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We explain the concept of dilemmas and how they underpin the logic of interpretive comparison. Existing work in interpretive theory refers mainly to ‘Big-D’ dilemmas that focus on ideational conflicts between traditions such as the clash between neoliberalism and state ownership. We add the notion of ‘small-d’ dilemmas that focus on the everyday, the routine and the mundane, choices, ‘court’ politics and realpolitik. We suggest that empirical, comparative, interpretive social science research revolves around the process of identifying the dilemmas that actors experience and the ways they respond to them, and puzzling about whether they vary according to the traditions in which they are situated. We suggest rules of thumb for identifying dilemmas.
We outline briefly the difference between naturalism and humanism before providing a summary of our key concepts of decentring, situated agency and plausible conjectures. In effect, we set the theoretical scene for the rest of the book and the underpinnings for comparative analysis based on dilemmas. We challenge the naturalist mantra of ‘different tools, shared standards’ and provide an alternative account of what constitutes valuable and rigorous interpretive research. We set out a new set of criteria by which interpretive comparative work should be assessed and towards which interpretive comparative researchers ought to strive. We focus on accuracy, openness and aesthetics. We show that not anything goes in comparative interpretive research.
The chapter introduces the idea of creative intuition and interpretation before summarising the book's contents. At the heart of this book is the idea of comparative intuition. People in general, and social scientists in particular, are engaged in ‘constant comparison’. Comparison is what enables us to make sense of events as they unfold across time and space. Interpretive research offers a distinctive approach to the comparative intuition because it consciously offers interpretations of interpretations. This chapter has five substantive sections. First, we outline our basic argument for a consciously and explicitly comparative interpretive approach. Second, we provide a brief summary of the interpretive approach. Third, we seek to justify the rigour and sensitivity of a comparative interpretive orientation. Fourth, we foreshadow in greater depth the structure of the book and detail of its component chapters. Finally, we provide guidance for readers on how to use the book, and in particular on how to combine its insights with those stemming from canonical texts in the field.
We explain, and illustrate with examples drawn from our own work, how interpretive researchers analyse comparative data. We argue that a comparative project compounds the uncertainty, confusion and paralysis that can set in when confronted with a 'mountain' of qualitative data. We argue it is not possible to 'somehow capture' this full complexity. We outline and defend the need for a consciously impressionistic orientation to data analysis. Rather than searching for a ‘Eureka!’ moment that confirms or refutes a narrow theory (in naturalist mode) or makes sense of the whole picture (in idiographic mode), a comparative focus on dilemmas enables the use of a kaleidoscope of different analytical lenses and tools to explore complex specificness in context. We outline rules of thumb for helping along the way.
In the Retrospective, we turn our methods back on our own book and ask, ‘what are the dilemmas of using the approach we advocate?’ It is an exercise in professional reflexivity as we reflect on the personal dilemmas that we navigated in writing this book. We ask, ‘what are the dilemmas of using our comparative approach?' Also, we impress upon the reader the merits of our approach by summarising the key terms of both the interpretive approach and our comparative interpretive approach. It is a short cut for those who like to skim books before reading them.
We outline the place of fieldwork in comparative interpretive research. Detailed qualitative fieldwork is central to most interpretive research, but practical guidance on how to navigate the field remains rooted to the idiographic tradition. The presumption is one of sustained immersion in a discrete setting. Interpretive comparison, however, necessarily requires partial immersion across multiple sites in shorter, more interrupted bursts. We call this yo-yoing. Crucially, the researcher must be alert to the surprises and moments of epiphany that can challenge initial assumptions and open new possibilities. We seek here to develop and illustrate key ‘rules of thumb’ that will enable researchers to manage the challenges and maximise the opportunities.
We look at the craft of writing. Although we discuss the challenges of writing that confront all social scientists, we focus on the dilemmas of writing up comparative interpretive research – dilemmas which we confront because we speak to a broader range of audiences. In doing so, we highlight the importance of seeing writing as integral to the research process, not something that starts once the research is done. We identify the rules of thumb for writing both linear and evocative narratives and discuss the dilemmas encountered in both approaches.
We look at how to design a comparative interpretive project and tackle the perennial case selection question. The problem here is one of justifying unorthodox comparison: a lot has been written on comparative case selection from a naturalist perspective, but this language is often an uncomfortable fit for interpretive projects. We argue that case selection is not something that is designed into a project from inception. For interpretive research, it changes as we go. We therefore suggest different strategies of case selection for different phases of a comparative interpretive project. We identify rules of thumb to guide design choices as the project or programme evolves.
Is it possible to compare French presidential politics with village leadership in rural India? Most social scientists are united in thinking such unlikely juxtapositions are not feasible. Boswell, Corbett and Rhodes argue that they are possible. This book explains why and how. It is a call to arms for interpretivists to embrace creatively comparative work. As well as explaining, defending and illustrating the comparative interpretive approach, this book is also an engaging, hands-on guide to doing comparative interpretive research, with chapters covering design, fieldwork, analysis and writing. The advice in each revolves around 'rules of thumb', grounded in experience, and illustrated through stories and examples from the authors' research in different contexts around the world. Naturalist and humanist traditions have thus far dominated the field but this book presents a real alternative to these two orthodoxies which expands the horizons of comparative analysis in social science research.
Key theorists and scholars of democracy have focused on understanding and enhancing the institutions and practices that shape decision-making. Indeed, the most influential contemporary normative account—the deliberative version—though increasingly adapted to the complex realities of contemporary politics, retains a tight focus on the conditions of legitimate will formation. This remains the core underpinning of the normative impetus for innovation and reform in contemporary democratic politics. Yet missing from even the adapted deliberative account is detailed consideration of what happens after will formation. I turn here to the policy and administration literature to show how the inescapably attritional and opaque policy process can magnify asymmetries that theorists and scholars of contemporary democracy, chief among them deliberative democrats, ought to be much better attuned to. I argue that in failing to consider these problems adequately, contemporary democratic thinkers, scholars, and reformers risk lending legitimacy to institutions and practices that might sustain the very biases they are mobilized against. As such, I identify institutional innovations and governing practices that can embed aspects of democratic deliberation “downstream” in the policy process in order to counter distortions and rebalance asymmetries. I conclude by calling for theorists, researchers, and reformers to explore the value of these institutions and practices, and to expand the repertoire of governing mechanisms available to counter the distortions that occur through the policy process.
Proper airway control in trauma patients who have sustained cervical spine fracture remains controversial.
This study was undertaken to survey the preferred methods of airway management in cervical spine fracture (CSF) patients, to evaluate the experience of handling such patients at a level-I trauma center, and to contrast the findings with recommendations of the American College of Surgeons Committee on Trauma.
The methods used for control of the airway in patients with fractures of their cervical spine support the recommendation of the American College of Surgeons (ACS) Committee on Trauma.
The study consisted of two parts: 1) a survey; and 2) a retrospective study. Survey questionnaires were sent to 199 members of the Eastern Association for the Surgery of Trauma and to 161 anesthesiology training programs throughout the United States. Three resuscitation scenarios were posed: 1) Elective airway—CSF—breathing spontaneously, stable vital signs; 2) Urgent airway—CSF—breathing spontaneously, unstable vital signs; and 3) Emergent airway—CSF—apneic, unstable. In addition, a three-year retrospective study was conducted at a level-I trauma center to determine the method of airway control in patients with cervical spine fractures.
Responses to the questionnaires were received from 101 trauma surgeons (TS) and 58 anesthesiologists (ANESTH). Respondents indicated their preference of airway methods: Elective airway: Nasotracheal intubation: TS 69%, ANESTH 53%. Orotracheal intubation: TS and ANESTH 27%. Surgical airway: TS 4%. Intubation with fiberoptic bronchoscope (FOB): ANESTH 20%. Urgent airway: Nasotracheal intubation: TS 48%, ANESTH 38%. Orotracheal intubation: TS 47%, ANESTH 45%. Surgical airway: TS 4%. FOB: ANESTH 16%. Emergent airway: Orotracheal intubation: TS 81 %, ANESTH 78%. Surgical Airway: TS 19%, ANESTH 7%. FOB: ANESTH 15%.
The retrospective review at the trauma center indicated that 102 patients with CSF were admitted; 62 required intubation: four (6%) on the scene, seven (11%) en route, five (8%) in the emergency department, 42 (67%) in the operating room, and four (6%) on the general surgery floor. Airway control methods used were nasotracheal: 14 (22%); orotracheal: 27 (43%); FOB: 17 (27%); tracheostomy: one (2%); unknown: three (4%). No progression of the neurological status resulted from intubation.
The choice of airway control in the trauma patient with CSF differs between anesthesiologists and surgeons. However, the method selected does not have an adverse affect on neurological status as long as in-line stabilization is maintained. The methods available are safe, effective, and acceptable. The recommendations of the American College of Surgeons Committee on Trauma for airway control with suspected cervical spine injury are useful. The technique utilized is dependent upon the judgment and experience of the intubator.