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  1. C Parker
  1. Leeds (East) Research Ethics Committee, Leeds, UK
  1. Correspondence to:
 C Parker
 Clinical Sciences Building, Room 5.2, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK; elaine.hazell{at}

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“Misconstructions of self”: a response

This response to Dr E A Kinsella’s1 article seeks to expose the errors of the theoretical method and concepts used by her to suggest a programme to improve the training of health professionals. It can be seen that Kinsella uses vague hermeneutic epistemological theory on which to base alleged insights into ethical issues, and that her defined “narrative and dialogic” view of the self does not produce only moral action as she intends. Her suggestions for improvement are based on a set of definitions that do not clarify organisations’ use of power, and her proposed solution to remove any potential for health service intimidation is ineffective.

The “monologic and dialogic”

Kinsella’s intention in her article is to show how the moral character of health professionals can be improved. For this purpose, she introduces the concepts of “monologic” and “dialogic”, each of which, according to her, has a twofold function. Each of the two concepts is taken to represent both epistemological conditions and moral evaluations. The epistemology at its simplest identifies the individual mind as monologic and the social mind as dialogic. A hermeneutic approach is then used to develop her conclusion about some training requirements of health professionals; she sets out to proceed from the monologic or individual understanding to the dialogic or social understanding. Similarly, in a development of her evaluative ideas, she seeks to show how the individual’s primitive thinking is socialised. Her concept of monologic also reflects ideas of selfishness, whereas her concept of dialogic is used to express moral concern.

To provide a general context for her perspective, it is perhaps helpful to consider that the conditions that all human beings abide by are related to space, time and material. It is this sharing of such conditions of life that, for example, enables western anthropologists to understand much about …

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  • Competing interests: None declared.