The shadow side of occupational therapy: Necropower, state racism and colonialism

Abstract

Background: In the Global North, advances in occupational therapy benefitted unduly from the oppression, disablement and suffering of thousands of people in the South (and beyond). To prevent the recurrence of these injustices, history must be unveiled and occupational therapists urged to come to terms with their own involvement and responsibility. Objective and Method: Utilising Achille Mbembe’s concept of necropolitics, this academic essay blends select historical and philosophical perspectives to explore occupational therapy’s concealed role in manifestations of institutionalised violence. Results: By examining its roles in World War II and France’s colonisation of Algeria, we make visible the development of occupational therapy’s distinct ‘shadow side’. In Nazi Germany’s Euthanasia Programme, it became a tool for identifying which lives were deemed ‘worthy of living’ and which were not, which indirectly contributed to the killing of 200,000 disabled persons. Under France’s colonial medical system, occupational therapy imposed Western standards that alienated and completely depersonalised Algerian patients. Conclusion and Significance: Entrenched in a (bio)economy that has endured beyond these events, occupational therapists must exercise vigilance, remaining mindful of the potential to unintentionally overlook individuals labelled as ‘unproductive’. This requires confronting the profession’s assumptions of inherent ‘goodness’ and acknowledging and addressing its shadow side.