Essay: How Is the Politics of Difference in Nursing Socially Constructed and Maintained?

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¶ … Politics of Difference in Nursing Socially Constructed and Maintained

The politics of difference and nursing

The significance of the politics of difference

The issue of diversity and the 'politics of difference' have assumed an important and compelling part of modern discourse in many fields and disciplines. This interrogation of difference extends along the axis of culture, ethnicity, gender, race and many other trajectories of diversity in modern society. As Colleen Varcoe (2004) states;

Diversity is a broad yet powerful idea that encompasses the ideas of difference and complexity. Multiple forms of diversity are important in nursing and health care, yet it is often only "cultural" diversity that comes to mind and commands attention. (Varcoe, 2004)

Vaecoe makes the important point germane to any discussion on the politics of difference that culture is often conflated with aspects such as ethnicity and that, "...attention to cultural diversity often focuses narrowly and defines people by nation, ethnicity, or race" (Vaecoe). This is indicative of the need for a rigorous and penetrating examination of the politics of difference in order to ascertain and prevent the marginalization and exclusion that often results from perceived difference and 'otherness'. This has become a central sociological, ethical and philosophical concern since the middle of the last century with the demise of colonialist ideologies.

While this chapter will explore the various modernist, post-structural as well as postmodern interpretations of the politics of difference, the focus of this discussion will revolve around the way that these views and debates impact on the healthcare and nursing profession. While there is a comparative paucity of studies that deal with specifically with the relationship between the politics and difference and nursing, this is addressed to some extent by writers like Vaecoe. In a study entitled, Advancing Nursing Scholarship in Diversity: Complexity and Equity the author states that "Diversity is of critical concern to Canadian society in general and Canadian health care and nursing in particular, because of our expressed commitment to justice and equity, especially in health care" (Vaecoe, 2004). This is a view that can be extended to other societies and cultures and refers to the various inequities and inequalities that take place in terms of the concept of difference and in relation to aspects such as age, ability, income, ethnicity, sexual orientation, geography, and other forms of difference. As Vaecoe emphasizes, "... attention to diversity is fundamental to a lessening of health inequities" (Vaecoe, 2004).

It is this sentiment and its implications for nursing profession that will be a central guiding trajectory of this study. This point is worth emphasizing at this juncture as it forms a fulcrum that will guide the following discussion. The issue of difference and its meaning in both a political and social sense in the society is even more relevant to the professional nurse. This refers to the expanded role of the professional nurse in the contemporary medical and healthcare environment. This role often includes aspects of community and social intervention and necessitates the need to understand the cultural background of patients. This is an aspect that will be dealt with at more length in the final section of this chapter.

In order to deal with and address the inequalities and the disparities in society that are encountered in the healthcare profession, it is important to realize that "....analyses of diversity must attend to language, power dynamics, the intersections among various forms of inequity, and the specific contexts within which inequities occur" (Vaecoe, 2004). Consequently, many theorists in the medical and other fields have seen the need to turn their attention to diversity with a "...conscious analysis of how various forms of diversity and difference intersect, and how language, taken-for-granted ideas, and dominance operate to foster inequity based on difference" (Vaecoe, 2004).

2. Understanding difference useful view of the politics of difference is provided by theorists who see this concept as an important means of understanding marginalization and oppression in modern post- colonial society. Scholars such as Michael Peters in his article Radical democracy, the politics of difference and education (1995) states the following.

The politics of difference emerges as the new desideratum for understanding the complex nature of oppression in education and the way in which multiple and contradictory subjectivities and identities are socially constructed at the intersections of race, gender, and class, among their configurations. (Peters. 1995, p. 55)

In essence the important concept of "social construction" is one that underlies the issue of difference and political difference; in that such difference is not innate but is often constructed by the cultural norms or societal structures that dominate that particular society. This also brings with it the implication that such differences may be socially constructed or constituted to deprive or marginalize certain groups or individuals.

In essence, Peters and others point out that the politics and exploration of difference is an essential aspect of modern, or postmodern, discourse that has emerged in the wake of the dissolution of colonialism. Importantly, this area of social and political discourse has been developed in an effort to counter a world view that is based on binary opposites and contraries. As many theorists and philosophers such as Derrida, Habermas, Heidegger and others point out, the method of binary opposites supports the existence of ' master narratives' and ideological bias, which does not take into account the validity and the relevant status of social, cultural and individuals differences. This interrogation of the binaries of difference is motivated by the realization that people cannot to be simplistically defined by sets of opposites such as black, white, working class, and middle class, female, male; and that these opposites are in reality socially constructed. This mode of thinking tends to reduce the essential individuality and humanity of the individual, resulting in false perceptions that translate into negative actions. This theoretical stance is the foundation of the deconstruction of hierarchical structures that is based on oppositional thinking.

Probably the most important strategy at work in deconstruction is the tracking down of hierarchical structured oppositions. According to Derrida, it has been a characteristic of the western philosophical and scientific tradition since the classical times to think in binary oppositions. Presence opposes absence, speech opposes writing, philosophy opposes literature, the literal opposes the metaphorical, the central opposes the marginal, life opposes death, the real opposes the imaginary, the normal opposes the pathological, etc. Derrida shows how one of the oppositional terms is always privileged, controlling and dominating the other (dominating 'the other').

Hierarchical Oppositions)

The above extract is quoted at length as it encompasses many aspects that need unpacking and which will form a locus of the present discussion. As will be discussed in this chapter, it therefore becomes obvious in the light of these points and the various aspects noted in the introduction to this section, that the study of difference is especially pertinent to the healthcare profession and nursing.

2.1. The concept of difference

The concept of difference raises a number of complex and intricate issues in the modern and postmodern context. What precisely is meant by difference? It can be argued that the question of difference in its deepest sense lies at the core of the problematics of Western philosophizing, extending from Plato's concept of the ideal as opposed to mundane reality. In a postmodern, or more correctly a post-structuralist context, the meaning of difference is related to the word 'defer' in the writings of Derrida. Essentially, the understanding of difference in Western thought is an important prolegomena to the understanding difference in the political and social sense in contemporary thought. The following brief overview of the concept of difference as it emerged from dualistic thinking in Western thought will provide necessary insight into the meaning of the politics of difference in the modern healthcare and nursing environment.

The dualistic view of reality has been a central area of concern in Western thought since the inception of Greek philosophy. As noted, the Platonic view of the ideal and the real forms constitutes the underlying basis of Western thought. This also refers to the separation between being and Being which is, according to important modern thinkers like Martin Heidegger, the fundamental and underlying structure of Western metaphysics. In other words, the dualism and difference between things was seen in the history of Western metaphysics as the basis for all reality and knowledge of the world.

The theory of Forms in Plato is a theory of reality that has profound implications for modern thought. Essentially, it is a philosophical standpoint that views reality as divided into truth and illusion. The world of illusion refers to the world of particulars and everyday experiences while the Forms are the ideal and 'real' reality that hides behind the material world. The ideal forms relate to the concepts of perfection and wholeness, while the particulars of the world are inferior and lack any real unity of nature.

There was just one world, the world of ideas. The sensible world was merely an image of the real… [END OF PREVIEW]

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