Inaugural Lecture by Adjunct Professor Srikant Sarangi:
Communicative contingencies and the interplay of expertise and ethics in medical/healthcare decision making.
In the medical/healthcare setting, models of decision making – and shared decision making – abound in order to keep pace with biomedical and socio-ethical landscapes in contemporary society. However, these models, invariably underpinned by rationalist, cognitivist and algorithmic principles, although process-oriented in spirit, underplay the ‘communicative contingencies’ that are a quintessential feature of decision making.
In this lecture, the main point of departure is that in many healthcare encounters, decision making is not always visibly evident and its communication does not routinely follow a linear order; instead, it is a dispersed, emergent activity and it is through the communication process itself decisions evolve as part of ecological adaptation and become consequential. In critically reappraising the twin notions of ‘expertise’ and ‘ethics’ and their interplay in situated contexts, Srikant Sarangi propose a framework of ‘communication ethics’ which extends my earlier work on ‘communication expertise’.
Srikant Sarangi will use two diverse healthcare scenarios – genetic counselling premised on a commitment to non-directiveness and emergency medical calls foregrounding a commitment to directiveness – to illustrate how notions of biomedical expertise and principles-based ethics manifest contingently at the communicative level by drawing on intuition and phronesis, while attending to lifeworld matters beyond the medically salient signs and symptoms.