Connelly J
Nuffield Institute for Health, University of Leeds, Leeds, UK.
J Manag Med. 2000;14(5-6):262-71. doi: 10.1108/02689230010362882.
To date the practice of health sector management has not been sufficiently theorised. An adequate theory should be able to answer the pre-eminent critique of managerial rationality and ethics mounted by Alasdair MacIntyre in After Virtue and should also offer robust analytical and ethical resources to identify and engage with the social, political, economic and moral issues underlying health sector management. Critical realism with its ontology of generative mechanisms, agency-structure relationships, valorisation of activity and ideology critique offers such resources in an empirically orientated but adequately theorised realist framework. Rather than negate MacIntyre, critical realism incorporates and transcends his key arguments regarding the rationality and ethics of management. This article introduces the main elements of critical realism and clears a conceptual space for the cumulation of critical realist case-studies and managerial craft knowledge.
迄今为止，卫生部门管理实践尚未得到充分的理论阐释。一个恰当的理论应能够回应阿拉斯戴尔·麦金太尔在《追寻美德》中对管理合理性与伦理提出的卓越批判，还应提供强大的分析和伦理资源，以识别并应对卫生部门管理背后的社会、政治、经济和道德问题。批判实在论凭借其关于生成机制的本体论、行动者与结构的关系、对活动的价值评估以及意识形态批判，在一个以经验为导向但理论阐释充分的实在论框架中提供了此类资源。批判实在论并非否定麦金太尔，而是纳入并超越了他关于管理合理性与伦理的关键论点。本文介绍了批判实在论的主要要素，并为批判实在论案例研究和管理实践知识的积累清理出一个概念空间。
