Newcastle University, Newcastle University Business School, 5 Barrack Road, Newcastle upon Tyne, NE1 4SE, UK.
Soc Sci Med. 2019 Jun;230:1-8. doi: 10.1016/j.socscimed.2019.03.038. Epub 2019 Mar 26.
This paper examines how power and knowledge are involved in the workings of speech and language therapy and in the work of speech and language therapists (SLTs). The paper draws on Foucault for its conceptual frame, with reference to his exposition of governmentality, biopolitics and pastoral power. Based on interviews with thirty-three SLTs in the UK, the findings show that evidence-based practice (EBP) is ever-present in speech and language therapy, despite its apparent absence; and that its power circulates in a multitude of ways. EBP as a process, and not an outcome, was workable. When competent practice was at risk, however, the SLTs challenged the dominance of EBP by saying it needed to 'get real' but then were troubled when it did. Working the 'wise' - those people involved with the client, including the SLTs themselves - was key to speech and language therapy; as was the making of subjects into biopolitical objects. At its most rewarding, but also most personally challenging, the work of SLTs involves mediating between different ways of being in the world and reimagining life, personhood and citizenship; to capture this complex labour process, the paper introduces the term 'pastoral labour'.
本文探讨了权力和知识如何参与言语治疗师的工作以及言语治疗师（SLTs）的工作。本文借鉴了福柯的概念框架，参考了他对治理、生命政治和牧领权力的阐述。基于对英国 33 名言语治疗师的访谈，研究结果表明，尽管证据为本实践（EBP）在言语治疗中明显缺失，但它却无处不在，而且其权力以多种方式流通。EBP 作为一个过程，而不是结果，是可行的。然而，当胜任的实践面临风险时，言语治疗师会通过说 EBP 需要“变得真实”来挑战其主导地位，但当它变得真实时，言语治疗师又会感到困扰。对“明智”的人——包括客户在内的涉及客户的人，包括言语治疗师自己——进行工作是言语治疗的关键；将主体制成为生命政治对象也是如此。最有意义的是，也是最具个人挑战性的，言语治疗师的工作涉及调解不同的世界观和重新想象生活、人格和公民身份；为了捕捉这一复杂的劳动过程，本文引入了“牧领劳动”一词。
