Policy as product. Morality and metaphor in health policy discourse.
Policy as product. Morality and metaphor in health policy discourse.
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政策即产品。
DOI：
10.2307/3528188
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
R. Malone
中科院分区：
文献类型：
--
作者：
R. Malone
卫生政策话语中的道德与隐喻没有哪门艺术比政治艺术更败坏其原则，更沾染警句式的迂腐。——米尔顿·齐格蒙特·鲍曼认为，在现代性中，道德已经被纳入公共话语，就好像它只是“道德工业”的产物一样。同样，美国当代政策理论中的一个关键话语依赖于政策“企业家”的概念，他们像商人一样“推销”政策创新，并为这些“产品”创造“需求”本文开始考虑将卫生政策作为产品谈论意味着什么，以及从这种政策制定的概念化中产生什么样的伦理和政策。其目的是指出我们共同语言的各个方面，并问：什么被遗漏了？还剩下什么？谁是最好的服务对象？什么变得不可见？在开始的时候，说明一下这篇论文不会做什么也是很重要的。这篇论文对我们目前在卫生政策方面的语言习惯进行了适度的批评，但它并没有试图为我们的语言习惯可能造成的“问题”提出一些全面的“解决方案”。过度规范地试图改变语言的流动和模式是有危险的，其中最重要的是有可能无意中使人们希望重新命名的东西变得微不足道。毕竟，语言不仅仅是我们记忆的东西，不仅仅是记住某些单词，然后把它们应用到某些事情上，而不是应用到其他事情上。相反，我们发现自己使用词语是因为它们对我们和周围的人已经有了意义；它们是意义的进化形式，已经是我们共同文化的一部分。大多数情况下，我们没有经过深思熟虑，就自然而然地说出了这些话。当我们无法表达时，我们感到痛苦；当我们看到一种迄今为止尚不成熟的体验被用语言表达出来时，我们会感到一种发自内心的解脱。但是，我们不能武断地、独立地决定把石头称为鞋子，同时还指望语言发挥它的作用，帮助我们彼此联系。因此，本文的目的不是设计一种新的语言体系，以某种方式使我们“更有道德”，而仅仅是引起人们对基于经济和商业语言的隐喻在美国卫生政策话语中日益无形地取代其他隐喻的方式的关注，并有助于讨论这可能如何限制我们对与政策制定有关的善的看法如果像查尔斯·泰勒和其他人令人信服地论证的那样，语言既具有描述功能又具有表征功能，那么我们使用的词汇和我们谈论我们所做的事情的常用方式就与我们是谁以及我们如何对待他人有很大关系。在这种观点中，词语不仅仅是标记事物；它们维持并修正了那些为我们在任何特定情况下的行动提供可能性的共同理解。语言不仅反映，而且塑造我们的真实；正如任何明智的父母所知，他们也会塑造我们。这一点尤其正确，也许在隐喻的情况下最容易看出，正如乔治·拉科夫和马克·约翰逊所表明的那样，隐喻在我们日常经验的语言中是中心的，无处不在Lakoff和Johnson用“争论就是战争”这一概念隐喻来说明他们的论点，这种隐喻出现在“他攻击对手的主张”、“那些主张是站不住脚的”等短语中。“重要的是要看到，我们不只是在谈论战争方面的争论，”他们说。“我们实际上可以赢得或输掉辩论。我们把和我们争论的人看作是对手....我们在争论中所做的许多事情都部分地由战争的概念构成”（第4页）。相比之下，他们建议我们考虑一种文化，在这种文化中，争论被视为参与者表演的舞蹈。在这样的文化中，人们会经历非常不同的争论。．..
Morality and Metaphor in Health Policy Discourse There ... is no art that hath bin more canker'd in her principles, more soyl'd and slubber'd with aphorisming pedantry then the art of policie. --Milton Zygmunt Bauman has suggested that in modernity, morality has been taken up in public discourse as though it were simply a product of "ethical industry."[1] In a similar way, a key discourse in contemporary policy theory in the United States relies on the notion of policy "entrepreneurs" who "market" policy innovations and create "demand" for these "products" as businesspersons do.[2] This paper takes up the project of considering what it means to talk about health policy as product, and what kind of ethics and policies emerge from such a conceptualization of policymaking. The aim is to point to aspects of our common language and ask: What is left out? What is left in? Who is best served? What is rendered invisible? It may also be important, at the start, to say something about what this paper will not do. The paper offers a modest critique of our current habits of language with reference to health policy, but it does not attempt to lay out some comprehensive "fix" for the "problems" our language habits may create. There are dangers in overly prescriptive attempts to alter the flow and pattern of language, not the least of which is the risk of inadvertently trivializing that which one might wish renamed. Language is not, after all, something we merely memorize, a matter of remembering certain words and applying them to certain things and not to others. Rather, we find ourselves using words because they already mean something to us and to those around us; they are evolving forms of meaning that are already part of our shared culture. Most often, words transparently come, without much deliberation on our part. We ache when we cannot find words; we feel a visceral relief when we see a hitherto inchoate experience put into words. But we cannot arbitrarily and independently decide to call a stone a shoe and still expect language to do its job of helping connect us to one another. This paper's aim, then, is not to lay out a new language system that will somehow make us "more moral," but merely to draw attention to the way metaphors based in the language of economics and business increasingly and invisibly supplant other metaphors in U.S. health policy discourse, and to contribute to the conversation about how this may constrain our vision of the good in relation to policymaking.[3] If, as Charles Taylor and others have convincingly argued, language has a constitutive function as well as a descriptive or representational one,[4] then the words we use and the common ways we talk about what we do have a great deal to do with who we are and how we act toward others. Words, in this view, do not merely label things; they maintain and modify the kinds of common understandings that set up our possibilities for action in any particular situation. Words not only reflect, but shape what is real to us; they also shape us, as any wise parent knows. This is especially true and perhaps easiest to see in the case of metaphor, which, as George Lakoff and Mark Johnson showed, is central to and ubiquitous in our language of everyday experience.[5] Lakoff and Johnson illustrated their thesis with the conceptual metaphor `argument is war,' which appears in such phrases as "he attacked his opponent's claims," "those claims are indefensible," and so on. "It is important to see that we don't just talk about arguments in terms of war," they observe. "We can actually win or lose arguments. We see the person we are arguing with as an opponent.... Many of the things we do in arguing are partially structured by the concept of war" (p. 4). By contrast, they suggest that we consider a culture where argument is viewed as a dance in which participants perform. In such a culture, people would experience arguments very differently. …