© 2019 Tatiana SIDOROVA
2019 — №1 (17)
Sidorova, T. A. (2019). Novye tehnologii kak faktor transformacii professional’noj identichnosti v medicine [New technologies as factor of transformation of professional identity in medicine]. Medicinskaja antropologija i biojetika [Medical anthropology and bioethics], 17 (1).
Keywords: doctor, identity, professional identity, professional identification, biomedical technologies, medical ethos, medical ethics, Hippocratic Oath
Abstract: In the article, identity is reviewed from the viewpoint of ethical-philosophical and psychological approaches. The concept of identity describes the state of the subject in its aspects of transition, variability, loss of identity, and the search for the authentic. A doctor’s professional identity is presented in personal and group aspects. The identification of the doctor is the result of his adoption of the norms and values of medical ethos and of the formation of personal life history in the context of the long history of medicine. The levels of the signifier and the signified are elicited in the doctor’s profession: subject-activity and reflective symbolic levels. The article describes how technologies are turning into a self-sufficient value, while technological progress leads to shifts in the specialist’s self-awareness and in the doctor-patient relationship, to deepening of medical specialization, as well as to supplementation and, next, replacement of the doctor’s skills and expertise with technical means. This exacerbates the problem of professional identification and creates risks for medical independence, objectivity and continuity. The article draws a conclusion on transformations in medical ethos, which is being created according to the “techno-logos” model.
Tatyana Aleksandrovna Sidorova is Cand. Sc. in Philosophy, Associate Professor at the Department of Fundamental Medicine, Institute of Medicine and Psychology of the Novosibirsk State University.
Identity in Scientific Discourses
The problem of identity in medicine is related to the doctor’s role, his relations with the patient, as well as interactions within the professional community. A projection in the philosophical, philosophical-anthropological and social-psychological discourse reveals various facets of professional identity.
Doctor’s Professional Identification
Professional identification of a doctor is the formation of an internal code within the value coordinates of the medical ethos. In the epoch of biotechnologies changes in the value orientation of medical professionals are occurring; they lead to the transformation of the doctor’s identity in its moral-psychological and social-group aspects. The doctor possesses a “strong” agency due to his professional independence. In medicine, unlike in any other profession, lineages are essential for its professional culture and cumulative ethos.
In the profession, we will discern the levels of that being designated and that designating. In that being designated objects, skills and people function as fulfillers of concrete tasks. The role of that designating is fulfilled in medicine by normative systems of medical ethics; a professional ethos obtains its language in it. One element of that designating are symbols accumulating the energy of group agency; they serve as a source for identification on an unconscious level. Today, the symbolic system is moving from the associations with the natural force and mercy to the signs of domination over life with the help of technologies. Before the institution of profession emerged, its model was created in medicine, as the unity of skills and reflexive mode of activity in the normative code of the Oath. Not only while being on duty but also at any other time, a doctor always remained a doctor. It is no wonder that in medicine a deontological ethos is forming – a system of requirements in the nature of inner conviction or unconditional duty. These norms secured an internal collegial cohesion, as well as moral-psychological justification of dedication. The process of professional identification primarily occurs not through the execution of that being designated, i. e. the substantial-technical aspect of the activity, but as a consequence of acceptance of that designating, when the norms and symbols of professional ethos become the foundation for the internal unconscious, the basis for behavior.
Doctor in Epoch of New Technologies
Technological artifacts in medicine witness about the level of medical treatment in the given culture, as well as the level of civilization development. Today, the technological era is embodied by molecular biology and the use of artificial intelligence. The tempo of modern transformations in the medical-clinical activities may cause external and internal personal conflicts. In the context of technological progress in medicine, doctors increasingly frequently find themselves in situations they cannot resolve with the help of the available normative means.
Expansion of technological possibilities transforms both the doctor and the patient, conditions problematization of professional identity. The autonomy of the patient legitimizes the patient’s wishes, turns the medicine into an element of the consumption industry. In pursuit of affirmation of priority, increases the temptation of the use of unchecked knowledge. The doctor enters the relationship of competition, patenting the newly discovered methods. Modernization and commercialization turn the doctor into an official and provider of services. His self-reliance and noncritical perception of new technologies; as a result, the distance between him and the patient increases, independence of the doctor and individuality of his choices are eliminated. The medical ethics narrows down to the corporate one. The medical ethos is rebuilt after the techno-logos pattern.
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