8 - The autonomous citizen and the future of the universal welfare policy

Summary

In the introductory chapter, one of the challenges facing the universal welfare state was said to be the increased individualism among its citizens. How would the increased demand for self-determination fit the standardized services provided by such a welfare state? To shed light on this problem, I will open this chapter with a story from the real life and times of the Swedish welfare state. It has to do with the welfare state's intervention in a process which can be technically complicated, unforeseeable, hard to manage politically, and dramatic. Powerful interests are involved – on the part of professional groups, politicians and administrators on a range of levels, and the citizens themselves. The process is, moreover, often ethically complex at the same time. It exhibits, in short, all the features of what in the methodological literature is called a “critical case,” that is, it puts our hypotheses and theories to the severest test. For our example has to do with the public regulation and direction of how we come into this life – with the conditions of childbirth in the Swedish welfare state, in other words. Our case has to do, in other words, with the welfare state's management of citizens' lives even before they are placed in the cradle. It should be added that, contrary to for example, the situation in the United States, in Sweden it is professional midwives who are take care of the child-delivery process.