Medicine, Health, and the Public Sphere in Britain, 1600-2000

Medicine, Health, and the Public Sphere in Britain, 1600-2000

Medicine, Health, and the Public Sphere in Britain, 1600-2000

Medicine, Health, and the Public Sphere in Britain, 1600-2000

Synopsis

Medicine is concerned with the most intimate aspects of private life. Yet it is also a focus for diverse forms of public organization and action. In this volume, an international team of scholars use the techniques of medical history to analyse the changing boundaries and constitution of the public sphere from early modernity to the present day.In a series of detailed historical case studies, contributors examine the role of various public institutions - both formal and informal, voluntary and statutory - in organizing and coordinating collective action on medical matters. In so doing, they challenge the determinism and fatalism of Habermas's overarching and functionalist account of the rise and fall of the public sphere.Of essential interest to historians and sociologists of medicine, this book will also be of value to historians of modern Britain, historical sociologists, and those engaged in studying the work of Juuml;rgen Habermas.

Excerpt

The College of Physicians in early modern London

Margaret Pelling

We have only to conjure up such epithets as ‘public health’, ‘private practice’ and ‘secret remedies’ to begin to realize how intimate is the relationship between medicine and concepts of privacy and the public. Moreover, medicine, with its apparently unique ethical responsibilities focusing on human survival on the one hand, and confidentiality and the human mind and body on the other, seems to have a major influence on the value attached to these concepts. As this chapter will try to illustrate, value and meaning are interdependent. A shift in values causes one or the other concept to become better defined. In what follows, the aim is to use an early modern case study to reveal the decidedly ambivalent antecedents of what professionalized societies in general, and Habermas in particular, take for granted as being valued positively. The subject of the case study is a small, isolated, homosocial medical institution in London, the College of Physicians, in the period before the English civil wars. My concern is with something like a ‘history of interiority’ for a select group of highly educated males as expressed in an account of themselves—the College’s Annals—which was at least semi-public. The College’s attempts at defining both itself, and its opponents, in the wider world of London medicine involved a complex of meanings for public and private in which we can perhaps see the germs of the modern stress on privacy, itself an aspect of the hegemony of the middle class.

We can also discern in the College something like the literate, self-regulating detachment that Habermas idealized as essential to the authentic public sphere. However, this too calls for close inspection, and, as a result, proves to be a peculiarly constructed phenomenon indicative as much of weakness as of strength. If the College achieved detachment, it was as a side-effect of dependency. Further, the medical role itself can be shown to entail status and gender disadvantages that are intrinsic to the style and content of the physician’s connection with the political process, and to his influence on the demarcation of the public and private realms. Privacy in the relationship between patient and practitioner emerges as contingent, compromised and at odds with the contemporary ideal in which the relationship was one necessarily involving other people. In general, the case study of the London physicians demonstrates how the closest possible proximity to the project of professionalization—and, it may be argued, a prominent

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