The Social Construction of Incompetency: Moving Beyond Embedded Paternalism Toward the Practice of Respect.

This article illustrates the less-acknowledged social construction of the concept of 'incompetency' and draws attention to the moral concerns it raises in health care encounters in the south Indian city of Chennai. Based on data drawn from qualitative research, this study suggests that surgeons subj...

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Published in:Health Care Analysis Vol. 28; no. 3; pp. 249 - 266
Main Author: Subramani, Supriya
Format: Article
Published: Springer Nature Sep2020
Subjects:
Online Access:View this record in EBSCOhost
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        10.1007/s10728-020-00395-w
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        atl: The Social Construction of Incompetency: Moving Beyond Embedded Paternalism Toward the Practice of Respect.
      aug:
        au: Subramani, Supriya
        affil:
          Swiss Excellence Federal Scholar (ESKAS), Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
          Department of Humanities and Social Science, Indian Institute of Technology Madras, Chennai, India
      su:
        India
        Cognition
        Medical practice
        Paternalism
        Respect
        Social constructionism
        Patients' attitudes
        Family attitudes
        Capacity (Law)
      sug:
        subj:
          Cognition
          Medical practice
          Paternalism
          Respect
          Social constructionism
          Patients' attitudes
          Family attitudes
          India
          Capacity (Law)
      keyword:
        Incompetency
        Qualitative inquiry
        Social construction
        Incompetency
        Qualitative inquiry
        Social construction
      ab: This article illustrates the less-acknowledged social construction of the concept of 'incompetency' and draws attention to the moral concerns it raises in health care encounters in the south Indian city of Chennai. Based on data drawn from qualitative research, this study suggests that surgeons subjectively construct the idea of incompetency through their understanding of the perceived circumstantial characteristics of the patients and family members they serve. The findings indicate that surgeons often underestimate patients and family members' capacity based on constructed assessments, which leads to paternalistic practice. In this article, I illustrate how these assessments influence the surgeons' practices and provide the moral and practical justifications for their actions. The constructed knowledge becomes a source for drawing normative justification for surgeons' actions and, in conjunction with socially enforced power relationships, results in patients and family members to be on the receiving end of disrespectful attitudes. Based on the data analysis and by drawing on philosophical analysis, I emphasize the need to focus on 'respect for persons,' to rethink the framework of 'capacity,' and to practice respect in hospital settings.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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