Objectivity as a Bureaucratic Virtue: The Lived Experience of Objectivity in an Israeli Medical Bureaucracy
Across bureaucratic contexts, “working in an objective manner” is a dominant ethical conception of appropriate bureaucratic conduct (e.g. Hoag 2011), constituting “objectivity” as a desired bureaucratic virtue. While anthropologists have examined local interpretations of objectivity and the implications of upholding objectivity as a virtue (e.g. Ferguson 1990; Herzfeld 1992), less is known about how bureaucrats themselves engage or negotiate this virtue in their everyday work. My dissertation directly addresses this lacuna through an ethnographic inquiry into how a group of Israeli medical bureaucrats cultivate an “objective disposition” when preparing data about medical treatments for the Israeli Medical Basket Committee (thereafter the Sal Committee, following its most known Israeli reference).
The Sal Committee meets annually to prioritize which new medical treatments will receive state subsidies as part of Israel’s public, universal healthcare system. Since Sal Committee’s decisions bear high stakes for patients and pharmaceutical companies, its work is executed amidst intense pressures. In response to these pressures, Sal Committee’s bureaucratic staff, who prepares information upon which the committee deliberates, stress their commitment to working “objectively.” Based on 16 months of participant-observation and interviews with staff members, I identified four central meanings they give to “working objectively:” (1) providing truthful data; (2) strictly following their bureaucratic timetable; (3) providing an authorless overview; (4) taking a non-emotional stance.
My dissertation considers how these conceptions shape the staff’s behaviors and affect the entire decision-making process. Situated at the intersection of anthropological scholarship on bureaucracy, ethics, and healthcare, and in conversation with scholarship in phenomenological philosophy and science and technology studies, this study shows how “objective” conduct is a product of a complex array of subjective experience, context-specific notions of “objectivity,” and dynamics of social power.