(en) This is a research study on users and professionals in Chilean public health in contexts of change and reform. By examining their accounts, we can understand how they are shaped as subjects of health, determined by three devices (dispositifs) that constitute what we call the health institution. The therapeutic, service and participation devices largely determine the experience of receiving care, working and participating in public health, shaping different scenarios in which power is exercised over individuals.
As health is a field in which relational professions predominate, an important scenario of power is the relationship that is reconfigured and acquires specificity in each of the devices in the form of therapeutic, service and participation relationships. We will see how, in each of these settings, subjects present themselves and represent others based on three manifestations that are particularly significant in their experiences, both by their presence and by their absence: to experience, to tell and to be heard.
The great challenge for health subjects is to keep open the possibility of governing their processes of subjectivation so that they are not merely the result of the determination they receive from the devices. The constant changes to which they are exposed demand new positions from them. New subjects require new institutions that allow them to meet and recognise each other in a reflective, hospitable and pluralistic framework. To achieve this, institutions must not be indifferent to what happens to health subjects and must be capable of providing the support they need.