Dear Ceri
Modernity is not an illusion, - Jumbo jets, television sets and "the machine that goes 'PING'". It just creates an illusion of certainty and uncertainty is something we don't want to live with - so we go for it. The government doesn't want patients to live with uncertainty either, so if you are concerned "contact your GP." (Then they have someone else to blame too.)
I agree that there is uncertainty in critical care (formerly a gas-man too). I am not sure that all intensivists are as reflective as you, Ceri and perhaps in common with most of medicine still believe that EBM will ultimately deliver.
Although I agree all of clinical practice involves negotiation and "acting to a set of shared values", to be effective this demands skill in communication - to which medicine is waking up (perhaps) and (as you say) an understanding of power relationships - to which it is not.
Modernity is useful, post modernity is useful, (even if we can't define them), we need to apply the insights they offer appropriately and not value one discourse over another (perhaps I'm post modern after all). I would suggest we are all "functional critical realists" in the end.
....and when I have my MI I will have the modern (not the premodern)CCU cause "it works"...but I'd quite like some old fashioned nursing care whilst I'm there too.
Best wishes
Dan
Dr Dan Munday
Consultant/Honorary Clinical Senior Lecturer in Palliative Medicine
Coventry PCT and
Centre for Primary Health Care Studies
University of Warwick
email [log in to unmask]
Tel 024 76246858
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