This is the introduction and first installment of a five-part series, Reclaiming Control: The History and Future of Choice in Our Health, examining how healthcare in the US has been built on the principle of imposing control over body, mind, and expression. However, that legacy stands alongside another: that of organizers, healers, and care workers reclaiming control over health at both the individual and systems levels. Published in five monthly installments from July to November 2022, this series aims to spark imagination amongst NPQ‘s readers and practitioners by speaking to both histories, combining research with examples of health liberation efforts.
As a public health practitioner and researcher, I have spent my career working both inside healthcare systems and with community-based organizations, fighting to hold healthcare institutions to transparency and different ways of work. Throughout those 16 years, I have heard many harrowing experiences—denial of care, lack of informed consent, explicit racism and xenophobia, medical bankruptcy—echoed across movement spaces and repeated in the narratives of women and gender nonconforming folks of color across the country. Despite inhabiting our own bodies every day, when we seek to make choices around counsel and care, we are frequently questioned, misdiagnosed, condescended to, harmed, or even left to die.
Unfortunately, this present-day reality is just the latest manifestation of a longstanding legacy of control that is fundamental to the design and delivery of healthcare in the United States. This system surrounds even individual clinicians, care workers, and healers who seek to look after us with heartfelt compassion and skill (and who, especially in the past 2.5 years, have done so at risk to themselves). It has been shaped by complex layers of history: racialized capitalism’s reduction of human bodies to commodified objects; patriarchy and religion working lockstep to dehumanize women and rigidify gender roles; and the weighting of professional over lived experiences. Each of these forces shapes our reality of and debates about what it means to control our own voices, minds, and bodies—and, in turn, to have control over our very being.
The Body as Object: Intersecting Histories of Oppression
In The Birth of the Clinic, which traces the rise of the medical gaze and the detached clinification of the body in the late 18th century, Michel Foucault shares French doctor and politician Francois Lanthenas’ reflection on the relationship between liberty and health. “Man will be totally and definitely cured only if he is first liberated…if medicine could be politically more effective, it would no longer be indispensable medically. And in a society that was free at last, in which inequalities were reduced…there would no longer be any need for academies and hospitals.”
In 2022, of course, we are nowhere near this idyllic scenario of widespread liberation, although there is a long legacy of organizing and movement building that has pulled us ever toward it. Poverty, structural racism, and other forms of systemic oppression are root causes of health inequities, therefore—as Foucault points out—a healthcare system designed primarily to treat illness—as opposed to the social causes of illness— could only ever serve as a band-aid. Indeed, by prioritizing the “medical gaze,” which turns people into objects of study, healthcare itself perpetuates those same oppressions.
To read more of Sonia Sarkar's article, please click here.
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