关注医疗质量：象征性暴力与审计官僚机构
Caring for quality of care: symbolic violence and the bureaucracies of audit.
作者信息
Emmerich Nathan, Swinglehurst Deborah, Maybin Jo, Park Sophie, Quilligan Sally
机构信息
School of Politics, International Studies and Philosophy, Queen's University Belfast, Belfast, UK.
Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK.
出版信息
BMC Med Ethics. 2015 May 8;16:23. doi: 10.1186/s12910-015-0006-z.
BACKGROUND
This article considers the moral notion of care in the context of Quality of Care discourses. Whilst care has clear normative implications for the delivery of health care it is less clear how Quality of Care, something that is centrally involved in the governance of UK health care, relates to practice.
DISCUSSION
This paper presents a social and ethical analysis of Quality of Care in the light of the moral notion of care and Bourdieu's conception of symbolic violence. We argue that Quality of Care bureaucracies show significant potential for symbolic violence or the domination of practice and health care professionals. This generates problematic, and unintended, consequences that can displace the goals of practice.
SUMMARY
Quality of Care bureaucracies may have unintended consequences for the practice of health care. Consistent with feminist conceptions of care, Quality of Care 'audits' should be reconfigured so as to offer a more nuanced and responsive form of evaluation.
背景
本文在医疗质量话语的背景下探讨关怀的道德观念。虽然关怀对于医疗服务的提供具有明确的规范意义，但不太明确的是，作为英国医疗治理核心内容的医疗质量与实践是如何关联的。
讨论
本文根据关怀的道德观念和布迪厄的象征性暴力概念，对医疗质量进行了社会和伦理分析。我们认为，医疗质量官僚机构具有实施象征性暴力或支配实践及医疗专业人员的巨大潜力。这会产生有问题的、意想不到的后果，可能会偏离实践目标。
总结
医疗质量官僚机构可能会给医疗实践带来意想不到的后果。与女性主义关怀观念一致，应重新构建医疗质量“审计”，以提供一种更细致入微、更具响应性的评估形式。
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