42 Critiques of critical theory

In some ways, talk of critical theory as a homogenous field of sociological inquiry is misleading because although many of the marginalised groups share much in common about their opposition to patriarchal, elite, and occidental power, there are many variations within each field. In black political philosophy, for instance, there are advocates for afropessimism, African liberalism, black feminism, conservatism, culturalism, socialism, and many other smaller fields. Feminism, critical disability studies, queer theory, and other approaches are the same. That said, there are coherent principles underpinning critical theory that have been unpacked in this chapter, and have been the source of some significant criticism over the last half century.

The first major critique of critical theory was that it oversimplified power relations, often framing them as a binary between those that ‘held’ power and those who did not. The problem with seeing power in this binary fashion is that it tends to ‘essentialise’ and bunch people together in relatively unrefined categories, labelling them based on their degree of shared, often unearned, privilege. Under this scheme, all men can be characterised as mysogynists, and all colonial settlers as perpetrators of historical trauma. Critics have argued that critical theorists are often quick to use abstract pronouns to describe those in power (’the medical profession’, ‘bodies’, and ‘the state’, for example), whilst individualising the victims of oppression ^[1].

Paradoxically, some argue, critical theory also depends upon the existence of marginalised others for its very existence, so can sometimes appear to engage in oppression fetishism when highlighting peoples’ plight. Robyn Autry has suggested, critical theory ‘is, after all, deeply invested in its Others; racial others, gendered others, economic others, indeed every other other, is at the focal point of the discipline’ ^[2]. And yet, often, ‘too narrow a lens is applied when studying some of these social others’, and so it disappoints, ‘because it doesn’t know its others very well’ (ibid).

William Cockerham has suggested that critical theories bring some powerful tools of analysis, but often fail to explain why power persistently creates ‘haves’ and ‘have-nots’ ^[3], and how people facilitate the process ^[4]. Cockerham has also argued that critical theory can be unrealistic and utopian, in calling for a world without power asymmetries, but that critical theorists rarely engage with how that world would work in practice. It is often said that critical theorists are good at diagnosing the structures of oppression in society, but have the greatest difficulty imagining a world where power asymmetries have been eliminated.

Terence Halliday believed that critical theorists had been so caustic in their criticism of the health professions over the last 50 years, that it has ’led to a totally cynical sociological view of the professions’ ^[5]. In a similar vein, Deborah Lupton has suggested that critical theory has a reputation for its ‘unrelenting nihilism’, and a failure;

‘to recognise that advances in health status and increase life expectancy which have occurred over the past century, associated with improvements in the human diet, reforms in sanitation and the supply of clean water, a rise of standards of housing, better contraceptive technologies and progress in medical treatment and drug therapies, are intrinsically linked to the requirements and demands of the capitalist economic system’ ^[6].

So, although critical theory occupied, and still occupies, a powerful place within the sociology of the professions, critical theory fell out of fashion, somewhat, in the 1990s. The rejection of Marxism and socialism as grand political philosophies and the rise of neoliberalism, combined with the growing influence of post-structuralism, and the sense that critical theory explained little about the inter-personal, relational, and agential nature of healthcare practice, led to new branches of the sociology of the health professions that we will explore over the remaining chapters of the book.

In some ways, this evolution was brought about by a realisation that the activism of the 1960s and 70s had been led by white, relatively privileged, men and women in the Global North. McGibbon et al. have argued that this can be seen in healthcare in the reforms in nursing and midwifery, which were largely led by elite white female professional leaders, and continued ‘to create fertile ground for oppression of marginalized and racialized peoples’ ^[7]. What emerged from this was the field of intersectionality, a subject we will return to later. But before we can do this, we need to look at some of the schools of thought that critiqued critical theory and offered alternative ways to view the work of the health professions. Starting with the work of Max Weber.

Over the last decade, new forms of critical theory have emerged, and we have seen a resurgence of concern for forms of racialised violence, oppression based on gender and sexuality, social division, and ableism that were the subject of heated debates for activists in the 1960s and 70. The legacy of the identity politics that was the hallmark of radical activism, has resonated strongly in the Black Lives Matter and #metoo movements over the last few years. But critical theorists have also shifted to embrace the idea that many marginalised groups share common struggles with patriarchal culture.