Canadian telehealth networks and the mapping of telehealth's virtual regions: A critique of Anthony Giddens's structuration theory.

摘要

Critical of the technical and policy-oriented literatures on telehealth applications and evaluation methods, this thesis explores the implications of current research that both promotes the growth of telehealth networks and develops assessment and implementation programmes based on precepts borrowed from Anthony Giddens's theory of structuration and other purportedly ‘reflexive’ theories originating from the post-World War II sociological orthodoxy. I argue that such theories, more so than providing a viable theory of telehealth technology uptake and assessment, in fact contribute to a decidedly dominatory conception of technology-user subjectivity. They also signal a marked inattention on the part of telehealth researchers to the significance of the existing power relations between different telehealth users, these deriving from the distinctively geographical implications of the formation of ‘virtual care regions’. The thesis concludes that rather than working to dissolve the materially existing health care hierarchies in the Canadian health care policy context, massified telehealth networks work to delimit the dimensions of accessibility accorded to particular groups in Canadian society, in a manner akin to the making of maps.