Constructing parental responsibility in the management of a genetic condition in telephone consultations

Abstract

This paper examines telephone consultations between genetic nurses of a specialised clinic and parents whose infants have been diagnosed with a mild hereditary disorder G6PD deficiency. This condition is life-long although adherence to certain lifestyle practices ensures a normal life for individuals with the condition. The specific focus of the paper is on parental responsibility in the management of a child’s condition. Previous studies have discussed parents’ accounts of their actions regarding the management of genetic conditions in interviews and face-to-face counselling sessions. These studies have shown that mothers and other female family members typically construct themselves as the primary care-givers responsible for the well-being of their families. Using theme-oriented discourse analysis (Roberts and Sarangi, 2005) and drawing on a corpus of 48 audio-recorded consultations, this paper examines how parental responsibility is constructed by the ‘second party’, the nurses, via advice-giving to the mothers. We show that the nurses do not hold the mothers solely responsible for the well-being of their children. The responsibility is ‘distributed’ among the two parents of a newborn child, other family members, the child and the nurses. While carrying primary responsibility for certain domains of care, the parents also serve as mediators between other ‘responsible parties’. In constructing the parents as mediators of future responsible actions by others in these interactions the nurses employ a range of discursive strategies, including modalisation, character/event work, reported speech, hypothetical formulations and rhetorical questions. We also examine how the nurses orient themselves to the mothers’ existing knowledge about the condition vis-à-vis advice giving trajectories. To conclude, we discuss how a more complex picture of responsibility reflects the context of a manageable but life-long condition.