ABSTRACT
The dualism is at the root of the issues concerning patients, power, responsibility and reform. Indeed, it is a choice between two incompatible concepts of order. The first is one of control, hierarchy and 'expertise' offered by others who know our interests best. The second concept of order is one of evolutionary trial and error, deduction and controlled experiment, surprise and dynamism. This is the choice between the design device of ideology and the filter device of experience. It implies quite different principles of latency, or the potential of the individual, and the evolutionary pattern of nature. A dynamist believes in an open-ended future in which spontaneity and choice releases local knowledge, invention and adaptation, and generates unforeseen benefits. A technocratic approach – by denying direct user feedback and response – makes things worse, and at the expense of both individual self-responsibility, and the security and control which it ostensibly offers.
