Moral issues in interactions between doctors and patients during consultations about obesity Helena Webb, King’s College London
Overview of presentation • Background to project • General points – moral issues in the consultations • Describing progress between appointments: ‘success’ vs lack of ‘success’ • Discussion
Background to project • PhD on doctor-patient interactions during medical consultations about obesity. • Two outpatient obesity clinics - routine appointments to encourage weight loss. • Observations over a period of 2 years. • 39 video recorded consultations, analysed according to the principles of conversation analysis (CA).
Moral issues in healthcare consultations • Fatness/obesity as a moral condition (Bordo, 1993; Sobal 1995; Rich and Evans, 2005; Saguy and Riley, 2005). • Healthcare as inherently moral (Parsons, 1956 and 75; Heritage, 2009). • Patients ‘obliged’ to seek expert help and make an effort to become well. • Moral concerns have a particular resonance when fatness is treated as a healthcare issue.
Moral issues in the clinic consultations • Doctor ‘acceptance’ of patient reports. • Use of praise and avoidance of blame. • Overtly neutral questions. • Patients display knowledge of their condition and willingness to follow advice. • Patients describe their progress between appointments in terms of success and lack of success. In doing so they take credit for successes and mitigate lack of success.
Discussion • Moral issues become visible in the talk between doctor and patient. • Normative concerns about fatness/obesity. • Normative concerns about patienthood. • Implications for medical practice.
Webb, H. (2009) I’ve put weight on cos I’ve been inactive, cos I’ve 'ad me knee done’: moral work in the obesity clinicSociology of Health & IllnessVolume 31 Issue 6, Pages 854 - 871 email@example.com