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“Bads” in healthcare: Negative experience as an impetus to reform in nineteenth and twentieth centuries
From Thursday 21 June 2018
To Friday 22 June 2018
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Cultural expectations of ‘good care’ change according to context. They vary according to time and place. They are constantly shaped and reshaped by knowledge and techniques of health professions; by bodily and emotional needs and sensations; by symbols and rituals of attention and of sympathy; by religious ideas; and by views of justice, of caring human relations and of the person’s dignity. Individual experiences sometimes harmonize with expectations so that patients, and their nurses, midwives and physiotherapists, all feel satisfied. But sometimes, whether during birth, while nursing a newborn or a dying person, or whether engaging in some other healthcare process, things can and do go wrong. Bad things can happen – and these can be compounded by the failure of systems to intervene, to ‘turn things around’. Those involved can be left with negative experiences and may suffer consequences. According to the Dutch Philosopher Annemarie Mol such experiences are termed ambiguously as “bads” in care: “There is something else that bothers me. It is that somehow writing about the goods of care is just too nice. Too cosy. There are also bads to address, but how to do so?”1

This international Conference will provide an opportunity for scholars from a range of disciplines to debate historical research relating to this subject. It will consider both individual and collective experiences of healthcare; explanations for bad care; and descriptions of ways in which individuals and groups have attempted to find impetus for reform. The history of Europe and its colonies in the 19th and 20th Centuries contain many examples of so-called “bads” in healthcare. During this time science based medical knowledge and techniques gained a powerful position within the logics of care and within the systems and practices of health professions. “Good” healthcare was redefined. And yet, the materiality, symbolisms and rituals of care continued to be understood in terms of the Judao-Christian religious context, coupled with bourgeois ideas of social justice, moral behaviour and human dignity. Through decades, different cultures of care responded to what they considered “bad” in attention, protection or kindness. During the “Age of Extremes” (1914-1991) – to use the term coined by Eric Hobsbawn – totalitarian ideologies and race biology, dictatorial regimes, authoritarian societies and economies at war put pressure on the multifaceted cultures of care; at times, healthcare was perverted and destroyed by these ideologies and political pressures.

From the 1960s on, organisations of victims and of patients, social and feminist movements as well as critical scholars launched historical studies and social inquiries to disclose neglect, failures of care, mistreatments and abuse in medical, psychiatric and foster care institutions in past and present. These processes are still ongoing and they contribute to reforms in healthcare, to acts of apology, to compensation and to commemorative cultures. The history of nursing, midwifery, physio- and other health therapies started to investigate the past role and responsibilities of denominational nurses and health professionals from the 1990s onwards. The aim of this European conference is to enlarge our understanding of how these professions were interlinked with “bads” in healthcare, of how they addressed and responded to negative experiences and how they contributed to the improvement of healthcare in the 19th and 20th centuries.

  1. Annemarie Mol: Care and its values. Good food in the nursing home, in: Mol, Annemarie, e. al. (eds.): Care in Practice. On Tinkering in Clinics, Homes and Farms, Bielfeld 2010, p. 215- 234, here p. 229.
Location Zurich University of Applied Sciences (ZHAW), School of Health, Winterthur (Switzerland).
Sabina Roth
freiberufliche Historikerin
Grossmannstrasse 34
CH-8049 Zürich

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