Benner's remnants: Culture, tradition and everyday understanding

Abstract

Background. Benner's account of meaning and embodiment in nursing depends on a theory which she has never fully articulated, although she makes numerous allusions to it. Behind the background of shared meanings hovers something called 'culture', which provides each individual with meaning, determines what counts as real for her, and actively hands down interpretation-laden practices. This view is based, Benner claims, on the Heideggerian assumption that the meaning and organization of a culture precedes individual meaning-giving activity.Aim. I explore Benner's implicit view of culture, drawing on her published work over 15 years, and offer an appraisal of it. In doing so, I attempt to make sense of some rather strange remarks Benner has recently made about 'remnants' of Cartesian and Kantian thinking being found in the everyday understandings of people with asthma.Methods. The concept of culture is developed with reference to both Benner's own work and that of the anthropologist, Clifford Geertz, whose work she frequently cites. Having identified the principal tenets of what we might conveniently call the Benner-Geertz theory, I proceed to interrogate the theory, using the recent anthropological literature - and, in particular, materialist attacks on the idea of culture as a system of meanings - in order to cast doubt on it. I also review, very briefly, an alternative way of understanding 'culture', which is not vulnerable to the same criticisms.Conclusions. Benner's implicit theory of culture is revealed, somewhat ironically, as an inverted form of Cartesian dualism. Its intellectual provenance is not Heidegger, who appears to reject it, but the sort of American sociology associated with Talcott Parsons. As a corollary, it is suggested that Benner's 'remnants' analogy cannot be justified, and that the idea of Cartesian and Kantian concepts permeating Western culture, infecting both the providers and receivers of health care, is a myth.