McMaster University, Hamilton, ON, Canada L8N 3Z5.
Nurs Inq. 2009 Sep;16(3):261-72. doi: 10.1111/j.1440-1800.2009.00450.x.
Notwithstanding the remarkable achievements made by medical science over the last half of the twentieth century, there is a palpable sense that a strictly medical view of human health, that is one founded on modernist assumptions, has become problematic, if not counterproductive. In this study, I argue that as nursing continues to eagerly welcome and indeed champion medical epistemology in the form of knowledge transfer, evidence-based practice, research utilization, outcomes-based practice, quantifiable efficiency and effectiveness, it risks becoming little more than a medical science addendum and indeed one that inherits the problems now facing contemporary medicine. The purpose of this study then is to attempt to resituate nursing as a discipline at work within an ontopolitical matrix of radical democratic pluralism. I begin by tracing a philosophical line from Kuhn's paradigms to Bloor's strong programme of Sociology of Scientific Knowledge. Following this, I attempt to explicate the thought of Bruno Latour as a philosophical alternative to Sociology of Scientific Knowledge. Next, I outline the radical pluralism of William Connolly in an effort to demonstrate its similarity to Latour's philosophy and finally how such a position is germane to contemporary nursing and the reality of politics. I do this with reference to the controversial issue of illicit drug use and harm reduction. In effect, I argue that such an issue cannot be dealt with using scientific evidence alone, but rather requires a philosophy of advocacy, what I term democratic advocacy, that is capable of responding to the politics of suffering, which is to say suffering that results from identity/difference.
尽管医学在过去的半个世纪取得了显著的成就，但人们明显感觉到，一种严格的医学健康观，即基于现代主义假设的健康观，已经变得有问题，如果不是适得其反的话。在这项研究中，我认为，随着护理继续热情地欢迎并确实拥护医学认识论，以知识转移、循证实践、研究利用、基于结果的实践、可量化的效率和效果的形式，护理有风险成为仅仅是医学科学的附录，甚至继承了当代医学所面临的问题。因此，本研究的目的是试图将护理重新定位为一门在激进民主多元主义的本体政治矩阵中运作的学科。我首先从库恩的范式追溯到布洛尔的科学知识社会学强纲领。之后，我试图阐明布鲁诺·拉图尔的思想，作为对科学知识社会学的哲学替代。接下来，我概述了威廉·康诺利的激进多元主义，以努力展示其与拉图尔哲学的相似之处，以及这种立场如何与当代护理和政治现实相关。我参考了关于非法药物使用和减少伤害的争议性问题来做到这一点。实际上，我认为，仅仅依靠科学证据是无法处理这样的问题的，而是需要一种倡导哲学，我称之为民主倡导，它能够应对苦难的政治，也就是说，由身份/差异导致的苦难。
