Health Decisions & Education in a Post-Modern Culture

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Postmodernism has roots in the "flower-power" and "personal development" subcultures that grew up in the 1960s as reactions to the perceived failure of intellectual reasoning (in the shape of politics, science and technology) to provide authentic well-being for individuals and communities.

"Post-modernism" blossomed into the generalised, self-expressive and self-validating "me" culture of the late 20th century. Manifestations of "postmodernism" quickly spread in entertainment, commerce ("consumerism") and education. In agriculture, postmodernist culture has emerged in the forms of the "organic farming" and "sustainable agriculture" movements.

"Postmodernism" is now creeping inexorably into healthcare services as the authority of expert experience (often contradictory) and science (socially insensitive) is progressively deconstructed. The essence of emergent post-modernist thinking is the subjugation of the question "Is this information logically or scientifically valid?" to the question "Do I authorise myself to use this information?" (see Reflective Practice & Decision-making).


*Childcare & Education in a Post-modern New Age: A New Paradigm for Raising Kids?


Postmodernism in Veterinary Medicine was pre-empted for me by John Hill, a British pioneer of the use of abattoir data for disease surveillance, who shocked me 25 years ago by saying "Farmers don't want Veterinarians to solve their problems, they want Vets to 'hold their hand' and stop them doing anything silly, while they solve their own problems".

In the United Kingdom in 2001-2, a soaring postmodernist culture, fired by the disillusionment of expert failures over BSE, Salmonella in eggs, swine fever and foot and mouth disease (to name but a few) has just led to a huge crisis over the expert-led introduction of a new vaccine (MMR) for children. There has been a crescendo of public outcry against the vaccine, flying directly in the face of science-based expert opinion. The plain fact is that in many developed countries the authority of professional expertise, political argument, science and technology are in the advanced stages of deconstruction (loss of faith in their authority).

Loss of, or more often "diminution of", faith in health professionals and medical science arises from two common sources...

The first and most important, is an experience of the failure of these authorities to provide an adequate solution to a health problem. For example, the failure of computer epidemic modelling and veterinary authorities to halt the World's worst Foot and Mouth Disease epidemic in 2001 (report).
Failure does not have to be some kind of error, it can just be that medical authorities do not yet have an "answer" to the problem being presented.

The second major cause of loss of faith arises from the increased levels of education, networking and personal development of many clients/patients of the present generation. People have access to vast resources of information, which may lead them to question the authority or validity of information and advice offered to them.
Insubstantial information or advice are not the only issues which can lead clients to "deconstruct" the authority of their medical or veterinary carer. In a paper to the World Small Animal Veterinary Association, Dr. David Kuhl (see Decision-making in Business) remarked: "The greatest burden a patient [or animal owner] must bear is the unknown, unresolved emotion of the caregiver - our fears of death, of failure, of uncertainty, of isolation and despair may be projected onto the patient, so we delay giving the message, trivialize its impact, or speak coldly about a matter of life and death."


*How can health professionals respond to: Postmodernism?

*Review of Decision-Making in Human & Veterinary Medicine: Introduction




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