Caring for quality of care: symbolic violence and the bureaucracies of audit

BMC Medical Ethics

Sally Quilligan¹  Sophie Park²  Jo Maybin³  Deborah Swinglehurst⁵  Nathan Emmerich⁴ 

[1] University of Cambridge, School of Clinical Medicine, Cambridge, UK;Research Department of Primary Care and Population Health, UCL Medical School, London, UK;The King’s Fund, London, UK;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

关键词: Audit;    Symbolic violence;    Bourdieu;    Ethics of care;    Quality of care;    Care;   

Others  :  1207610
DOI  :  10.1186/s12910-015-0006-z

 received in 2014-08-27, accepted in 2015-02-16,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Emmerich et al.; licensee BioMed Central.

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