As a healthworker I’ve been reflecting on the role of power in institutionalized sites of power such as hospitals, schools, prisons, psychiatric facilities, etc. On the left there is a popular discourse about medicine that sets up a binary. Medicine is alienating, hierarchical, and evil. Herbs, holism, popular healing, etc., is liberating. If you look at the role of capitalism in mediating even alternatives within, this binary crumbles immediately. Still there’s a particular problem for us who want to seem liberatory participatory social practices in society.
Some things require specialized knowledge that bring with it inherent hierarchies of knowledge that give it’s bearer power over others (potentially). Obviously this is mediated and rendered pathological by institutionalization of power through the state and capital (e.g. look at the role of law in both empowering and controlling physicians, and the exclusive power they are given over the populace which corresponds to a form of “state power” in the domain of health). As libertarians, how do we conceive of such professions that are embedded with power? We should push the boundaries of non-professional journalists, teachers, healthcare providers and make as much popular practice as possible. But some degree of specialization is required. Specialization is not inherently evil or pathological, but it’s worth thinking about how we hold such professionals accountable to society as a whole, when society may not have the resources necessary to judge the specifics.