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Qualitative Health Research
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"Innocent Parties" and "Disheartening" Experiences: Natural Rhetorics in Neuro-Rehabilitation Admissions Conferences

Lesley Griffiths

Department of Sociology, College of Nursing and Midwifery at University College, Swansea

David Hughes

Mid and West Wales College of Nursing and Midwifery at University College, Swansea

This research investigates how neuro-rehabilitation staff attend to the issue of patient deservingnesss" in admissions conference talk. Examined are the instances in which staff move from a reporting mode dealing with clinical information to a storytelling mode that conveys personal and moral information for example, that the patient is an "innocent party" in an accident, that the patient has family commitments, or that relatives have struggled bravely in the face of adverse circumstances and deserve help. The distinctive story like segments involved, which are analyzed as "natural rhetorics," appear to be deployed to strengthen the argument for admission by providing a moral under pinning for decisions ostensibly taken on medical grounds. The authors argue that the wider context of resource constraint and rationing, the uncertainty of rehabilitation outcomes, and the dynamics of interdisciplinary teamwork all help to explain the presence of natural rhetorics in admissions discussions.

Qualitative Health Research, Vol. 4, No. 4, 385-410 (1994)
DOI: 10.1177/104973239400400404
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