Lecture 9: Critical Theory

How is colonization present in nursing?

• influenced by colonial assumptions, which have shaped its theories, education, and practice

• the intellectual development of nursing has been dominated by Western epistemologies, marginalizing Indigenous and non-Western knowledge

• white privilege and racism in nursing continue to sustain colonial thinking

What concept is the key to understanding socioeconomic factors influence in health disparities?

intersectionality

What theories/perspectives does McGibbon et al., combine to highlight imbalances in nursing?

• postcolonial theory

• feminist postcolonial perspectives

• critical social justice

What has nursing education traditionally ignored, that reinforces dominant ideologies?

historical colonial contexts

What does McGibbon et al., argue that health disparities are rooted in?

social, economic, and political structures

What should nursing focus on to acknowledge how ________ affects patient care and access to healthcare?

anti-oppressive practices; neocolonialism

What are 4 decolonization strategies in nursing?

• critical self-reflection

• incorporating indigenous and marginalized voices

• shifting from an individualistic biomedical model to a holistic, community-based, and culturally inclusive approach

• advocacy and policy engagement

What are 2 processes involved in the colonization of nursing?

• colonization of nursing’s intellectual development

• white privilege and racism that sustain colonizaing thinking and action in nursing

Define postcolonialism.

• unequal relations of power that are the legacy of a colonial past and neocolonial present

• ways in which the cultures of dominant groups have, redefined local meanings, and dictated social structures

Define colonialism.

• areas outside of Europe were occupied by European countries and ‘settled’

• strategy justified by racialized colonial discourse about the necessity of civilizing the world

Define neocolonialism.

all forms of control of prior colonies or populations such as indigenous people who continue to live under condition of internal colonialism

Define postcolonial perspectives.

seek to expose these colonizing processes and their impact on contemporary structure and systems, which create and sustain colonial oppression

What are the 3 elements of Habermas’ critical social theory?

1. Encouraging critical reflection in nursing students

2. Promoting dialogue and democratic participation

3. Addressing social justice in nursing curriculum

What are the elements of encouraging critical reflection in nursing students?

• nursing education should challenge dominant ideologies in healthcare, such as medical paternalism and structural inequalities

• students should critically analyze how power structures, policies, and social determinants influence patient outcomes

• reflective practice exercises can help students recognize bias, privilege, and systemic oppression in healthcare

What are the elements of promoting dialogue and democratic participation?

• Habermas emphasizes communicative action, where open dialogue is used to reach understanding

• nursing educators can create a student-centered learning environment

• encouraging discussions on ethical dilemmas, patient advocacy, and cultural competence fosters democratic participation in healthcare decision-making

What are the elements of addressing social justice in nursing curriculum?

• nursing education should integrate social justice, health equity, and advocacy

• students should explore how racism, colonialism, and socioeconomic status affect health outcomes

• incorporating critical pedagogy can empower students to be agents of change in healthcare

What does post-positivist theory suggest about ontology?

• a material world exists

• not all things can be sensed, understood, or placed in a cause-effect relationship

• senses give us an imperfect understanding of the material/external world

What does constructivist theory suggest about ontology?

• reality is constructed by individual perception

• no absolute truth or validity exists

• truth is relative, subjective, and based on perception or a particular frame of reference

What does critical theory suggest about ontology?

• reality is constructed by those with the most power at a particular point in history

• reality is plastic and at all times imperfectly understood

• over time, reality is shaped by numerous social, political, economic, and cultural forces

• imperfectly shaped stories become accepted reality

What does critical theory suggest about epistemology?

• research is a transaction that occurs between the researcher and the participants

• the perceptions of the researcher and the participants naturally influence knowledge generation

• perceptions are determined by the context; contextual awareness and its relationship to the participant’s understanding of reality

• objectivity is not a desired goal

What does constructivist theory suggest about ontology?

• research is a transaction between the researcher and the participants

• the perceptions of the researcher and the participants naturally influence knowledge generation

• research emphasizes the meaning given to human experiences

• objectivity is not a desired goal

What does post-positivist theory suggest about ontology?

• researchers are naturally biased

• objectivity/controlled bias is the ultimate goal

• objectivity encourages triangulation and replication of findings, scrutiny of research from a larger community of scientists, and the rejection of poorly conducted research

Narrow definition of critical theory?

a school of thought derived from the Frankfurt school and refers to several generations of social theorists founded in Marxist tradition to critique and challenge power and structures

Broad definition of critical theory?

any philosophical approach that seeks to liberate people from all forms of oppression and actively works to create a world in accordance with human needs

Critical theory is centered on…

critique, resistance, struggle, emancipation

Critical theory is a type of ______ rather than a theory.

approach

Critical theory as a worldview is…

• a response to positivism and Enlightenment philosophies

• reality is historically influenced and contextually based

What are the goals of critical theory?

• social change

• to deconstruct the status quo and the idea that there is a unitary truth known using one way or method

• emancipation and empowerment of marginalized and oppressed groups

• reflexivity

What does critical theory question?

existing societal structures and hierarchies

What does critical theory attempt to do?

• critique society

• name injustices

• change society

Critical theory uses ______ to expose ______ that keep people from reaching their full potential.

social awareness; social inequities

What is research related to critical theory related to?

• related to social justice and human experience to promote local change through global social change

• begin with the knowledge that systems are biased against others, such as women or marginalized ethnic groups

• not only studies power imbalances but also seeks to change them

• research in nursing should be focused on exposing oppression and power hierarchies

Critical theory assumption?

societies are based on ideology

Define ideology.

• dominant systems of values, beliefs, attitudes, preferences, and structures in society (includes culture)

• primary obstacle to human liberation

• organized set of beliefs which sustain inequities in society

Define neoliberalism.

the expansion of the free market, which is increasingly made possible by the rapid growth of global information and communication

Define conflict theory.

society is composed of groups competing for resources, with underlying power struggles

Name 3 different types of feminist theories.

1. Marxist feminist theories

2. Liberal feminist theories

3. Non-Marxist radical feminist theories

What are Marxist feminist theories?

• women’s position in society is a consequence of property relation of capitalism

• both women and mn are viewed as property, but women are exploited through objectification in roles that serve men’s interests

What are liberal feminist theories?

legal constraints and customs are the basis for women’s subservient role to society

What are Non-Marxist radical feminist theories?

believe patriarchy (characterized by power, dominance, hierarchy, and competition) oppresses women

Define queer theory.

challenges all notions of fixed identity and is often associated with gay and lesbian studies

Define critical race theory.

social construct of race and race identity and the reality of discrimination

Define post-structural theory.

challenge structuralism views including those pertaining to the interpretation of language and texts in humanities, economics, and cultures in social sciences

Define postcolonial theory.

challenges the ingrained assumptions in Western knowledge

What did Horkenheimer say about critical theory?

• proposes a contextual analysis of phenomena

• postulates that to establish a truth historical conditions within which a said truth emerges must be considered

• critiquing outwardly as well as self-critiquing to prevent the dogmatisms and totalitarianisms it questions

What is modernity?

society that emerged from industrial capitalism, based on Enlightenment ideas of reason, freedom, and science

Define postmodernism.

• logical rejection of modernity

• recognizes diversity, while modernity pushes sameness

• information and communication technologies help make cultural diversity a reality

• personal freedom were not automatic through progress, reason, science, etc.

• skepticism towards all universal or absolute truths that have been used to legitimize political and scientific projects such as communism or dominance of the unconscious mind

What does Hanbermas believe?

• argues emancipation from domination is possible through rational communication and interactions

• supported emancipation from domination is possible though rational communication and interactions

• supported employment of negotiation as an integral to communicate action, realizing that negotiation must be conducted without the power of coercion by either of the interacting parties

What did Hanbermas emphasize?

communication

Hanbermas discounted the importance of ______ and ______ constraints on changing social systems.

material; structural

What did Freire do with critical theory?

• applied critical theory to education and developed programs to liberate individuals and groups and make them economically independent

• work is greatly influenced pedagogy, focusing on the importance of education

What did Foucault believe?

• concerned with the notions of fracture and difference, rather than continuity and context

• claimed that some shared common structures, systems of terms

• confronted subjective philosophy, which emphasizes the person as a private and independent individual

• encourage thinking differently from the existing mode of thinking within the times and within the context in which one lives

Discourse analysis in critical theory?

language as the primary social bond in contemporary society

How does critical theory apply to nursing?

• identifying social inequities related to health and transform through innovative knowledge application to improve equity

• modifying disparities through dialogue and increased participation by individuals about their healthcare

• construct research on social and situational realities that are part of daily experiences

• improve practices of inequities within the healthcare system

What did Kari Martinsen’s “Philosophy of Care” indicate?

• provided analytic and critical tools to describe the reality of the nursing discipline and of the social crisis in which it was immersed

• found that the discipline was part of positivism and the capitalist system, without praxis of liberation

• believed that the discipline failed to examine and recognize its fragmented nature “as it pretended a holistic perspective on care”

• proposes that we must question the nature of Nursing, its contents and internal structure, its historical origin and the genesis of the profession

Describe the reverse care law.

those who need care most receive the least

What perspectives did Martinsen use to create the “Philosophy of Care”?

• social perspective with philosophical critique

• socio-historical perspective → cannot be removed from their social environment and the community in which they live

Who are the 3 theoretical sources for the “Philosophy of Care”?

• Karl Marx

• Merleau-Ponty

• Michel Foucault

How did Karl Marx inspire Kari Martinsen’s theory?

• criticized individualism and the satisfaction of the need of the rich at the expense of the poor

  • Martinsen’s view is that it is important to expose the phenomenon when it comes to health services

    • exposure of this reality can be a force for change

    • nurses must question the nature of nursing, its content and inner structure, its historical origin and the genesis of the profession

  • Martinsen’s historical interest has a critical and transformative intention

How did Merleau-Ponty inspire Kari Martinsen’s theory?

• indicates that the human body is situated in the world

  • Martinsen adjusts it to Nursing as that relationship professionals in this discipline have with the body, through actions, attitudes, words, tone of voice, and gestures

How did Michel Foucault inspire Kari Martinsen’s theory?

• the phenomenology underlines the importance of history in our experiences

  • Martinsen reflected on the effects diverse phenomena have on Nursing, such as what disciplinary structure or characteristics should be in our current practice and in its spatial disposition

What does critical theory believe about nursing education?

creates and legitimizes forms of conscience that reinforce hegemonic structure

Describe the “teaching-learning process”.

• can be an opportunity to construct and reconstruct new abilities and skills

• enable broader understanding of the proxies of the Nursing discipline

• generate greater analytical and intervention capacity in different healthcare environments, against diverse daily situation

• must encourage reflexive self-critique, empowering future nursing professionals and developing their potential change agents

What should teaching aim to do according to critical theory?

• explain how socially configured ideologies influence educational activity

• providing responses to the needs of the profession and healthcare system

The learning process can _________ and create _________.

demolish prevailing structures; new forms of healthcare relationships

What research method is usually used in critical theory?

participative action-research

What is the focus in critical theory nursing research?

• transformation of the structure of social relationships

• liberating human beings

• guiding knowledge to emancipate through self-reflection

• questioning power relationships of power

Critiques of critical theory in literature?

• fails to show why it is better than other theories of knowledge, science, or practice

• suffers from being cliquish, conformist, elitist, immodest, anti-individualist, naivety, being too critical, and being contradictory

• focus too much on criticizing the current world rather than trying to make a better world

• dense language and unfamiliar terms; those who are oppressed need to understand and contribute

• lack of appreciable observable impact

• can be narrowly focused on issues they seek toc hange

• fail to ee themselves as one of many voices

How does Participatory Action Research help apply critical theory?

• helps stimulate community involvement and develop a solution to community issues

• approaches have been used to support action to improve community life

• projects are designed to reduce disparities in health and enlighten researchers

• researcher and the community or group members, often in underserved communities, work in collaboration to construct a particular activity or process to address health0related problems or needs

• community members are encouraged to contribute important information about the realities of the current situation and identify how it can be improved

• helps to empower participants to create a better solution to an issue, it also allows ofr the participants to employ their unique perspectives to develop a more realistic, useful, and sustainable solution

• may also help develop projects that neither perspective could have generated independently