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Between professional values and the social valuation of patients: The fluctuating economy of pre-hospital emergency work

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  • Nurok, Michael
  • Henckes, Nicolas

Abstract

A number of authors have shown how medical decisions are influenced by social values; others have minimized the putative influence of values and have argued that medical decisions are predominantly constrained by the organization of medical work. Based on fieldwork in France and the USA observing pre-hospital resuscitations, we seek to resolve these views by showing that while judgments about the social value of a patient do influence professional decisions, so do judgments about the work that must be accomplished to manage a case. Pre-hospital emergency work has many facets that are variably valued by different professionals at different moments of an emergency's trajectory. These values compete with each other in what we call a "fluctuating economy". This article analyses the role of social, technical, medical or surgical, heroic, and competence values in the course of pre-hospital emergency work. We show how these values may conflict or align with each other, forcing professionals to constantly establish priorities during an emergency trajectory.

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  • Nurok, Michael & Henckes, Nicolas, 2009. "Between professional values and the social valuation of patients: The fluctuating economy of pre-hospital emergency work," Social Science & Medicine, Elsevier, vol. 68(3), pages 504-510, February.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:3:p:504-510
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    References listed on IDEAS

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    1. Baszanger, Isabelle, 1985. "Professional socialization and social control: From medical students to general practitioners," Social Science & Medicine, Elsevier, vol. 20(2), pages 133-143, January.
    2. Nurok, Michael, 2001. "The death of a Princess and the formulation of medical competence," Social Science & Medicine, Elsevier, vol. 53(11), pages 1427-1438, December.
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    Cited by:

    1. Gansel, Yannis & Danet, François & Rauscher, Catherine, 2010. "Long-stay inpatients in short-term emergency units in France: A case study," Social Science & Medicine, Elsevier, vol. 70(4), pages 501-508, February.
    2. Anita Majchrowska & Jakub Pawlikowski & Mariusz Jojczuk & Adam Nogalski & Renata Bogusz & Luiza Nowakowska & Michał Wiechetek, 2021. "Social Prestige of the Paramedic Profession," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    3. Wamsiedel, Marius, 2020. "Credibility work and moral evaluation at the ED," Social Science & Medicine, Elsevier, vol. 248(C).
    4. Justin Mausz & Elizabeth Anne Donnelly & Sandra Moll & Sheila Harms & Meghan McConnell, 2022. "Role Identity, Dissonance, and Distress among Paramedics," IJERPH, MDPI, vol. 19(4), pages 1-16, February.

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