Oral Presentation The 26th International Nursing Philosophy Conference 2023

Neoliberalisation of nursing: Reifying consequences on the devastating transformations in healthcare (#33)

Mohamad Hamze Al-Chami 1 , Wendy Gifford 1 , Thomas Foth 1
  1. University of Ottawa, Ottawa, ON, Canada

In this presentation, we discuss the implications of the neoliberal transformations of nursing care that are justified under the term economization. We emphasize that neoliberalism must rather be understood as a specific rationality or governmentality that goes beyond mere economization and implies a specific way of understanding people living in our societies. Drawing on the work of German critical theorist Axel Honneth, we present a critical social-political and moral philosophical perspective that conceptualizes these transformations as pathological consequences with devastating impacts on how we understand what human beings and social relations are. We argue that in a neoliberal context, nursing care becomes a form of reification that contributes to indignity and neglect. Reification is the treating of human beings as lifeless objects from a ‘neutral stance’ with no emotional engagement or phenomenological understanding. The pathologic consequences are ‘detached’ relationships that lead to “forgetfulness of recognition” which contradicts the assumed ethical foundations of nursing, a caring profession based on the subjective and unique personal needs of patients. One aspect of the neoliberal rationality is regarding human being as homo economicus where decisions are based on an economic logic and positivist scientific stance that “objectifies” and neutralizes relationships, leading to the detachment of nurses and dehumanization of patients. Thus, nursing care is reduced to an instrumental rationality that focuses on calculating care for economic efficiency, diminishing any possibility for nurses to engage with patients to understand their unique qualitative lifeworld that impacts sickness and healing. In this presentation we urge nurses to raise their voices against a neoliberal rationality that programs their ideas of what “good care” is and restricts their agency through efficiency standards. Adopting a critical approach to knowing is a way to liberate nursing from the neoliberal rationality and resist the devastating transformation taking place in health care.