CRITICS-L: New book: Party or Patient?

Stefan Sjostrom stefan.sjostrom at
Fri Jul 11 14:41:55 UTC 1997

I'd just like to provide some information about a book that I've completed
recently. I hope it may be of interest to some list-members. My apologies
for any cross-postings.

The book is titled: Party or Patient? Discursive pratices relating
to coercion in psychiatric and legal settings. (The Book is written in
English and published in Sweden)

 I have conducted an ethnographic fieldwork at a psychiatric clinic in
Sweden for 18 months, primarily at an emergency unit. The aim of the
fieldwork has been to study the staff's (doctors, nurses and mental health
workers) descriptive
discourse concerning patients, particularly in matters concerning
compulsory care. Thus, I have followed doctor-patient communication at the
emergency unit, report meetings for the nursing staff and round meetings. I
have also been able to follow the more informal dimensions of clincical
work, such as conversations about patients at the nursing office or around
the coffee table.

In another part of the study, adminsitrative court hearings have been
audiotaped. In these hearings, patients from the clinic appear as adverse
parties to their chief psychiatrist and are represented by a public
defender. In theoretical terms: individuals are recontextualised when they
leave the clinic as patients and become parties in court. The encounter
between the psychiatric and legal institutions in court can be seen as
problematic, since they have quite different traditions in how they deal
with people, knowledge and decision-making. The psychiatrists find it
somewhat difficult to explain their expert knowledge to the laymen in
court. Furthermore, to fully understand clinical judgements, one need to
have a  knowledge about the concrete everyday circumstances under which
patients live at treatment units.

In brief, results suggest that the clinical practice of coercion is carried
out in a paternalistic fashion To a large extent, the staff also apply a
somewhat circular logic, working under an assumption that patients are
mentally ill when they make decisions. If this may appear quite logical in
a treatment institution, it is somewhat surprising that similar assumptions
of illness and a paternalistic view on patients that are legal parties is
visible in court. Legal professionals such as judges and public defenders
appear to adapt their actions to an assumption of one of the key issues the
court is set to evaluate, namely that the patient is mentally ill.

Stefan Sjostrom

Stefan Sjostom: Party or Patient? Discursive practices relating to
coercion in psychiatric and legal settings. Borea, Umeå 1997. (Linköping
Studies in Arts and Science 153) ISBN 91-972690-4-2

(the Book can be ordered from the publisher Borea by email:
borea at ; fax + 46 (0)90 14 32 89; snail mail: Borea,
Spinettstraket 3E, 903 25 Umea, Sweden. )

More information about the book is also available on Borea's Web-site:

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Stefan Sjostrom
PhD, Senior Lecturer
Department of Media and Communication
Umea University
S- 901 87 Umea

(home: V:a Esplanaden 13 A, S- 903 25 Umea, Sweden)

Tel:   +46 (0)90- 16 77 97 (office), 16 78 45 (office fax), 12 66 03 (home)
Email: stefan.sjostrom at

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