Beth Kewell

Language games and tragedy: The Bristol Royal Infirmary disaster revisited

Abstract Actors in health organizations often participate in language games which encompass clinical, professional, and organizational subject matter. Such language games intersect within the hospital environment. This paper appraises issues of clinical risk through the re-examination of the language games which formed a part of one of Britains worst medical disasters, namely the Bristol Royal Infirmary tragedy. A textual, grounded analysis of transcripts from the oral hearings of the ‘Bristol Inquiry’ (n = 74) provides the paper with a qualitative dataset, within which medical language games are analysed. The paper concludes that clinical actors work within discourses of risk (McDonald et al. 2005) that are partly constructed within, and by, participation in language games (Wittgenstein 1953). In the case of the Bristol Royal Infirmary tragedy, these games manifested contrasting interpretations of risk and safety which reflected a tainted interpretation of data by different parties at different times of the unfolding tragedy. Sensemaking of reputation appears to have played an important part in the construction of these interpretations of risk.

The shifting sands of uncertainty: Risk construction and BSE/vCJD

It is more than a decade since scientists in the UK put forward evidence of a link between the emergence of a new variant of Creutzfeldt-Jakob Disease (vCJD) in humans, and a diminishing epidemic of Bovine Spongiform Encephalopathy, or BSE, in cattle. In the wake of this anniversary, the paper revisits two scientific narratives of risk, forged at different points along the developmental pathway of BSE science, including a series of advisory reports provided to the UK government between 1989 and 1994, and a symposium held in 2001 to assess the impact of the Phillips Inquiry. While the primary pathology of BSE became apparent relatively early on, uncertainties remain about the origins of BSE and its human variant, vCJD. The paper examines the handling of this sensitivity, and its communication, within these key documents, noting changes in patterns of uncertainty construction over time.

Regenerative Medicine and New Labour life science policy: rhetorics of success, narratives of sustainability and survival

Advances in stem cell science and tissue engineering are being turned into applications and products through a novel medical paradigm known as regenerative medicine. This paper begins by examining the vulnerabilities and risks encountered by the regenerative medicine industry during a pivotal moment in its scientific infancy: the 2000s. Under the auspices of New Labour, British medical scientists and life science innovation firms associated with regenerative medicine, received demonstrative rhetorical pledges of support, aligned with the publication of a number of government initiated reports presaged by Bioscience 2015: Improving National Health, Increasing National Wealth. The Department of Health and the Department of Trade and Industry (and its successors) held industry consultations to determine the best means by which innovative bioscience cultures might be promoted and sustained in Britain. Bioscience 2015 encapsulates the first chapter of this sustainability narrative. By 2009, the tone of this storyline had changed to one of survivability. In the second part of the paper, we explore the ministerial interpretation of the ‘bioscience discussion cycle’ that embodies this narrative of expectation, using a computer-aided content analysis programme. Our analysis notes that the ministerial interpretation of these reports has continued to place key emphasis upon the distinctive and exceptional characteristics of the life science industries, such as their ability to perpetuate innovations in regenerative medicine and the optimism this portends – even though many of the economic expectations associated with this industry have remained unfulfilled.