Neoliberal Rationality: A Primary Impetus for Reification and Derecognition of the Patient in Nursing Care
Bibliographic record
Abstract
In this article, I discuss the implications of the neoliberal transformations on healthcare that are justified under the aegis of economic efficiency. Drawing on the work of German critical philosopher Axel Honneth, I present a critical-social and philosophical perspective that reinterprets these transformations as pathological consequences with devastating impacts on how we understand what human beings and social relations are. I argue that in a neoliberal context, nursing care becomes a form of reification defined as 'forgetfulness of recognition' of the human identity of the patient which contradicts the assumed ethical foundations of nursing. The article provides a detailed account on how neoliberal rationality that governs nursing performance promotes an objective and a 'neutral stance' of care that neglects emotional engagement and deals with the patient as an object or a thing which violates all dimensions of patient recognition. I also emphasize that neoliberalism must rather be understood as a specific form of governmentality that goes beyond mere economization and structures a specific way of understanding people in the healthcare context. Neoliberal rationality, as conceptualized in this article, not only considers human being as homo economicus, where decisions are based on economic ideals, but also neutralizes relationships and disseminates an 'objective' and purely scientific stance in caring interactions. This leads to the detachment of nurses and reification of patients. Thus, nursing care is reduced to an instrumental rationality that focuses on technical care, which diminishes any possibility for nurses to engage with patients and understand their unique phenomenological world necessary for coping and recognition. Finally, nurses are urged to raise their voices against neoliberal rationality that programs their ideas of what 'good care' is. A critical emancipatory mode of thinking provides an opportunity to challenge neoliberal rationality and revitalize nursing agency to resist the devastating transformations taking place in health care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.031 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.007 | 0.148 |
| Scholarly communication | 0.013 | 0.013 |
| Open science | 0.003 | 0.014 |
| Research integrity | 0.007 | 0.014 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".