Public Professional Accountability: A Conditional Approach

Vriens, Dirk; Vosselman, E.G.J.; Groß, Claudia

doi:10.1007/s10551-016-3345-x

Cited by 17 publications

(15 citation statements)

References 42 publications

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“…One clear example is the advocacy by Vriens et al . () of what they describe as a ‘conditional approach’ to professional accountability. Their argument largely inverts the currently dominant approach to accountability in public sector healthcare systems.…”

Section: Sociology and The ‘Ethics Of Ethics’mentioning

confidence: 99%

Managing ethical uncertainty: implicit normativity and the sociology of ethics

Cribb

2019

Sociology Health & Illness

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This article illustrates and discusses the idea of ‘implicit normativity’, and specifically its relevance to the management of ethical uncertainty. In particular I consider (i) the role implicit normativity plays in masking and containing potential ethical uncertainty and (ii) the contrast and boundary between implicit normativity and ‘overt ethics’ where ethical contestation – as well as particular processes and agents – are highlighted as salient. Using examples I show how the idea of implicit normativity can be applied not only to specific practices but also to whole fields of practice. The notion of ‘moral settlements’ – along with the explanatory role of the threat of ‘chaos’ – is introduced and elucidated to develop these points. I argue that attention to the management of ethical uncertainty shows the critically important contribution that an ambitious sociology of ethics can make to clinical ethics, including by helping to formulate and drive home questions about the ‘ethics of ethics’. The account presented here has resonances with work that seeks to use sociological lenses to move beyond conventional bioethics, including Petersen's (2013) call for a ‘normative sociology’.

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Section: Sociology and The ‘Ethics Of Ethics’mentioning

confidence: 99%

Managing ethical uncertainty: implicit normativity and the sociology of ethics

Cribb

2019

Sociology Health & Illness

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“…Through drawing papers together in this way, we have been able to explore structural and cultural conditions across a range of healthcare contexts, and question to what extent healthcare professionals and others tasked with managing uncertainty are supported to do (Vriens et al . 2016). The collection has extended our understandings of the role uncertainty and certainty play in healthcare trainees’ socialisation, knowledge and action (Atkinson 1984, Fox 1957, 1959, Light 1979), and highlighted the significance of social processes such as trust and continuity, and the existential element of uncertainty as part of the implicit fabric of care.…”

Section: Resultsmentioning

confidence: 99%

“…Research into the social, symbolic and technical aspects of managing uncertainty, together with its implications for medical training across both the formal and so‐called ‘hidden’ curriculum (Lempp and Seale 2004), would help inform the development of practical support systems to enable healthcare professionals to meet these challenges (Vriens et al . 2016).…”

Section: Resultsmentioning

confidence: 99%

Understanding and managing uncertainty in health care: revisiting and advancing sociological contributions

Mackintosh

Armstrong

2020

Sociology Health & Illness

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In this collection we revisit the enduring phenomenon of uncertainty in health care, and demonstrate how it still offers coherence and significance as an analytic concept. Through empirical studies of contemporary examples of health care related uncertainties and their management, our collection explores the different ways in which uncertainty may be articulated, enacted and experienced. The papers address a diverse range of healthcare contexts ‐ Alzheimer’s disease, neonatal surgery, cardiovascular disease prevention, cancer, addiction (use of alcohol and other drugs during pregnancy), mental health/disorders and medical education – and many tackle issues of contemporary relevance, such as an ageing population, and novel medical interventions and their sequelae. These empirical papers are complemented by a further theoretical contribution, which considers the role of ‘implicit normativity’ in masking and containing potential ethical uncertainty. By mapping themes across the collection, in this introduction we present a number of core analytical strands: (1) conceptualising uncertainty; (2) intersections of uncertainty with aspects of care; (3) managing uncertainty; and (4) structural constraints, economic austerity and uncertainty work. We reflect on the methodological and theoretical stances used to think sociologically about uncertainty in health care, and the strengths, silences and gaps we observe in the collection. We conclude by considering the implications of the insights gained for ‘synthesising certainty’ in practice and for future research in this area.

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“…Vriens, Vosselman, et al note that over the past 30 years, professionals have been held to increasingly stringent standards [222]. This change has come about from a variety of pressures, including public scandals, incidents of malpractice, increased managerialism, and market competition coupled with increasing societal expectations.…”

Section: The Polarizing Effect Of Modernizationmentioning

confidence: 99%

“…This change has come about from a variety of pressures, including public scandals, incidents of malpractice, increased managerialism, and market competition coupled with increasing societal expectations. It is influencing professionals to work according to procedures and defined standards [222]. This is true for chiropractic, and additional pressure comes from the rise of evidence-based practice.…”

Section: The Polarizing Effect Of Modernizationmentioning

confidence: 99%

Vitalism in contemporary chiropractic: a help or a hinderance?

Simpson

Young

2020

Chiropr Man Therap

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Background: Chiropractic emerged in 1895 and was promoted as a viable health care substitute in direct competition with the medical profession. This was an era when there was a belief that one cause and one cure for all disease would be discovered. The chiropractic version was a theory that most diseases were caused by subluxated (slightly displaced) vertebrae interfering with "nerve vibrations" (a supernatural, vital force) and could be cured by adjusting (repositioning) vertebrae, thereby removing the interference with the body's inherent capacity to heal. DD Palmer, the originator of chiropractic, established chiropractic based on vitalistic principles. Anecdotally, the authors have observed that many chiropractors who overtly claim to be "vitalists" cannot define the term. Therefore, we sought the origins of vitalism and to examine its effects on chiropractic today. Discussion: Vitalism arose out of human curiosity around the biggest questions: Where do we come from? What is life? For some, life was derived from an unknown and unknowable vital force. For others, a vital force was a placeholder, a piece of knowledge not yet grasped but attainable. Developments in science have demonstrated there is no longer a need to invoke vitalistic entities as either explanations or hypotheses for biological phenomena. Nevertheless, vitalism remains within chiropractic. In this examination of vitalism within chiropractic we explore the history of vitalism, vitalism within chiropractic and whether a vitalistic ideology is compatible with the legal and ethical requirements for registered health care professionals such as chiropractors. Conclusion: Vitalism has had many meanings throughout the centuries of recorded history. Though only vaguely defined by chiropractors, vitalism, as a representation of supernatural force and therefore an untestable hypothesis, sits at the heart of the divisions within chiropractic and acts as an impediment to chiropractic legitimacy, cultural authority and integration into mainstream health care.

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Public Professional Accountability: A Conditional Approach

Cited by 17 publications

References 42 publications

Managing ethical uncertainty: implicit normativity and the sociology of ethics

Managing ethical uncertainty: implicit normativity and the sociology of ethics

Understanding and managing uncertainty in health care: revisiting and advancing sociological contributions

Vitalism in contemporary chiropractic: a help or a hinderance?

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