Expertise-based judgments and individual responsibility in organizations: the case of psychiatrists in prisons
Le Bianic, Thomas
IRISSO Université Paris-Dauphine France, http://shadyc.ehess.fr/document.php?id=101
The functioning of modern and complex organizations increasingly relies upon expertise-based judgments performed by professionals. These expertises can be directed either towards objects (material or immaterial), processes or, increasingly, individuals. When their skills and formal knowledge are applied to individuals, professionals are expected to assess, evaluate and categorize people in order to give them access to specific treatments within the organisation. Once realised, theses judgments circulate in organisations, and can sometimes be detrimental to the professionals or experts who have produced them. In the classical approach of professions, individual responsibility (e.g. in case of expertise failures) was collectively taken in charge by the professional community, in the frame of professional ethics. More and more, professionals are made individually accountable of the expertise-based judgments they produce. Are we assisting to a transfer of responsibility from the organisational level to the professional level (because of increasing organisational demands addressed to professionals), and secondly, from the professional level (collegial discipline) to the individual level?
An ongoing fieldwork on the role played by psychiatrists in French prisons, will serve as an illustration of this general trend in the role fulfilled by professionals in organisations. Mental health professionals in prisons are increasingly solicited by the penitentiary administration in order to deliver ?certificates? to prisoners attesting, for example, that a given inmate can be left alone in his prison cell, is not likely to commit suicide or will not be violent with his co-inmates. The wave of suicides that recently occurred in French prisons has shown that, in case of unintended problems, psychiatrists can be made individually responsible of the certificates they have produced and can be individually sanctioned by the penitentiary administration. We can also observe various forms or professional resistance to these increasing demands of expertise by organisations, professionals trying to delineate more strictly their area of competence. These expertise-based judgments, located at the frontiers of medical care and organisational needs, will be used as a case study in order to shed light on these new processes of responsabilisation of professionals in organisations.