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PubMed1993

Social change and the control of psychotropic drugs-risk management, harm reduction and 'postmodernity'.

This paper argues that in order to understand the broad tide of change in drug control in recent times, we need to link these changes to a general understanding of social change. The paper sketches out how modern society arose and how it is giving way to the postmodern. Two themes are then developed. The first concerns the way that the state shrinks in postmodernity and links this to drug control, mentioning the example of random drug testing in the workplace as a good example of the change. It then moves to looking at the related shift in social control regimes from the 'corporal' regime of the premodern through the 'carceral' regime of the modern to population and risk management in the postmodern. It argues that in society in general there is a tension between carceral discipline and the amoral management of risk and that this is exhibited in drug control as a struggle between individual treatment and law enforcement on the one hand and 'harm reduction' on the other. This is illustrated by reference to a persistent tension within the NCADA enterprise.

Journal Article↗

PubMed2000

Consumerism, disorientation and postmodern space: a modest test of an immodest theory.

There has recently been an explosion of theoretical literature on social space. A central claim in this literature is that postmodern spaces are experienced as confusing or disorienting by human subjects. This claim remains untested. The paper reports results from a small-scale survey conducted in one form of postmodern space--the shopping mall. It suggests that unsupported assertions about the disorienting effects of postmodern space and their associated influence on consumerist activities should be treated with scepticism. Through practice humans are able to develop routines which enable them to competently navigate these spaces.

Community Participation↗

PubMed1998

The small and the ordinary: the daily practice of a postmodern narrative therapy.

In this article, I contrast assumptions of a modernist worldview and a postmodern worldview as they relate to clinical practice. Two exercises are described that help therapists develop insight into and practice with the kind of thinking that is consistent with a postmodern narrative clinical practice. Particular attention is paid to the ways that even the small and the ordinary--single words, single gestures, minor asides, trivial actions--can provide opportunities for generating new meanings. Five concepts that I routinely use in my professional and personal life and that are consistent with a postmodern narrative practice--discourse, externalizing the internalized discourse, exceptions, power as the means to produce a consensus, and characteristics of narrative--are illustrated.

Adult↗

PubMed2000

Postmodernism and the sacred: reclaiming connection in our greater-than-human worlds.

This article addresses the many faces of postmodernism and offers the critique that postmodernism taken up in a particular extremist way can tend to sacrifice the sacred, the spiritual, and the recognition of our "greater than human" worlds in a quest for the particular. In response to this critique, I speak to a postmodern family therapy practice that is informed by values of connectedness, community, and communion; enacted through love and pragmatics; and committed to recognition of our obligation to ecological practice.

Family Therapy↗

PubMed2001

The postmodern turn in group therapy.

The postmodern critique, often referred to as social constructionism, has influenced nearly all disciplines, including recently the domain of psychology--and most particularly psychoanalysis. This article presents an exposition of the "postmodern turn," including some historical perspective, a description of its theoretical elements as related to psychological practice, as well as standard objections to its theories. This author believes that many of the concepts inherent to a social constructionist approach are compelling for theory and practice in group therapy. Clinical case studies are cited in describing how postmodern theories present a natural fit for group therapy. Furthermore, specific implications of this model are delineated for the arduous task of leading groups.

Culture↗

PubMed1996

Environmental ways forward in a postmodern (nursing) world.

In this paper I am interested in showing how nurses' concerns for environmental issues reflect larger shifts in modern/postmodern thinking. Changes through premodern, modern, and postmodern times are highlighted. Focus is especially upon the natural world and damage to it in the name of human progress--from which humans also ultimately suffer. Nurses seeking to find environmentally sound ways forward in their practice are experiencing and enacting a postmodern 'mood', and by speaking out about the futility of perpetuating modernist environmental concepts, they are engaging in postmodern dialogue. Nurses recognise as well however, that when they challenge entrenched and environmentally damaging practices in their workplaces, they open themselves to disturbing currents of change in which stability and meaning may readily be lost.

Attitude of Health Personnel↗

PubMed2000

Between the modern and the postmodern. The possibility of self and progressive understanding in psychology.

Psychology assumes defensible notions of human subjectivity and understanding. Yet, some versions of postmodernism, including some of those currently influential within psychology, eschew the possibility of the kind of understanding-capable personhood on which modern psychology has depended. The authors argue for a skeptical, middle-ground position that might allow psychologists to resist a forced choice between modernism and postmodernism in their subject matter and understanding. The authors set up their argument with 2 stories of human development and change. These stories assume no fixed, essentialist foundations of the sort favored in classically modern psychologies, yet they maintain the possibility of both self and understanding within a real but contingent physical, biological, and sociocultural world. The authors then articulate a middle-ground position as one that avoids the fixed foundationalism, essentialism, and absolute certitude of modernity, without endorsing the radical arbitrariness, antisubjectivism, and anarchistic relativism of some versions of postmodernity.

Ego↗

PubMed2005

Foundation Trusts: economics in the 'postmodern hospital'.

Foundation Trust Hospitals are community-controlled health care providers which have increased autonomy about how they produce outcomes for the British National Health Service. Although there is a literature on hospital economics it is unclear how these innovative providers will behave, if they have to compete for scarce resources with other hospitals. This paper reviews some of the earlier theories, such as the neoclassical theory of the firm, and discusses their relevance along with 'newer' economic theories such as the transaction costs and evolutionary theory of the firm, plus organizational and human resources theory, to the performance of Foundation Trusts. Much contemporary health care provision is shaped along modernist lines, using scientific endeavour to maximize the impact on health outcomes and technical and social efficiency. However, there is an increasingly postmodern standpoint--critical of modernity--being taken by both patients and hospital staff, to deconstruct processes in the organizations that serve them. Foundation Trusts are postmodern hospitals insomuch as they (to attract scarce resources in a competitive environment), need to marshal the diverse theories of the firm together in order to provide a mass-customized, quality experience, transparently and at least cost--whilst maintaining a stable organizational culture for staff.

Community Health Services↗

PubMed1998

A theory of international bioethics: multiculturalism, postmodernism, and the bankruptcy of fundamentalism.

The first of two articles analyzing the justifiability of international bioethical codes and of cross-cultural moral judgments reviews "moral fundamentalism," the theory that cross-cultural moral judgments and international bioethical codes are justified by certain "basic" or "fundamental" moral priniciples that are universally accepted in all cultures and eras. Initially propounded by the judges at the 1947 Nuremberg Tribunal, moral fundamentalism has become the received justification of international bioethics, and of cross-temporal and cross-cultural moral judgments. Yet today we are said to live in a multicultural and postmodern world. This article assesses the challenges that multiculturalism and postmodernism pose to fundamentalism and concludes that these challenges render the position philosophically untenable, thereby undermining the received conception of the foundations of international bioethics. The second article, which follows, offers an alternative model -- a model of negotiated moral order -- as a viable justification for international bioethics and for transcultural and transtemporal moral judgments.

Advisory Committees↗

PubMedDate not supplied

Medical care and postmodern management.

Because of the persistent influences of modern philosophies of management, health care has suffered from a monomania for economic thinking in a world thought of as a simple, unchanging machine. This form of management fails in the Netherlands, even in its own economic terms. We argue that best management is postmodern management and is inspired by postmodern thinking. It assumes that there is a non-reducible plurality of forms of life in human society which mostly interact in a powerful and complex way. It, therefore, stresses simplicity and dynamics in structure making. It advocates the principle of freedom, within constraints, for the staff of the medical organization. As a paradigm of new management we suggest the deconstruction of the present piecework payment per activity of doctors: it is static, expensive and fails to control the quality of medical care. Instead, two dynamic structures are suggested consisting of a payment per treated patient, together with the creation of a limited number of teams of highly qualified medical controllers. Both of these measures should improve the quality of health care as well as its cost-effectiveness.

Delivery of Health Care↗

PubMed1999

Postmodern attitudes about health: a population-based exploratory study.

OBJECTIVE: This paper presents a preliminary exploration of the prevalence of postmodern attitudes about health. DESIGN: In a region of southeastern Australia structured telephone interviews with a random sample of 209 participants. RESULTS: Responses suggesting postmodern attitudes to health were prevalent: the majority of respondents appear to hold a holistic view of health, believe in individual responsibility for achieving health, reject medical authority, hold consumerist values, prefer natural products over chemical drugs, think most prescription drugs have side effects, do not believe all illnesses require medication from doctors and hold anti-technology sentiments. However, results reveal that most people have much faith in science. CONCLUSION: Attitudes prevalent among the public in south eastern Australia are congruent with the philosophy of most complementary therapists. This may be one reason for the growth of complementary medicine.

Attitude to Health↗

PubMed1998

Nursing in the health care system of the postmodern world: crossroads, paradoxes and complexity.

Entering the postmodern world in which society is confronting crossroads, paradoxes, and complexity, the health care system is encountering a transformation more comprehensive and revolutionary than has ever been seen before. Analysis of the state of nursing vis a vis these transformations indicates that the current paradigm does not ensure the existence of the profession in the postmodern health care system. That is because of increased difficulties in consolidating the economic and quality issues into the core of nursing, and in understanding the complexity inherent in health related situations.

Health Care Reform↗

PubMed2001

Making midwives: postmodern conditions and midwifery training in Saint Lucia.

Drawing on material from fieldwork conducted on the island of Saint Lucia, I examine how Saint Lucian nurse-midwives and student midwives negotiate multiple ways of understanding and evaluating their practices and roles in light of contradictory and powerful cultural, historical, and political forces. I argue that, although Saint Lucian nurse-midwives may not qualify as "postmodern" according to the criteria proposed by Davis-Floyd and Davis (1996), they are nonetheless struggling with postmodern conditions as they negotiate between competing healing ideologies. I illustrate the significance of these negotiations through analyzing: (1) the ways nurse-midwives understand and articulate the healing ideologies at play in Saint Lucia, (2) historical and ideological aspects of the Saint Lucian nurse-midwifery training program, and (3) a classroom discussion during which student reported on "bush-midwives."

Attitude of Health Personnel↗

PubMed1996

A postmodern perspective on feminist gerontology.

This article argues the need for research in a feminist gerontology that is informed by postmodern and poststructuralist theories. Feminist gerontology is defined and described as part of a larger movement in the field toward critical gerontology. A brief summary of postmodern thought is followed by questions for researchers in gerontology and guidelines for feminist research which is interpretive, interactive, critical, and change-oriented.

Aged↗

PubMed2004

Surviving as a postmodern social worker: two Ps and three Rs of direct practice.

Social workers interested in postmodernism have been provided an abundance of theory, but little to guide them in direct practice in diverse child welfare roles. In this article, two Ps and three Rs of practice based on postmodernist principles are discussed: positioning, power, resource sharing, resistance, and reflection. Professionals working in the delivery of frontline human services are struggling to work both with and in communities to celebrate diversity and localized constructions of reality while fulfilling professional and agency mandates. Informed by the broad theory of postmodernism, the two Ps and three Rs of practice allow workers to be mandated agents of the system, while deconstructing their privileged position.

Canada↗

PubMed1997

Modernity, postmodernity and disability in developing countries.

This paper examines the implications of two theoretical perspectives, modernity and postmodernity, for provision of community-based disability services in developing countries. The author argues that modernity's embrace of the 'wonders' of science and technology have significantly affected our understanding of what community is. Modernity, in fact, leads us to view communities in one of two major ways: as inferior, or as ideal. Both views are deeply flawed. Postmodernity's profound scepticism of truth claims and authority provides a useful critique of community conceived in modern terms. The critique is helpful to the extent that it reveals the power of language in constructing our ideas of community. It also highlights a new way of thinking about participation, individualism and choice in community disability initiatives.

Developing Countries↗

PubMed1998

An emancipatory impulse: a feminist postmodern integrated turning point in nursing research.

This article critiques the current debates regarding feminism, postmodernism, and feminist/postmodernism within nursing research. The critique classified the debates into three identifiable constructs: dissatisfaction, fragmentation, and integration. The authors propose a solution from the integration debate as an emancipatory "workable" turning point for nursing research. The solution is situated within feminism and draws on the epistemological constructs of both modernism and postmodernism. Nursing research is framed within the proposed ontological links that characterize the integrated solution.

Female↗

PubMedDate not supplied

Reconceptualizing vulnerability: deconstruction and reconstruction as a postmodern feminist analytical research method.

Nursing research informed by postmodern feminist perspectives has prompted many debates in recent times. While this is so, nurse researchers who have been tempted to break new ground have had few examples of appropriate analytical methods for a research design informed by the above perspectives. This article presents a deconstructive/reconstructive secondary analysis of a postmodern feminist ethnography in order to provide an analytical exemplar. In doing so, previous notions of vulnerability as a negative state have been challenged and reconstructed.

Anthropology, Cultural↗