Institutions of care, moral proximity and demoralisation: The case of the emergency department

Hillman, Alexandra ORCID: https://orcid.org/0000-0003-1859-1075 2016. Institutions of care, moral proximity and demoralisation: The case of the emergency department. Social Theory and Health 14 , pp. 66-87. 10.1057/sth.2015.10

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Abstract

This article draws on concepts of morality and demoralisation to understand the problematic nature of relationships between staff and patients in public health services. The article uses data from a case study of a UK hospital Emergency Department to show how staff are tasked with the responsibility of treating and caring for patients, while at the same time their actions are shaped by the institutional concerns of accountability and resource management. The data extracts illustrate how such competing agendas create a tension for staff to manage and suggests that, as a consequence of this tension, staff participate in processes of ‘effacement’ that limit the presence of patients and families as a moral demand. The analysis from the Emergency Department case study suggests that demoralisation is an increasingly important lens through which to understand health-care institutions, where contemporary organisational cultures challenge the ethical quality of human interaction.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Social Sciences (Includes Criminology and Education)
Subjects:	H Social Sciences > H Social Sciences (General)
Additional Information:	This work is licensed under a Creative Commons Attribution 3.0 Unported License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material.
Publisher:	Palgrave Macmillan
ISSN:	1477-8211
Funders:	Wellcome Trust
Date of First Compliant Deposit:	30 March 2016
Date of Acceptance:	27 April 2015
Last Modified:	23 May 2023 21:00
URI:	https://orca.cardiff.ac.uk/id/eprint/73293

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