Neither Petri Dish Nor Statistic: Keeping the Personal and the Political in Health Care and Public Health
Brett McCarty, MDiv, ThD, Duke University, Durham, NC
Far too often, the work of both health care and public health is deeply depersonalizing. Like scientists gathered around a petri dish, physicians in lab coats can gather around an intubated patient whose story has been transformed into a series of lab results and machine readouts. And like statisticians examining a spreadsheet, public health professionals can examine a body politic whose common life has been transformed into population-level numbers. How are we to understand and respond to the dehumanization of vulnerable people?
This paper begins by giving a brief historical and philosophical overview of the reduction of persons in contemporary health care and public health. By drawing on Michel Foucault’s The Birth of the Clinic and his later work on biopower, as developed by Jeffrey Bishop in The Anticipatory Corpse (U. of Notre Dame Press, 2011), we can understand the modern loss of storied, communal existence. Over the last 250 years, there have been specific transformations in our understanding and practice of the care of both people and their communities, ranging from the birth of the modern clinic to the rise of technocratic state powers. By linking the dehumanizing forces in health care and public health, we can formulate a more adequate response that keeps both realities in mind.
The paper then seeks to offer constructive responses to these twin crises in health care and public health, drawing together both empirical and theoretical sources for each. In light of Bishop’s critique of health care, how might modern biomedicine not ultimately abstract person from their storied existence but instead order its interventions within a wider understanding of human existence and flourishing? Two empirical sources form this response. In Scott Stonington’s The Spirit Ambulance: Choreographing the End of Life in Thailand (UC Press, 2020), an anthropologist describes how families seek to craft good deaths for their elders in light of the (mal)formative power of biomedicine. In Wes Ely’s Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU (Scribner, 2021), a physician describes how work in the ICU has begun to consider the holistic human needs of the patient through practices like lighter sedation, earlier ambulation, and prioritizing patient stories and communities. By drawing from theoretical work in Eleonore Stump’s Wandering in Darkness: Narrative and the Problem of Suffering (Oxford, 2010), we can understand how such narrative-driven, “Franciscan” responses can inform and align with regnant analytic, “Dominican” modes of knowing.
Likewise, how might public health not depoliticize people but instead intervene in ways attentive to textured communal realities? The paper explores qualitative research conducted by the author on the contemporary opioid crisis to describe localized ways that public health responses can be attentive to the holistic common good. This work demonstrates possibilities for faith-based responses to draw together often-siloed sectors in collaboration. By drawing from the political theology of Luke Bretherton’s Resurrecting Democracy: Faith, Citizenship, and the Politics of a Common Life (Cambridge, 2014), the paper argues for how public health might intervene in ways that inculcate rather than enervate the political agency of communities. The paper then concludes by arguing for forms of agency in health care and public health that resist the dehumanization of vulnerable persons and their communities by holding together both the personal and the political in the work of care.
This paper begins by giving a brief historical and philosophical overview of the reduction of persons in contemporary health care and public health. By drawing on Michel Foucault’s The Birth of the Clinic and his later work on biopower, as developed by Jeffrey Bishop in The Anticipatory Corpse (U. of Notre Dame Press, 2011), we can understand the modern loss of storied, communal existence. Over the last 250 years, there have been specific transformations in our understanding and practice of the care of both people and their communities, ranging from the birth of the modern clinic to the rise of technocratic state powers. By linking the dehumanizing forces in health care and public health, we can formulate a more adequate response that keeps both realities in mind.
The paper then seeks to offer constructive responses to these twin crises in health care and public health, drawing together both empirical and theoretical sources for each. In light of Bishop’s critique of health care, how might modern biomedicine not ultimately abstract person from their storied existence but instead order its interventions within a wider understanding of human existence and flourishing? Two empirical sources form this response. In Scott Stonington’s The Spirit Ambulance: Choreographing the End of Life in Thailand (UC Press, 2020), an anthropologist describes how families seek to craft good deaths for their elders in light of the (mal)formative power of biomedicine. In Wes Ely’s Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU (Scribner, 2021), a physician describes how work in the ICU has begun to consider the holistic human needs of the patient through practices like lighter sedation, earlier ambulation, and prioritizing patient stories and communities. By drawing from theoretical work in Eleonore Stump’s Wandering in Darkness: Narrative and the Problem of Suffering (Oxford, 2010), we can understand how such narrative-driven, “Franciscan” responses can inform and align with regnant analytic, “Dominican” modes of knowing.
Likewise, how might public health not depoliticize people but instead intervene in ways attentive to textured communal realities? The paper explores qualitative research conducted by the author on the contemporary opioid crisis to describe localized ways that public health responses can be attentive to the holistic common good. This work demonstrates possibilities for faith-based responses to draw together often-siloed sectors in collaboration. By drawing from the political theology of Luke Bretherton’s Resurrecting Democracy: Faith, Citizenship, and the Politics of a Common Life (Cambridge, 2014), the paper argues for how public health might intervene in ways that inculcate rather than enervate the political agency of communities. The paper then concludes by arguing for forms of agency in health care and public health that resist the dehumanization of vulnerable persons and their communities by holding together both the personal and the political in the work of care.