Theory and Practice
(The illustration is from the “Book on the Usefulness of Animals” – an Iranian manuscript of the 13th century AD. The artist is Ibn Bakhtishu. )
Theory without practice is a hollow and pointless pursuit. But practice that is not informed by a theory that is grounded in clear thinking and careful observation lacks clarity and direction and can lead to quite disastrous results, even if it is well intended. An effective politics of health must involve a bold and energetic practice that is guided by a well thought through theory.
The Connection with Health
What does health have to do with political and economic theory? Everything. Microbes and physical lesions are only two of the factors that determine health. Whether people will actually fall sick or become injured, and whether treatment will be available to them if they need it, are dependent upon social, economic, and political factors. And the kinds of economic and political arrangements that are put in place depends on the economic and political theories that guide the actions of doctors, health planners, politicians and ordinary people. In this section of the POH page we explore some of those political and economic theories and philosophies that are of vital importance to anyone who is concerned with the health of the planet and its inhabitants.
Key Issues
In many circles theory has a bad name. You hear people say “I’m just concerned about practical matters. I couldn’t care less about theory.” Yet the fact is that whenever we deliberately choose one course of action over another, we are guided by theory. It is our “theory” that for some reason our course of action is better tailored to achieve the outcome we desire than is some other course of action. The idea of our being able to choose between theory and practice is illusory. Our only real choice is between action that is guided by theories that are conscious and well considered and action based on theories that are unconscious and muddled. For this reason the “Politics of Health” page is concerned with theory.
We are concerned with developing a theory of the politics of health that is informed, effective and comprehensive. Ours is a “knowledge based page.” We are interested in making real changes in the world. And we want to explore every aspect of our topic. Our understanding of “politics” extends to the full range of interpersonal decision making about how shared space and resources will be used. Politics in our understanding of the term is as concerned with the dynamics of power and choice that take place within a family, a school, or a place of business as much as those that take place between nations. It is concerned with the full range of health, from the physical health of the individual organism to the social and spiritual health of all social and ecological systems.
In general the Politics of Health site is guided by the philosophy of values oriented pragmatism. This approach is described in the article “You Can't Turn Back the Sun.” Values oriented pragmatism designates a broad and inclusive approach that attempts to incorporate the best insights from a wide variety of economic and political theories.
As we look at health issues from a variety of perspectives, the philosophy of a values oriented pragmatism constantly reminds us that we must remain grounded in a central question: how does this way of seeing things, and the practices associated with it, further the fundamental values that seem to be common to all people regardless of race, sex, nationality and culture? We believe that are there such transcultural values that can provide us, as a globalist community, a foundation upon which to build. We have attempted to indicate what these values are in the article “Globalization For Health” (see the home page) .
The primary importance of values is implicit in all the work and writings of David Werner throughout his long and varied career. But in some of his papers he focuses our attention more sharply on those values that need to be highlighted for examination and discussion if we are to achieve a truly healthy world. In his article “Alma Alta and the Institutionalization of Primary Health Care,” he reminds us of some of the primary values that were affirmed in that ground-breaking document, and then traces the betrayal of those value as people attempted to implement them in the real world. In his article “Communication as if People Matter” he emphasizes the importance of participatory democracy (bottom up control), equity, compassion, health for all, and sustainability – all key values that must be addressed in any philosophy dealing with the politics of health. In the article “What We Learned From Maria” Werner reminds us how easy it is for even the best intentioned of human beings to lose track of their core values in the push and pull of confusing and difficult situations.
In this section of the POH site, we will be exploring those broad philosophical perspectives that clarify for us the meaning of a “politics of health,” and we will be looking at those specific ideas that can be gleaned from a number of political and economic theories that might give us insight into how to best further the health of the planet and all its inhabitants.
The POH site is persuaded that theory and practice are too important to be left to the experts. They affect all of us in vital and unmistakable ways. Theory is therefore the concern of everyone. Let’s take just three examples. “Unregulated capitalism will automatically lead to the best of all possible conditions for all people.” That is theory.” Its called market fundamentalism. “The survival of the fittest is the implacable law of evolution. Therefore we must base our social systems on competition and the right of the clever and privileged to build their well being on the backs of the poor.” That is theory. Its called social Darwinism. “The USA has a special mandate from God to be at the head of a world empire, and has the right to crush any nation or person who would challenge this right.” That is theory. It is called manifest destiny. These are some of the theories that may be destroying the world that belongs to all of us and to our children. The struggle to challenge these destructive theories and replace them with theories that will provide us all with a future worth living and working towards needs to be brought out of the academy and into the streets.
Connections With Other Topics
All the topics included on the POH page involve the interplay between theory and practice. Here we only highlight some of the most obvious examples.
Most people at least give lip service to the idea that the best form of government is a democracy. But what about the need for democratic principles being applied to our places of work, our schools, and our families?
Some people feel that in the idea of “ecology” we find the over-riding theory of life that is needed in the modern world. It is an idea well worth considering.
Political theories about democracy and effect not only whether we elect our leaders, but also whether we include children in shaping their own curriculum and the policies and procedures of the schools they attend.
If we believe that truth is best protected by the free and open competition between ideas, then the theory and practice of every aspect of social life must in fact (as well as in theory) be discussed in public forums which are include the full range of opinions on any given topic.
The neo-liberal economic theory that now dominates the economic practices of the world is clearly tailored to meet the short term needs the wealthy. But when they ignore the matter of sustainability, they are not ultimately in anybodies interests. Clearly theories and practices that are equitable, sustainable and efficient can and must be developed.
Religion always mixes with politics. It is inevitable. Of course we would affirm the need for a careful separation of church and state. But the potential of both positive and negative effects from our spiritual beliefs during this period of time when it seems that we have entered into what in is being conducted by both sides as a holy war.
Perhaps the most critical philosophical issue having to do with stategies for change concerns the use of violence. Of course any person can create scenarios in which the use of violence would clearly justified and perhaps even morally required. The parole board that interviewed me many years ago asked whether I would not use violence if I had the opportunity to in order to stop a group of rapists who were attacking my mother. Given those circumstances, I undoubtedly would have. Yet in all the years that have followed never once has this situation presented itself to me.
Conclusion
The only war worth fighting at this time is in the trenches of the mind. We need to struggle for a new consciousness that is adequate for the needs of the globalized family that we have now become. It is everybody’s business to read about the theories that will make or break our future, to discuss them, and to help build more adequate ones. It is an important form of political action to discuss theories with our friends, our families, and our co-workers. The field of battle may be in an email to an acquaintance, a letter to the editor, an article written for a class, or on a placard to be carried in a march for peace. The struggle against slavery, the women’s movement, the organization of labor, the anti-colonial movements, and the gay liberation movement have all taught us a simple fact: when consciousness is raised, practice will follow in its step. Vigorous and extensive action is of course necessary to bring actual facts into conformity with our vision of a more just and compassionate society. But we must remember that when change is forced on people by the strength of arms and violence rather than by aggressively challenging the ideas that serve as the foundation of the old order, it almost invariably results in some new form of oppression. So, again, we must bring theory and philosophy to the streets. How people see things makes all the difference.