Ethics, Interprofessionalism and Healthcare Dr. Vicky Gunn Learning and Teaching Centre Why is interprofessionalism an ethics issue? Where does it fit within an ethics framework?
Is interprofessionalism a response to increasing complexity (in terms of specialization) and the consequential awareness that this has an impact on healthcare outcomes? Psycho-dynamics as a way of mediating complexity? Why is interprofessionalism an ethics issue? Where does it fit within an ethics framework?
Does ethics require us to reflect on what and how we give value to one form of experience/knowledge over another? Does ethics encourage us to reflect on practice when the evidence suggests the possibility of achieving better healthcare outcomes? a growing body of evidence
suggests interprofessionalism offers greater benefits for patient care and safety than multiprofessionalism (Bleakley, et al., 2006, p. 467) Interprofessional relationships continue to be characterized by conflict rather than co-operation.. (Irvine, et al, 2002, p.199)
Is interprofessionalism a response to increasing complexity (in terms of specialization) and the consequential awareness that this complexity has an impact on healthcare outcomes? Irvine et als Useful Framework (2002)
Professional divisions Authority and the division of labour Subverting medical dominance
Professional organization Different value systems (cf Irvine, et al, 2004) Legal effects Rather than promoting more egalitarian and collaborative social formations, healthcare teams tend to reflect, reproduce and perpetuate the traditional divisions of labour, status systems and systems of
authority. (Irvine, et al., 2002, p. 204) Irvine et al continued
Cultural barriers: Intellectual baggage Language (eg in shock) Intra-professional variation Identity Training Psycho-dynamics as a way of understanding the complex relational
interprofessional issues Lets try this assumption: When we list apparent obstacles to interprofessionalism, we are just embodying inter-group emotionality and psychodynamics within a reason-based framework. The actual behaviours and attitudes expressed are far less reason-based
Emotiona litygiven a body throu gh factorsweuse to explainand exp lore interprofessiona lism
STRUCTURAL OBSTACLES CULTURAL OBSTACLES Optional inter-group responses to conflict (or, how do groups respond to one another?)
Acknowledge dependence Compete Focus on changing the other gro upsvalues,
practices,perceived behavio urs Silence, inaction, & ingroup resentment Potentia l for conflict and
error increases Collaborate and compromise multiprofessiona lly Avoidan
ce Performtoleration Is IPE responding to a question of how are professionals and interprofessionals created? ie exploration of the socialization processes.
Bourdieus Habitus: the coercive power of covert educational practice to reproduce the dominant values and beliefs of professional fields
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