Pastoral power and the promotion of self‐care

Abstract

In many countries government policy is becoming increasingly reliant on citizens taking greater responsibility for their health and wellbeing and limiting their consumption of public services. In this paper I develop Foucauldian perspectives on the work required to create and maintain responsibilised subjects, focusing on the role of 'pastors' - specialists, experts and therapists who promote desirable subjectivities (Waring and Latif ). Drawing from ethnographic research, I consider how government policies for the promotion of self-care within the English healthcare system not only place increased emphasis on patients taking responsibility for their own health and wellbeing, but also seek to constitute new pastoral subjectivities as responsible for conducting the conduct of patients. I look at efforts to constitute pastoral subjectivities through an assemblage of management knowledge, educational practices and training materials. I argue that efforts to enrol and train pastors are unlikely to accomplish governmental objectives because of the availability of alternative guides for action drawn from professional training, established routines, and forms of social belonging.

Nurses' attitudes towards support for and communication about sexual health—A qualitative study from the perspectives of oncological nurses

“…The theoretical concepts of power, disciplining and normalisation have through many years provided an alternative view for research about the medical clinic, professionals and patients (Campbell, 2011;Cook & Brunton, 2015;Glasdam, Praestegaard, & Henriksen, 2013;Jones, 2018;McCabe & Holmes, 2014;McCarthy, 2010;Rose, 1990Rose, , 1994). Foucault regarded power as a relation.…”

Health Promotion Practices and Michel Foucault: A Scoping Review

“…Fourteen studies were developed in Brazil 11 -24 and 1 in Argentina. 25 Nine studies were developed in Europe: 4 in the United Kingdom, 26 -29 2 in Denmark, 30,31 2 in Sweden, 32,33 and 1 in Belgium. 34 Five studies were developed in North America: 4 in Canada 35 -38 and 1 in the United States.…”

“…The articles addressed the following HP practices: 13 addressed governmental and international organization HP policies and programs; 12,15,18,21 -24,26,30,32,33,37,39 8 addressed health education, medication adherence and change of habits carried out in individual appointments; 16,19,20,27,29,31,34,40 one addressed aging and physical activity 11 ; one addressed healthy eating and physical activity 36 ; 3 addressed health education campaigns for the prevention of infectious diseases with a behavioral approach 25,38,44 ; one addressed HP in the work environment 28 ; one addressed HP in the school space 43 ; one addressed traffic behavior and alcohol consumption while driving. 17…”

Community pharmacy and public health: preserving professionalism by extending the pharmacy gaze?

“…The 'pastoral' metaphor, conjuring the idea of flocks to be managed, can be extended to pharmacists as well as patients. In agreeing to act as conduits of disciplinary power, community pharmacists present opportunities for State regulation and intervention, thereby becoming subjects of disciplinary power themselves (Jones 2018). 'Pastoral power' and 'the pharmacy gaze' are embedded in a broader governmentality which operates as a form of power that exploits professional ambiguity to 'manage' the subjectivities of community pharmacists working in an increasingly corporate retail environment.…”