Humanizing Institutions: A New Topic for the Politics of Health Knowledge Network
A new topic has recently been added to our site: “Humanizing Institutions.” Wow. That sounds dull. Originally we were going to call it “The Politics of Everything You Never Dared to Think About,” but we decided we had to tone it down a bit. Still, under this innocent-sounding title we plan to deal with some exciting and volatile ideas that could, if implemented, change the world in which we function day-to-day.
This new section will complement the web site’s existing emphases on physical health and the health of societies with careful consideration of issues related to interpersonal health. We will also more explicitly include within the scope of “politics” our day to day living in families, schools, work places and other social groups.
Perhaps the set of shared values that should guide our common efforts on local, national and international levels is best captured by the term “democracy.” In the narrow sense, democracy means rule by the people. Alex Tocqueville, a shrewd observer of American life, was generally sympathetic toward the fledgling experiment in democracy that he observed. Even so, he warned of a danger. Majority rule can itself become a form of tyranny. It is for this reason that the principle of rule by the majority must be balanced by the realization that the rights of individuals and minorities must be protected. It was this understanding that undoubtedly led the framers of the constitution of the United States to amend the constitution with the bill of rights.
These considerations suggest that a broadened understanding of democracy needs to include recognition of the importance of several sub-values:
Participation in decision making within the social spaces one occupies.
Self-determination in the pursuit of happiness.
The dignity and worth of the individual.
The unifying theme in this section is this: if the world is to survive as a place fit for human habitation, the ordinary institutions within which we live and do business must themselves become democracies. Democracy is a powerful and transformative idea that must be brought into our families, our places of work, our schools, our religious institutions, and our health agencies. Democracy, as we define it below, mandates that social life be guided by two principles:
the full participation of everybody in formingthe goals and policies that shape the life we share, and
an appreciation of minorities, and people withs pecial vulnerabilities, and protection of their rights.
There appears to be an emerging consensus across the political spectrum, and across national boundaries, that democratic values should provide the agreed upon guidelines for our common efforts. We see these values reflected, for example, in the United Nations Declaration of Human Rights. Unfortunately these values are regularly set aside when they appear to be impediments to more pressing concerns.
The policies and procedures that embody the goals and dictate the organizational structures of the major institutions in a society ideally should reflect the fundamental values of that society. When the institutions of a society conduct their business in a manner that is flagrantly at odds with its values, serious ethical and functional problems arise. Lack of harmony between values and practices in a society poses serious threats to the personal and interpersonal well being of its members.
There are undoubtedly many people who feel democratic values should hold sway in the political sphere of life, but that they are not relevant for the business, educational, religious, governmental, law enforcement, and social service organizations that carry out the day to day business. It is argued that democratic ideals are nice in theory, but that they are not efficient in practice. Throughout this section we will be looking at examples that challenge this pessimistic assumption. We will argue that by relying on democratic institutions we will be able to educate our children better, provide for a higher level of health care, deal with those who deviate from society’s norms in a more rational, humane, and effective manner, and create and distribute the goods and services in society more effectively. Democratic values should and can be made to inform the interactions between people in all spheres of life. Indeed, if they don’t, the preponderance of non-democratic practices will likely spill over and threaten the survival of democracy in the political sphere as well.
One can think of democracy as being a mean between two extremes: totalitarianism and anarchy. In a totalitarian social structure there is little or no participation in decision making. In an anarchistic structure everybody is making decisions, but the processes of negotiation and orderly decision making are lacking, so the structure falls into chaos. In a democratic social structure one finds orderly and participatory patterns of decision making and planning that reflect and embody the previously designated subvalues of democracy.
In the quest for control, many people who are strong defenders of political democracy exhibit totalitarian tendencies in the institutions and bureaucracies they lead. On the level of institutional life, perhaps the most salient analysis of the totalitarian structure is to be found in Erving Goffman’s concept of the total institution (see his book, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates, 1961). The democratic alternative might best be described as a participatory pattern of administration. In a participatory system all the people who live in a particular social space participate in creating the norms and goals that structure the situation. In the “Humanizing Institutions” section these themes will be explored as they pertain both to the institutions of society that have mandates to care for vulnerable or deviant groups, and to the regular institutions of education, government and business.