College aantekeningen
Lecture 4 (week 5)
This is an elaboration of lecture 4 OB. With extra explanations of models and pictures. This lecture was given in week 5, that is why the document says lecture 5.
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Voorbeeld van de inhoud
Lecture 5OB
Professionals
In this course we look at organisations, groups and individuals. We are interested in
different layers.
Agenda
- Professionalism: concepts and theories
- System approach vs professional approach
- Deprofessionalisation
What is a profession?
- Task: can differ majorly.
- Function: more stable over time, can differ between organisations with different
tasks, over time will probably have the same meaning/tasks in one organization.
- Occupation: set of tasks which is also stable if u perform the same kind of occupation
in another organisations. Specific skill sets, set of tasks which is stable over more
organisations. Maybe different quality criteria/indicators for defining an occupation
over organisations.
- Profession: even more stability. There are quality indicators which define the tasks of
the profession. One person can be fired, but they will still remain a doctor e.g. More
cosmopolitan view, much more focused on the professional group rather than the
organization. Being part of the professional group and performing well here in is
important for professionals.
- Freidson: a profession is a special status in the division of labour that is supported by
an official and sometimes public belief that it is worthy of that status.
Professional autonomy
- It could refer to the individual or the group
- One part is about skill and liberty. Being autonomous in doing your own work with
your skill set. And also being free in doing what you need to. Both the ability (skill)
and you are allowed to as it is your own domain (liberty).
- According to Beauchamp and Childress (10), ‘virtually all theories of autonomy view
two conditions as essential for autonomy: liberty (independence from controlling
influences) and agency (capacity for intentional action)
- So its about the privilege and ability of self-governance which professionals have
- The quality and state of being independent and self-directing, especially in decision
making, enabling professionals to exercise judgement as they see fit during the
performance of their job.
- In the Netherlands, a lot of physicians aren’t employed by the hospital, this has to do
with autonomy. They should only worry about their job and patients. However,
that’s changing now.
1
, Types of autonomy
- Political autonomy: when a professional group is involved with policy, can decide a
lot, even if you are affected by the policy you are not a part of making it. You are
either part of it or you aren’t.
- Economical autonomy: you are allowed to set your own prices, what you earn. It is
changing, a lot of pressure behind this
- Clinical autonomy: hc professionals are allowed to say something about their own
domain, which care is given. 2 forms:
o Focused on the process: autonomy changing here all the time bc a lot of
people are involved in process and there are protocols
o Focused on content: deciding what kind of treatment is given is usually done
by one person, the doctor. So the autonomy here doesn’t change much.
Different views on professionalism
- A list of traits and behaviors
- As a role played in society (functionalism)
- As a social construction
- As means and affect of social control (critical studies)
1. Professionalism as a list of traits and behaviours
Of the profession
Organized professional group that:
- Defines standards of training
- Criteria of competence
- Quality criteria
- A code of ethic
- Has exclusive rights to perform certain tasks (in legislation usually, BIG)
Of a professional
- Specialised knowledge
- Altruistic – they do something which is good for society
- Reflexivity – the ability with being autonomous, reflecting on own behavior
2. Professionalism as a role played in society (functionalism)
- Professions have certain traits and behaviours because of the relevant function they
have for the society. It is difficult for us to control them because of the specific
knowledge they have. So have to trust them. We hope they can control themselves,
we hope they are doing a good job for society.
- Professionals are expected to act in the public interest, have a unique role
- Because of this important function they have certain rights (self regulation); social
contract based on trust.
- Trust versus control
- The confidence in professionals and level of trust has changed, people are more and
more higher educated so we doubt professionals. However, we want professionals
to do self-judgement and have a system of control so that our trust in them can still
remain. The social contract is always difficult, you sometimes see a doctor messing
up and it shakes people’s confidence and trust.
2
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