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First published on February 7, 2008 Science, Technology & Human Values 2008, doi:10.1177/0162243907312954
Dealing with Independence: Doctoring in Physical Rehabilitation Practice
Rita Struhkamp, Ph.D.*,
Annemarie Mol, Ph.D.,
and
Tsjalling Swierstra, Ph.D.
University of Twente, Faculty of Behavioral Sciences
* To whom correspondence should be addressed. E-mail: struhkamp{at}hotmail.com.
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Abstract |
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By now, the laboratory tradition, crafting transportable knowledge that allows for comparison, has been amply studied. However, other knowledge traditions, notably that of the clinic, deserve further articulation. The authors contribute to this by unraveling some specificities of rehabilitation practice. How do laboratory and clinical traditions in rehabilitation relate to independence? The first seeks to quantify peoples independence; the latter attends to qualitatively different ways of being independent. While measuring independence is a matter of aggregating scores on a priori established dimensions, clinical rehabilitation concerns coordinating different ways of being independent. While independence scales map a linear development in time, rehabilitation participants juggle with time, including uncertain futures in their present. In clinical practice, then, independence is neither a single, coherent, fact nor a clear-cut, stable goal. Instead, professionals as well as patients work by creatively doctoring with the large variety of elements that are relevant to daily life with long-term disabilities.

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