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In defence of professional judgement

  • Robin Downie and Jane Macnaughton
Summary

A judgement may be defined as an assertion made with evidence or good reason in a context of uncertainty. In psychiatry the uncertainty is inherent in the professional context and the evidence derives from academic literature and scientific studies as they are applied to a specific patient. The nature of the uncertainty and the factors that should inform professional judgement are explored in this article. Professional judgement currently faces two serious challenges: an obsession with numbers, which comes from within medicine, and the ‘patient choice’ agenda, which is politically inspired and comes from outside medicine. In this article we strive to defend professional judgement in the clinic against both challenges.

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Copyright
Corresponding author
Robin Downie, Emeritus Professor of Moral Philosophy, University of Glasgow, Glasgow G12 8QQ, UK. Email: r.downie@philosophy.arts.gla.ac.uk
Footnotes
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Declaration of Interest

None.

Footnotes
References
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Bate, P, Robert, G (2005) Choice. BMJ; 331: 1488–9.
Downie, R, Macnaughton, J (2000) Clinical Judgement. Evidence in Practice. Oxford University Press: 7889.
Downie, R, Macnaughton, J (2007) Bioethics and the Humanities. Attitudes and Perceptions. Routledge-Cavendish: 117–20.
Downie, R, Randall, F (2008) Choice and responsibility in the NHS. Clinical Medicine: 8: 182–5.
General Medical Council (2008) Consent: Patients and Doctors Making Decisions Together. GMC.
Honderich, T (ed) (2005) The Oxford Companion to Philosophy. Oxford University Press.
Jones, R (1995) Why do qualitative research? BMJ; 45: 131–2.
Law, S, Britten, N (1995) Factors that affect the patient-centredness of a consultation. British Journal of General Practice: 45: 520–4.
Meakin, R (2007) Teaching medical students professionalism. What role for the medical humanities? Journal of Medical Ethics: Medical Humanities; 33: 105.
Peters, R (1967) The Concept of Education. Routledge & Kegan Paul.
Randall, F, Downie, R (2006) The Philosophy of Palliative Care. Critique and Reconstruction. Oxford University Press: 3544.
Reid, T (1975 reprint) Thomas Reid's Inquiry and Essays (eds Lehrer, K, Beanblossom, R) Bobbs-Merril.
Royal College of Physicians (2005) Doctors in Society. Medical Professionalism in a Changing World. Report of a Working Party. Royal College of Physicians.
Sartre, J-P (1943) Being and Nothingness (trans H Barnes). Methuen.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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In defence of professional judgement

  • Robin Downie and Jane Macnaughton
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