职业规范与态度问题:透过洞察力建构“好医生”与“坏苹果”。

IF 1.7 4区 医学 Q1 LAW
Paula Case
{"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}
引用次数: 0

摘要

在为医生和其他医疗保健专业人员举办的“从健康到实践”听证会上,从业者对自己过去的不当行为或表现不佳的“洞察力”是决定结果的核心。虽然洞察力在法律框架中并不重要,但它已成为一种监管手段,用于区分“好医生”和“坏苹果”,为了保护公众,他们应该被排除在这个行业之外。这篇文章将专业纪律中的“洞察力”概念作为福柯式坦白的一个例子——一种讲真话的仪式,要求医生完全承认和承认自己的错误,并与以前的自我断绝关系。如果成功,忏悔使从业者重新融入职业社会秩序。“洞察”随后被追踪为一个有争议的地点,在超过25年的时间里,医生的适应性实践上诉,探索其临床起源,扩展和现代应用。积累的判例法证实,洞察力是实践决策的根深蒂固的基本要素,也是保护患者的核心监管策略,同时强调,它不可避免地会受到真实性问题的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Professional regulation and attitudinal issues: constructing the 'good doctor' and the 'bad apple' through the device of insight.

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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Medical Law Review
Medical Law Review MEDICAL ETHICS-
CiteScore
3.10
自引率
11.80%
发文量
50
审稿时长
>12 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信