Concluding lessons/takeaways for practitioners
The complexity of perspective that a diffractive, cultural humility
framework invites is both potentially daunting to grasp and yet
promising in its ability to broaden and deepen understandings of
technologised patient-caregiver experiences and health-care exchanges.
As a means of moving forward from the grasp of epistemological
paralysis, we propose the following steps: Our framework encourages
health practitioners (including researchers) to preserve ambiguity and
contingency as productive of reflexive research and clinical practices.
It encourages the slowing down of efforts to seek immediate
epistemological certainty. Moreover, our framework invites opportunity
for the health practitioner to pay granular analytical attention to the
here and now problematics germane to contemporary health care delivery.
In other words, if we can imagine evaluative practices as analogous to
our embodied maps, we can consider how vital the clinical assessment is
as a diffractive recording of what has been emphasised in the
health-care exchange and as consequence, allowed for or bracketed from
consideration. Engagements such as risk management and assessment,
treatment planning, and evaluation of patient’s drug adherence are not
grappled with analytically or ethically as stable fixed objects
independent of the contingencies of scientific practices and their
social-psychical health worlds, but as discursive-material phenomena
that emerge differently and continuously within the complex relational
fields of the clinical exchange. In other words, health practices,
including how diagnosis and interventions are embodied and lived by
patients, and the power relations that shape them are understood to have
relational affects. Viewing culturally humble practice this way invites
an opportunity to engage clinical inquiry and assessment as a deeply
ethical practice29 that attends to the forms of
patient and clinician accountability and responsibility emergent in the
clinical encounter