Ethics Policies: Medical Hegemony and the Decoding Practices of Subaltern Publics. An Ethnographic Inquiry into a Pilot Participatory Device on Ethical Deliberation

By David Smadja

This article focuses on participatory structures in hospitals by providing a sociological and ethnographic inquiry and by observing the everyday life of these committees, as well as by analyzing the very content of inside deliberation. The purpose is to highlight a new kind of policy, which I suggest labeling “ethics policies.” The ethical committee is conceptualized by decision makers as an institution dedicated to hosting an ethical discussion that is disconnected from medical decisions. It is inclusive and likely to rebalance the relationship between physicians and nurses, between men and women, and finally between physicians and patients. The ethical committee is embedded in a context characterized by the increasing role of management at the hospital. The question is therefore whether this participatory device is inclusive or not. By using Stuart Hall’s conceptual approach of encoding-decoding, I intend to challenge the realistic model of explanation, which rests exclusively on power, in order to improve our understanding of these ethical institutions.


  • deliberation
  • ethics
  • gender
  • hegemony
  • management
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