Self-Regulation: A Cognitive Perspective Towards Restoration of Medical Practice

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Abstract:

The NHG guidelines developed by Dutch general practitioners can be seen as paradigmatic examples of self-regulation. It will be argued that because of the inherent tendency of these guidelines to become interpreted and used by nonprofessionals, they become external instruments referring to an external motivation undermining professionalism. It is argued that Braithwaite's idea of responsive regulation in health care in which self-regulation by guidelines is meant to enhance professionalism will not succeed unless it is interpreted in a practical cognitivist framework as developed for example by S L Hurley and other moral realists. In this framework the focus will be on the reduction of bias rather than benchmarked performance indicators.

Keywords: COGNITIVISM; HEALTH CARE; PRACTICAL REALISM; PROFESSIONAL AUTONOMY; PROFESSIONS; SELF-REGULATION

Document Type: Research Article

Publication date: December 1, 2010

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  • Legisprudence aims at contributing to the improvement of legislation by studying the processes of legislation from the perspective of legal theory. The content of the journal covers legislation in a broad sense. This comprises legislation in both the formal and the material sense (from national and European parliaments, regulation, international law), and alternatives to legislation (covenants, sunset legislation, etc.). It also takes in regulation (pseudo-legislation, codes of behaviour and deontological codes, etc.). The journal is theoretical and reflective. Contributions to the journal make use of an interdisciplinary method in legal theory. Comparative and system transcending approaches are encouraged. Sociological, historical, or economic studies are taken into account to the extent that they are relevant from the perspective of interdisciplinary legal theory. Dogmatic descriptions of positive law are not taken into consideration.
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