Abstract
While Michel Foucault’s work on the birth of the clinic in Enlightenment France, and the subsequent development of the ‘medical gaze’ as a diagnostic method, has been widely discussed and critiqued, there is little in medical education that deals with his later work on ‘technologies of self’. This work focuses on identity construction as a ‘work’ that is both aesthetic (self-forming) and ethical (practices of the self in relation to others). Foucault returned to late Greek and early Roman sources to show that the forming of self is a characteristic strand throughout Western cultural practices and not a modern invention.
In relation to communication and teamwork in medicine, Foucault’s mapping of power as both resistance and a form of making identities can be readily adapted to explain the nature of clinical team dynamics. Central to how capillary power operates, as a means of resistance to dominant discourses, is parrhesia or ‘truth telling’, also a ‘speaking out’ and ‘moral courage’. While much has been made of ‘whistleblowing’ in medical culture, parrhesia offers a more powerful concept for understanding the dynamics of speaking out in interprofessional team settings, as an essential component of patient safety.
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Agamben, G. (1998). Homo sacer: Sovereign power and bare life. Palo Alto, CA: Stanford University Press.
Allard, J., Bleakley, A., Hobbs, A., & Vinnell, T. (2007). ‘Who’s on the team today?’: Collaborative teamwork in operating theatres should include briefing. Journal of Interprofessional Care, 21, 189–206.
Beger, H. G., & Arbogast, R. (2006). The art of surgery in the 21st century: Based on natural sciences and new ethical dimensions. Langenbecks Archives of Surgery, 391, 143–148.
Bleakley, A. (2001). From lifelong learning to lifelong teaching: Teaching as a call to style. Teaching in Higher Education, 6, 113–116.
Bleakley, A. (2002). Teaching as a gift: The gendered gift and teaching as hospitality. In G. Howie & A. Tauchert (Eds.), Gender, teaching and research in higher education. London: Ashgrove.
Bleakley, A. (2006a). ‘You are who I say you are’: The rhetorical construction of identity in the operating theatre. The Journal of Workplace Learning, 18, 414–425.
Bleakley, A. (2006b). A common body of care: The ethics and politics of teamwork in the operating theater are inseparable. Journal of Medicine and Philosophy, 31, 1–18.
Bleakley, A., Bligh, J., & Browne, J. (2011). Medical education for the future: Identity, power and location. Dordrecht, Netherlands: Springer.
Bleakley, A., Boyden, J., Hobbs, A., Walsh, L., & Allard, J. (2006). Improving teamwork climate in operating theatres: The shift from multiprofessionalism to interprofessionalism. Journal of Interprofessional Care, 20, 461–470.
Bleakley, A., Hobbs, A., Boyden, J., & Walsh, L. (2004). Safety in operating theatres: Improving teamwork through team resource management. Journal of Workplace Learning, 16, 414–425.
Bleakley, A., Marshall, R., & Brömer, R. (2006). Toward an aesthetic medicine: Developing a core medical humanities undergraduate curriculum. Journal of Medical Humanities, 27, 197–214.
Daston, L., & Galison, P. (2007). Objectivity. New York: Zone Books.
Flynn, T. (1987). Foucault as parrhesiast: His last course at the College de France. Philosophy and Social Criticism, 12, 213–229.
Foucault, M. (2001). Fearless speech. New York: Semiotext[e].
Franĕk, J. (2006). Philosophical parrhesia as aesthetics of existence. Continental Philosophy Review, 39, 113–134.
Frank, A. W. (1999). Relations of power and ‘informed choice’: Commentary on Rose Weitz’s ‘watching Brian die’. Health, 3, 239–246.
Gawande, A. (2009). The checklist manifesto: How to get things right. London: Profile Books.
Gawande, A. A., Zinner, M. J., Studdert, D. M., & Brennan, T. A. (2003). Analysis of errors reported by surgeons at three teaching hospitals. Surgery, 133, 614–621.
Giddings, A. E. B., & Williamson, C. (2007). The leadership and management of surgical teams. London: The Royal College of Surgeons of England.
Hardt, M., & Negri, A. (2001). Empire. Cambridge, MA: Harvard University Press.
Hardt, M., & Negri, A. (2006). Multitude: War and democracy in the age of empire. Harmondsworth, England: Penguin.
Hardt, M., & Negri, A. (2009). Commonwealth. Cambridge, MA: Harvard University Press.
Heron, J. (2001). Helping the client: A creative practical guide (5th ed.). London: Sage.
Hobbs, A., & Bleakley, A. (2005, March 18–19). Close-call reporting. In Risk management: Health care risk report.
Iedema, R. (Ed.). (2007). The discourse of hospital communication: Tracing complexities in contemporary health care organizations. Basingstoke, England: Palgrave Macmillan.
Levinas, E. (1969). Totality and infinity. Pittsburgh, PA: Duquesne University Press.
Lingard, L., Reznick, R., DeVito, I., & Espin, S. (2002). Forming professional identities on the healthcare team: Discursive construction of the ‘other’ in the operating room. Medical Education, 36, 728–734.
Lingard, L., Reznick, R., Espin, S., Regehr, G., & DeVito, I. (2002). Team communications in the operating room: Talk patterns, sites of tension, and implications for novices. Academic Medicine, 77, 232–237.
McGushin, E. (2007). Foucault’s askēsis: An introduction to the philosophical life. Evanston, IL: Northwestern University Press.
Pignatelli, F. (1993). Dangers, possibilities: Ethico-political choices in the work of Michel Foucault. Philosophy of Education. Retrieved from http://www.ewd.uiuc.edu/EPS/PES-Yearbook/93_docs/PIGNATEL.HTM
Pronovost, P., & Vohr, E. (2010). Safe patients, smart hospitals: How one doctor’s checklist can help us change health care from the inside out. New York: Hudson Street Press.
Rabinow, P. (1994). Modern and countermodern: Ethos and epoch in Heidegger and Foucault. In G. Gutting (Ed.), The Cambridge companion to Foucault (pp. 197–214). Cambridge, England: Cambridge University Press.
Sharpe, M. (2007). A question of two truths? Remarks on parrhesia and the ‘political-philosophical’ difference. Parrhesia, 2, 89–108.
Sorensen, R., & Iedema, R. (Eds.). (2008a). Managing clinical processes in health services. Sydney, New South Wales, Australia: Mosby, Elsevier.
Sorensen, R., & Iedema, R. (Eds.). (2008b). Managing clinical processes in health care. London: Elsevier.
Strauss, A., Schatzman, L., Ehrlich, D., Bucher, R., & Sabshin, M. (1963). The hospital and its negotiated order. In E. Freidson (Ed.), The hospital in modern society (pp. 147–169). New York: Free Press of Glencoe.
Whyte, S., Lingard, L., Espin, S., Ross Baker, G., Bohnen, J., et al. (2008). Paradoxical effects of interprofessional briefings on OR team performance. Cognition, Technology & Work, 10, 287–294.
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Bleakley, A. (2014). Theorizing Team Process Through a Foucauldian Perspective: Gaining a Voice in Team Activity at the Clinical Coalface. In: Patient-Centred Medicine in Transition. Advances in Medical Education, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-319-02487-5_12
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