Medical Professionals Conflicts and Quandaries in Medical Practice

Medical Professionals: Conflicts and Quandaries in Medical Practice offers a fresh approach to understanding the role-related conflicts and quandaries that pervade contemporary medical practice. While a focus on professional conflicts is not new in the literature, what is missing is a volume that delves into medical professionals’ own experience of the conflicts and quandaries they face, often as a result of inhabiting multiple roles. The volume explores the ways in which these conflicts and quandaries are exacerbated by broader societal forces, including changing scientific and technological paradigms, commercialization, and strengthened consumer movements, which simultaneously expand the scope of roles and responsibilities that medical professionals are expected to fulfill, and make it more difficult to do so. Several empirical chapters analyze data from qualitative interview studies with clinicians and other stakeholders. The studies highlight the burdens on clinicians who are expected to make informed and justified judgments and decisions in the midst of competing pressures; authors describe the methods that clinicians use to address the associated tensions within specific contexts. Two conceptual chapters follow and offer some innovative ways to think about the challenges facing medical professionals as they strive to make sense of the changing landscape within healthcare. The first reflects on the challenges to clinical practice in the midst of shifting and often competing definitions of disease and associated ideologies of care. The second reflects more broadly on the utility of value pluralism as a framework for conceptualizing and working through moral and professional quandaries. The book concludes with a chapter containing suggestions for how members of the medical profession might reframe their thinking about their roles, responsibilities, and decision-making in the midst of inevitable quandaries such as those presented here. This book will be of vital reading for academics, researchers, educators, postgraduate students, and interested health care practitioners and administrators.

Part I OverviewChapter 1Role-Related Conflicts and Value-Laden Quandaries Confronting Today's Medical ProfessionalsKathleen Montgomery and Wendy Lipworth Part II Empirical Explorations of Conflicts and QuandariesChapter 2Respecting Patient Autonomy: Some Telling Challenges for Medical Professionals Who Treat Seriously Ill PatientsChristopher Jordens and Kathleen Montgomery Chapter 3Off-label Prescribing: The Borderlands Between Clinical Practice and ExperimentationNarcyz Ghinea, Ian Kerridge, and Wendy Lipworth Chapter 4Clinical Quandaries Associated with Accelerated Access to Cancer MedicinesJessica Pace, Narcyz Ghinea, Miriam Wiersma, Bronwen Morrell, Ian Kerridge, and Wendy Lipworth Chapter 5Managing and Regulating Conflicts of Interest in MedicineWendy Lipworth and Kathleen Montgomery Chapter 6Medical Professionals as Expert Advisors in Macro-allocation: Problems of Dual Agency and Conflict of InterestSiun Gallagher Part III Reconceptualization and Concluding ObservationsChapter 7After Dominance: The Elastic Politics of MedicineChristopher Jordens Chapter 8Value Pluralism — The Bare BonesMiles Little Chapter 9Making Sense of Professional Conflicts and QuandariesWendy Lipworth and Kathleen Montgomery

Kathleen Montgomery is Professor of the Graduate Division and Emerita Professor of Organizations and Management at the University of California, Riverside.Wendy Lipworth is a bioethicist and health social scientist and Associate Professor at The University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics.