Journal of Applied Linguistics and Professional Practice, JAL Vol 2, No 3 (2005)

Bureaucratic Rituals in Health Care Delivery

Aaron Cicourel
Issued Date: 28 Aug 2013

Abstract


Following Roberts (1964), D’Andrade (1981; 1989; 1995), and Hutchins (1995), cultures and communities therein can be viewed as socially distributed cognition and socially organized knowledge systems (Schütz, 1962). The paper focuses on Western medical practices we will call bureaucratic ‘rituals’ that rely on folk knowledge and evolving, socially organized conceptual systems and technical activities we call ‘science’ and ‘technology’. All information processing involves expanding and compressing or limiting the processing capacity of individuals and collectivities. Cultural myths or beliefs about the origin of illness and possible cures persist despite what Max Weber (1968) called the rationalization of society. Bureaucratic rituals take on a life of their own and can create extensive technological domains of limited intelligibility for patients. It is, however, the patient, at least initially, who is the key source of information for triggering loosely coupled networks of oral and written or electronic communication and miscommunication. Patients’ ability to understand medical information can be hampered if they have anxiety-producing doubts about the care they receive, or fear that they may possess a serious or terminal illness (Crawford, 2005).

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DOI: 10.1558/japl.v2.i3.357

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