Anticipation and Medicine: A Critical Analysis of the Science, Praxis and Perversion of Evidence Based Healthcare

Anticipation and Medicine- Front Cover
Anticipation and Medicine
Title Page
Copyright Page
Dedication
Contents
Preface
Acknowledgments
Introduction
Chapter 1: The care paradox
	Introduction
	The regulation, appraisal and implementation of new forms of care and diagnosis
	The anticipatory care paradox
	Collateral harms
	Overdiagnosis
	Securitisation
	Absolute, normative, health
	Care without borders
	Qualified health
	Doing the good
	What is anticipatory care?
	Two modes of cure
	Presence to suffering
	Notes
Chapter 2: Science and politics
	Introduction
	Evidence Based Medicine
	Logical empiricism (or logical positivism)
	Positivism and healthcare
	Healthcare and social norms
	Science and politics: a turn from the left to the right
	Subjective pragmatism and radical empiricism
	Social democratic logical empiricism and neoliberal pragmatism
	Notes
Chapter 3: Science and politics – a case history: breast
cancer screening
	Introduction
	Background to the breast cancer screening controversy
	The decision to continue screening and neoliberal pragmatism
	Note
Chapter 4: Language, harm and overdiagnosis – a case history:
the real cancer paradox
	Introduction
	Recap
	Altering the meaning of overdiagnosis and shaping public opinion
	Overdiagnosis
	Making meaning non-conscious or ungraspable
	Altering the meaning of diagnostic names and public opinion
	The real cancer paradox
	Notes
Chapter 5: Politics and consciousness
	Introduction
	Scientific-political-economic philosophy
	Alienation and commodity fetishism
	Agency and decision-making
	Anticipatory care, agency, alienation and commodity fetishism
	Marx’s theory of labour power, alienation and commodity fetishism
	Ownership of the means of production
	The employment exchange
	Production phase
	Product exchange
	Innovation and the anticipatory care paradox
	Notes
Chapter 6: Subjectivity, care-labour and Lacan’s structures
of discourse
	Introduction
	Lacan’s structures of discourse
	The university discourse
	Institutional knowledge, persuasive rhetoric and commodity fetishism
	The institutional discourse and knowledge
	The individual’s discourse, care-labour and care-consumer
	The mirror stage and alienating identity
	Anticipation and alienation
	Note
Chapter 7: Subjectivities of care – a case history:
alienating identities
	Introduction
	Alienation
	Care-labour subjectivity and anticipatory care: a Lacanian discourse analysis
	The screener as care-identifier or diagnostician, entrapment of care-labour, and the master structure of discourse
	The cancer diagnosis as a product in exchange – the coercion to be a care-consumer
	Resistance, consciousness and the hysteric discourse
	The Graph of Desire and the subjectivity of the care-therapist
	Subjectivity
	The Graph of Desire
	Jouissance
	Fantasy
	Subjectivisation
	Castration
	Care-providers: an example of two contrasting subjectivities
	Perversion
	Notes
Chapter 8: The opportunity costs of neoliberal pragmatist
anticipatory care – a case history: a molecular
genetic ‘signature’ for cancer risk
	Introduction
	The context and rationale for the development of Oncotype-DX
	The health technology appraisal process in the UK
	Opportunity costs
	The erosion of public healthcare services
	The threshold(s) for decisions to license new technology
	The ICER
	The InCEST (Incremental Cost and Effectiveness Sacrifice Threshold) taboo and sovereignty
	The InCEST (Incremental Cost and Effectiveness Sacrifice Threshold) taboo and sovereignty
	Innovation
	Oncotype-DX
Chapter 9: Two impossibilities: burnout and the depersonalisation
of care-giving
	Introduction
	Anticipatory care, the care-giving relationship and subjectivity
	The care-giving relationship and ‘doing the good’
	The Ego-Ideal and the Ideal-Ego
	Burnout for inter-personal care-givers
	Anticipatory care removes love from care
	The unconditional demand
Chapter 10: Neoliberal pragmatism incites perversion: the
capitalist discourse
	Introduction
	From the perspective of the care-provider
	The destabilisation of the care-provider’s subjectivity by anticipatory care
	The weakening of the power of the Name of the Father
	Perversion
	Increasing self-referentiality
	The capitalist discourse
	Notes
Chapter 11: The Oedipus complex and perverse care-provision:
a case history
	Introduction
	Recap
	The Oedipus complex
	Forming a more or less stable subjectivity
	Sexuation and a relation to the Phallus
	Perversion and subjectivity
	Capitalism and perversion
	A case history
	Paradoxical care
	The care-provider and his actions
	Over-treatment
	Under-treatment
	Paterson’s Law
	Note
Chapter 12: The biopolitics of anticipatory care: Spinoza
and the prohibition of health
	Introduction
	Recap
	Epistemology and Spinoza
	Descartes’s circular argument
	Spinoza, Lacan, consciousness
	Anticipation as affect incites commodity fetishism
	The incest taboo and sovereignty
	The transition from the pre-capitalist to the capitalist era
	The pre-capitalist era
	The capitalist era
	Application to anticipatory care and the InCEST taboo
	Anticipatory care prohibits health
	Note
Conclusion
References
Index