ObjectiveTo provide insights on emergent ethical tensions experienced by mental health practitioners during system re-organisation, which is sufficiently grounded in empirical data at the local level to inform policy on recovery at institutional and provincial levels.MethodEthnographic methods using narrative and critical phenomenological resources over 24 months.FindingsEveryday ethical tensions emerged at the confluence of different experiences of time, for example, how a context of increasing pressure to decrease patients’ length of stay at the hospital challenged efforts to listen to and advocate (...) for what mattered to patients and maintain the integrity of interventions. In this context, practitioners drew on clinical language and that of personal recovery to strategically ‘push back’, ‘play with’ or ‘take back’ time.DiscussionExamining everyday practices through ethnographic methods can illuminate the everyday ethical tensions that arise when mental health professionals and psychiatrists grapple with, often competing, goods. Critical phenomenological resources can help expand the structural considerations in empirical ethics, excavate underground practices and raise questions about the conceptual categories undergirding normative ethics. Experiencing-with practitioners in clinical contexts as they encounter and creatively resolve ethical tensions also propose a normative ethics of possibility, to help bridge the gap between empirical and normative ethics.ConclusionFocus on the relationship between policy, temporal practices and ethics suggests a reconfiguration of time and re-imagination of ethics in institutional settings in ways that can ultimately benefit patients and professionals alike. (shrink)

Building on foundational work in activity theory and cultural psychology, this article examines children's play to discern how biomedical practices and understandings of illness are negotiated, modeled, and reproduced among children dealing with a parent's cancer. Using discourse analytic methods, I analyze a videotaped playroom interaction involving three preschool-age girls, all of whom have a parent with cancer, and myself. The article employs notions of `frame' and `footing' to illustrate fantasy and reality as overlapping and embedded frames of experience that (...) organize children's playroom activities in distinctive ways. The shifting alignments and participation structures within the playroom environment illuminate the strategic ways in which children laminate personal experience onto the play frame. Through attention to children's talk and embodied action, I show how children key different interactional frames to expand the realm of epistemological and cognitive resources available to them as they seek cultural understanding. (shrink)