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TLets487540
Reflexivity in Professional Practise and The Social Construction of Defensive Medicine:
[Thesis]
Bradder, Annette Mary
A Study of Discourses of Risk in Medical Practice.
University of Liverpool
2007
Ph.D.
University of Liverpool
2007
Abstract: Viewed in the context of a so-called 'compensation crisis' in the UnitedKingdom, defensive medicine broadly refers to a response by doctors to the risk ofbeing sued in an action for negligence. However, the interrelated risk discourses of a'compensation crisis' and defensive medical practice are suffused with controversyand confusion. For example, influenced by the methods of positivism, narrowlyconstructed 'cause' and 'effect' studies of defensIve medicine have tended toheighten controversy and confusion around the phenomenon. Accordingly, whilstsome researchers seem perplexed by the findings of their studies, others appear tohave simply abandoned their projects. Thus, in contrast to simplistic 'cause' and'effect' methods a key aim in this thesis is to adopt a social constructionist, andtherefore a reflexive approach to the study of medical practice and discourses of risk.Underpinned by theories of risk and control, the discussion draws upon theoreticalconcepts that include contestation and therefore 'reflexivity' in knowledge,'governmentality', trust, autonomy and discretion. In acknowledging in this thesisthat risks associated in public discourse with defensive medicine might have somefoundation in reality, unlike most studies informed by positivism, neither defensivemedicine nor risk are understood as objective realities. Rather, risk is largelyconsidered in relation to representations of the world as being anxious or in crisis ofsome kind. In sum, thi~/study suggests that 'reflexivity' in professional practice andmedical discourses of risk may be viewed within a nexus of social, political,technological and cultural transformation, entailing for example, the organization oftrust relations, indeterminacy, and the erosion of control. The thesis is structuredaround seven chapters. The initial chapters ground the later analysis of datagenerated via semi-structured interviews with hospital doctors in England and Wales.
Bradder, Annette Mary
University of Liverpool
مطالعه متن کتاب p
[Thesis]
276903
a
Y
