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Valuing healthcare improvement: implicit norms, explicit normativity, and human agency

Journal Article


Abstract


  • I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements. And improvement itself is unavoidably normative: it assumes that things could and should be better than they are. I seek to show that normativity will always be implicated in the creation of evidence, the design of programs, the practice of healthcare, and in citizens’ judgements about that care, and to make a case that engaging with this normativity is worthwhile.

Publication Date


  • 2018

Citation


  • Carter, S. M. (2018). Valuing healthcare improvement: implicit norms, explicit normativity, and human agency. Health Care Analysis, 26 (2), 189-205.

Scopus Eid


  • 2-s2.0-85031902831

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/3449

Has Global Citation Frequency


Number Of Pages


  • 16

Start Page


  • 189

End Page


  • 205

Volume


  • 26

Issue


  • 2

Place Of Publication


  • United States

Abstract


  • I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements. And improvement itself is unavoidably normative: it assumes that things could and should be better than they are. I seek to show that normativity will always be implicated in the creation of evidence, the design of programs, the practice of healthcare, and in citizens’ judgements about that care, and to make a case that engaging with this normativity is worthwhile.

Publication Date


  • 2018

Citation


  • Carter, S. M. (2018). Valuing healthcare improvement: implicit norms, explicit normativity, and human agency. Health Care Analysis, 26 (2), 189-205.

Scopus Eid


  • 2-s2.0-85031902831

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/3449

Has Global Citation Frequency


Number Of Pages


  • 16

Start Page


  • 189

End Page


  • 205

Volume


  • 26

Issue


  • 2

Place Of Publication


  • United States