Professional Resistance in Social Work: Counterpractice Assemblages

Physician resistance to injustice: A scoping review

Throughout history, physicians have been involved in acts of resistance to systems of harm and injustice. However, resistance has seemed to have had little legitimate place in physician professionalism or in formal professional practice. As the challenges to physicians and the profession continue to mount, there is a pressing need to understand how it might be articulated and understood. To do that we need to consider past instances of physician resistance to injustice and harm. A scoping review was conducted to understand how often and in what contexts physicians have been engaged in resistance. A search of multiple bibliographic databases returned 2123 papers, which, after filtering for relevance and inclusion, left 60 articles for full-text review. Of these, 95% were from the United States, suggesting that issues of legitimacy are even more acute outside the U.S. Narrative findings were organized around four themes: professional responsibility to resist, legitimate resistance, resistance to perceived threats, and resistance as moral agency. When physicians have resisted, they have done so with a sense of moral agency albeit with different levels of altruism. They have often engaged in resistance when they felt their personal and professional interests are threatened, with particular emphasis on threats to physician autonomy. The study suggests that, within the U.S. at least, physician resistance is a matter for concern but, it has been approached with little or no guidance or grounding. Moreover, there is a longstanding tension between those who have argued that physicians have a professional responsibility to resist and those who have considered resistance to be extraneous and even harmful to their work as healers. At a time when physicians are facing an ever-growing number of practical, ethical, and moral challenges, professional acts of resistance are of critical concern within the profession.

Challenging the Constraints of Neoliberalism and Biomedicalism: Repositioning Social Work in Mental Health

This article explores the impact of neoliberalism and biomedicalism on social work mental health care practice through presenting the results of a Canadian provincial study which illustrates the experiences of social work service users, providers, and supervisors. While Canada has a universal health care program, the intensification of the free-market approach is evident in the shifts from public sector support to growing rationalization and marked cutbacks to the provision of social welfare services. The specific impact of neoliberal economic restraint on social justice in mental health services has pressured practitioners to adopt medicalized, short-term strategies, under efficiency-based models. The participants in this study reported significant co-occurring concerns with the state of mental health service delivery, and results suggest social work is increasingly co-opted by the conservative individualizing, pathologizing, and contextualizing dominant biomedical framework in the provision of mental health social services and lack of professional practice autonomy.

What Role Should Resistance Play in Training Health Professionals?

The role that resistance plays in medicine and medical education is ill-defined. Although physicians and students have been involved in protests related to the COVID-19 pandemic, structural racism, police brutality, and gender inequity, resistance has not been prominent in medical education's discourses, and medical education has not supported students' role and responsibility in developing professional approaches to resistance. While learners should not pick and choose what aspects of medical education they engage with, neither should their moral agency and integrity be compromised. To that end, the authors argue for professional resistance to become a part of medical education. This article sets out a rationale for a more explicit and critical recognition of the role of resistance in medical education by exploring its conceptual basis, its place both in training and practice, and the ways in which medical education might more actively embrace and situate resistance as a core aspect of professional practice. The authors suggest different strategies that medical educators can employ to embrace resistance in medical education and propose a set of principles for resistance in medicine and medical education. Embracing resistance as part of medical education requires a shift in attention away from training physicians solely to replicate and sustain existing systems and practices and toward developing their ability and responsibility to resist situations, structures, and acts that are oppressive, harmful, or unjust.

Resistance Redux

The last 15 years have witnessed renewed interest in resistance in and around organizations. In this essay, we offer a conceptual framework to thematize this burgeoning conceptual and empirical terrain. We critically explore scholarship that examines resistance in terms of its manifestations and political intent or impact. We offer four fields of possibility for resistance scholarship: individual infrapolitics, collective infrapolitics, insubordination, and insurrection (the “four I’s” of resistance). We conclude by considering the relationship between resistance theory and praxis, and pose four questions, or provocations, for stimulating future resistance research and practice.

Exploring Social Justice in Mixed/Divided Cities: From Local to Global Learning

BACKGROUND

University of Haifa and the University of Maryland, Baltimore faculty developed a parallel binational, interprofessional American-Israeli course which explores social justice in the context of increasing urban, local, and global inequities.

OBJECTIVES

This article describes the course's innovative approach to critically examine how social justice is framed in mixed/divided cities from different professional perspectives (social work, health, law). Participatory methods such as photo-voice, experiential learning, and theatre of the oppressed provide students with a shared language and multiple media to express and problematize their own and others' understanding of social (in)justice and to imagine social change.

FINDINGS

Much learning about "self" takes place in an immersion experience with "others." Crucial conversations about "the other" and social justice can occur more easily within the intercultural context. In these conversations, students and faculty experience culture as diverse, complex, and personal.

CONCLUSIONS

Students and faculty alike found the course personally and professionally transformative. Examination of social justice in Haifa and Baltimore strengthened our appreciation for the importance of context and the value of global learning to provide insights on local challenges and opportunities.