On the Politics of Ignorance in Nursing and Healthcare
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Downloaded by [New York University] at 09:35 13 September 2016 On the Politics of Ignorance in Nursing and Healthcare Ignorance is mostly framed as a void, a gap to be filled with appropriate knowledge. In nursing and healthcare, concerns about ignorance fuel searches for knowledge expected to bring certainty to care provision, preventing risk, accidents or mistakes. This unique volume turns the focus on ignorance as something productive in itself, and works to understand how ignorance and its operations shape what we do and do not know. Focusing explicitly on nursing practice and its organisation within con- temporary health settings, Amélie Perron and Trudy Rudge draw on con- temporary interdisciplinary debates to discuss social processes informed by ignorance, ignorance’s temporal and spatial boundaries, and how ignorance defines what can be known by specific groups with differential access to power and social status. Using feminist, postcolonial and historical analyses, this book challenges dominant conceptualisations and discusses a range of ‘non- knowledges’ in nursing and health work, including uncertainty, abjection, denial, deceit and taboo. It also explores the way dominant research and managerial practices perpetuate ignorance in healthcare organisations. In health contexts, productive forms of ignorance can help to future-proof understandings about the management of healthy/sick bodies and those caring for them. Linking these considerations to nurses’ approaches to chal- lenges in practice, this book helps to unpack the power situated in the use of ignorance, and pays special attention to what is safe or unsafe to know, from both individual and organisational perspectives. On the Politics of Ignorance in Nursing and Healthcare is an innovative Downloaded by [New York University] at 09:35 13 September 2016 read for all students and researchers in nursing and the health sciences inter- ested in understanding more about transactions between epistemologies, knowledge-building practices and research in the health domain. It will also be of interest to scholars involved in the interdisciplinary study of ignorance. Amélie Perron is Associate Professor in the School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada. Trudy Rudge is the Professor of Nursing (Social Sciences and Humanities) at Sydney Nursing School, University of Sydney, Australia. Routledge Key Themes in Health and Society Available titles include: Turning Troubles into Problems Clientization in human services Edited by Jaber F. Gubrium and Margaretha Järvinen Compassionate Communities Case studies from Britain and Europe Edited by Klaus Wegleitner, Katharina Heimerl & Allan Kellehear Exploring Evidence-based Practice Debates and challenges in nursing Edited by Martin Lipscomb On the Politics of Ignorance in Nursing and Healthcare Knowing ignorance Amélie Perron and Trudy Rudge Forthcoming titles include: Empowerment A critique Downloaded by [New York University] at 09:35 13 September 2016 Kenneth McLaughlin Living with Mental Disorder Insights from qualitative research Jacqueline Corcoran On the Politics of Ignorance in Nursing and Healthcare Knowing ignorance Amélie Perron and Trudy Rudge Downloaded by [New York University] at 09:35 13 September 2016 Add AddAddAdd Add Add AddAdd AddAdd AddAdd First published 2016 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 A. Perron and T. Rudge The right of Amélie Perron and Trudy Rudge to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Perron, Amélie, author. On the politics of ignorance in nursing and healthcare : knowing ignorance / Amélie Perron and Trudy Rudge. p. ; cm. -- (Routledge key themes in health and society) Includes bibliographical references and index. I. Rudge, Trudy, author. II. Title. III. Series: Routledge key themes in health and society. [DNLM: 1. Nursing. 2. Politics. WY 16.1] RT41 610.73--dc23 2015008183 ISBN: 978-1-138-81966-5 (hbk) ISBN: 978-1-315-74427-8 (ebk) Typeset in Times New Roman by Taylor & Francis Books Downloaded by [New York University] at 09:35 13 September 2016 The certainty of incoherence in reading, the inevitable crumbling of the soundest constructions, is the deep truth of books. Since appearance constitutes a limit, what truly exists is a dissolution into common opacity rather than a development of lucid thinking. The apparent unchangingness of books is deceptive: each book is also the sum of the misunderstandings it occasions. Georges Bataille, The Bataille Reader (Botting, F. and S. Wilson. (1997). The Bataille Reader. Oxford: Wiley-Blackwell.) Downloaded by [New York University] at 09:35 13 September 2016 ‘Perron and Rudge provide an indispensable and clearly articulated work that situates the concept of ignorance in its rightful place as knowledge. The remarkable notion that nurses and others in health care pay attention to what is unknown, silenced, hidden, glossed over, and simply ignored should become an essential—a foundation to practice that is rooted in critical ana- lysis. This is an important book as we head further into the 21st century, where the recognition and acknowledgement of what we do not know may be just the thing that saves humans and the planet. On the Politics of Ignorance in Nursing and Health Care is imperative reading to underpin the framework of any pedagogical, scholarly, clinical, administrative, or activist endeavor.’ Paula N. Kagan, PhD, RN, Associate Professor, School of Nursing, DePaul University Chicago, USA Editor, Philosophies and Practices of Emancipatory Nursing: Social Justice as Praxis, Routledge, 2014 (with Marlaine C. Smith and Peggy L. Chinn) ‘Perron and Rudge have delivered a provocative and original work. Shining a light on the darkness of ignorance, the authors reveal its uses and its political power in health care policy and practice. An intelligent and penetrating piece of scholarship, this is a book to unsettle the reader’s certainties. Be prepared to embrace an ethics of discomfort!’ Sioban Nelson, Professor, Vice-Provost Academic Programs, Vice-Provost Faculty and Academic Life, University of Toronto, Canada Downloaded by [New York University] at 09:35 13 September 2016 Contents Acknowledgments viii 1 Introduction 1 2 Ignorance: Current conceptualisations 12 3 Ignorance: Knowledge interrupted 29 4 Abjection, taboo and dangerous knowledge 43 5 The (bio)politics of ignorance 56 6 Ignorance in nursing: Its uses and abuses 69 7 Conclusion 81 Abbreviations 88 References 89 Index 107 Downloaded by [New York University] at 09:35 13 September 2016 Acknowledgments We wish to acknowledge all those nurses who ‘know’, whether intuitively, empirically or experientially, and whose knowledge continues to be resisted and ignored. We would also like to acknowledge participants and colleagues who provided feedback and wide-ranging discussions about ignorance in all its forms. We would like especially to acknowledge our colleagues Sandra West and Virginia Mapedzahama, who were our first collaborators on these matters;1 participants at the Philosophy in the Nurses’ World, Banff,CanadaMay25–27, 2014, where Trudy Rudge presented on ‘What has ignorance got to do with it?’; and Colleen Varcoe and the participants at the CRiHHI Critical Inquiry series, Nursing School, UBC, Vancouver, Canada—thank you for your interest and feedback about a paper entitled ‘White ignorance: A lens to “explore” settler societies and discredited knowledge(s)’. Downloaded by [New York University] at 09:35 13 September 2016 1 This is part of a research project on black migrant nurses: Mapedzahama, V., T. Rudge, S. West and A. Perron (2011). ‘The unknowing ‘other' or un/knowing the ‘other'? Theorising ignorance and the maintenance of white privilege in Australian nursing workplaces.’ New Orleans, 6th International Conference on Interdisciplinary Social Sciences. 1 Introduction It is a common sentence that Knowledge is power; but who hath duly considered or set forth the power of Ignorance? George Eliot, Daniel Deronda, 1876 Up to this time in the history of man there has, with few exceptions, been an infatuated pursuit of this will-o’-the wisp, knowledge. Why should not man now turn his glance to ignorance, if it were only for a little while and for the sake of fair play? Richard Dowling, Ignorant Essays, 1858 These two quotes, published twenty years apart during the nineteenth century, provide an interesting starting point for our introduction because both indicate a rupture with the dominance of knowledge as the only way to ‘know’. They also suggest a view of ignorance as something worthy of thinking and exploration, if only for balance and ‘fairness’.