘work’ in clinical consultations about a viral STI diagnosis: the particular ‘dirtiness’ of viral STIs, clinicians as moral agents, the ‘non‐judgmental’ clinician, women juggling truth‐telling and risk and clinicians prescribing moral work. Clinicians support and educate women more effectively if they recognise subjective, moral aspects of sexual health consultations rather than assuming that effective clinical teaching is rational, scientific and non‐judgmental.