Abstract
In the United Kingdom, clinical governance has become a master narrative for health care over the last decade. While many see this political imperative as embodying both enlightening and humanistic goals, I argue that it has also become an apparatus for resuscitating a hypermodernist worldview which further conceals the political drivers of health care delivery. While resistance to clinical governance seems futile, insistence on the inclusion of historical analysis in understanding modern health care delivery may be profitable. Drawing from selected dramatic texts by Henrik Ibsen, an historical moment of clinical governance may be analysed showing the complex interplay of the personal, social, empirical and ethical dimensions of health care delivery.
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JC Maxwell, On Governors (Proceedings of the Royal Society: Number 100, 1868).
N Weiner, The Human Use of Human Beings (Cambridge, Massachusetts: Da Capo Press, 1988).
B Latour, Science in Action ( Milton Keyes: Open University Press, 1988).
M-L Courvoisier and A Wenger, “How to Make the Most of History and Literature in the Teaching Medical Humanities: The Experience of the University of Geneva,” Medical Humanities 31: 51–54.
R Room, “Governing Images and the Prevention of Alcohol Problems,” Prevention Medicine 3 (1): 11–23.
ND Jewson, “The Disappearance of the Sick-Man from Medical Cosmology,” 1770–1870, Sociology 10 (2): 225–244.
D Carnall, “NHS Information Strategy Launched,” British Medical Journal 317 (1998): 901.
Given that the medical schools (of the 1930s in Australia, at least) used to require it as a core unit of study, it is regrettable that contemporary medical education finds little space for the history of medicine in an already flooded curriculum.
S Shapin, A Social History of Truth (Chicago: University of Chicago Press, 1994).
Latour, Science in Action.
B Latour, We Have Never Been Modern (New York: Harvester Wheatsheaf, 1993).
B Latour, Clarendon Lectures (Oxford: Oxford University Press, 2002).
S Wallace and P Staiger, “Informing Consent: Should ‘Providers’ Inform ‘Purchases’ about the Risks of Drug Education?” Health Promotion International 13 (2): 167–172.
S Wallace, When Technologies Fail: The Methodological Dilemma of Privilege Versus Consensus (School of Mines, Paris: Annual International Conference of the Society for the Social Studies of Science, 2004).
T Kidder, The Soul of a New Machine (Boston: Little, Brown and Company, Inc., 1981).
Consider the case of Joseph Bazalghette’s magnificent, but usually unacknowledged, contribution to public health in the modern age or Gerard Geison’s 1995 historiography of Pasteur.
Latour, Science in Action.
The enduring belief in the curative powers of healthy waters was demonstrated by the English football management in its preparation of players for the 2006 World Cup.
GN Gilbert and M Mulkay, Opening Pandora’s Box: A Sociological Analysis of Scientists’ Discourse (Cambridge: Cambridge University Press, 1984).
S Wallace, Controlling Alcoholism: Technologies of Trust in a Struggle for Scientific Authority (Melbourne: University of Melbourne Press, 1999).
It is deeply ironic that the process of implementing evidence-based medicine is largely prosecuted on inspirational–aspirational rather than empirical grounds.
H Waitzkin, “Is Our Work Dangerous? Should It Be?” Journal of Health and Social Behavior 39 (1998): 7–17.
See the famous “truth will out device” in Gilbert and Mulkay, Opening Pandora’s Box; R Wallis, One the Margins of Science: The Social Construction of Rejected Knowledge (Keele: University of Keele Press, 1979); and W Schafer, ed., Finalization in Science: The Social Orientation of Scientific Progress (Dordrecht: Reidel, 1983).
See S Wallace, Controlling Alcoholism, and S Shapin, “Cordelia’s Love: Credibility and the Social Studies of Science,” Perspectives on Science 3 (3): 255–275.
Wallace, Controlling Alcoholism.
Shapin, “Cordelia’s Love.”
M Meyer, Ibsen (Ringwood Victoria: Penguin Books, 1971).
Acknowledgements
I would like to thank the anonymous reviewers and Professor Stephan Strobel for a number of helpful and generous contributions to this paper.
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Wallace, S. Governing Humanity. J Med Humanit 29, 27–32 (2008). https://doi.org/10.1007/s10912-007-9052-y
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DOI: https://doi.org/10.1007/s10912-007-9052-y