The Needle and the Damage Done: Research, Action Research, and the Organizational and Social Construction of Health in the "Information Society"

Abstract

This paper critically reviews the action research paradigm that has evolved over the last 50 years within and outside The Tavistock Insitute, with reference to radical shifts in the social construction of medicine and health that are occurring as a result of the transition toward the "information society." The medical domain has been chosen as an appropriate space within which to review the action research paradigm because it bridges both the past and future of the Institute. The paper firstly considers the original conception of action research and sociotechnical systems, and the role of consultants, in relation to Foucualt's analysis of power relations, social control, and "dividing practices." It then describes and analyzes recent developments in the field of medicine and healthcare service provision that, on the one hand, offer opportunities for increased self-management and control by consumers over physical, social, and emotional "self-hood" and on the other could lead to further social surveillance and the domination and subjectification of the individual. Drawing on recent work using innovative models of action research in the field of HIV/AIDS, the paper concludes by discussing ways in which action research could harness developments in information and communication technologies to maximize individual and collective engagement in new forms of organizational and social relations.

Action research: Explaining the diversity

“…Yet despite a long history which originates, at the latest, with Lewin's application of experimental logic and social psychological theory to practical social problems (1946), it is simultaneously evident (Elden & Chisholm, 1993;Dickens & Watkins, 1999;Reason & Bradbury, 2001) that the meanings attached to the term, the sources of inspiration deployed and the practices it sanctions are so diverse that there appears to be no unifying theory. Indeed this diversity may be increasing with the recent appropriation of postmodernist discourse by some organizational researchers (Barry, 1997;Cullen, 1998;Treleaven, 2001).…”

The Internet, Global Healthcare Management Systems, and Sustainable Development: Future Scenarios

“…The healthcare systems of the twentieth century were characterized by hierarchies of institutional and professional control (Cullen, 1998;Rosenau, 1993;Kothari and Mehta, 1988;Foucault, 1982) while the global village of the twenty-first century is evolving towards inversion of economic, political and social hierarchies. Traditional institutions are becoming more integrated in technological healthcare markets and network infrastructures where professionals and consumers may be able to participate in a community model of healthcare, 5 or where the digital divide may yet deepen the inequalities between the privileged and the poor in the new world economy.…”

Multisector Collaboration: An Action Research Approach

“…Action inquiry operates not only on a number of levels, and in a number of different contexts but also across a number of different disciplines including management (Mårtensson and Lee, 2004), marketing (Perry and Gummesson, 2004), operations research (Prybutok and Ramasesh, 2005), education (Vecchiarelli et al, 2005), and medicine (Cullen, 1998). Irrespective of context and/or discipline, however, there are advantages to an actionoriented approach.…”