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Approval and Disapproval in the Narratives of Colorectal Cancer Patients and Their Carers

Centre for Values, Ethics and the Law in Medicine, University of Sydney, Australiamilesl{at}blackburn.med.su.oz.au

Christopher F.C. Jordens

Kim Paul

Emma Sayers

Dhananjayan Sriskandarajah

Centre for Values, Ethics and the Law in Medicine, University of Sydney, Australia

In examining the narratives of colorectal cancer patients and their carers, we have noted that approval and disapproval are expressed in many ways that reflect their importance in the process of medical care. When people construct free narratives that trace important segments of their biographies, they emphasize the approval and disapproval which others express for their choices, actions and moral qualities. They also want their own approval or disapproval for others to count in significant ways. Approval is widely recognized for its importance in human development, and it is generally a positive force. The seeking of inappropriate approval, however, may have unfortunate consequences. For health professionals, for example, conflicts may arise when they come to seek peer approval ahead of client approval, and when a career comes to matter more than the real social purposes for which the career is intended. Identification of the conflicts that this divided loyalty may induce helps in understanding some of the underlying issues which narratives raise. It is possible to construct a formal structure that can be used to examine the part which the seeking and receiving of approval play in the values expressed in medical narratives generally. Similar and equally powerful meanings attach to disapproval.

Key Words: approval • approval discord • biography • career development • colon cancer • health care • narratives

Health:, Vol. 3, No. 4, 451-467 (1999)
DOI: 10.1177/136345939900300406


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