The Needle and the Damage Done: Research, Action Research, and the Organizational and Social Construction of Health in the "Information Society"

Abstract

This paper critically reviews the action research paradigm that has evolved over the last 50 years within and outside The Tavistock Insitute, with reference to radical shifts in the social construction of medicine and health that are occurring as a result of the transition toward the "information society." The medical domain has been chosen as an appropriate space within which to review the action research paradigm because it bridges both the past and future of the Institute. The paper firstly considers the original conception of action research and sociotechnical systems, and the role of consultants, in relation to Foucualt's analysis of power relations, social control, and "dividing practices." It then describes and analyzes recent developments in the field of medicine and healthcare service provision that, on the one hand, offer opportunities for increased self-management and control by consumers over physical, social, and emotional "self-hood" and on the other could lead to further social surveillance and the domination and subjectification of the individual. Drawing on recent work using innovative models of action research in the field of HIV/AIDS, the paper concludes by discussing ways in which action research could harness developments in information and communication technologies to maximize individual and collective engagement in new forms of organizational and social relations.