Inscription, Iteration, Transformation

In “Knowledge in policy”, Freeman and Sturdy propose a phenomenology with the aim of “knowing knowledge” (Freeman & Sturdy, 2014, p. 2). Knowledge can have different forms called “inscribed”, “embodied” and “enacted”. This framework is presented as a way to categorize and describe the form, the circulation and the transformation of knowledge in policy making. In the paper, we intend to focus on inscribed knowledge, and particularly on documents conceived as essential artefacts of public policies (Freeman & Maybin, 2011). Freeman and Sturdy defined inscribed knowledge as “written down in texts, or represented in pictures and diagrams; or it may be incorporated into instruments, tools and machines, among other things” (Freeman & Sturdy, 2014, p. 10). This form of knowledge is particularly “stable”, “easily reproducible” and “highly mobile” so “it can be communicated or made available to many different individuals separated in time and/or space” (Freeman & Sturdy, 2014, p. 10). This statement draws from works in sociology of science and technology. These works, especially Latour’s (1987) studies of the laboratory work and Law's (1986) analysis of control at distance particularly emphasize the power of inscriptions in constraining social action over time and space. By analysing the circulation and translation of two health policy documents, respectively, the eHealth Action Plan 2013-2018 and the Joint policy programme for patients with chronic disease(s) called “Integrated Care for Better Health”, we intend to address the following research questions: Do health policy documents intend to constrain health practitioners Actions and how? Do these documents actually influence health practitioners’ practices? Is this influence of documents independent from the context in which documents are translated? We address these questions by drawing on two PhD researches focusing on the devising and implementation of the above mentioned policy plans. By relying on interviews, observations and document analysis, we describe the policy strategies inscribed in documents as well as key moments of both documents’ trajectories. In so doing, we first emphasise that documents work by iteration (going back and forth between different kinds of actors and being related to and referred to in other documents). Second, we argue that documents contribute as much to create the very content of polices as to enforce the meaning they supposedly embody.