Re: Impact of WHO concepts? [or, Biopsychosocialism Rules OK?]
Er, um, yeah, thanks Shelley T. I posted some comments titled “ICF/ICIDH-
2 crit [rebalance]” on this list on 23 Nov. 2001, illustrated with the
Royal Navy classification of chamber pots, one of the world’s briefly
memorable literary occasions. I’d like to oblige further after Philip
Scullion’s enquiry, but don’t actually make any practical use of ICF and so
ought not say too much on that aspect. Practical investigation is going
forward in many places. There is already a journal-published lit of about
2000 items on the field-testing leading up to ICF. It will grow.
The Dutch National Instt. of Public Health++ [RIVM] has been keeping
track of the action with a newsletter and a downloadable bibliog., which
has been at www.rivm.nl/publichealth/whocc-icidh -- I couldn’t get into
this site just now to check that this stuff is all still available. Might
be down or busy temporarily, or the URL may have changed. I think RIVM is
likely to keep it up somehow or other, because there’s bound to be a
widening circle of people involved with ICF whether as users (active or
passive, i.e. classifiers or DPs whose biopsychosocial functioning is being
classified - “No, Madam, this won’t hurt at all”), theorists, critics,
whatever.
The ICF site is at:
http://www3.who.int/icf/icftemplate.cfm
The old ICIDH-2 site, where one could get into the draft version and see
what kind of animal it was, has gone – one is redirected now to the ICF
site, where the index can be glimpsed, but you can’t actually browse in it
(yet). They may eventually upload the whole thing – the site is under
development – but at present you have to buy it to browse seriously.
Probably many medical libraries will eventually have it - but only 5 out
of 23 COPAC libraries (i.e. UK major research universities) have a copy at
present.
I don’t see it figuring heavily in the Get-Well Card stores - ICF is
about 300 pages in English. The Japanese version is perhaps more artistic.
Re Philip’s question about the basic ICF concepts: “…If this were adopted
enthusiastically, as the basis for the provision of health and social care
services in the UK, would we see substantial changes. Could we anticipate
improvements?”
One could argue (and I guess Shelley T. may bring in some Foucaultian
perspective on this…) that “what it’s called” can in the long run have
quite an effect on people’s thinking, and maybe another decade after that
some effect on the provision of services. But such a cause-and-effect
would be extremely hard to differentiate amidst all the other static and
changing factors. In the shorter term, changes in the “provision of health
and social care services” will be heavily dependent on budgets, management
competence, flexibility, professional training, DP compliance or
stroppiness, etc, and a slew of concepts and motivations accumulating
during the past 40 years. (I mean, amidst all that past slew, ICIDH
probably did have some effects during 40 years, for better or worse -- but
I doubt that many people looking back would say it was a major factor in
their working life or their personal rehab process).
Enterprising DPOs here and there could try to steer the bandwagon, i.e.
taking the line that ICF has officially been launched, it’s going to be
used increasingly, it does accommodate some ‘social model’ or ‘social
construction’ aspects (under the “biopsychosocial” terminology), there’s a
lot of confusions and ambiguities, so the strategy will be to get on board
and emphasize the more acceptable parts, get pro-actively into the training
game, produce the series of “Medical Idiots Guide to ICF”, “Social Work
Idiots Guide to ICF”, etc.
But none of that is likely, during the foreseeable (15-20 year?) future, to
have much effect on budgets, available personnel, DP’s control of
resources, design of housing and public space. I mean, the ICF is a
classification, a glorified list. Sexy it is not. There will be very many
other, more immediate, political and social factors that are likely to
impact on service provision.
On a broader front, battle will continue on the question of
whether ‘universal concepts of disablement’ do actually exist (against 150
years of anthropological research), underpinning the ambition of
a ‘universal language of descriptive classification’ (against 100 years of
linguistic research); or whether this is merely another type of arrogant
(probably male) ‘scientific fundamentalism’ enabling the globocrats
[or (g)lobotomised bureaucrats] to increase their ‘control’ over
the ‘bodies of the oppressed’ (etc), and maybe a few kama positions in
between.
breathlessly,
m99m
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