SUNDHED SOM SANDHED: En videnspolitisk intervention i det offentliges styring af sundhed og dennes betydning og konsekvenser for borgeren.

HEALTH AS TRUTH: A knowledge-political intervention in the public management of health and its importance and implications for the citizen.

Johansson, Nicolaj

4. semester

Idræt, Kandidat

2013

2013-06-03

71

Specialet undersøger, hvordan det offentlige, med en styringsmentalitet præget af ideen om, at sundhed er sandhed, forsøger at forme borgeres handlinger. Det ser også på, hvordan disse styringsstrategier er med til at skabe bestemte typer borgere og afgrænse borgerens mulighedsrum for at være borger. Formålet er at lave en videnspolitisk intervention, dvs. at udfordre, hvordan viden om sundhed bliver til og bruges, og derigennem udvide, hvad sundhed kan betyde. Metodisk bygger specialet på en genealogisk tilgang (at skrive nutidens historie), forstået som en videnspolitisk intervention, der identificerer og belyser ubekvemme fakta. Denne operationalisering af genealogien former det teoretiske begrebsapparat, som skal understøtte en anderledes historieskrivning af sundhed. Analysen bruger begreber som pastoralmagt (en måde at få mennesker til at styre sig selv), viden, magt og subjektivering (hvordan vi formes som bestemte slags borgere). Specialet konkluderer, at det offentlige, gennem forskellige former for styringsmentalitet, i høj grad forsøger at strukturere borgeres adfærd ved at præsentere sundhed som en ubestridt sandhed. Det snævrer borgerens mulighedsrum i relation til sundhed, fordi sandheden defineres ud fra bestemte kriterier for, hvad sundhed er, og hvordan man skal handle sundt. Når sundhed gøres til sandhed, bliver det et krav at være sund – både for den enkeltes og for samfundets skyld. Pastoralmagt viser sig, når myndigheder opfordrer den enkelte til at ændre adfærd og til at overtage sundhed som sandhed som eget mål. Det er styring på afstand, fordi borgeren selv forventes at ændre sig. Dermed fremstår valget groft sagt som at være loyal mod sig selv og fællesskabet ved at vælge sundheden – eller at lade være og risikere marginalisering. Samtidig viser specialet, at borgere i varierende grad kan indtage andre subjektpositioner ved at tillægge andre diskurser (forståelsesrammer) større vægt end diskursen om sundhed som sandhed.

This thesis examines how public authorities, guided by the idea that health equals truth, seek to shape citizens’ actions. It also explores how these governing strategies help construct certain kinds of citizens and limit the space of possibilities for being a citizen. The aim is to make a knowledge-political intervention, meaning a challenge to how knowledge about health is produced and used, in order to broaden what health can mean. Methodologically, the thesis uses a genealogical approach (writing a history of the present) as a knowledge-political intervention that identifies and highlights uncomfortable facts. This operationalization of genealogy informs the theoretical toolkit used to support a different account of the history of health. The analysis draws on concepts such as pastoral power (a way of getting people to govern themselves), knowledge, power, and subjectification (how we are shaped as particular kinds of subjects). The thesis concludes that public authorities, through different forms of governing mentality, strongly seek to structure citizens’ behavior by presenting health as an unquestioned truth. This narrows citizens’ room for maneuver around health, because truth is defined by specific criteria for what health is and how to act healthily. When health is treated as truth, being healthy becomes a direct requirement—both for the individual and for the common good. Pastoral power is evident when authorities invite or encourage individuals to change their behavior and to adopt health-as-truth as their own goal. This is governing at a distance, because the change is expected to be self-directed. As a result, the choice is framed, roughly, as being loyal to oneself and the community by choosing health—or opting out and risking marginalization. At the same time, the thesis shows that citizens can, to varying degrees, take up other subject positions by giving more weight to other discourses (frames of understanding) than the discourse of health as truth.

[Dette resumé er genereret ved hjælp af AI]

sundhed ; intervention ; magt ; viden ; subjekt ; styringsmentalitet ; genealogi

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