How can health professionals respond to Postmodernism?

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A natural, reactive "human nature" response when our power-base is challenged is to simply strengthen it - to bolster it up with "more of the same". This defensive response may be coupled perhaps with an attack on the power-base of the challengers. I believe we are seeing this type of struggle already in the "evidence and reason" wars over antibiotic resistance and food safety. The deep wisdom of both marketing and philosophy tells us that once a "product" is deconstructed (loses consumer confidence) market resistance ensues as surely as night follows day. We can either accept that "sales" will never recover, or drain our resources trying to recapture lost dreams!

What role can healthcare workers and veterinarians play in a postmodernist situation?

The defeatist - also known as "Go to hell!" - option, when faced with a postmodernist challenge, is to totally abdicate professional power and responsibility - to "leave them to it" or "let them burn their fingers without me". This is neither a personally rewarding nor a financially rewarding line to follow. Will veterinarians be rejected or superfluous in the postmodern epoch of human history? I think not! The client-veterinarian and patient-Doctor relationship has been a bastion through troubled times and difficult decisions in the past and has great potential for the future. We could, for example, just re-package our professional services to be more palatable and constructively helpful to postmodern clients. Stockdale (2002) gives a nice example in connection with the breast-versus-bottle baby-feeding decisions...

The "modernist" approach was to "educate" mothers about the scientific research evidence in favour of the health-promoting, life-enhancing properties of breast-feeding. However, this approach created an experience of "responsibility, burden and self-sacrifice" in many scientifically-compliant suckling mothers and an experience of "guilt and secrecy" in those who, for lifestlye or suckling-problem reasons, did not breast-feed. Postmodernist midwives do not seek to directly influence the choice of feeding method in this way. Instead, they offer direct skin-to-skin contact between mother and infant immediately after birth. In most cases this experience of physical intimacy at a critical time initiates the natural propensity of the child to suck and the mother to suckle, without any need for a lengthy, reasoned debate. Mother and infant naturally enter a relaxed and mutually-nourishing experience. In some cases the mothers choose, or are forced by circumstances, to bottle feed their infants, but they are free to do this without reneging on an earlier commitment and without rejecting professional guidance.

The postmodernist client has learned that science is retrospective data derived from limited, carefully-controlled situations. Information of any kind, beliefs, diagnostic findings, experience, scientific research, field trials, ideas etc. can be helpful to the decision-making process, but the selection and communication of information (i.e. "education") easily becomes an authoritative process, riddled with bias and susceptible to hidden agendas. In this context the postmodernist veterinarian or Doctor is one who has evolved from the role of "authority figure" via "client educator" to the role of "client facilitator" (also known as "healer") offering the client timely experiences in self-awareness, self-discovery, self-education, self-empowerment and self-discipline (collectively bound in the cliche "personal growth"). The motivation for the client's participation in this relationship is the decision-maker's awesome creed: "The buck stops here!".


Decision-Making in Human & Veterinary Medicine: Introduction & Index   Author details


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