A hibridização do discurso médico-paciente no evento discursivo parto

Abstract

This thesis is based on a research that investigated the representations and identities of doctors and women patients in a state hospital, in Maranguape,Ceará, adopting Critical Discourse Analysis. In order to carry out this research, the ethnographic-discursive methodology was used to generate and collect data. The selected methods were: participant observation, field notes and ethnographic interviews. The data was collected and generated at the low-risk maternity ward in this hospital, and the fieldwork began in March 2010, lasting for two years. This research is justified as a possibility to investigate the relevant topic of representations and identities,in the interface of Linguistics and society. In this work, my interest is focused on the hybridity of medical discourse with issues of institutional power, world views, gender, ethnicity, and poverty, in their relation with society in the discursive event childbirth. This topic was examined with the support of Critical Realism and Critical Social Science. The results of this study question the linguistic devices involving women´s suffering in a socially vulnerable context. The main contribution of the studyis to propose epistemological tools to indicate how the articulation of theoretical categories and lexical choices, among other elements, line up to construct legitimation and subjection identities, dialectically related to discourses (representations) in a societal context which favors the naturalization of suffering in the discursive event childbirth. The results point to the ideological and hegemonic struggle, power and resistance in this event. Doctor-patient control relations represent the model of risk medical rationality which considers the patients as in a moral deficit and which exerts doctor interactional control with wide technical, scientific mastery over the women´s bodies. Obstetrics uses its invasive surgical protocols in low-risk delivery, rejecting non-invasive practices in natural delivery care. Doctor legitimation identities hold a hegemonic struggle with the use of invasive accelerating technologies in childbirth, considered as violence against women when they are unnecessary. Women´s identities in distress and pain flow reify childbirth suffering as natural, hidden by social and political issues that place them in a disadvantageous position in the dividing lines of social exclusion and misery. Thus, obstetrical practices act discursively as symbolic, institutional, epistemological and scientific violence.