Sociolog
Sociolog is a chronicle of reflections written by Sociology and Social Policy Research staff and postgraduate students.
Articles on this page:
- An Interview with Kevin Dew
- Politicization of Sexual Violence
- A conversation with Trish Nickel and Chamsy el-Ojeili (2009-2010)
- What is the future of public engagement with Bioethics in new Zealand? A brief comment.
- What Madness will Fashion Designers Turn to Next?
- Tips for Young Researchers: Lessons from the Disability Project
- Alzheimers Awareness Week
- Inquiring into Chiropractic
An Interview with Kevin Dew
Kevin Dew is Professor of Sociology at Victoria University of Wellington. Prior to his current appointment he worked for eight years as a lecturer and researcher in the Department of Public Health at the Wellington School of Medicine and Health Sciences. His research interests include health professional-patient interaction, health inequalities and public health.
Read 'An interview with Kevin Dew' (PDF, 82KB) conducted by Psychology Aotearoa.
Politicization of Sexual Violence
by Dr Carol Harrington
Since the end of the Cold War, international democracy building projects have proliferated as part of new approaches to global security by NATO and its allies, including New Zealand. I became interested in the democracy building industry when I worked for the Central European University which shared buildings in Budapest with the Open Society Institute, both parts of multi-billionaire philanthropist George Soros' network of projects and organizations. Of course Soros' operation was small change alongside the democratization operations funded by the European Union, United States and United Nations in the post socialist region. Similar democratization interventions run by states, international organizations and private philanthropy can be found in Africa, the Middle East, Asia and the Pacific. These international efforts at instigating social transformation around the globe cry out for sociological attention. Democratization and security experts' interest in sexual violence piqued my particular sociological curiosity.
This curiosity led to a book tracing anti-sexual violence feminism as a distinct theme within liberal governmental discourse and practice: Politicization of Violence: From Abolitionism to Peacekeeping London, Ashgate. The book uses Foucault's definition of 'government' as thoughtful and systematic practices and techniques designed to alter human conduct. Foucault's conceptualization of government helped me make sense of the activities of networks of state bureaucracies, international organizations, and non-governmental organizations that formulate and implement democratization programs. These networks link together in the goal of transforming distant populations into democratic societies. Interestingly, such networks produce masses of information about sexual violence abuse and exploitation indeed the sheer volume of this information formed one of the initial puzzles that prompted my research path. I became intrigued with the acronyms and other forms of short-hand that experts on sexual violence used when talking to each other. The routine use of the acronyms SGBV [sexual and gender based violence] and SEA [sexual exploitation and abuse], for example, point to taken for granted knowledge and stabilization of meanings among communities of self acknowledged experts. My book unpacks this sexual violence knowledge and expertise by tracing its genealogy within international politics.
My investigation into the geneaology of international sexual violence knowledge and expertise led me to researching abolitionist politics, international feminist organizations in the UN system, the human rights knowledge industry and trauma science. I traced how and why these various traditions converged and propelled sexual violence from the fringes of international feminist politics onto the agenda of the UN Security Council and the Department of Peacekeeping Operations. I also investigated various international programs and policies that seek to govern the problem of sexual violence. My data collection and analysis drew upon the development of Foucault's work on governmentality, by Nikolas Rose, Mitchel Dean, and Colin Gordon in particular. This approach suggests investigating both the rationality and techniques of government, thus I did not seek to write a comprehensive legal or intellectual history of sexual violence but rather focused upon the knowledge and expertise that informed international governmental practices.
My book did not seek to dismiss feminist global anti-violence efforts but I did want to raise critical questions about the somewhat suspicious sudden global success of international feminist anti-violence movements. My analysis discusses how the problem of sexual and gender based violence has rationalized global and regional powers intervention into the domestic government of distant populations and territories. Such intervention often enjoys the support of local and international women's NGOs. Law and order concerns justify an armed foreign presence while depoliticizing this presence and representing it as an empowering partnership.At the same time, political opposition to foreign intervention can be criminalized and vilified.
Read more about Politicization of Sexual Violence at: http://www.ashgate.com/isbn/9780754674580
A conversation with Trish Nickel and Chamsy el-Ojeili (2009-2010)
by Dr Rhonda Shaw
Academics lead busy lives, their research areas are often highly specialised, and their speaking and writing communities sometimes surprisingly narrow. The following interview is the product of an electronic conversation initiated in October 2009 with Trish Nickel and Chamsy el-Ojeili. The interview was designed to get around the constraints of time and to hear el-Ojeili and Nickel talk about their work.
Rhonda: Trish, you arrived here at the end of 2007 and very soon struck up lively conversation with Chamsy when you both discovered common intellectual interests in critical theory and post-Marxism. Over the course of the last two years those conversations have continued but you have increasingly realized - often through supervising graduate students together - points of difference in your work. Could you explain?
Trish: I think that Chamsy and I would both call ourselves critical theorists and political sociologists. Those are two labels that I think that both of us wear comfortably. In my view, this means that we are both involved in thinking critically about political formations and power and we both want to see people have more control over the circumstances that govern their lives. However, we have different interpretations of the same scene. Michael Ryan once wrote, ‘I think who I have known and what I have read and seen and heard’. In this sense, it often may seem that Chamsy and I think about the same things, but we have known, read, seen and heard different people, books, framings, and tones. I was especially surprised to find that post-Marxism was being discussed by critical theorists in the Antipodes; probably Chamsy had to deal with this in ways that I initially did not because it wasn’t on my radar in North America. I don’t think of post-Marxism, as it is framed by Laclau and Mouffe, as belonging to the tradition of critical theory. My own work is not about ‘rethinking the socialist project’; my work is about ideology critique. Ideology critique for me is about locating those narratives, structures, and spaces that govern us without our realizing it. Post-Marxism, in my view, distracts us from the work of ideology critique, especially where it digresses to method.
Chamsy: Well, I do consider myself a political sociologist, and I’m okay with the critical theory label too, but critical theory is, like Theory generally, a big baggy thing with lots of room for lots of stuff, in my opinion. So, for me, the post-Marxists fit in there too. I think they see themselves very much as in the business of exploring the narratives, practices, institutions ‘that govern us’, although they don’t like the term ‘ideology’ because it smacks too much of authoritarian, elitist views of people as stuck in ‘false consciousness’, and it relies on what they see as a now untenable distinction between ideology and Science. I agree with Trish that we shouldn’t be so coy and silly about things, and we can’t get rid of the task of ideology critique. Post-Marxism was, for me, something that had to be encountered, and I like a number of thinkers plausibly labelled post-marxist – Castoriadis, Heller, Lefort. My real problem with post-Marxism as developed by Laclau and Mouffe is that there’s just no analytical or political advance on the sort of stuff you find within the Marxian tradition. You see, I still place myself within the field of Marxian thought and think out of this rich, plural Marxian tradition (but not just out of it). Post-Marxism is an absurd, irritating label really for an attempt to raise a bunch of questions to Marxism – about science, class, political parties, determinism, history, ethics, etc (see Tormey and Townshend, 2006, Key Thinkers From Critical Theory to Post-Marxism) – because all of these questions were raised within Marxism already. The trouble is, as I indicated, that they just don't do any better, and, for me, there’s nothing in the post-Marxist field that matches the analyses of the likes of Perry Anderson, Immanuel Wallerstein, Fredric Jameson, Giovanni Arrighi and others: that is, those sophisticated Marxists still give us the best work on world politics, the logic of the social, the politics of culture, and so on. There's just nothing that matches Marxism still.
Trish: I don't think that critical theory is quite as ‘baggy’ for me as it is for Chamsy. This may be a matter of weighting and taste ... click here to continue conversation
What is the future of public engagement with Bioethics in New Zealand? A brief comment.
by Sarah Donovan
Processes of public consultation are increasingly heralded in the Bioethics domain as a mechanism for assuring the ethical integrity of healthcare provision, particularly within the area of new genetic and reproductive technologies. As a positive legacy of the Cartwright Report (1988), a shift away from a model of bureaucratic paternalism has led to the championing of ideals of consent, partnership and informed decision-making as ideals of contemporary healthcare in New Zealand. As consumers of these practices affecting our health, it’s nice to feel that our opinion, at least theoretically, counts. However, the reassuringly consultative ethos evident in public health literature and government health reports produced in New Zealand the last decade or so may not be a luxury we should take for granted when it comes to having our say more generally about the development and appropriate implementation of emerging healthcare practices. Recent changes in the landscape of bioethics governance in New Zealand seem to suggest the likelihood of a diminishing political commitment to processes of public engagement, particularly in the area of biotechnology.
In March 2009, Toi te Taiao:the Bioethics Council was perfunctorily disestablished by the recently elected National-led government. Housed within the Ministry for the Environment, the Council had been established in 2002 on the recommendation of the Royal Commission on Genetic Modification. Following the receipt of over nine thousand public submissions expressing concern with the cultural, ethical and spiritual implications of genetic engineering, the Royal Commission observed that at that time no suitable body existed in New Zealand to respond to these concerns. The terms of reference for the newly established Council expressed a clear commitment to fostering processes of public engagement, being to “develop and implement [other] strategies to involve, communicate and consult with the public and other stakeholders about the ethical, cultural and spiritual dimensions of biotechnology”. The Council’s website profiled its own work on issues such as xenotransplantation, the use of human embryos, and the findings of a 2008 public consultation project on pre-implantation genetic diagnosis. In addition, the webpage posted links to other sites of ethical interest. As such, this site arguably constituted the sole public bioethics resource in New Zealand at the time.
In the press release indirectly announcing the dissolution of the Bioethics Council, Minister for the Environment Nick Smith commented that the work of the Council was “somewhat duplicated” by other agencies and that the Government preferred to “invest in frontline services that really matter for New Zealanders not expensive slogans”. Such remarks would seem to suggest a view that the public have little interest in involvement in decisions around biotechnologies, and that such processes are not something that ‘really matter’ to ordinary people. The Council’s website is no longer accessible on the internet (having been recently archived off-line to the National Library) and similarly this measure indicates that fostering greater public access to bioethics information may be a low priority within the current political climate in New Zealand. This evident shift away from previous attempts to democratise public policy around health technologies would seem to set New Zealand apart from a broad international trend towards greater rather than fewer opportunities for public involvement in bioscience debates, in recognition of growing public mistrust in science. The apparent haste to dismantle such avenues for engagement here seems puzzlingly retrograde.
A stated aim of the Bioethics Council was to enhance public trust in the regulation of emerging health technologies. In the absence of a body working to fulfill this brief, and a user-friendly way for ordinary people to keep abreast of new developments, exactly how the current government now plans to determine ‘what really matters for New Zealanders’ with an interest in such issues remains to be seen.
Sarah Donovan has just submitted her PhD thesis entitled 'Compelling Choices: Tensions in the Practice and Experience of Prenatal Screening in New Zealand'. This qualitative based research focused on how routine prenatal screening is constructed as a choice in contemporary public health discourse. The interviews for the research explored the extent to which pregnant women experience their decision-making as informed and autonomous.
What Madness will Fashion Designers Turn to Next?
by Bronwyn McGovern
Wellington's Dominion Post newspaper recently included an article on fashion designer Dame Vivienne Westward's latest collection shown at Milan Fashion Week (19/01/10: B5). It was reported several hundred fashion experts burst into rapturous applause and cameras flashed as her collection opened with a disheveled model emerging from a cardboard box. He wore a sleeping bag slung around his neck. Westward's display themed and styled upon a notion of the roving vagrant demonstrates the absurd and tasteless grabs for attention some in the fashion industry will go to in order to get their name out there. My suggestion then, the fashion industry could next target the mentally ill as a commodity is not necessarily a ridiculous proposition.
I chose to adopt a tongue-in-cheek response to this article to highlight Westward's exploitation of marginalised and stigmatised individuals in order to sell clothes to privileged and elite people in society. By doing so, she simultaneously romanticises the rough sleeping aspect of homelessness, perpetuates stereotypes of homeless people and reduces the serious issue of homelessness to a fashionable condition.
Being homeless is not usually a lifestyle choice. Nor is there any romance to be found in homelessness. Despite Westward's playing with ideas about belongings homeless people could possess or the clothing they might wear, homeless individuals are often poorly attired when enduring freezing weather conditions. Consequently many experience chronic health problems that can eventuate in deathly outcomes for some.
Compare this reality with the irony evident in Westward's admission that the closest she had come to the experience of homelessness was arriving home to find she did not have a door key, what a disaster that is, dying to get into your house and you can't (my emphasis).
(Bronwyn McGovern's doctoral work researches street life in Wellington and includes studying the every day lives of homeless people).
Tips for Young Researchers: Lessons from the Disability Project
by Lana Moriarity
Your first research project is pretty much like your first day of high school. Inside, you feel excited, maybe even nervous, about what you might find. If indeed you manage to find anything. For, without some clear directions, it's easy enough to get lost.
Here, I discuss my first research project on 'disability'. I begin with a brief background on disabled people in society, as this provides the general context for my project. I then discuss my study on disability and some of its key outcomes. Lastly, I talk about key elements of a successful project I hope may help other young researchers.
Today, social attitudes toward disabled people are shifting. In New Zealand, for example, we now have accessible public buildings and public facilities. On the Victoria University campus, we even have Disability Support Service, which provides advice and assistance to students and staff. However, the inclusion of disabled people in everyday life is a very recent phenomenon. It is also not a universal phenomenon. In many countries around the world, persons with disabilities are kept in the confines of home, or seen as cursed. Moreover, even in nations now moving towards inclusion, (like New Zealand), the full potential of many disabled people goes unrealised in their struggle for adequate support, an inclusive education, and a decent job. The disadvantage is revealed in statistics, which show that disabled people, on average, are less qualified and earn lower incomes compared to non-disabled peers.
Ultimately, these struggles boil down to historical constructions of disabled people as 'other' to the non-disabled; they have been seen as inferior, or incapable, and with industrialisation, as a societal burden. Hence, in most parts of the world persons with physical and mental impairments have been locked away in isolated institutions. They have suffered conditions that some may regard as dehumanising, breaches of human rights, or simply 'torture'. New Zealand had such institutions, within which gross atrocities were committed. Today, thankfully, they have all been closed
The idea that disabled people have 'human rights', and deserve to be included in society, is a recent phenomenon. It took immense struggles similar to those of women and racial minorities to even convince United Nations Member nations that disabled people deserved their own human rights convention. Before then, disability was only implicitly acknowledged, or 'tagged on' to other human rights treaties. This offered poor protection to disabled people because states simply tended to ignore their concerns. Finally, on the 13 December 2006, the UN General Assembly formally adopted the Convention on the Rights of Persons with Disabilities (CRPD) the first human rights treaty of the 21st Century.
States are now able to sign and ratify the CRPD. New Zealand, who played an important role in the treaty negotiations, ratified the convention on the 26 September 2008. Our country was one of several nations that petitioned for a disability treaty and the inclusion of disabled people in its development. It is an important piece of legislation for the 17 percent of adults and children in New Zealand with disability.
The development of the CRPD in New Zealand formed the basis for my research. As a person with experience of disability, I was interested in the treaty and what it meant for disabled people. As a social policy major, I was interested in the partnership forged between the Government and disabled people during the treaty's development. Namely, I was interested in how successful (or not) this partnership had been. Part of my curiosity was piqued by some previous work I had done on partnership, collaborative processes, and governance.
In order to find out more, I undertook qualitative interviews with key informants in the disability sector, most of who were involved in the convention's development. My sample included members of parliament, policy analysts, and disabled people (or their representatives). The sample was generated through ';snowball sampling': where you are guided by suggestions on helpful sources. In all, I conducted 11 interviews, mainly in the home or work-place. For this, I had to have ethics approval from the Victoria University Human Ethics Committee.
In general, I found that the key informants I interviewed had very congruent views on the relationship that was formed between the Government and disabled people. Most viewed the partnership positively. The Government had included disabled people on its official delegations to the United Nations. They also had consulted disabled people and their representatives throughout the convention negotiations. In addition, informants discussed general benefits of nation-states and civil society working together on the treaty, such as the fact it educated officials and disabled people, and resulted in more specific and practical articles. Informants also mentioned particular limitations of partnership. It depended, for example, on officials' supportive of governance processes. Hence, it can never be 'equal', as officials have ultimate decision-making power.
In addition, significant optimism was expressed about the potential of the convention to assist both disabled people and advocates in New Zealand. Informants talked about the CRPD as a 'tool' to hold the Government to account on disability issues, and to educate society on disability rights. They felt the convention built on, and legally reinforced, the New Zealand Disability Strategy (2001), an important piece of domestic legislation. A summary was sent to participants of the results, who were invited to provide feedback.
In all, my research did not quite fit with previous literature which had been quite scathing of partnership processes. Here, the context under which the convention was developed becomes important. In New Zealand, the partnership was developed under a Labour-led Government highly supportive of governance processes. It also did not fit with research scathing of the ability of human rights treaties to make a difference. Here, my research could not confirm nor deny previous research. However, it did point to ways the treaty may be usefully employed by disability advocates.
In summary, the project, took over 6 months to complete, between Nov 08 to July 09. I thoroughly enjoyed the research (although it was hard-work), and it opened up opportunities I never dreamed about at the beginning. For instance, I had lunch with a cabinet minister in the Beehive! And, it took me to Sydney, where I presented the research at the Disability Studies Conference. I plan to finish up with a journal article at the end of this year.
Here I want to deviate now, from the project itself, and talk about some things that I personally learned as a young researcher that may help other young researchers. I will bullet point and expand on some main factors I think are relevant to a successful project. These issues fall into two main categories: 'uncontrollable' and 'controllable' factors.
Uncontrollable factors
Windows of Opportunity
In part the success of your project is going to depend on windows of opportunity. By this, I refer to whether the issue resounds for people (meaning they will want to talk about it), and whether they have the time to talk about it. I was lucky. My project fell just before Christmas, when people were already pretty relaxed and almost on holiday. It also fell just after the ratification of the Convention in New Zealand, so the issue was at the forefront of people's minds.
By 'windows of opportunity' I also refer to the fact the issue is on the political agenda, which means it is probably going to get funded by somebody or bodies.
Controllable factors
Preparation
Reading literature before you go and interview people is crucial. You don't have to do a lot. However, it's good to do some. It means you know, in general, what questions to ask in the first place (even if you don't yet know your main angle). It also helps make you look more professional and credible to informants.
Hard work
Research is not easy. Transcribing in verbatim takes literally hours and hours of work. Analysing data also takes time. It may seem muddy and confusing. However, a good plan of action always helps....leading me to
A good plan of action
This means different things to different people. Some people are happy to have a few hooks, wade right in and await a surprise. However, as a new researcher, knowing what I was looking for before the interviews, and when analysing the data, helped. I felt I had a path to follow. So, when I analysed each transcript (which I loaded into the 'INVIVO' software programme), I looked for my question, then looked at my informant's answer, and straight away cut and paste and plonked it into a separate folder. I did this with every respondent. Then I could simply compare all the responses together to ascertain 'themes' (pertinent points in the research).
Even doing this, it was still sometimes hard analysing the data. This is because I investigated three separate issues ('partnership', 'advocacy', and 'the impact of the convention'), which in the end resulted in TOO much data. If I had gone back, I would have just focused on one of these issues. In fact, it is what I am going to do for the journal article. In all, this means I am using maybe 10% of the data as a whole!
A supportive supervisor
A supportive supervisor can make all the difference. Often this is blind chance, you meet the right person at the right time and it clicks. Other times, you need to go hunting for such jewels. This person is your rock, to go to for any support you may need. In saying that, the best supervisor may leave you to learn for yourself as you go.
Conclusion
My project on disability reflected a personal interest I had in the topic. Through the project, I met remarkable people, learned a lot of interesting things, and had the opportunity to travel. As a young researcher, follow your interests, it makes the journey more enjoyable, and you never know where it will lead. Just make sure, that, like your first day in high school, you relax, get to know people, and have a map so you know where you're going!
Alzheimers Awareness Week
by Dr Allison Kirkman
The week beginning 26th July 2009 was Alzheimers Awareness week and you would have seen banners with the blue forget-me-not flower, the symbol for Alzheimers New Zealand, around the city. 'It is an ideal time for me to write about the contribution that sociology can make to our understanding of the paid and unpaid work of people who care for people with dementia and their families. Alzheimers disease is the most common form of dementia. In 2008 there were an estimated 40,746 New Zealanders (1% of the total population) with some form of dementia and this is predicted to rise to 74,821 (1.5% of the total population) in 2026. The term dementia refers to a disease of the brain, which may be the result of a number of different illnesses, including Alzheimer's disease (first identified by Alois Alzheimer, a German physician, in 1906). Dementia predominantly affects people aged over 65 years and becomes more common with increased age. However there is also increasing incidence of early-onset dementia in people less than 65 years and sometimes as young as 40 years. People with dementia experience impaired brain function, affecting language, memory, perception, personality and cognitive skills. It is a progressive disease and there is currently no known cure. At a personal level it is a devastating diagnosis for a person and their family and friends and at a societal level there is an economic and social cost - what is called the burden of disease - which has consequences for all of us.
Many people with dementia live in the community and are cared for by spouses, partners and other family members as well as paid carers. New Zealand has a large voluntary sector, large enough for it to be sometimes known as the third sector the other two being the public and private sectors. The 23 Alzheimers Societies situated around New Zealand are part of this voluntary sector and have been established since 1986 under the umbrella of the national organisation, Alzheimers New Zealand. The societies' role includes education and awareness campaigns (such as the one we will see next week), provision of support for people with dementia and their carers, and advocacy. Media coverage of dementia usually includes comment from Alzheimers New Zealand. Indeed the media is one of the main sources of publicly available information about Alzheimers disease and this coverage has been spurred on by the growth of advocacy organisations like Alzheimers New Zealand. Until recently dementia has been a stigmatised condition and not readily talked about, and those people with dementia encountered what has been called a social death. It is only with the disclosure by some high profile people, or their relatives, that there has been more public awareness of the condition. An example of this would be the publicity, including two books and a film about the philosopher, Iris Murdoch, and closer to home, the writer, Maurice Shadbolt. And when Mike Baldwin of the television programme, Coronation Street, developed dementia a phone number for how to gain information about Alzheimers disease was screened at the end of each programme.
One focus of Alzheimers New Zealand is on support for people with dementia within the community and there is a range of paid workers employed by the organisations. The positions of support workers vary with some workers called field workers or community workers. Many of these workers are nurses while in some organisations social workers are employed. Other workers in the office may include a manager, clerical assistants, fund raising coordinators and educators in the larger societies, while in the smallest societies one person may fulfill all of these functions. These workers are mainly women and they typically have different conditions of employment than those nurses and social workers employed in the public and private sector. For example, some characteristics of voluntary organisations that differentiate them from other health care organisations are that they are frequently dependent on fundraising for a large portion of their operation (hence the awareness and fund raising campaign next week), the paid workers frequently work in part time positions, and the numbers working in any one location are usually small. In addition, the work involves supporting not just the person with the illness but also the unpaid family carers. In New Zealand, like other similar societies, there have been policy shifts away from residential and institutional care and towards informal care usually provided by families within the community. In New Zealand this policy programme has been referred to as ageing-in-place. This government emphasis is reflected in the Health of Older People Strategy that lists one of its goals as providing community-level health care and disability support to enable older people to age in place (Ministry of Health 2002: 57) and in numerous other policy documents.
In 2007 I undertook some research to study the situation of women who chose to work for Alzheimers New Zealand, especially nurses and social workers who could receive better remuneration working in the public health system. Despite their lack of secure full-time work, the participants in this study regarded their own situations as very favourable, compared with other female providers of health care, such as unpaid family caregivers and rest home workers. The dominant discourse through all the responses from the field workers who I interviewed or who completed surveys was that of being able to make a difference. When asked the best aspects of the position almost all the women used the discourse of making a difference either for the person with dementia or their families, for example: getting those with common interests together for self-help, getting people to share their problems, I can seem such a small player in the field but can make such a difference.
Discussions about their job satisfaction were set within the context of this overarching discourse. Given the professional qualifications that many of the women had gained before working within the health and social services sector it is likely that this discourse also featured in these education programmes, including nursing and social work. Nevertheless there were issues that resulted in dissatisfaction. These included working for a not-for-profit organisation that depended on fundraising and working for a committee of volunteers. Fundraising was an issue that was especially acute given that most had previously worked in occupations that did not require this involvement. The dependence on fundraising for this sort of support is a reason for making a contribution next week if we encounter a collector from Alzheimers New Zealand. They will be out at the Railway Station and supermarkets around Wellington and many of the collectors will be family members and friends of people with dementia as well as those who work for the Alzheimers Societies. In the future, with an ageing population, all of us are likely to know someone with dementia and becoming informed is one way of being able to support them.
If you want to find out more about Alzheimers disease go to the Alzheimers New Zealand website. There you will also be able to read and listen to personal accounts of people whose lives have been changed by dementia.
An account of the research referred to above can be found in Kirkman, A. Supporting the caregivers: working in community dementia care in Hidden Health Hazards in Womens Work edited by Celia Briar, Dunmore, Palmerston North, 2009: 107-119.
Inquiring into Chiropractic
by Prof. Kevin Dew
Today anyone with a work-related injury can access chiropractors, osteopaths and acupuncturists, to name a few, for treatment. This was not always the case. This year is the 30th anniversary of the release of a report on the Commission of Inquiry into Chiropractic in New Zealand. The Commission was established to determine whether chiropractic patients should have access to ACC benefits or not and what role chiropractic should play in health service delivery in New Zealand. There was a massive and dogged opposition to chiropractic, and for some who presented at the Commission the goal was to annihilate chiropractic in New Zealand. A small and dedicated group of chiropractors were put through the wringer at this Inquiry, but the outcome of the Inquiry was not only the survival of chiropractic, but also benefits have accrued to other therapeutic systems outside of orthodox medicine.
Recently I attended a conference commemorating the Commission of Inquiry Report into Chiropractic. I was invited as a guest speaker by the New Zealand Chiropractic Association, the conference hosts. The invitation came as a result of some letters I had published in the New Zealand Medical Journal (more of that later) but it gave me the opportunity to re-visit a topic that had been a very insightful case study in research I had undertaken for my PhD exploring the regulation of medical practices in New Zealand. As part of this research I had spent many hours in the Alexander Turnbull Library going through cartons of archived material on the Commission of Inquiry. It was most illuminating.
I suspect that very few people would know about this Inquiry as it seemed so specific. The Inquiry came about as a result of a petition from chiropractors and their patients to allow chiropractic patients access to ACC benefits. At that time, in the late 1970s, ACC would allow chiropractic patients to receive ACC benefits if a medical practitioner had referred the patient to the chiropractor. At the same time the Medical Council had a ruling that it was unethical for any medical practitioner to refer a patient to a chiropractor. And there lay the problem.
The Inquiry was meant to last a few weeks, but went on for over a year. My data then consisted of thousands of pages of written submissions to the Inquiry and transcriptions of oral presentations. My argument focused on the rhetorical fine-line that chiropractors had to walk in order to avoid being seen as irrational and too different on the one hand, and being seen as too much the same as the medical profession on the other. I have argued that this fine line is one that other alternative therapeutic practices have to take when negotiating with the state and the medical profession.
Attending the conference gave me a different set of insights from those provided by the thousands of pages I had read in the archive. I now have a much better sense of the experience of those chiropractors involved in this long and intense Inquiry. What I came away with was a respect for the very real sacrifices that individual chiropractors had to make in the teeth of a resolute and well resourced opposition.
Hearing the experiences of those chiropractors involved in the Inquiry was an eye-opener. I knew that the process would have been arduous. Anyone who took the stand was represented by counsel but faced the counsel of the opponents. What I did not realise, and the conference presentations made this most transparent, was how gruelling the process was for the chiropractors and the sacrifices they had to make.
Clive Mudgway, who took the stand for the chiropractors, was grilled by the combined counsels of the medical profession, physiotherapists and others for over two weeks. For your average citizen two-hours of such intense examination would no doubt be exhausting - two-weeks seems incredible. At the time, and this may still be the case, this was the longest cross examination in the history of any inquiry in New Zealand.
Not only would this have been immensely energy sapping, but the chiropractors who attended the Inquiry received no compensation for their time. In addition, in order to fund legal counsel and expenses for expert witnesses from overseas, all registered chiropractors had to pay a levy and many gave donations. For those attending this was quite a price to pay to secure a better future for the profession and resist attempts to obliterate it.
Indeed the Commission did not recommend the extinction of chiropractic. In fact the Commissioners found strongly in favour of the chiropractors. They not only recommended that chiropractors should have access to ACC benefits and that the medical profession should rescind its ruling against referrals to chiropractors, but also recommended that chiropractors should oversee all the training of spinal manipulation in New Zealand and have access to hospitals. The first two of these recommendations were followed up, but the latter two were never implemented.
Nevertheless the Inquiry can only be seen as a resounding defeat for the medical profession at that time, to its shock and horror. Reading the submissions it can be seen that the medical profession repeatedly shot itself in the foot, with witnesses fabricating stories of chiropractic malpractice that were found to be untrue, witnesses called in from oversees who were found to have been involved in illegal activities and so on. The medical profession was at the height of its status and prestige in the late 1970s and as such expressed an arrogance that I am sure would not have been well received by the Commissioners.
So this Inquiry is indeed something worth commemorating. It is certainly the most extensive inquiry of its kind in New Zealand and perhaps the world. But as a sociologist it is interesting to note that I was not initially invited because of my research into the Inquiry. I was invited as I had criticised, in the letters column of the New Zealand Medical Journal, what was in my opinion some very poorly interpreted research into the use of the title doctor in New Zealand. This was the first time I had written letters to the NZMJ. I initially had no intention of writing a letter, but when I thought about it I concluded that it was unlikely that anyone else would, and that in part I should take some responsibility as an academic to enhance the level of debate. So in a curious happenstance my arguments about poor research led to my attendance at a very enlightening and pleasurable conference. This reminded me again of how much more I could understand about events by meeting and hearing from those involved in them, in this case meeting and hearing some of the people involved in such a momentous event in the relationship between health professionals in New Zealand.