The patient and power: sociological perspectives on the consequences of holistic care

In contemporary community health care, practitioners are encouraged to view clients as rounded individuals who have the right to participate in health care decisions. This broader and more egalitarian view is termed here ‘holistic care’. It is contended that such an approach is at least partially a response to sociological critiques of earlier, more authoritarian and bio-reductionist forms of professional-client interaction. This paper examines how sociological commentators have responded to this new approach by contrasting two, very different perspectives. Interpretations based on the work of Jürgen Habermas tend to see holistic care as an advance on bio-medical approaches, in that it introduces mutual understanding and communication free from coercion into the professional/client relationship. Conversely, commentaries based on the ideas of Michel Foucault regard holistic care, with its surveillance of the psycho-social circumstances of clients, as extending bio-medicine's control of the body to include control of the human personality as well. It is argued that these differing interpretations of the consequences of holistic care reflect a wider debate concerning the possibility of human progress.