Ethics, Interprofessionalism and Healthcare

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Ethics, Interprofessionalism and Healthcare

• Dr. Vicky Gunn
• Learning and Teaching Centre

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• Why is interprofessionalism an ethics issue?
  Where does it fit within an ethics framework?
• Is interprofessionalism a response to increasing
  complexity (in terms of specialization) and the
  consequential awareness that this has an impact
  on healthcare outcomes?
• Psycho-dynamics as a way of mediating complexity?

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Why is interprofessionalism an ethics issue?
Where does it fit within an ethics framework?
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• Does ethics require us to reflect on what and how
  we give value to one form of experience/knowledge
  over another?
• Does ethics encourage us to reflect on practice
  when the evidence suggests the possibility of
  achieving better healthcare outcomes?

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• a growing body of evidence suggests
  interprofessionalism offers greater benefits for
  patient care and safety than multiprofessionalism
  
• (Bleakley, et al., 2006, p. 467)

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• Interprofessional relationships continue to be
  characterized by conflict rather than
  co-operation..
• (Irvine, et al, 2002, p.199)

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Is interprofessionalism a response to increasing
complexity (in terms of specialization) and the
consequential awareness that this complexity has
an impact on healthcare outcomes?
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Irvine et als Useful Framework (2002)

• Professional divisions
• Authority and the division of labour
• Subverting medical dominance
• Professional organization
• Different value systems (cf Irvine, et al, 2004)
• Legal effects

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• Rather than promoting more egalitarian and
  collaborative social formations, healthcare teams
  tend to reflect, reproduce and perpetuate the
  traditional divisions of labour, status systems
  and systems of authority.
• (Irvine, et al., 2002, p. 204)

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Irvine et al continued

• Cultural barriers
• Intellectual baggage
• Language (eg in shock)
• Intra-professional variation
• Identity
• Training

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Psycho-dynamics as a way of understanding the
complex relational interprofessional issues
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Lets try this assumption

• When we list apparent obstacles to
  interprofessionalism, we are just embodying
  inter-group emotionality and psychodynamics
  within a reason-based framework. The actual
  behaviours and attitudes expressed are far less
  reason-based

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Optional inter-group responses to conflict (or,
how do groups respond to one another?)
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Is IPE responding to a question of how are
professionals and interprofessionals created?
ie exploration of the socialization processes.
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Bourdieus Habitus

• the coercive power of covert educational
  practice to reproduce the dominant values and
  beliefs of professional fields