I would like to suggest another way to go further toward a new economy of power relations, a way which is more empirical, more directly related to our present situation, and which implies more relations between theory and practice. It consists of taking the forms of resistance against different forms of power as a starting point. To use another metaphor, t consists of using this resistance as a chemical catalyst so as to bring to light power relations, locate their position, (...) and find out their point of application and the methods used. Rather than analyzing power from the point of view of its internal rationality, it consists of analyzing power relations through the antagonism of strategies.[…]Let us come back to the definition of the exercise of power as a way in which certain actions may structure the field of other possible actions. What, therefore, would be proper to a relationship of power is that it be a mode of action upon actions. That is to say, power relations are rooted deep in the social nexus, not reconstituted "above" society as a supplementary structure whose radical effacement one could perhaps dream of. In any case, to live in a society is to live in such a way that action upon other actions is possible-- and in fact ongoing. A society without power relations can only be an abstraction. Which, be it said in passing, makes all the more politically necessary the analysis of power relations in a given society, their historical formation, the source of their strength or fragility, the conditions which are necessary to transform some or to abolish others. For to say that there cannot be a society without power relations is not to say either that those which are established are necessary or, in any case, that power constitutes a fatality at the heart of societies, such that it cannot be undermined. Instead, I would say that the analysis, elaboration, and bringing into question of power relations and the "agonism" between power relations and the instransitivity of freedom is a permanent political task inherent in all social existence.[…]In effect, between a relationship of power and a strategy of struggle there is a reciprocal appeal, a perpetual linking and a perpetual reversal. At every moment the relationship of power may become a confrontation between two adversaries. Equally, the relationship between adversaries in society may, at every moment, give place to the putting into operation of mechanisms of power. The consequence of this instability is the ability to decipher the same events and the same transformations either from inside the history of struggle or from the standpoint of the power relationships. The interpretations which result will not consist of the same elements of meaning or the same links or the same types of intelligibility, although they refer to the same historical fabric, and each of the two analyses must have reference to the other. In fact, it is precisely the disparities between the two readings which make visible those fundamental phenomena of "domination" which are present in a large number of human societies.Michel Foucault has been teaching at the Collège de France since 1970. His works include Madness and Civilization , The Birth of the Clinic , Discipline and Punish , and History of Sexuality , the first volume of a projected five-volume study. (shrink)

Background For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. Method We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers that defined or discussed the (...) notions at a conceptual level. The reviews and papers were analyzed as text transcripts. Results We identified 10 themes that were common to all the types of centredness. At a conceptual level we could not identify thematic differences between the types of centredness. These findings were subjected to a philosophical critique using ideas derived from Wittgenstein. Conclusion Different types of centredness are required in different contexts. The differences are justified by their practical utility. The unifying themes of centredness, however, reflect a movement in favour of increasing the social, psychological, cultural and ethical sensitivity of our human encounters. (shrink)

Accepting as a given that the humanities disciplines are not product or “results” driven, this paper argues that the core of an interdisciplinary field of medicine and humanities, or medical humanities, is an interpretive enterprise that is not readily open to quantitative assessment. A more humanistically oriented medical practice can derive, however, from the process that produces new insights and works toward the development of a new, mutually shared, and humanizing language.

The call for a narrative medicine has been touted as the cure-all for an increasingly mechanical medicine. It has been claimed that the humanities might create more empathic, reflective, professional and trustworthy doctors. In other words, we can once again humanise medicine through the addition of humanities. In this essay, I explore how the humanities, particularly narrative medicine, appeals to the metaphysical commitments of the medical institution in order to find its justification, and in so doing, perpetuates a dualism of (...) humanity that would have humanism as the counterpoint to the biopsychosociologisms of our day. (shrink)