The NHS Confederation has produced a report highlighting a potential “shortfall” in the NHS in England’s budget by 2011. I heard one of their spokeswomen on the BBC news this morning and she summarised the Confederation’s message. They are recommending more “efficiency”, better “productivity” and a reduction in the range of services offered by the NHS. In their report they make it clear that the changes will require reducing the number of NHS staff and having clinicians perform more doctor-patient interventions.
Another way of putting this is to say they think the answers lie in less staff providing a greater number of uniform interventions to more people.
I find these conclusions dehumanising. They turn subjects into objects. Health and illness are experiences. They are not events or products.
I’ve just finished reading The Postmodern Prince by John Sanbonmatsu. It covers an area of academic activity I’m not familiar with – political critical theory. However, a few passages struck me loud and clear.
Holbach and Helvetius had portrayed “Man” as a rational, self-interested subject – and manipulable object. This rationalist view sharply separated culture and nature, subject and object, thought and feeling, and so on,
In the 1920s, Georg Lukacs elaborated Marx and Engels’ critique in his brilliant work, History and Class Consciousness, with his famous description of reification – the cultural process in capitalism by which subjects are turned into objects, and objects into seeming “subjects”, under the twin pressures of commodification and rationalisation.
What all forms of idealism, past, present, or future, have in common is the suppression of experience as the basis of human knowledge and practice.
Ethical relations, broadly speaking, depend on what Daniel Brudney calls “attentiveness to the other”. Without this attentiveness, we risk mistaking a “who” for a “what” – that is, a being or a subject for a thing – and so come to justify all manner of political violence.
Empathy – this powerful natural capacity of ours – must be held at bay, sublimated into the rationalist’s passion for dispassion.
One of the hallmarks of modernity is rationalisation, the progressive reduction of the lifeworld to quantifiable procedures and methods. But in stripping nature of its mystery, the Enlightenment disfigured the nonhuman. This, in turn, has led to our own disfigurement, a “disenchantment” as technological innovation and scientific revolution yielded ever more powerful ways of controlling human beings, and not “only” other animals.
These quotes capture, for me, the essence of something fundamentally important. Our systems are falling apart, and it strikes me that the greatest failure of our current political, economic and social systems is the way they de-humanise, the way they turn the “subject” into an “object”. It’s life-denying.
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