Risk and the politics of boundary work

Autor: Lianne Holten, Eddy Houwaart, Raymond De Vries, Carla G. van El, Bahareh Goodarzi, Arie Franx
Přispěvatelé: RS: CAPHRI - R4 - Health Inequities and Societal Participation, Metamedica, APH - Quality of Care, Midwifery Science, Amsterdam Reproduction & Development (AR&D), Human genetics, APH - Personalized Medicine
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Health Risk & Society, 20(7-8), 379-407. Routledge/Taylor & Francis Group
Goodarzi, B, Holten, L, van El, CG, de Vries, R, Franx, A & Houwaart, E 2018, ' Risk and the politics of boundary work: preserving autonomous midwifery in the Netherlands ', Health risk & society, vol. 20, no. 7-8, pp. 379-407 . https://doi.org/10.1080/13698575.2018.1558182
Health risk & society, 20(7-8), 379-407. Routledge
ISSN: 1369-8575
DOI: 10.1080/13698575.2018.1558182
Popis: Midwives’ position in maternal and newborn care (MNC) in the Netherlands is unique:unlike many other countries, they have retained the authority over risk assessment andreferral. We studied why and how midwives formally gained their position as gatekeepers,a role formally granted in 1987 by the Study Group for the Revision of theKloosterman List (SGKL), a group of representatives from all professions and organisationsinvolved in Dutch MNC. We analysed the minutes of the SGKL’s meetingsand conducted interviews with eight key-informants who were involved in the SGKL’sdecision process. We used theories of professional boundary work and cultural theoriesof risk to analyse the negotiations regarding the authority over risk assessment andreferral in MNC that occurred between the representatives of midwives, generalpractitioners, and obstetricians in the SGKL. Our study offers new insights intoprofessional boundary demarcation and the contest for control of risk managementthat occur at the political level of MNC. We show that beliefs regarding risksassociated with childbirth and concern with the protection of professional interestscan differ not only between but also within professions that seek to police and extendtheir boundaries. Negotiations are shaped by a dynamic interaction between thesebeliefs and interests, creating the possibility for otherwise unexpected transprofessionalcoalitions and redefining boundaries in unexpected ways. Our findings offer thepossibility to view disputes in MNC as occurring between beliefs and interests, insteadof between professional groups. These insights can reframe policy discussions in MNCand point to the need for further analysis of the boundary work that occurs in politicaland regulatory arenas.
Databáze: OpenAIRE
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