Disputes over the figures of the COVID-19 pandemic: Epistemic diversity, dissemination of science, and political opposition.

The health policies imposed by multiple national governments after the emergence of SARS-CoV-2 were publicly justified by official figures on the deaths that the new virus would have caused and could cause in the future. At the same time, however, groups of people from different countries expressed their scepticism about those figures. Although they were categorised as 'anti-science', 'spreaders of misinformation' or 'conspiracy theorists' in some media, many of those sceptics claimed to be based on scientific evidence. This article qualitatively analyses a sample of the content published by sceptics on their social media between 2020 and 2022. More specifically, it examines the shared documents supposedly coming from the scientific community. We find very diverse content ranging from unsubstantiated assumptions to documents produced by prestigious scientists inviting questions about the fatality rates, the mathematical models anticipating millions of deaths, and the real numbers of people who died from COVID-19. The disputes surrounding the official figures lead us to a reflection about the relationship between, epistemic diversity, the dissemination of science, censorship, and new forms of political opposition. We also touch upon the nature and ethics of scientific controversy in times of a 'war' against 'misinformation'.

Social justice in Canadian nursing professional documents: A Foucauldian discourse analysis.

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.

Violence, Misrecognition, and Place: Legal Envelopment and Colonial Governmentality in the Upper Skeena River, British Columbia, 1888.

This paper is concerned with exploring legal atmospheres during colonial expansionism and the early period of confederation of British Columbia. By describing the theatrical and performative aspects of legal colonialism, the archival documents from this time represent interesting, yet oft-overlooked, significances that attention to sensory and affective experiences captures. Examining "affective atmospheres" disclosed in such colonial settings reveals ways that the colonial regime promulgated its influence in non-rational, non-legal manners. As well, drawing out the material conditions of topography shows how the environment acts more than just a backdrop for the staging of legal expansionism, as it acts also as a constitutive force in the development of colonial legal arrangements. At the same time, the colonial regime was forgetful of these same contextual, topographical, and atmospheric origins of law insofar as it promulgated myths of the universality, objectivity, and superiority of English law.

Practising care in a pandemic: Accounting for everyday life during COVID-19 among people who inject drugs.

From the outset of the COVID-19 pandemic, fears have been raised worldwide regarding the unique challenges facing socially marginalised people such as those who inject drugs. This article draws on in-depth interviews conducted during the first year of the pandemic with people who inject drugs living in urban and regional Australia. Perhaps the most surprising finding to emerge was the number of participants who reported minimal disruption to their everyday lives, even improved wellbeing in some instances. Attempting to make sense of this unanticipated finding, our analysis draws on the concept of 'care', not as a moral disposition or normative code but as something emergent, contingent and realised in practice. Working with Foucault's ethics and recent feminist insights on the politics of care from the field of Science and Technology Studies, we explore how care was enacted in the everyday lives of our participants. We examine how participants' daily routines became objects of care and changed practice in response to the pandemic; how their ongoing engagement with harm reduction services afforded not only clinical support but vital forms of social and affective connection; and how for some, care was realised through an ethos and practice of constrained sociality and solitude.

The salutogenic gaze: Theorising the practitioner role in complementary and alternative medicine consultations.

Research on why people use complementary and alternative medicine (CAM) shows clients value the CAM consultation, where they feel listened to and empowered to control their own health. Such 'empowerment' through CAM use is often theorised as reflecting wider neoliberal imperatives of self-responsibility. CAM users' perspectives are well studied, but there has been little sociological analysis of interactions within the CAM consultation. Specifically, it is unclear how user empowerment/self-knowledge relates to the CAM practitioner's power and expert knowledge. We address this using audio-recorded consultations and interviews with CAM practitioners to explore knowledge use in client-practitioner interactions and its meaning for practitioners. Based on our analysis and drawing on Foucault (1973), The Birth of the Clinic: an archaeology of medical perception and Antonovsky (1979), Health, Stress and Coping, we theorise the operation of power/knowledge in the CAM practitioner-client dyad by introducing the concept of the 'salutogenic gaze'. This gaze operates in the CAM consultation with disciplining and productive effects that are oriented towards health promotion. Practitioners listen to and value clients' stories, but their gaze also incorporates surveillance and normalisation, aided by technologies that may or may not be shared with clients. Because the salutogenic gaze is ultimately transferred from practitioner to client, it empowers CAM users while simultaneously reinforcing the practitioner's power as a health expert.

Homo œconomicus: A Key for Understanding Late Modernity Narcissism?

This paper describes the form that narcissism takes in contemporary society in the light of Homo œconomicus - a concept developed by philosopher Foucault to describe a key figure of late modernity: the entrepreneur of himself whose core values are utility (every action must be directed towards production) and optimization (what costs more than it produces is a dead branch to be cut). Homo œconomicus is the subject of so-called "achievement society." Its imperative is summed up in the formula "You can!" that generates heavy constraints because it is introjected as "If I can, then I must!," and self-coercion is more fatal than hetero-coercion because no resistance can be put up against oneself. He is also the subject of the "society of the spectacle" in which a part of the world represents itself in front of the rest of the world and shows itself to be superior to it. The spectacle is not simply a set of images, but a type of social relationship between people mediated by images, generating alienation from oneself and from the Other. Using Homo œconomicus as a grid for understanding contemporary pathological forms of narcissism, I describe the values and the life-world of narcissistic persons including the ways they experience time, space, others, and their own body. I finally suggest a therapeutic of this form of existence based on the recognition of its value-structure.

The foundations of influencing policy and practice: How risk science discourse shaped government action during COVID-19.

COVID-19 demonstrated the complex manner in which discourses from risk science are manipulated to legitimize government action. We use Foucault's theory of Governmentality to explore how a risk science discourse shaped national and local government action during COVID-19. We theorize how national government policymakers and local government risk managers were objectified by (and subjectified themselves to) risk science models, results, and discourses. From this theoretical position we analyze a dataset, including observations of risk science discourse and 22 qualitative interviews, to understand the challenges that national government policymakers, risk scientists, and local government risk managers faced during COVID-19. Findings from our Foucauldian discourse analysis show how, through power and knowledge, competing discourses emerge in a situation that was disturbed by uncertainty-which created disturbed senders (policymakers and risk scientists) and disturbed receivers (risk managers) of risk science. First, we explore the interaction between risk science and policymakers, including how the disturbed context enabled policymakers to select discourse from risk science to justify their policies. This showed government's sociopolitical leveraging of scientific power and knowledge by positioning itself as being submissive to "follow the science." Second, we discuss how risk managers (1) were objectified by the discourse from policymakers that required them to be obedient to risk science, and paradoxically (2) used the disturbed context to justify resisting government objectification through their human agency to subjectify themselves and take action. Using these concepts, we explore the foundation of risk science influence in COVID-19.

Our individual order of things directs how we think we feel.

ABSTRACTOur work draws upon Foucault's idea that the order of things, defined as the way we categorise our world, matters for how we think about the world and ourselves. Specifically, and drawing upon Pekrun's control-value theory, we focus on the question of whether the way we individually order our world into categories influences how we think about our typically experienced emotions related to these categories. To investigate this phenomenon, we used a globally accessible example, namely, the categorisation of knowledge based on school subjects. In a longitudinal sample of high school students (grades 9-11), we found that judging academic domains as similar led to judging typical emotions related to those domains as more similar than experienced in real life (assessed via real-time assessment of emotions). Our study thus shows that the order of things matters in how we think we feel with respect to those things.

Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity.

This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change.

An inconvenience to the nurse's practice: A Foucault-inspired study of ethnic minority patients.

Ethnic minority patients have been discussed and problematised in Western health literature. Drawing on an interpretation of central parts of the French philosopher Michel Foucault's authorship, we analysed a broad selection of materials to identify mechanisms through which the truth about ethnic minority patients is constructed. We identified a single, yet consistent discursive strategy that we termed 'figure of inconvenience' in which ethnic minority patients were classified and assigned a specific subjection illustrating them as 'inconvenient' to the nurse's practice. Concurrently, their relatives were afforded the position of substitutes. The discourse exemplifies how the behaviour or appearances of ethnic minority patients cannot be reconciled with the traits of ethnic Danish patients. Finally, we discussed implications that such a strategy may have for the provision of healthcare services for ethnic minority patients in Denmark.

How identity is produced and experienced in the context of mandated community-based mental health care: An application of the theories of Grosz and Foucault.

Despite changes to research and practice, that, to some degree, acknowledge that people are shaped by their contexts, the treatment of mental illness remains largely focused on interventions that take place at the level of the individual. Conceptualizing mental illness as something that resides in individuals can lead to reliance on neurobiological and psychotherapeutic solutions, and away from conversations about not only contextual causes of mental distress, but also sociopolitical solutions to mental distress. Further, it can lead to the use of mental health interventions that focus on the biology of an individual without a consideration for how those interventions themselves may have psychological, social, or political consequences that act to shape an individual's identity, agency, and relationship to their community. This paper examines one medicolegal intervention, the community treatment order, using the philosophical work of Grosz and Foucault to consider how this intervention affects the experience and construction of identity, and the impact of this on an individual's sense of agential membership in a community. This discussion aims to increase understanding of the individual and social implications of interventions for mental illness, and provide a conceptualization of the relationship between identity, agency, and ethics which can inform critical research and nursing practice more broadly.

"From the Known to the Unknown:" Nature's Diversity, Materia Medica, and Analogy in 18th Century Botany, Through the Work of Tournefort, the Jussieu Brothers, and Linnaeus.

The growth of botany following European expansion and the consequent increase of plants necessitated significant development in classification methodology, during the key decades spanning the late 17th to the mid-18th century, leading to the emergence of a "natural method." Much of this development was driven by the need to accurately identify medicinal plants, and was founded on the principle of analogy, used particularly in relation to properties. Analogical reasoning established correlations (affinities) between plants, moreover between their external and internal characteristics (here, medicinal properties). The diversity of plants, names, and botanical information gathered worldwide amplified confusion. This triggered the systematisation of the collection and referencing of data, prioritizing the meticulous observation of plant characteristics and the recording of medicinal properties as established by tradition: it resulted in principled methods of natural classification and nomenclature, represented by the genus, to enhance reliability of plant knowledge, which was crucial in medical contexts. The scope of botany increased dramatically, with new methods broadening studies beyond traditional medicinal plants. The failure of chemical methods to predict properties, particularly of unknown flora, amplified the reliance on analogy and on natural affinities.

Directives Limiting Care in the Perianesthesia Setting: A Foucauldian Case Study Report.

PURPOSE: The purpose of this inquiry is to explore how adult patients with limiting directives, their families, and clinicians make decisions about resuscitative status during anesthesia. Although current practice guidelines recommend mandatory reconsideration of do not resuscitate and other limiting directives before anesthesia, the automatic suspension of directives limiting care continues in the adult perianesthesia setting. How patients and clinicians talk about these limiting directives is underexplored in the literature. DESIGN: This qualitative inquiry used the Foucauldian Poststructural Case Study Design. METHODS: Data were collected through interviews and observation of patients with existing advance directives who underwent surgery, family members, and perianesthesia clinicians who participated in their care. Contextualizing analysis, a qualitative methodology that fits well with Foucauldian Poststructural Case Study Design, was used to rigorously examine the data. FINDINGS: Twenty-seven participants completed the observation and interview components of the study. Observation data were collected from an additional 18 participants. Four authoritative discourses that constructed choices available to patients and clinicians were identified. The "We'll just suspend" discourse permeates perianesthesia culture and produces a will to suspend the limiting directive among clinicians. Discourses about lack of time, a desire not to talk about advance directives unless it is essential to care, and confusion about who is responsible for addressing the limiting directive were also identified in the case. In addition, patients had difficulty translating advance directive choices into the perianesthesia context, and this difficulty may be misunderstood by clinicians as agreement with the plan of care. Finally, power networks may sequester knowledge about patients' choices, leading to tension among clinicians and creating barriers to honoring patients' advance directive choices. CONCLUSIONS: Results suggest that even where policies of mandatory advance directive reconsideration exist, patients may experience environments that constrain their choices and decision-making agency.

Foucault and medicine: challenging normative claims.

Some of Michel Foucault's work focusses on an archeological and genealogical analysis of certain aspects of the medical episteme, such as 'Madness and Civilization' (1964/2001), 'The Birth of the Clinic' (1973) and 'The History of Sexuality' (1978/2020a). These and other Foucauldian works have often been invoked to characterize, but also to normatively interpret mechanisms of the currently existing medical episteme. Writers conclude that processes of patient objectification, power, medicalization, observation and discipline are widespread in various areas where the medical specialty operates and that these aspects have certain normative implications for how our society operates or should operate. The Foucauldian concepts used to describe the medical episteme and the normative statements surrounding these concepts will be critically analyzed in this paper.By using Foucault's work and several of his interpreters, I will focus on the balance between processes of subjectification and objectification and the normative implications of these processes by relating Foucault's work and the work of his interpreters to the current medical discipline. Additionally, by focusing on the discussion of death and biopower, the role of physicians in the negation and stigmatization of death is being discussed, mainly through the concept of biopower. Lastly, based on the discussion of panopticism in the medical discipline, this paper treats negative and positive forms power, and a focus will be laid upon forms of resistance against power. The discussed aspects will hopefully shed a different and critical light on the relationship between Foucault's work and medicine, something that eventually can also be deduced from Foucault's later work itself.

Farewell to humanism? Considerations for nursing philosophy and research in posthuman times.

In this paper, I argue that critical posthumanism is a crucial tool in nursing philosophy and scholarship. Posthumanism entails a reconsideration of what 'human' is and a rejection of the whole tradition founding Western life in the 2500 years of our civilization as narrated in founding texts and embodied in governments, economic formations and everyday life. Through an overview of historical periods, texts and philosophy movements, I problematize humanism, showing how it centres white, heterosexual, able-bodied Man at the top of a hierarchy of beings, and runs counter to many current aspirations in nursing and other disciplines: decolonization, antiracism, anti-sexism and Indigenous resurgence. In nursing, the term humanism is often used colloquially to mean kind and humane; yet philosophically, humanism denotes a Western philosophical tradition whose tenets underpin much of nursing scholarship. These underpinnings of Western humanism have increasingly become problematic, especially since the 1960s motivating nurse scholars to engage with antihumanist and, recently, posthumanist theory. However, even current antihumanist nursing arguments manifest deep embeddedness in humanistic methodologies. I show both the problematic underside of humanism and critical posthumanism's usefulness as a tool to fight injustice and examine the materiality of nursing practice. In doing so, I hope to persuade readers not to be afraid of understanding and employing this critical tool in nursing research and scholarship.

Using Foucault to (re)think localisation in chronic disease care: Insights for nursing practice.

Ageing populations and rising rates of chronic disease globally have shifted key elements of disease management to ideas of integrated care and self-management. The associated policies and programmes often focus on intervention and support beyond the sites of the hospital and clinic. These shifts have significantly impacted the delivery and practice of nursing for both nurses and the clients with whom they work. This article argues that Foucault's comments on space, place and heterotopia (1986) are useful in exploring these changes from a philosophical perspective, to draw out the complexity of these programmes and add texture to discussions on the ways these shifts to localisation and the dominant discourses of self-management and responsibility have reconfigured nursing practices. The theoretical discussion is augmented with illustrations from an Australian integrated health care programme.

Subjectivity as the site of struggle: students' perspectives toward sino-foreign cooperation universities in the era of discursive conflicts.

While students' perspectives are crucial for international/transnational institutions' development, their preferences towards certain values should not be taken for granted, as the possibility of lived experience is confined by individuals' subjectivity, which derives from power and knowledge but does not depend on them (Deleuze; Foucault, 1988). Drawing on empirical data collected from Chinese sino-foreign cooperation universities, this study illustrates how the constructed neoliberal and authoritarian subjectivity influences students' perception towards the enrolled universities, and their struggle in self-examination about what counts as truth, especially privileged by the discursive conflicts. It further argues while such critique to the politically imposed discourses represents the first step for "the care of the self" as Foucault proposes, the students have inevitably confronted the danger of the sense of lost.

Turning the gaze: Digital patient feedback and the silent pathology of the NHS.

Online review and rating sites, where patients can leave feedback on their experience of the health-care encounter, are becoming an increasing feature of primary care in the NHS. Previous research has analysed how digital surveillance is re-shaping the clinical gaze, as health-care professionals are subject to increased public monitoring. Here, we draw on an empirical study of 41 GP practice staff to show how the gaze is turning, not simply from the patient to the health-care provider, but additionally to the body politic of the NHS. Drawing on focus group and interview data conducted in five UK practices, we show how discourses of online reviews and ratings are producing new professional subjectivities among health-care professionals and the extent to which the gaze extends not only to individual health-care interactions but to the health-care service writ large. We identify three counter-discourses characterising the evolving ways in which online reviews and ratings are creating new subjects in primary care practices: victimhood, prosumption versus traditional values and taking control. We show how the ways in which staff speak about online feedback are patterned by the social environment in which they work and the constraints of the NHS they encounter on a day-to-day basis.

Physiotherapists Both Reproduce and Resist Biomedical Dominance when Working With People With Low Back Pain: A Qualitative Study Towards New Praxis.

Despite recommendations to incorporate physical and psychosocial factors when providing care for people with back pain, research suggests that physiotherapists continue to focus on biological aspects. This study investigated how interpersonal and institutional norms influence this continued enactment of the biological aspects of management. We used theoretically-driven analysis, drawing from Foucauldian notions of power, to analyse 28 ethnographic observations of consultations and seven group discussions with physiotherapists. Analysis suggested that physiotherapy training established expectations of what a physiotherapist 'should' focus on, and institutional circumstances strongly drew the attention of physiotherapists towards biological aspects. Resistance to these forces was possible when, for example, physiotherapists reflected upon their practice, used silences and pauses during consultations, and actively collaborated with patients. These circumstances facilitated use of non-biomedical management approaches. Findings may assist physiotherapists to rework the enduring normative focus on biomedical aspects of care when providing care for patients with back pain.

Energy Communities and the Tensions Between Neoliberalism and Communitarianism.

The convergent development of (renewable) distributed electricity sources, storage technologies (e.g., batteries), 'big data' devices (e.g., sensors, smart meters), and novel ICT infrastructure matching energy supply and demand (smart grids) enables new local and collective forms of energy consumption and production. This socio-technical evolution has been accompanied by the development of citizen energy communities that have been supported by EU energy governance and directives, adopting a political narrative of placing the citizen central in the ongoing energy transition. But to what extent are the ideals that motivate the energy community movement compatible with those of neoliberalism that have guided EU energy policy for the last four decades? Using a framework inspired by Michel Foucault's idea of governmentality, we analyze the two political forms from three dimensions: ontological, economic and power politics. For the ontological and the economic dimensions, neoliberal governmentality is flexible enough to accommodate the tensions raised by the communitarians. In the dimension of power politics however, the communitarian logic does raise a fundamental challenge to neoliberal governmentality in the sense that it explicitly aims for a redefinition of the 'common good' of society's energy supply based on democratic premises.