Owning responsible actions/selves: Role-relational trajectories in counselling for childhood genetic testing
Issue: Vol 9 No. 3 (2012) Discourse and Responsibility
Journal: Journal of Applied Linguistics and Professional Practice
Subject Areas: Writing and Composition Linguistics
Abstract:
This paper offers a role-relational perspective on responsibility, as a complement to the agency-and-intentionality dimension usually associated with responsible action. A role-relational perspective foregrounds a dynamic notion of role vis-à-vis self-other relations in owning responsible actions/selves. I use the conduct, and by adopting a thematic discourse analytic framework, the findings suggest that parental accounts orient towards the following: balancing of advantages and disadvantages of childhood testing; benefits of knowing for present and future purposes; and the role-relational work counselling context of childhood genetic testing as a way of illustrating the complex role-relational trajectories which underpin parental accounts of moral and causal responsibility. Drawing upon the distinction between ‘excuse’ and ‘justification’ in accounting for underpinning the decision about testing. Although articulation of moral and causal responsibility is nuanced in parental accounts, justifications for actions/decisions mainly take the form of causal responsibility, expressed typically in the ‘if-then’ format.
Author: Srikant Sarangi
References :
Arribas-Ayllon, M., Sarangi, S. and Clarke, A. (2008a) Managing self-responsibility through other-oriented blame: Family accounts of genetic testing. Social Science & Medicine 66 (7): 1521–1532. http://dx.doi.org/10.1016/j.socscimed.2007.12.022
Arribas-Ayllon, M., Sarangi, S. and Clarke, A. (2008b) Micropolitics of responsibility vis-à-vis autonomy: Parental accounts of childhood genetic testing and (non)disclosure. Sociology of Health and Illness 30 (2): 255–271. http://dx.doi.org/10.1111/j.1467-9566.
2007.01037.x
Austin, J. (1991a [1956]) A plea for excuses. In P. French (ed.) The Spectrum of Responsibility, 39–54. New York: St Martin’s Press.
Austin, J. (1991b [1966]) Three ways of spilling ink. In P. French (ed.) The Spectrum of Responsibility, 55–61. New York: St Martin’s Press.
Baier, K. (1991) Types of responsibility. In P. French (ed.) The Spectrum of Responsibility, 117–128. New York: St Martin’s Press.
Clarke, A. (ed.) (1998) The Genetic Testing of Children. Oxford: BIOS Scientific Publishers.
Clarke, A. and Flinter, F. (1996) The genetic testing of children: A clinical perspective. In T. Marteau and M. Richards (eds) The Troubled Helix: Social and Psychological Implications of the New Human Genetics, 164–176. Cambridge: Cambridge University Press.
Clarke, A., Sarangi, S. and Verrier-Jones, K. (2011) Voicing the lifeworld: Parental accounts of responsibility in genetic consultations for polycystic kidney disease. Social Science & Medicine 72 (11): 1743–1751. http://dx.doi.org/10.1016/j.socscimed.2010.06.040
Downing, C. (2005) Negotiating responsibility: Case studies of reproductive decision-making and prenatal genetic testing in families facing Huntington disease. Journal of Genetic Counselling 14 (3): 219–234. http://dx.doi.org/10.1007/s10897-005-0619-3
Emmett, D. (1966) Rules, Roles and Relations. London: Macmillan.
Fletcher, J. (1967). Moral Responsibility: Situation Ethics at Work. Philadelphia, PA: The Westminster Press.
Forrest, K., Simpson, S. A., Wilson, B. J., van Teijlingen, E. R., McKee, L., Haites, N. and Matthews, E. (2003) To tell or not to tell: Barriers and facilitators in family communication about genetic risk. Clinical Genetics 64 (4): 317–326. http://dx.doi.org/10.1034/j.1399-0004.2003.00142.x
Goffman, E. (1961) Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Garden City, NY: Doubleday.
Goffman, E. (1981) Forms of Talk. Oxford: Blackwell.
Hallowell, N. (1999) Doing the right thing: Genetic risk and responsibility. Sociology of Health and Illness 21 (5): 597–621. http://dx.doi.org/10.1111/1467-9566.00175
Hallowell, N., Arden-Jones, A., Eeles, R., Foster, C., Lucassen, A., Moynihan, C. and Watson, M. (2006) Guilt, blame and responsibility: Men’s understanding of their role in the transmission of BRCA1/2 mutations within their family. Sociology of Health and Illness 28 (7): 969–988. http://dx.doi.org/10.1111/j.1467-9566.2006.00515.x
Hallowell, N., Foster, C., Eeles, R., Ardern-Jones, A., Murday, V. and Watson, M. (2003) Balancing autonomy and responsibility: The ethics of generating and disclosing genetic information. Journal of Medical Ethics 29 (2): 74–83. http://dx.doi.org/10.1136/jme.29.2.74
Hare, R. M. (1964) The Language of Morals. Oxford: Oxford University Press.
Harper, P. S. and Clarke, A. (1990) Should we test children for adult genetic diseases? The Lancet 335 (8699): 1205–1206. http://dx.doi.org/10.1016/0140-6736(90)92713-R
Hill, J. and Irvine J. (eds) (1993) Responsibility and Evidence in Oral Discourse. Cambridge: Cambridge University Press.
Mead, G. H. (1934) Mind, Self, and Society: From the standpoint of a Social Behaviourist. Edited by C. W. Morris. Chicago: University of Chicago Press.
Merton, R. (1957) Social Theory and Social Structure. Glencoe, IL: Free Press.
Niebuhr, H. R. (1999 [1963]) The Responsible Self: An Essay in Christian Moral Philosophy. Louisville, KY: Westminster John Knox Press.
Pilnick, A. (2002a) What ‘most people’ do: Exploring the ethical implications of genetic counselling. New Genetics and Society 21 (3): 339–350. http://dx.doi.org/10.1080/
14636770216003
Pilnick, A. (2002b) ‘There are no rights and wrongs in these situations’: Identifying interactional difficulties in genetic counselling. Sociology of Health & Illness 24 (1): 66–88. http://dx.doi.org/10.1111/1467-9566.00004
Pomerantz, A. (1978) Attributions of responsibility: Blamings. Sociology 12 (1): 115–121. http://dx.doi.org/10.1177/003803857801200107
Roberts, C. and Sarangi, S. (2005) Theme-oriented discourse analysis of medical encounters. Medical Education 39 (6): 632–640. http://dx.doi.org/10.1111/j.1365-2929.2005.02171.x
Sarangi, S. (2000) Activity types, discourse types and interactional hybridity: The case of genetic counselling. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 1–27. London: Pearson.
Sarangi, S. (2010) Professional values in interaction: Non-directiveness, client-centredness and other-orientation in genetic counselling. In S. Pattison, B. Hannigan, R. Pill and H. Thomas (eds) Emerging Values in Healthcare: The Challenge for Professionals, 163–185. London: Jessica Kingsley.
Sarangi, S. (2011) Role hybridity in professional practice. In S. Sarangi, V. Polese and G. Caliendo (eds) Genre(s) on the Move: Hybridisation and Discourse Change in Specialised Communication, 271–296. Napoli: Edizioni Scientifiche Italiane.
Sarangi, S., Bennert, K., Howell, L. and Clarke A. (2003) ‘Relatively speaking’: Relativisation of genetic risk in counselling for predictive testing. Health, Risk and Society 5 (2): 155–169. http://dx.doi.org/10.1080/1369857031000123939
Sarangi, S., Brookes-Howell, L., Bennert, K. and Clarke, A. (2011) Psychological and sociomoral frames in genetic counselling for predictive testing. In C. N. Candlin and S. Sarangi (eds) Handbook of Communication in Organisations and Professions, 235–257. Berlin: De Gruyter Mouton.
Sarangi, S and Clarke, A. (2002) Constructing an account by contrast in counselling for childhood genetic testing. Social Science & Medicine 54 (2): 295–308. http://dx.doi.org/10.1016/S0277-9536(01)00029-6
Scheff, T. (1968) Negotiating reality: Notes on power in the assessment of responsibility. Social Problems 16 (1): 3–17. http://dx.doi.org/10.2307/799520
Scott, M. H. and Lyman, S. M. (1968) Accounts. American Sociological Review 33 (1): 46–62. http://dx.doi.org/10.2307/2092239
Shaver, K. G. (1985) The Attribution of Blame: Causality, Responsibility and Blameworthiness. New York: Springer-Verlag. http://dx.doi.org/10.1007/978-1-4612-5094-4
Silverman, D. (1987) Communication and Medical Practice: Social Relations in the Clinic. London: Sage.
Strong, P. and Davis, A. (1978) Who’s who in paediatric encounters: Morality, expertise and the generation of identity and action in medical settings. In A. Davis (ed) Relationships Between Doctors and Patients, 48–75. Farnborough, UK: Saxton House.
Tannen, D. and Wallat, C. (1982) A sociolinguistic analysis of multiple demands on the paediatrician in doctor/mother/child interaction. In R. J. di Pietro (ed.) Linguistics and the Professions, 39–50. Norwood, NJ: Ablex.
Tates, K. and Meeuwesen, L. (2001) Doctor–patient–child communication: A (re)view of the literature. Social Science & Medicine 52 (6): 839–851. http://dx.doi.org/10.1016/S0277-9536(00)00193-3
Taylor, C. (1991) Responsibility for self. In P. French (ed.) The Spectrum of Responsibility, 214–224. New York: St Martin’s Press.
Taylor, L. (1972) The significance and interpretation of replies to motivational questions: The case of sex offenders. Sociology 6 (1): 23–39. http://dx.doi.org/10.1177/003803857200600102
White, S. (2002) Accomplishing ‘the case’ in paediatrics and child health: Medicine and morality in inter-professional talk. Sociology of Health and Illness 24 (4): 409–435. http://dx.doi.org/10.1111/1467-9566.00302