Dear Ceri,


Yes, there is a need not to replicate errors and to have safe and reliable
regularised practice. There are also the agendas of cost effectiveness, quality
and evidence.

I think the problem with taking a purely modernist agenda in health is then the
denial of difference. I am not suggesting post modernism is the answer as you
rightly say, there would be no regularisation and anything would go. There is
something to be said for some standardisation and ensuring equity of services
and treatment regimes etc! I think my biggest concern is that care is a
creative process as well as a regularised one. The 'therapeutic' technical
rationalist approach to care and knowledge for care interventions risk the loss
of the creative and dare I say it 'art' of care/medicine.

The knoweldge to care is situated within a structural heirarchy already which
prioritises particular knowledge, one could take a gendered approach here but
it is wider than this. Certain knowledge are given more credence simply becasue
they are traditionally scientific, rational, unbiased rather than that which
comes out of processes which can not be easily measured and defined or infact
replicated. We have seen this with NICE.

perhaps the acceptance that there are different 'truth' about care is something
to be acknowledged and prioritised. Thus these can be used in association with
the 'modernist' measure of knoweldge to develop a more 'enlightened'
modernising health care system?

I don't know, these are just my thoughts at the moment, and I have lurked
specifically because I am not sure how much sense I would make here!

Quoting No Name <[log in to unmask]>:

> In a message dated 25/05/2004 10:04:12 GMT Daylight Time,
> [log in to unmask] writes:
>
> > Yes there are the linear moments of regularity and
> > prediction,however, because of the dynamic and complex nature of
> interaction
> > between knowledges, contexts, processes and structures of care, there can
> > never
> > be true replication.
> >
>
> I agree.
>
> Please note my previous response to Sarah Fraser for the meaning of "care."
>
> True replication is impossible, but there is no need to replicate errors of
> omission.
>
> Modernity/modernism is about understanding the predictability of the world
> and decreasing unpredictability. But this is where I am on shaky ground,
> hence
> my request for advice.
>
> Ceri
>