9. Recognize the infrastructural nature of hierarchy.



Section 2: Exercise 5 More on power imbalances

The following photograph was taken on the wards by a photographer/surgeon. Describe what you see, and then answer the questions below.

Andreas Schreiber, Unititled. With permission.

  1. What does this photograph say about the structured nature of power?How do conventions and rituals reaffirm power relationships?
  2. Listen to another comment by Dr. McCann. Whose problem is McCann's experience? Discuss the role of hospital rituals--give examples of how they may empower or disempower individuals.
  3. Give examples from what you have seen in your clinical sites that illustrate how seating arrangements, dress, order of entry and other formalities depict hierarchical relationships.
  4. Is the doctor-patient hierarchy necessarily a negative? Can you identify a transition where it stops being a negative and becomes a positive?What might justify a power imbalance? The clinical correlate will provide you with some references to use in your answer. Clinical correlate 6: Doctor as placebo Imagine an illustrative scenario.
  5. Now imagine a scenario where there is a conflict between the patient and the doctor around the issue of power; for example, when the patient makes a decision against medical advice. How would you handle such a conflict?