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PERSONALISTIC CONCEPT OF A PROFESSION
RESPONSIBILITY OF HEALTH CARE PROFESSIONALS
Profession
î used for any prestigious occupation
Old Medieval î it is a symbol rather than a reality
î Person Professions were affiliated with divinity (theology),
physic (medicine), law Robert Merton
î These are centered on a counselor-client relationship î Explains the social value of a profession
î It is based on a work that heals, guide or protect a person î £nowing-doing-helping

Industrial î £nowing - value placed upon systematic knowledge and

î Fostered the profession but also depersonalized them intellect
(centered more on exchange of power) î Doing ± value placed upon technical skill and trained capacity
î Helping ± value placed upon putting k

Post-Industrial Moore and Rosenblum: use a scale to define professionalism.

î Source of power will no longer be economic ownership Professionals must rate high on the following attributes:
(capitalist or socialist) but based on knowledge and its 1. practice full time occupations
communication 2. committed to a calling
î People will be dependent on the professionals 3. distinguished from others by various signs and symbols and
identified by their peers ± formalized in organizations
4. have esoteric but useful knowledge and skills through
specialized education which is lengthy and difficult
THREE FOLD DEPERSONALIZATION (that must be eliminated) 5. expected to have service orientation
6. have autonomy of judgment and authority restrained in
using their knowledge and skill knowledge and skill to work
The Client: in the service of others
î Depersonalized by the proliferation of specialism î Accounting, engineering, architecture and other arts are
î They are no longer thought of as a complex organism but as considered profession but their objective is not personal but
a collection of organs productive.
î Parts of the body are healed but not the person as a whole
³A true profession is rooted in theory but aimed at practice´
The Professional: î Doesn¶t produce things external to persons but a service directly
î Depersonalized by a loss of clear identity to persons themselves
î goals of research vs the goals of practice î it aims at healing, making them whole, and freeing them to act on
î Examples: Ministers, lawyers and physician counsel clients in their own
ways that is same as the psychoanalysts. î help in the full sense is concerned precisely with problems which
are deeply personal, or are matters of life and death
The Professional-Client Relationship:
î Ivan Illich, studied the problems of the 3rd world developing The proper task of the medical professional is to deal with problems
countries with the biological and psychological levels of human functioning.
î Contends that the industrial model for organizing the
professionals has progressively restricted access to a. Psychological ± counseling
knowledge and skill b. Biological ± role as a teacher; information it give is based on a
î Placing them in the hands of the elites on whom the public is concrete assessment of personal health and the possible ways of
more and more dependent but from whom the public receives dealing with the problems it present
less and less adequate service
IDEALS OF THE MEDICAL PROFESSION
î Based on the history of medicine, physicians has been
considered both priests and scientists
î Duality reflects the mind-body of the human who is sick

î Priest: has direct relation to life and death which gives it a sacred
character; deals with the sacred dignity of the human person

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 p In Greece, western medicine originated î To achieve this:
p Asclepius ± first father of medicine ; ³mild god´ p Therapist must win the trust and help the client to
p He have shrines where the sick came to worship, interpret the symptoms
sleep and have their dreams interpreted p He must be able to let the patient determine the
p Christianity has been the religion most concerned with underlying meaning and must come to an
organized health care because of its belief in personal understanding about his sickness
charity and the integral relation of the body to the p He also must help the client acquire new skills in
human person coping with the problems of life and terminate
î Scientific: 19th century rapid development dependence on the therapist.
p Retarded by priestly aspects î Dependence of the client on the therapist is a recapitulation of the
THE CHRISTIAN PHYSICIAN parental relationship.
î the physician who wants to develop a sound ethical judgment î The therapist is a good mother in taking on the attitude of
must: ³unconditional benign acceptance´. ± Carl Rogers
1. Have a profound respect for the medical profession as a î The therapist is a good father in the increasing role of
vocation that has both scientific and priestly aspects interpretation and confrontation with reality. The libidinal, erotic
2. Have a clear understanding of the limits of this profession elements of the transference of the client to the therapist are
and of its interrelation to and dependence on other gradually turned toward the real love objects of the client¶s
professions that also deal with the human person independent life.

THE CHRISTIAN PERSPECTIVE Clients must accept the tasks of:

î Trusting the therapists and trying to recover health and
Positive normal independence.
î Christian health care professionals have a ³calling´ î Therapist must take their parts in:
î Sickness ± evil desecrator of the temple î Being faithful to the trust given by the clients
î Christian physician is a minister of God î Listen and sympathize to a certain degree
p Cooperating with him in helping suffering human î Set limits on ³acting out´ and by clients and must insist on
beings overcome their suffering in order to live more ³working through´
fully î Approve and reinforce the client¶s progressive achievement
î Christian Medical professional finds a model in Jesus Christ of insight
p Can imitate Jesus¶ compassion for the patient and his î Gradually confront them more and more with demands of
reaching out to the most neglected reality
î Christian attitude: profound dependence on God; gives the î For therapist to be ethically true, they must be aware of counter-
inspiration, insight, and courage to carry out their work as transferrence (development of a relationship in which the therapist
professionally and as skillfully as possible. begins to use the client to meet the therapist¶s own emotional
î Scientific approach to a disease is built on the devotion of needs) and strive to keep this within limits.
objective truth and effort to advance this truth through research
and criticism î Formalized contract are given at the beginning of every therapy.
î Dedication to objective truth and scientific integrity is an ethical In this contract:
value of the highest order î Therapist make sure clients understand and accept the goals and
limits of therapy
Negative î And are aware that they can hold a therapist liable for the
î Scientific method is understood and practiced often and tends to therapist¶s half of the contract.
Reductionism
p Assertion that the scientific method is exclusive road to MEDICAL MODEL
truth
î Goal: to treat a physical illness and restore normal function
PERSONALIZING THE HEALTH CARE PROFESSION
î At the heart of every profession, there is a counseling relationship
between persons Physician Patient
î Ethical decisions about health matters depend:
- Cooperative effort of patients and professionals o Diagnose the disease o Relieved from blame for
- Peer relationships o Prescribe treatment his/her condition
o Make a prognosis o Must be cooperative
PSYCHOANALYTIC MODEL
î client comes to the therapist because of painful anxieties that
makes normal life difficult/impossible
Patient Passivity
î Goal: to resolve conflicts whose unconscious origin that is
î Patient is responsible for his health thus, the professional has no
unknown Therapist¶s responsibility is not to diagnose but to help
rights over the patient except those given by the patient¶s
the client to come to an understanding of the causes of her
informed consent
problems and to come with them more effectively.

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 î Main ethical issue of the medical model î Responsibility to acquire the art of medical dialogue ± help
patients say what need to be said
Essential features of a Medical Contract 1. First rule ± the professional repeat back to the patient
î The contract limits the obligations assumed but implied contract what the professional has heard that seems significant
between patient and physician obligates the physician to help the and to ask whether it is what the patient meant
patient discover the problem and determine the appropriate help 2. Second rule ± to obtain the patient¶s cooperation by
to it (medical). explaining the purpose of question
î Professional relationships must base on trust. Physician must î Professionals have the right to require honesty and frankness
establish trustworthiness within the limits of the contract. As it from clients.
relates to trust it must have 3 elements: p Psychological factors may cause communication
î Concern to be distorted by unconscious self-deceit, denial,
p Professional contract is something more than a confusion or panic.
contract; it is a covenant in theological sense. ± Paul î Health care professionals cannot expect truth from their
Ramsey patients unless they are equally truthful with them.
p It implies the promise to continue care of the patient
even if the patient is no longer able to insist on its CONFIDENTIALITY
fulfilment
î Patient have the right to the truth about their health because they
î £nowledge and Skill in Medicine have the primary responsibility for their health
p Health care professionals have the responsibility to be î Right to privacy
expert in both science and the art of health care, up-to- î Human community is base on free communication
date knowledge, experienced, of good judgment and î How is a professional to act when questioned by others about
skilled in procedures. patient¶s condition
î Communication p The meaning of any human statement must always be
determined from the context in which communication
HEALTH CARE FEES occurs
p Obligation to reply to a question with unambiguous and
î In a capitalist society, a professional should be paid as any accurate information then depends on the questioner¶s
worker is paid according to the laws of supply and demand. right to such information
î A service is just as much a commodity for exchange with a value
measured in monetary terms as is any product Responsibility of health care professionals
î Since the rise of health insurance, most health care is paid by a 1. To strive to establish and preserve trust at both the
third party, the insurer or the government who determined emotional and rational levels
standard fees. 2. To share the information they possess with those who
î Professional fees are not payments measured by the value of the legitimately needed an order to have an
service provided but a STIPEND to be measured only by what 3. To refrain from lying or giving misinformation
professionals need to live and work without distraction 4. To keep secret information which is not legitimately
needed by others
Fundamental Principle
î Professionals are public servants who have no right to
expect in return for services anything more than a standard PEER RELATIONSHIPS
of living that will make it possible for them to perform those
services with liberty of mind and health of body and to î Good personal relationships with their colleagues in the health
adequately fulfill family and social obligations. team
î In health care the problem of mutual responsibility is crucial
Negative: î A federal commission concluded the malpractice suits frequently
p Medical profession as a profitable profession; it result
was believed that the stimulus has been the chief 1. From poor communication between physicians and
cause of the rapid technological development patients
p Fee is actually part of therapy 2. From no personal communication
3. From patient, misinformed , unrealistic expectations
PROFESSIONAL COMMUNICATION about the benefits of treatment
4. From growing public conviction those consumers need
î Adequate communication between professional and client is a to defend themselves against arrogant, self-serving
fundamental ethical requirement. professionals.
î hat are the duties of physicians and nurses?
p Obligation to listen to the patient ± ³the medium Remedies for the malpractice problem
is the message´, the way the patients are î Peer review ± no one is competent to evaluate {
communicating may be the most significant professional performance except peers in the
symptom profession.
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 î Disciplining a profession must first of all concern those
who suffer from malpractice or regret. Health care
consumers must know and defend their own rights by
available economic, legal, and political means.

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GoŠ nˆ…†† th…y ar… born aga‰n.dz ([ohn 3: 3)


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