Behind the medical mask : medical technology and medical power
This thesis explores the role of technology as a resource in the structure of medical domination of birth and death, stressing technology's pivotal position at the intersection of control and uncertainty. Based in Intensive Care and Obstetrics (between which the health status of patients diverges sharply), it notes the convergence of technology used and examines the contest for control within the labour process. This includes using technology to facilitate a 'standardized' birth or death; a more retrospectively defensible event. In general, the 'burden of proof' is concluded to lie with those wishing not to intervene rather than the reverse. Given the (cognitively male) biomedical model, mind-body dualism is an assumption embedded in medical technology: this is especially significant in childbirth, where it fractures the woman's ontological experience of giving birth. Its positivistic and pathological emphasis is associated with a reification of processes and a commodification of their 'solution': which becomes located in technology. It is argued that commodification in health provision will increase with the further application of market principles to the NHS. It is concluded that 'uncertainty', endemic to medicine and a possible challenge to control, is proactively manipulated and pressed into the service of medical domination. Technology is used to mask uncertainty and aid the medical profession's control of patients/relatives, and subordinate work groups. A technological fix may be viewed as the opposite to re-discovering societal dreams and myths, however, more paradoxically, it is concluded that dreams and myths have become attached to technology. Thus, the symbolic role of technology is: to provide hope of continued survival (or cure), the veiling of existential uncertainty and the offer of 'absolution' - should all efforts fail (a freedom from guilt in the assurance that "everything possible was tried"). Its 'heroic' project is viewed as an existentially 'masculine' health provision and 'feminized' health care is posited as an alternative.