Negotiating palliative care expertise in the medical world
Negotiating palliative care expertise in the medical world
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DOI：
10.1016/s0277-9536(02)00346-5
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发表时间：
2003-07-01
影响因子：
5.4
通讯作者：
Capewell, S
中科院分区：
文献类型：
--
作者：
Hibbert, D;Hanratty, B;Capewell, S
本文探讨姑息医学和更广泛的医学世界之间的关系。它利用了一项焦点小组研究的数据，在该研究中，来自一系列专业的医生讨论了为心力衰竭患者开发姑息治疗的问题。在概述护理组织的观点时，参与者就自己和其他专业的作用和专业知识进行了谈判。我们的分析认为，姑息医学的专业知识，参考其技术和不确定的组成部分。它展示了如何利用这些来促进和挑战医学专业和护理之间的界限。姑息医学对护理的技术贡献的界限被认为是正统医学中特别一致的。相比之下，它的不确定的专业知识，代表的“整体”和“心理社会”的议程，是潜在的妥协，在医学界的奖励科学和理性。我们展示了如何通过将姑息治疗扩展到传统的时间（生命终结）和病理（癌症）实践领域之外的举措来质疑这两种专业知识的一致性。(C)2003爱思唯尔科技有限公司版权所有。
This paper explores the relationship between palliative medicine and the wider medical world. It draws on data from a focus group study in which doctors from a range of specialties talked about developing palliative care for patients with heart failure. In outlining views of the organisation of care, participants engaged in a process of negotiation about the roles and expertise of their own, and other, specialties. Our analysis considers the expertise of palliative medicine with reference to its technical and indeterminate components. It shows how these are used to promote and challenge boundaries between medical specialities and with nursing. The boundaries constructed on palliative medicine's technical contribution to care are regarded as particularly coherent within orthodox medicine. In contrast, its indeterminate expertise, represented by the 'holistic' and 'psychosocial' agendas, is potentially compromising in a medical world that prizes science and rationality. We show how the coherence of both kinds of expertise is contested by moves to extend palliative care beyond its traditional temporal (end-of-life) and pathological (cancer) fields of practice. (C) 2003 Elsevier Science Ltd. All rights reserved.