{"title":"职业规范与态度问题:透过洞察力建构“好医生”与“坏苹果”。","authors":"Paula Case","doi":"10.1093/medlaw/fwaf032","DOIUrl":null,"url":null,"abstract":"<p><p>In fitness-to-practise hearings for doctors and other health care professions, the practitioner's 'insight' into their past misconduct or deficient performance takes centre stage in determining outcomes. Although insight does not feature in the statutory framework, it has emerged as a regulatory device used to distinguish the 'good doctor' from the 'bad apple' who should be excluded from the profession in order to protect the public. This article frames the concept of 'insight' in professional discipline as an example of Foucauldian avowal-a ritual of truth-telling which requires the doctor's full acknowledgement and admission of wrongdoing and a disavowal of their former self. If successful, avowal enables reintegration of the practitioner into the profession's social order. 'Insight' is then tracked as a contested site in doctors' fitness to practise appeals across a period of more than 25 years, exploring its clinical origins, expansion, and modern application. The accumulated case law confirms insight as a deeply embedded staple of fitness to practise decision-making and a core regulatory strategy for protecting patients, while highlighting that it is inevitably compromised by issues of authenticity.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 3","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396809/pdf/","citationCount":"0","resultStr":"{\"title\":\"Professional regulation and attitudinal issues: constructing the 'good doctor' and the 'bad apple' through the device of insight.\",\"authors\":\"Paula Case\",\"doi\":\"10.1093/medlaw/fwaf032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In fitness-to-practise hearings for doctors and other health care professions, the practitioner's 'insight' into their past misconduct or deficient performance takes centre stage in determining outcomes. Although insight does not feature in the statutory framework, it has emerged as a regulatory device used to distinguish the 'good doctor' from the 'bad apple' who should be excluded from the profession in order to protect the public. This article frames the concept of 'insight' in professional discipline as an example of Foucauldian avowal-a ritual of truth-telling which requires the doctor's full acknowledgement and admission of wrongdoing and a disavowal of their former self. If successful, avowal enables reintegration of the practitioner into the profession's social order. 'Insight' is then tracked as a contested site in doctors' fitness to practise appeals across a period of more than 25 years, exploring its clinical origins, expansion, and modern application. The accumulated case law confirms insight as a deeply embedded staple of fitness to practise decision-making and a core regulatory strategy for protecting patients, while highlighting that it is inevitably compromised by issues of authenticity.</p>\",\"PeriodicalId\":49146,\"journal\":{\"name\":\"Medical Law Review\",\"volume\":\"33 3\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396809/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Law Review\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/medlaw/fwaf032\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Law Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/medlaw/fwaf032","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
Professional regulation and attitudinal issues: constructing the 'good doctor' and the 'bad apple' through the device of insight.
In fitness-to-practise hearings for doctors and other health care professions, the practitioner's 'insight' into their past misconduct or deficient performance takes centre stage in determining outcomes. Although insight does not feature in the statutory framework, it has emerged as a regulatory device used to distinguish the 'good doctor' from the 'bad apple' who should be excluded from the profession in order to protect the public. This article frames the concept of 'insight' in professional discipline as an example of Foucauldian avowal-a ritual of truth-telling which requires the doctor's full acknowledgement and admission of wrongdoing and a disavowal of their former self. If successful, avowal enables reintegration of the practitioner into the profession's social order. 'Insight' is then tracked as a contested site in doctors' fitness to practise appeals across a period of more than 25 years, exploring its clinical origins, expansion, and modern application. The accumulated case law confirms insight as a deeply embedded staple of fitness to practise decision-making and a core regulatory strategy for protecting patients, while highlighting that it is inevitably compromised by issues of authenticity.
期刊介绍:
The Medical Law Review is established as an authoritative source of reference for academics, lawyers, legal and medical practitioners, law students, and anyone interested in healthcare and the law.
The journal presents articles of international interest which provide thorough analyses and comment on the wide range of topical issues that are fundamental to this expanding area of law. In addition, commentary sections provide in depth explorations of topical aspects of the field.