No Blame No Gain? From a No Blame Culture to a Responsibility Culture in Medicine

Healthcare systems need to consider not only how to prevent error, but how to respond to errors when they occur. In the United Kingdom’s National Health Service, one strand of this latter response is the ‘No Blame Culture’, which draws attention from individuals and towards systems in the process of understanding an error. Defences of the No Blame Culture typically fail to distinguish between blaming someone and holding them responsible. This article argues for a ‘responsibility culture’, where healthcare professionals are held responsible in cases of foreseeable and avoidable errors. We demonstrate how healthcare professionals can justifiably be held responsible for their errors even though they work in challenging circumstances. We then review the idea of ‘responsibility without blame’, applying this to cases of error in healthcare. Sensitive to the undesirable effects of blaming healthcare professionals and to the moral significance of holding individuals accountable, we argue that a responsibility culture has significant advantages over a No Blame Culture due to its capacity to enhance patient safety and support medical professionals in learning from their mistakes, while also recognising and validating the legitimate sense of responsibility that many medical professionals feel following avoidable error, and motivating medical professionals to report errors.     

Integrating emotion and other nonrational factors into ethics education and training in professional psychology

ABSTRACT

Any professional or scientific discipline has a responsibility to do what it can to ensure ethical behavior on the part of its members. In this context, this paper outlines and explores the criticism that to date the emphasis in ethics training in professional psychology, as with other disciplines, has been on the rational elements of ethical decision making, with insufficient attention to the role of emotions and other nonrational elements. After a brief outline of some of the historical background to the development and understanding of ethical decision making, relevant theoretical and empirical literature on the influence of emotional and other nonrational factors on our ethical decisions is reviewed. The implications of this literature for ethics education and training are outlined, particularly with respect to the use of case studies. An integrative approach is proposed, and conclusions and recommendations are offered with respect to such an approach.     

Student Counselors' Moral,Intellectual, and Professional Ethical Identity Development

Professional identity is characterized by the integration of individuals' professional and personal selves. The authors used a multiple regression design to examine counselor professional ethical identity development, with specific attention to moral and intellectual development. Student counselors (N = 59) completed the Modified Subject‐Object Interview (Monson & Hamilton, 2010 ), Defining Issues Test–2 (Rest, Narvaez, Bebeau, & Thoma, 1999a ), and Learning Environment Preferences scale (Moore, 1987 ). Moral development was the most significant predictor of professional ethical identity development. Preparatory and research strategies to enhance professional ethical identity formation are discussed.     

Human and Global Identities: Different Prototypical Meanings of All-Inclusive Identities

The impact of identities encompassing all human beings (e.g., human and/or global identities) on intergroup relations is complex, with studies showing mostly positive (e.g., less dehumanization), but also negative (e.g., deflected responsibility for harm behavior), effects. However, different labels and measures have been used to examine the effects of these all-inclusive superordinate identities, without a systematic empirical examination of the extent to which they overlap or differ in their sociopsychological prototypical content. This study examined whether different labels activate the same contents in laypeople's conceptualization. Two hundred and forty-eight participants openly described one of six labels: “All humans everywhere”; “People all over the world”; “People from different countries around the world”; “Global citizens”; “Citizens of the world”; and “Members of world community.” Results from quantitative content analyses showed that the different labels activated different thematic attributes, representing differences in their core prototypical meaning. We propose that a general distinction should be made between labels that define membership based on human attributes (e.g., biological attributes) and those that evoke attributes characteristic of membership in a global political community (e.g., attitudinal attributes), as their effect on intergroup relations may vary accordingly.     

Introduction: the image of Islam in Russia

ABSTRACT

Russia has a long, complicated and, at times, contradictory relationship with Islam and Muslims. Islam is classified as one of the ‘traditional’ religions, along with Christianity, Judaism and Buddhism. Throughout Russia’s history across the centuries, the efforts by the state and Muslims to define their relationship have led to contradictory outcomes. This special issue grew out of a conference that took place in 2016, seeking to explore the complicated nature of the image of Islam in Russia from a multidisciplinary perspective. A collection of six contributions explore how Islam is viewed and projected in the public and media sphere in contemporary Russia, including state attempts to ‘manage’ the development of Islam, initiatives to transform the public image of Muslims and the charitable work of a mosque at the local level.     

Building a terrorist house on sand: a critical incident analysis of interprofessionality and the Prevent duty in schools in England

ABSTRACT

In 2015, a duty came into effect requiring all public bodies, including schools, to engage with the UK Government’s Prevent counter-terrorism strategy. This article presents two case studies from mid-size English cities, exploring the moral prototypes and institutional identities of professional mediators who made schools aware of their duties under Prevent. Mediators in each case included serving and former police, teachers and policy advisers, the majority of whom are now private consultants or operating small 3rd sector agencies. Drawing from in-depth interviews with 14 professionals, the article details the ways in which participants constructed their relationship to normative, deliberative and legal obligations. The article focuses on the recurrence of a high profile critical media incident in which a young child was allegedly subject to a referral for writing about living in a ‘terrorist’ (rather than ‘terraced’) house. Reaction to this incident was archetypal of the fear of media moral panic in reconstituting mediators’ identities as Prevent professionals, illustrating how the enframing of events shifts professional moral codes, policy interpretation and implementation.     

Ferenczi and Freud – From psychoanalysis as a “professional and personal home” to the creation of a “psychoanalytic home” for the patient1

Abstract

The author explores the relationship between Sándor Ferenczi and Sigmund Freud in the light of their correspondence. This allows us to see how Freud was able to offer and create for Ferenczi a “professional and personal home” that enabled the latter to find a much more meaningful and creative contact with himself. According to the author, this experience played an important role in Ferenczi’s later readiness to offer to and create with his patients a similar “psychoanalytic home.” As Freud was not able to share such clinical research work with Ferenczi, a conflict developed between them whose nature has occupied psychoanalysts ever since, and whose seeds can be found in the 1246 letters that they exchanged between January 1908 and May 1933. From this point of view, Ferenczi’s Clinical diary (written in 1932 and published only in 1985) can be seen as the continuation of the dialogue they had entertained for so many years, as well as Ferenczi’s attempt not to give up the “professional and personal home” that they had created together.