Abstract
Rationale: Conventional models of cultural humility - even those
extending analysis beyond the dyad of healthcare provider-patient to
include concentric social influences such as families, communities and
institutions that make the clinical relationship possible - aren’t
conceptually or methodologically calibrated to accommodate shifts
occurring in contemporary biomedical cultures. More complex models are
required that are attuned to how advances in biomedical, communications
and information technologies are increasingly transforming the very
cultural and material conditions of health care and its delivery
structures, and thus how power manifests in clinical encounters.
Methodological Intervention: In this paper, we offer a two-pronged
intervention in the cultural humility literature. At a first level of
analysis, we suggest the need to broaden understandings of culture and
associated workings of power to accommodate the effects of biomedicine’s
technologising turn. A second level of intervention invites
experimentation to broaden the availability of methodological tools to
analyse and assess the multidimensionality of technologies and their
agentic effects in healthcare encounters. Drawing from new materialism
theories, practices of care are approached “diffractively” as
contingent and dynamic material-discursive events. Our neo-materialist
framework for cultural humility expands analytical sight-lines beyond
hierarchical relationships and dichotomies privileging humans
(practitioner and/or patient) as sole actants in the clinical exchange.
Attended to are the ongoing dynamics of practices entangling big-data
driven knowledges and interventions, pharmacological technologies and
material instruments and devices, diseases, and the
bodies/subjectivities of health care providers and patients. We
investigate the implications for clinical assessment if a cultural
humility framework is methodologically attuned to the clinical encounter
as a discontinuous, discursive-material process producing multiple,
contextually emergent data moments and objects for analysis. Engaging
evaluative inquiry diffractively allows for a different ethical practice
of care, one that attends to the forms of patient and health provider
accountability and responsibility emerging in the clinical encounter.