Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Treating Others: Human Sciences in Theory and Practice
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tives of social engineering far enough. Autonomy is one principle, but an outright
ban on smoking or the casual use of alcohol might be a far more effective “treatment”
of a population than the individual damage repair after the fact of abuse of
any such agents. There must be some constraints on the side of both goods and
rights, and the freedom to pursue what happiness each can seek in some activities
may lead to what could be called “other” victimless crimes.” Self-infliction, however,
quite frequently burdens the society at large—and the caregivers in particular—for
which they might have a self-interest as well as altruistic opinions on the
restraint of personal freedoms to pursue certain excesses. The full circle is turned
when we might exercise such care of an individual or population that we permit
them to do nothing at all lest they expose their lives to any danger from experiencing
life’s vagaries, while being constrained by such respect for the autonomy of others as
to be unable to take any action in treatment for any at any time. The reductio ad
absurdum would be that we should not even be acquainted with the “other”, since
just observing them and knowing they exist might be interference in their autonomy,
and ignorance of their existence would further relieve us of any obligation to intervene
in their welfare. Surely, the Human Sciences must have a role in steering us out
of such a theoretic impasse for a practical resolution of how to represent, respect and
relieve others and assist them in rehabilitation for empowerment in self-actualization.
Post-Colonialism, Neo- and Otherwise
The subaltern may speak, but not usually through one of their number being
lifted up above the mass becoming a neo-colonialist speaking for the voiceless masses
through amplified positions in the colonizers’ world. Advocacy must recognize otherness,
and acknowledge that it is never possible to perfectly represent despair from
comfortable agencies within the developed world. I have run into a problem with
advocacy becoming agency, transforming quickly to ownership in perpetuity of a
human problem, with a guarantee of failure in treatment in order to keep the problem
and agency budget growing. If advocacy means representing the downtrodden,
there should be a rapid transition to work the advocate out of a job rather than
enshrine it in perpetuity as a goad to the conscience and purses of the comfortable.
Chauffeured limousines of aid agency advocates have the look of self-interest above
representation—doing very well by doing good. Advocacy is better tolerated if the
representation is over against the interests of the society—and over the advocate’s
own; that does not mean that the sincere are always effective, but the inverse is
hypocritical.
It is not simplistic to say that the way to treat the inequities of post-colonialism
is to get beyond it. Institutionalization of a second-class status is reinflicting the
injury and again enshrining dependency in perpetuity. The goal of good treatment
is not to create compliant patients, but to produce empowered healthy healers. A
successful treatment may be a threat to the agency, but not to the person who is
treating. Agency ought to be a self-limited condition extinguished by its success.
All Men Are Created Equal
Perhaps, but that equality is not very apparent now, however far we stand from
that creation. And, the inequities in resources, capabilities, richness of life-world
and experience grows ever more disparate, since it is difficult to cultivate some of the
finer expressions of the Human Sciences while engaged in a desperate struggle for
subsistence. It takes a certain consumer surplus of capital, of energy, of leisure to
dedicate a higher proportion of our attention and effort to the nonvegetative func-
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