Foucault and the professions – an uneasy marriage? Using Foucault in the study of health care and medical professions

The paper explores the usefulness of foucauldian concepts for the study of medical professions. This appears to be an open question. The focus of Foucault’s studies was on technologies of power, not on institutions where they are wielded or social groupings doing it. Instead of prisons (or schools, factories, hospitals etc.) he studied disciplinary practices, instead of states or political actors rationalities of government. This seems to locate him rather far off from the studies of professions, where the central subject is the professional group. On the other hand, Foucault is regularly quoted when the role of medical expertise as a source of social control is discussed. He is presented as a theorist of medical power-knowledge that is placed in the hands of professional groups.

The paper clarifies Foucault’s position by looking at the way he framed health issues in his studies. Here the notion of biopower and his history of governmental rationalities take centre stage. They introduced a major shift in his thought: alongside disciplinary techniques came mechanisms of security that safeguard the vital processes of individuals and populations. The history governmental rationalities traces the development of these mechanisms of security from the 16^th century to the current neo-liberal welfare society. Health, health care and medical expertise have a prominent place in it. This detour through foucauldian corpus has a double effect: Firstly, it frees the concept of medical power from a one-sided concentration on discipline and control. Secondly, it situates medical expertise in the succession of governmental rationalities. Together they open up a perspective to the formation of medical professions and to their various and historically variable tasks in society.