Ideology in the clinical context: chronic illness, ethnicity and the discourse on normalisation

Abstract

This paper is based on a comparative study examining how Chinese and white families manage the care of a chronically ill child. The circumstances of their lives that shape their experience of illness are explored. It is argued that the ideologies which underpin Western health care practices, in this case, the ‘ideology of normalisation’, often differ from the perspectives held by non‐Western immigrants, and others who do not have access to the ideology. The discrepancies in viewpoints between patients and practitioners can lead to a different set of goals in the treatment encounter, with the possibility of misunderstandings in the clinical context. The ‘ideology of normalisation’ is used to show how professional ideologies serve as a means of separating out families into those who comply and those who do not. In other words, the ideology, and the moral discourse on normalisation, permit professionals to evaluate families and to categorise them. This categorisation has consequences for patient care, they might be refused treatment. Yet, this ideology is not based merely on ‘value‐free professional theories’, but is located within the moral order. The socio‐political, economic and historical factors that underpin the ideology are discussed. Copyright © 1989, Wiley Blackwell. All rights reserved