Jensen Casper Bruun
Department of Organization and Industrial Sociology, Copenhagen Business School, Kilen, Kilevej 14A, 4.56, 2000 Frederiksberg, Denmark.
Health Care Anal. 2008 Dec;16(4):355-74. doi: 10.1007/s10728-007-0076-2. Epub 2007 Dec 18.
Power, dominance, and hierarchy are prevalent analytical terms in social studies of health care. Power is often seen as residing in medical structures, institutions, discourses, or ideologies. While studies of medical power often draw on Michel Foucault, this understanding is quite different from his proposal to study in detail the "strategies, the networks, the mechanisms, all those techniques by which a decision is accepted" [Foucault, M. (1988). In Politics, philosophy, culture: Interviews and other writings 1977-84 (pp. 96-109). New York: Routledge]. This suggestion turns power into a topic worth investigating in its own right rather than a basic analytical resource. It also suggests that technologies form an integral part of the networks and mechanisms, which produce and redistribute power in medical practice. The paper first engages critically with a number of recent discussions of technology and power in health care analysis. It then formulates an alternative conception of this relationship by drawing on Foucault and historian of science and technology Geoffrey C. Bowker's notions of infrastructural inversion and information mythology. Illustration is provided through a case study of a wireless nursing call system in a Canadian hospital.
权力、支配地位和等级制度是医疗保健社会研究中普遍使用的分析术语。权力通常被视为存在于医疗结构、机构、话语或意识形态之中。虽然对医疗权力的研究常常借鉴米歇尔·福柯的观点，但这种理解与他提出的详细研究“决策被接受所凭借的策略、网络、机制以及所有那些技术”的建议截然不同[福柯，M.（1988年）。《政治、哲学、文化：1977 - 1984年访谈及其他著作》（第96 - 109页）。纽约：劳特利奇出版社]。这一建议将权力变成了一个本身就值得研究的主题，而非一种基本的分析资源。它还表明，技术是网络和机制的一个组成部分，这些网络和机制在医疗实践中产生并重新分配权力。本文首先批判性地参与了近期关于医疗保健分析中技术与权力的一些讨论。然后，通过借鉴福柯以及科学技术史学家杰弗里·C·鲍克的基础设施倒置和信息神话概念，阐述了这种关系的另一种概念。通过对加拿大一家医院的无线护理呼叫系统的案例研究进行说明。
