ABSTRACT
One of the basic constraints that hedges round many hospital encounters is that involving 'awareness' and information control. This has been discussed primarily with regard to dying patients and their awareness – or otherwise – of their prognosis. Many patients in the teaching hospital have control over a vital resource in the bedside teaching encounter: knowledge and understanding of the diagnosis and treatment of their own illness. Clearly, the range of knowledge available to the patient, the detail, the degree to which it is warrantable by reference to medical opinion and theory – these will all differ from individual to individual. The adjudication of the gravity of medical news, and its possible effects on the patient, is an ever-present feature of bedside teaching and clinical work. The spectacle of the clinic calls for dramaturgical skills on the part of clinicians. The social construction of reality in this context rests on a collaborative enactment of clinical medicine.
