Humanizing Institutional Policies

by HealthWrights Staff,

The policies and procedures that embody the goals and dictate the organizational structures of the major institutions in a society ideally should reflect the fundamental values of the society. This seems self-evident. When the institutions of a society conduct their business in a manner that is flagrantly at odds with its values, serious ethical and functional problems arise. This lack of harmony between values and practices in a society poses serious threats to the personal and interpersonal well being of its members.

Perhaps the set of shared values that should guide our common efforts on local, national and international levels is best captured by the term “democracy.” In the narrow sense, democracy means rule by the people. Alex Tocqueville, a shrewd observer of American life, was generally sympathetic toward the fledgling experiment in democracy that he observed. Even so, he warned of a danger. Majority rule can itself become a form of tyranny, he pointed out. It is for this reason that the principle of rule by the majority must be balanced by the realization that the rights of individuals and minorities must be protected. It was this understanding that undoubtedly led the framers of the constitution of the United States to amend the constitution with the bill of rights. These considerations suggest that a broadened understanding of democracy needs to include a recognition of the importance of several sub-values:

Participation in decision making within the social spaces one occupies.

Self-determination in the pursuit of happiness.

The dignity and worth of the individual.

Civil liberties.

There appears to be an emerging consensus across the political spectrum, and across national boundaries, that these values should provide the agreed upon guidelines for our common efforts. We see these values reflected for example, in the United Nations Declaration of Human Rights. Unfortunately these values are regularly set aside when they appear to be impediments to more pressing concerns. Also there are undoubtedly many people who feel these values should hold sway in the political sphere of life, but are not relevant for the business, educational, religious, governmental, law enforcement, and social service organizations that carry out the day to day business of society. In this section of the Politics Of Health site we will examine the proposition that democratic values should and can be made to guide and inform the interactions between people in all spheres of life. Indeed, if they don't, the weight of non-democratic practices will threaten the survival of democracy even in the political sphere.

One can think of democracy as being a mean between two extremes: totalitarianism and anarchy. In a totalitarian social structure there is little or no participation in decision making. In an anarchistic structure everybody is making decisions, but the processes of negotiation and orderly decision making are lacking, so the structure falls into chaos. In a democratic social structure one finds orderly and participatory patterns of decision making and planning that reflect and embody the previously designated sub-values of democracy.

On the level of institutional life, perhaps the most salient analysis of the totalitarian structure is to be found in Goffman’s concept of the total institution. The democratic alternative could be best described, perhaps, as a participatory pattern of administration. In a participatory system all the people who live in a particular social space participate in creating the norms and goals that structure the situation. These themes will be explored as they pertain both to the institutions of society that have mandates to care for vulnerable or deviant groups, and to the regular institutions of education, government and business that carry out the day to day functions that are necessary in any society. It is sometimes argued that democratic ideals are nice in theory, but that they are not efficient in practice. Throughout this section we will be looking at examples that challenge this cynical and pessimistic assumption. There is evidence that democratic social structures are not only more humane, but in the long run, more efficient as well. By relying on democratic institutions we will educate our children better, provide for a higher level of health care, deal with those who deviate from society's norms in a more rational, less expensive and more effective manner, and create and distribute the goods and services in society in a more effective manner.

***

Links to key articles highlighting how Institutional Policy affects the well-being of those who serve and are served by them.

Total Institutions

The Characteristics of Total Institutions, by Erving Goffman

An Outline of Total Institutions Characteristics

How Language Controls Thought

Total institutions and the Inmate's Re-entry to Society

Scapegoating: A Tough Weed to Uproot

Democratic Institutions

Participatory Administration

Changing Patterns in Residential Services

for the Mentally Retarded

Ben and Jerry's institutional modeling

The Dignity of Risk, by Robert Perske

Additional Resources

For a good bibliography on Goffman see the The Goffman Page.

The Disability History Museum states that it's mission is "to promote understanding about the historical experience of peoples with disabilities by recovering, chronicling and interpreting their stories."

For an entertaining web-site published by a socially responsible business, check out Ben and Jerry's. (You will love their cow.)

For a brief bio about Wolf Wolfensberger and some information about workshops he will be giving, this is a good site.

Link World provides interesting links pertaining to humanistic economics, among other things. There are some very interesting links in the sections entitled "Politics and Economics," and Politics and history."

If you wish to delve a little more deeply into cooperatively owned businesses, here are a couple of good places to check out:

The Canadian Cooperative Association

The University Center for Cooperatives.

http://www.politicsofhealth.org/index.php/poh/topics/humanizing_institutions/humanizing_institutional_policies