No abstract

The least paternalistic steering includes making the dilemma explicit and offering the user the opportunity of sharing the responsibility for the handling of the situation. However, due to the complexity of the interactions no strategy can be found to either completely prevent the occurrence of dilemmatic situations, or definitely maintain the user's self-determination during dilemmatic situations. Paternalism may occasionally be a just way of enhancing future autonomy.

No abstract

The aim is to examine the discursive organization of ''user-centred'' team meetings in the Swedish rehabilitation sector. The ''users'' are aged between 4 and 30 and have been ascribed different kinds of impairments. The teams consist of one user and/or her/his relatives and different professionals. The analysis is primarily based on transcriptions of 18 audiotaped team meetings held by 10 different teams and focuses on two dimensions of dominance in interaction: the amount of talk and topic control. The findings point to professional dominance, but parents also have a great influence on the topic control. The degree of participation and the control of topics of the users who participate in the meetings vary, but most of the users become involved primarily by responding to the questions and suggestions of professionals and parents. In order to increase the users' control of the interactions the participants need to continuously discuss the organization of the conversations. The findings are related to complicating aspects of the conversations, including institutionalization, representation difficulties, varying communicative abilities, and expectations of expertise and adult liabilities.