Critical Perspectives on Health, Illness, and Medicine in Finland

A recent special issue of the Finnish philosophical magazine niin & näin (2/2021) focuses on questions of health, illness, and medicine from a multidisciplinary and critical perspective. As I was planning the issue during the first months of the pandemic, I wanted to bring together researchers who are interested in how personal experiences of illness and health as well as medical notions and practices are entangled with complex social and political systems, structures, and norms. The key idea was that it is important for philosophers and other humanities scholars and social scientists to create knowledge about experiences of illness and health, but it is likewise important to pay attention to how those experiences are shaped by society and culture and to how medicine and medical practices are entangled with structures of power (see also Viney et al. 2015).

The pandemic has particularly shown how crucial it is to listen to personal stories of illness and to examine critically the different biases, blind spots, and oppressive practices involved in healthcare that not only prevent individuals from receiving the help they need but also undermine citizens' trust in public health practices and guidelines. At the same time, the spread of COVID-19 has revealed an urgent need to contest disinformation about illness and healthcare and to recognize the dangers of emotional and evocative narratives about individual experiences that easily become viral and representative and which may be used to spread propagandist and pseudoscientific claims (see also Mäkelä et al. 2021).

The writers of the special issue have backgrounds in philosophy, medical ethics, theater, musicology, anthropology, narrative studies, and journalism. They discuss the meanings and forms of care as well as the notions of disability and ability: What kind of bodies are seen as capable or disabled? What kinds of care are there other than medical? How do stories affect how we understand illness, health, and wellbeing? And how do cultural values influence our understanding about healing and medical evidence?

The contributors look at the ways in which structures of power shape and are brought forth in personal experience, for example, in the soundscapes of care homes (Tarja Rautiainen-Keskustalo), in the scenes of theater (Riikka Papunen), in media narratives about dying (Samuli Björninen), and in anorexia patients' stories (Åsa Slotte). They develop new ways and methods of encountering illness and disability. For example, musicologist Tarja Rautiainen-Keskustalo's article reminds readers that buzzwords like "listening" and "empathy" are often used to turn focus away from the systemic problems of healthcare: staff shortages, stress, and difficult working conditions. In contrast, Rautiainen-Keskustalo's text outlines a method of listening that brings forth institutional structures in care homes: listening carefully to empty halls, occasional footsteps, wheelchairs, and scattered voices reveals how structures of power are materialized in spaces inhabited by fragile bodies. Actor and researcher Riikka Papunen, in turn, examines the relationship between a disabled and a non-disabled actor based on her own and her colleague's experiences of performing in disability theater productions. The non-disabled actor's role is to support the disabled actor, but Papunen underscores that the relationship should be redefined and understood as mutual: the support works in two directions. She also notes how harmful the traditional view of an actor as mentally and physically able-bodied is: "As long as ability is seen as an ideal that has to be reached and as an unquestioned norm of being a human and as the only right way of being, the polarized situation between mental disability and mental capability is maintained and only becomes stronger."

Other articles focus on the cultures of healing and the marginalized role of folk medicine in the Finnish healthcare system (Marja-Liisa Honkasalo) as well as on the way medical evidence is employed in medical decisions (Pekka Louhiala and Oskar Lindholm) and in policies concerning the treatment of addiction (Susanne Uusitalo). These texts scrutinize how the efficacy of different treatment practices is assessed, and the writers emphasize that the interpretation of medical evidence is always culturally mediated and that every medical decision contains...