Medical Professionals: Conflicts and Quandaries in Medical Practice, 1st Edition (Hardback) book cover

Medical Professionals

Conflicts and Quandaries in Medical Practice, 1st Edition

Edited by Kathleen Montgomery, Wendy Lipworth


158 pages

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Hardback: 9781138550117
pub: 2018-09-04
eBook (VitalSource) : 9780203712221
pub: 2018-09-05
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Medical Professionals: Conflicts and Quandaries in Medical Practice offers a fresh approach to understanding the role-related conflicts and quandaries that pervade contemporary medical practice. While a focus on professional conflicts is not new in the literature, what is missing is a volume that delves into medical professionals’ own experience of the conflicts and quandaries they face, often as a result of inhabiting multiple roles. The volume explores the ways in which these conflicts and quandaries are exacerbated by broader societal forces, including changing scientific and technological paradigms, commercialization, and strengthened consumer movements, which simultaneously expand the scope of roles and responsibilities that medical professionals are expected to fulfill, and make it more difficult to do so.

Several empirical chapters analyze data from qualitative interview studies with clinicians and other stakeholders. The studies highlight the burdens on clinicians who are expected to make informed and justified judgments and decisions in the midst of competing pressures; authors describe the methods that clinicians use to address the associated tensions within specific contexts. Two conceptual chapters follow and offer some innovative ways to think about the challenges facing medical professionals as they strive to make sense of the changing landscape within healthcare. The first reflects on the challenges to clinical practice in the midst of shifting and often competing definitions of disease and associated ideologies of care. The second reflects more broadly on the utility of value pluralism as a framework for conceptualizing and working through moral and professional quandaries. The book concludes with a chapter containing suggestions for how members of the medical profession might reframe their thinking about their roles, responsibilities, and decision-making in the midst of inevitable quandaries such as those presented here.


This book will be of vital reading for academics, researchers, educators, postgraduate students, and interested health care practitioners and administrators.

Table of Contents

Part I Overview

Chapter 1

Role-Related Conflicts and Value-Laden Quandaries Confronting Today's Medical Professionals

Kathleen Montgomery and Wendy Lipworth


Part II Empirical Explorations of Conflicts and Quandaries

Chapter 2

Respecting Patient Autonomy: Some Telling Challenges for Medical Professionals Who Treat Seriously Ill Patients

Christopher Jordens and Kathleen Montgomery


Chapter 3

Off-label Prescribing: The Borderlands Between Clinical Practice and Experimentation

Narcyz Ghinea, Ian Kerridge, and Wendy Lipworth


Chapter 4

Clinical Quandaries Associated with Accelerated Access to Cancer Medicines

Jessica Pace, Narcyz Ghinea, Miriam Wiersma, Bronwen Morrell, Ian Kerridge, and Wendy Lipworth


Chapter 5

Managing and Regulating Conflicts of Interest in Medicine

Wendy Lipworth and Kathleen Montgomery


Chapter 6

Medical Professionals as Expert Advisors in Macro-allocation: Problems of Dual Agency and Conflict of Interest

Siun Gallagher


Part III Reconceptualization and Concluding Observations

Chapter 7

After Dominance: The Elastic Politics of Medicine

Christopher Jordens


Chapter 8

Value Pluralism — The Bare Bones

Miles Little


Chapter 9

Making Sense of Professional Conflicts and Quandaries

Wendy Lipworth and Kathleen Montgomery

About the Editors

Kathleen Montgomery is Professor of the Graduate Division and Emerita Professor of Organizations and Management at the University of California, Riverside.

Wendy Lipworth is a bioethicist and health social scientist and Associate Professor at The University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics.

About the Series

Routledge Studies in Health Management

The health care sector is now of major significance, economically, scientifically and societally. In many countries, health care organizations are experiencing major pressures to change and restructure, while cost containment efforts have been accentuated by global economic crisis. Users are demanding higher service quality, and health care professions are experiencing significant reorganization whilst operating under increased demands from an ageing population.

Critically analytic, politically informed, discursive and theoretically grounded, rather than narrowly technical or positivistic, the series seeks to analyse current health care organizations. Reflecting the intense focus of policy and academic interest, it moves beyond the day to day debate to consider the broader implications of international organizational and management research and different theoretical framings.

The series welcomes proposals on the following themes:

  • What organization theories best shed light on current health care organizations?
  • How does organizational change take place in health care organizations?
  • How can novel health policy arenas (e.g. patient safety and quality) be conceptualised?
  • Which narratives of health care reforming become influential and why in the political and policy domains?
  • Who are the key actors in current health care reform? E.g. Rise of management consulting and think tanks.
  • ‘doing more with less’ in health care post the 2008 economic crisis; what is the assessment of policies and strategies adopted?
  • Why do countries vary in their experience of health care reform?
  • What are the key developments within the health care professions and their implications for health care management?
  • How important is the push from Science and Technology reshaping health care systems?
  • What are the broader social and organizational effects of new ICTs in health care settings?

Learn more…

Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Business Ethics
BUSINESS & ECONOMICS / Decision-Making & Problem Solving
BUSINESS & ECONOMICS / Government & Business