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The Ethnographic
Radiographer
Ruth M. Strudwick
The Ethnographic Radiographer
Ruth M. Strudwick
The Ethnographic
Radiographer
Ruth M. Strudwick
School of Health & Sports Sciences
University of Suffolk
Ipswich, UK
© The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or
the editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.
This Palgrave Macmillan imprint is published by the registered company Springer Nature Singapore
Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
Firstly, thank you to my husband Mike for his constant support.
Thank you to my two doctoral supervisors: Dr. Stuart Mackay
and Dr. Steve Hicks.
Thank you to all my colleagues and particularly to Nancy for reading this
book and providing encouragement.
Finally, I would like to dedicate this book to my Dad, Anthony (Tony)
Cooper, who always believed in me, and died before he could see this book
in print.
Contents
2 Ethnographic Methods 13
6 Radiography Education 73
vii
viii Contents
Index133
1
Introduction to Ethnography
and the Ethnographic Researcher
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021 1
R. M. Strudwick, The Ethnographic Radiographer,
https://doi.org/10.1007/978-981-16-7252-1_1
2 R. M. Strudwick
Introduction
Ethnography has become for me a way of living and seeing the world.
Since the research methodology was introduced to me back in 2006
when I started my doctoral journey, I have seen the benefits of ethno-
graphic research and it has taken a grip on me. In reading this book you
should be convinced of the benefits of ethnography as a research method-
ology and its application to radiography. I love the simplicity of the
methodology but the structured way in which the research can work suits
my personality and the way in which I like to undertake research. The
ethnographic researcher is able to spend time with the participants of the
study and get to know them, learn about different groups of people and
study the ways in which groups of people live, behave, work and interact
with one another. For me, this is fascinating, getting to know people,
how they think and behave and asking questions opens a whole new world.
Ethnographic research employs the full range of research methods
available to any researcher using an obvious, common sense approach.
Observation is a key method of data collection, along with asking ques-
tions in both informal and formal settings using interviews and focus
groups. The ethnographic researcher also studies the artefacts and ‘props’
used within the group. This is very similar to the ways in which we all
make sense of our world, using all the senses. For me, the simplicity is
key. Yet, the ethnographic researcher can also utilise a systematic and
rigorous approach to research which also appeals to my structured and
logical brain. It is a great way to learn about different groups of people.
My introduction to ethnography as a methodology came by way of
being introduced to the film Paris is Burning (1990), an American docu-
mentary which was filmed in the mid-1980s. The film uses ethnographic
methods to study the ‘Ball Culture’ of New York city and the African-
American, Latino, Gay and Transgender communities involved in it. The
film director Jennie Livingston spent time with the group to learn about
ball culture and voguing. She also researched African-American history,
literature and culture, as well as reading up on queer culture and the
nature of subcultures. As well as spending time with the group, Livingston
undertook audio interviews with several of the ‘ball people’. The main
1 Introduction to Ethnography and the Ethnographic Researcher 3
scenes in the film were shot at the ‘Paris is Burning’ ball in 1986. The film
shows the culture of the group being studied through film clips of their
lives and their preparation for attending balls and through interviews
with the key members of the group.
This ‘opened my eyes’ to ethnographic research where the researcher
spends time with the participants, becoming and being part of the group
or culture being studied. The way in which the participant’s stories were
captured and illustrated allowed me, as the viewer, to gain an understand-
ing of their world and what it was like to be part of the group. Providing
such an insight into different groups of people was the hook for me.
Ethnography has its roots in both British social anthropology, where
researchers travelled the world to study foreign cultures and in American
Sociology (from the Chicago school) which used observation to explore
groups on the margins of urban industrial society. The task of these two
distinct groups was the same, to provide cultural descriptions of the
groups they had studied (Brewer 2000). Since then, ethnography has
developed and moved into other spheres such as education, health care
and social work. It has become a recognised form of qualitative research.
In many respects ethnography is really the most basic form of social
research; it bears a close resemblance to the routine ways in which we
make sense of the world around us in everyday life (Hammersley and
Atkinson 1995). Ethnography is as relevant now in contemporary
research as it was in historical anthropology.
Ethnography involves the study of a particular social group or culture
in their naturally occurring setting (Hobbs and May 1993; McGarry
2007). This means that the researcher moves ‘into the field’ and needs to
have access to the group. The researcher needs to become part of the cul-
ture being studied to gain understanding and insight and in order to
document their findings. In ethnography the researcher needs to have
direct and sustained contact with the group of people being studied
within their cultural setting, that is, where they are situated or where they
meet as a group. This involves watching what happens, listening to what
is said and asking questions (O’Reilly 2005). It also involves collecting
data to ‘throw light on’ the issues that are the focus of the research
(Hammersley and Atkinson 1995). The group should be studied in its
4 R. M. Strudwick
culture in radiography. The studies that had been written were focussed
on one particular aspect of radiography and the culture associated with it.
For example, Karasti et al. (1998) looked at the effect of teleradiology on
culture using ethnography in Finland, Larrson et al. (2008) investigated
knowledge in image production using observation in Sweden and Brooks
(1989) reviewed patient care in radiotherapy using interviews and obser-
vation. It became apparent that there was a gap in the literature at that
time, with very few ethnographic studies looking generally at the culture
in an imaging department and focussing specifically on diagnostic radiog-
raphers. Ethnography did not appear to be a widely used methodology in
radiography research. Since that time others have undertaken and pub-
lished ethnographic studies in radiography (Hayre et al. 2018; O’Regan
et al. 2019; Holmstrom 2019). The purpose of my doctoral thesis was to
write in detail about the work and workplace culture of the diagnostic
radiographer in order that those outside of radiography could gain an
insight into the profession and so that those within the profession of
radiography could critically evaluate their own profession and develop
their own practice.
I want to convince you that exploring who we are as a profession and
what the nuances are of our professional culture are key to understanding
why we behave in particular ways and how the diagnostic radiographer
fits into the healthcare system. The implications of studying and under-
standing radiography from this perspective mean seeing the profession in
a different light. Many of the studies carried out previously in radiogra-
phy are scientific and quantitative in nature and do not take account of
people’s ideas, feelings and values.
In understanding ourselves we can only improve. We can work better
with others, collaborate and work with others in the interprofessional
team, and we can improve the care that we provide to our service users.
These aspects are explored further in Chap. 7 – Interprofessional Learning
and Working, and Chap. 8 – Relationships with Service Users and Values-
Based Practice.
1 Introduction to Ethnography and the Ethnographic Researcher 7
of the different situations I have been in, along with the research findings
of others that will formulate these chapters.
more in-depth analysis. These four key themes appeared more frequently
throughout the study, from both the observations and the interviews.
The four key themes demonstrated new knowledge about the culture
within the department and were not found to be discussed in depth in
previous literature. The four key themes were: involvement with patients,
use of dark humour, blame culture and visible product. The four key
themes are shown in italics in Table 1.1.
Throughout this book data from my doctoral research findings, my
other research along with the research findings of others both in the field
of radiography and within ethnographic research will be used to give
rigour to the arguments presented in the text.
References
Allen D (2004) Ethnomethodological insights into insider-outsider relation-
ships in nursing ethnographies of healthcare settings. Nursing Inquiry 2004,
11(1), p14–24.
Brewer J D (2000) Ethnography. Open University Press, Buckingham.
1 Introduction to Ethnography and the Ethnographic Researcher 11
Brooks C (1989) Idealism and realism in patient care during radiotherapy treat-
ment. Radiography Today. Vol 55, Issue 627, August 1989, p16–21.
Fetterman D J (1989) Ethnography – Step by Step. Sage, California.
Gold R L (1958) Roles in Sociological fieldwork. Social forces, Vol. 36,
pp217–223.
Hammersley M and Atkinson P (1995) Ethnographic Principles in Practice. (2nd
Edition) Routledge, London.
Hayre C M, Blackman S, Calton K and Eyden A (2018) Attitudes and percep-
tions of radiographers applying lead (Pb) protection in general radiography:
An ethnographic study. Radiography (February 2018), Vol 24, Issue 1,
p e13-e18.
Hobbs D & May T (Eds.) (1993) Interpreting the field – Accounts of ethnogra-
phy. Oxford University Press, Oxford.
Holmstrom A (2019) Radiography Students’ Learning of Plain X-Ray
Examinations in Simulation Laboratory Exercises: An Ethnographic
Research. Journal of Medical Imaging and Radiation Sciences, Vol 50, Issue
4, December 2019, p557–564.
Karasti H, Reponden J, Tervonen O and Kuutti K (1998) The teleradiology
system and changes in work practices. Computer Methods and Programs in
Biomedicine, 57 (1998), 69–78.
Larrson W, Lundberg N and Hillergard K (2008) Use your good judgement –
Radiographers’ knowledge in image production work. Radiography (2008),
https://doi.org/10.1016/j.radi.2008.09.003.
McGarry J (2007) Nursing relationships in ethnographic research: what of rap-
port. Nurse Researcher 2007, 14, 3, p7–14.
O’Regan, Robinson L, Newton-Hughes A and Strudwick R (2019) A review of
visual ethnography: Radiography viewed through a different lens.
Radiography, Vol25, Supplement 1, October 2019, p s9-s13.
O’Reilly K (2005) Ethnographic Methods. Routledge, London.
Paris is Burning (1990) Directed by Jennie Livingston, Academy Entertainment
Off White Productions.
Strudwick R M (2011) An Ethnographic Study of the Culture in a Diagnostic
Imaging Department. DProf Thesis, Unpublished, University of Salford.
Strudwick R, Mackay S & Hicks S (2011) Is There a Blame Culture in Diagnostic
Radiography? Synergy. December 2011, p4–7.
Strudwick R, Mackay S & Hicks S (2012) Cracking up? The use of dark humour
in the radiography department. Synergy. February 2012, p4–7.
12 R. M. Strudwick
Strudwick R, Mackay S & Hicks S (2013) It’s good to share – The importance
of discussion and story-telling in diagnostic radiography. Imaging and
Therapy Practice. March 2013, p27–31.
Strudwick R M (2014) The Radiographic Image: A Cultural Artefact?
Radiography, Vol 20. Issue 2, May 2014, p143–147.
Strudwick R (2015) Creating a Professional Culture. Imaging & Therapy
Practice, September 2015 p23–29.
Strudwick R (2016) Labelling patients. Radiography, Vol 22. Issue 1, February
2016, p50–55.
Strudwick R (2018) Blame Culture in the National Health Service (NHS), UK
in Thomas W, Hujala A, Laulainen S & McMurray R (2018) The Management
of Wicked Problems in Health and Social Care. Routledge, London.
Strudwick R (2020) Ethnographic investigations of a diagnostic imaging depart-
ment in Hackett P M W & Hayre C M (2020) Handbook of Ethnography
in Healthcare Research. Routledge, London.
Vine T, Clark J, Richards S and Weir D (2018) Ethnographic Research and
Analysis: Anxiety, Identity and Self. Palgrave Macmillan, London.
Wolcott H F (1999) Ethnography – A Way of Seeing. Altamira Press, Oxford.
2
Ethnographic Methods
Introduction
As outlined in Chap. 1, the main research methods used in ethnographic
research are observation, focus groups or interviews and the examination
of documents and artefacts. Ethnography employs several research meth-
ods, which link findings together and allow for what Richardson and St.
Pierre (2005) call crystallisation. Richardson and St. Pierre (2005) argue
against the more quantitative term ‘triangulation’ saying that this term
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021 13
R. M. Strudwick, The Ethnographic Radiographer,
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directly control all important agencies of production. It should own all
the land, the public utilities such as railroads and telegraph lines, the
mines, and all the agencies of production (pp. 481-488).
Both individualism and socialism represent extremes; most men
take a midway stand as regards the proper functions of government.
The greatest good of the greatest number among the people cannot
be secured unless the government interferes to some extent with the
free play of economic forces. It must prevent gross injustice
wherever gross injustice appears. No government fulfils its highest
aim unless it becomes an ever-active force in making our common
life more human and more fruitful in the good will of class toward
class and of man toward man. On the other hand it must take care
not to invade the field of private enterprise so far as to take upon
itself greater burdens than can be properly carried.
Too much government is as bad as too little. In a democracy,
where public officials are chosen by popular vote, often with little
reference to their personal ability, there are obvious limits to what a
government can do and do well. The individualist starts with the
assumption that governments are always inefficient when they
meddle in affairs of everyday life. The socialist, on the other hand,
assumes that governments can always secure better results than
private enterprise in any field of economic activity. The truth, as
usual, lies between the extremes. To fix a rigid line between the two
sets of functions, as one would draw the boundary of two countries
on a map, is impossible. To attempt this would be to forget that
civilization is ever moving on, bringing new social needs in its train.
Every proposal to extend the functions of government must be
determined on its own merits and not upon the basis of its
conformance to any rule.
The World a Great Laboratory for Government as a
Experiments in Government.—Everywhere science.
throughout the world the process of experiment in forms of
government is going on, twenty-four hours a day, in ceaseless round.
And it has been going on for more than two thousand years. Every
experiment in political organization that the human mind can suggest
has had, or is having, its trial somewhere. During the past few years
we have seen earth’s proud empires pass away and new republics
rise in their stead, just as two thousand years ago the great Roman
republic collapsed and an empire took its place. The astronomer who
scans the heavens with his telescope commands no such laboratory
of endless experiment and sees no such continuous panorama of
change as the student who watches with naked eye the political
activities of his fellow-men. That is what makes the study of
government, when carefully pursued, the most interesting and most
instructive of all studies. “On earth”, as the poet Pope has said,
“there is nothing great but man”. And it is in his organized activities
that man shows himself at his best.
General References
James Bryce, Modern Democracies, especially Vol. I, pp. 24-50; II, pp. 335-
610;
Woodrow Wilson, The State, pp. 1-68;
J. Q. Dealy, The State and Government, pp. 119-181;
J. W. Garner, Introduction to Political Science, pp. 86-204;
Stephen Leacock, Elements of Political Science, pp. 3-51; 141-153;
Cyclopedia of American Government. (See under State Government, Social
Compact Theory, Separation of Powers, etc.).
Group Problems
1. To what extent should the government engage in business? The original
functions of government. Growth of governmental activities. Extent of
governmental enterprises in European countries. Government enterprises in
America. Effects of government enterprises on private initiative. Effects on the
government itself. Relation of government activities to the maintenance of
democracy. Conclusions. References: J. W. Garner, Introduction to Political
Science, pp. 273-310; Woodrow Wilson, The State, pp. 41-57; Stephen
Leacock, Elements of Political Science, pp. 386-409; J. G. Brooks, The Social
Unrest, pp. 46-67.
2. The faults of democratic government. References E. L. Godkin, The
Unforeseen Tendencies of Democracy, pp. 96-144; Emile Faguet, The Cult of
Incompetence, pp. 12-36; A. M. Kales, Unpopular Government in the United
States, pp. 21-90; Alleyne Ireland, Democracy and the Human Equation, pp. 80-
118; A. B. Cruikshank, Popular Misgovernment in the United States, pp. 1-27.
3. The merits of democratic government. References: C. W. Eliot, American
Contributions to Civilization, pp. 1-102; James Bryce, Modern Democracies,
especially, Vol. II, pp. 527-610; J. Q. Dealey, The State and Government, pp. 338-
353.
Short Studies
1. What end does the state serve? Woodrow Wilson, The State, pp. 58-68.
2. The stages in the development of government. J. Q. Dealey, The State
and Government, pp. 24-45.
3. The divine right of kings. R. G. Gettell, Readings in Political Science, pp.
118-120; Cyclopedia of American Government, Vol. I, p. 605.
4. The Mayflower compact. William MacDonald, Documentary Source Book
of American History, p. 19; Edward Channing, History of the United States, Vol. I,
pp. 308-310.
5. Does federalism mean weak government? A. V. Dicey, The Law of the
Constitution, pp. 162-172; James Bryce, American Commonwealth, Vol. I, pp.
334-341.
6. The system of checks and balances. W. B. Munro, The Government of the
United States, pp. 47-52; The Federalist, No. 47.
7. The meaning of self-government. P. L. Kaye, Readings in Civil Government,
pp. 15-21.
8. The relation of government to economic life. S. P. Orth, Readings in the
Relation of Government to Property and Industry, pp. 25-38.
9. The first principles of democracy. F. A. Cleveland and Joseph Schafer,
Democracy in Reconstruction, pp. 48-66.
10. Jeffersonian and Jacksonian democracy. A. C. McLaughlin, Steps in the
Development of American Democracy, pp. 78-116.
11. The outlook for democracy in America. F. A. Cleveland, Organized
Democracy, pp. 438-448.
12. The economic functions of government. C. J. Bullock, Introduction to
the Study of Economics, pp. 478-492.
Questions
1. What is the difference between a state and society? Is India a state? Are the
Esquimos a state? Are pirates citizens or subjects of a state? Did the Mayflower
Pilgrims constitute a state before they touched land?
2. Has the doctrine of evolution affected our ideas concerning the origin of
government? Are there any primitive types of government in the world today?
3. Give some examples of the “constructive work of government” besides those
mentioned in the text.
4. Why are ancient classifications of government practically useless today?
When you say that the United States is a federal democratic republic what ideas
do you intend to convey in each of the three italicized words?
5. Do you believe that the plan of government now existing in the United States
would be suitable for (a) the British Empire; (b) China; (c) Switzerland; (d)
Canada? Tell why or why not in each case.
6. Make up lists of the functions which properly belong to national, state, and
local governments respectively. Give your reasons for placing such things as
“education”, “fire-protection”, “public health”, “criminal law”, “conservation of natural
resources”, and “regulation of commerce” in one or the other list.
7. James Madison once said that the concentration of legislative, executive, and
judicial powers in the same hands would be “the very definition of tyranny”. What
did he mean? Was he right? Does the same danger exist today?
8. Arrange the mandatory functions of government in what you believe to be
their order of importance and give reasons for your arrangement.
9. Can you name any characteristics of American government other than those
given in the text? Do the following things distinguish American government from
other governments: woman suffrage, an elective president, the absence of an
hereditary nobility, two-chambered legislatures, a supreme court?
10. In what ways may direct government be better than representative
government and in what respects not so good? (Consider such general problems
as ensuring responsiveness to the will of the people, deliberation, the absence of
corruption, educational value, and expense.)
11. What did President Wilson mean when he said that the world must be made
“safe for democracy”? Can the world be safe for democracy while great and
powerful monarchies remain? What changes in addition to the dethronement of the
Kaiser did Americans consider essential in order to make Germany a democracy?
12. Argue against the proposition that the study of government is the study of a
science.
Topics for Debate
1. Written constitutions have been a hindrance rather than a help to the
development of American democracy.
2. Andrew Jackson was more of a democrat than Thomas Jefferson.
3. It is not right under any circumstances to subject a people to government
without their own consent. #/
CHAPTER V
THE CITIZEN, HIS RIGHTS AND DUTIES
The purpose of this chapter is to explain who are citizens, what their rights
and duties are, and how training for citizenship is obtained.
By Edward Simmons
In the New York Criminal Court House.
This mural decoration is placed above the pen in
which the prisoners are kept. Equality, holding a globe
and compasses, displays a sternness and rigor which
Fraternity, with a kindly grip of the arm, is seeking to
soften. Liberty, to the right, has broken the chain which
held him down, in spirit as well as in body. These three
words, Liberté, Egalité, Fraternité, formed the motto of
the French Revolution, and they have been the slogan
of militant democracy ever since.
Short Studies
1. First steps in civil liberty. James H. Tufts, Our Democracy, pp. 101-116.
2. What are the “privileges and immunities” of citizens? Arnold J. Lien,
Privileges and Immunities of Citizens of the United States, especially pp. 31-68.
3. Expatriation. G. B. Davis, Elements of International Law, pp. 143-151; W. E.
Hale, International Law (4th ed.), pp. 239-255.
4. Freedom of speech and of the press. Cyclopedia of American Government,
pp. 57-58; T. M. Cooley, Constitutional Limitations, pp. 596-638.
5. Freedom of worship. James Bryce, American Commonwealth, Vol. II, pp.
763-771; C. W. Eliot, American Contributions to Civilization, pp. 18-21.
6. The rights of the citizen against the government. F. A. Cleveland,
Organized Democracy, pp. 80-96.
7. The right to fair judicial process. Emlin McClain, Constitutional Law of the
United States, pp. 315-332.
8. How the hindrances to good citizenship may be removed. S. E. Baldwin,
The Relation of Education to Citizenship, pp. 27-54.
9. The playground as a place of education for citizenship. Joseph Lee, Play
in Education, pp. 360-391.
10. How the business man can help his community. Henry Bruère, The
New City Government, pp. 384-400.
11. How women can serve their community. Mary R. Beard, Woman’s Work
in Municipalities, especially pp. 319-337.
12. May the obstacles to good citizenship be overcome? James Bryce, The
Hindrances to Good Citizenship, pp. 105-134.
13. School government as a training for citizenship. U. S. Bureau of
Education Bulletin No. 8 (1915), pp. 7-31; Irving King, Education for Social
Efficiency, pp. 158-176.
Questions
1. What is the difference between the following: citizens, subjects, nationals,
residents, denizens, aliens?
2. What is meant by the expression to “swear allegiance”? To “forswear
allegiance”? Repeat the oath of allegiance. When is the oath taken (a) by aliens;
(b) by citizens?
3. Are the following American citizens by birth: (a) a boy born abroad, of alien
parentage, whose parents came to the United States and were naturalized after he
was over twenty-one years of age; (b) children of Chinese parents, born in the
United States; (c) children of American parents, born in the Philippines; (d)
children of Porto Rican parents, born in Europe since 1917?
4. Name four important civic rights. Arrange in each case a set of facts which
would constitute a violation of a civic right.
5. The constitution provides that the people shall have the right to assemble
peaceably. Would it be a violation of this right to require that a permit from the
police must be had in order to hold any meeting in the streets or in the public
parks?
6. Discuss the extent to which the public school is a “miniature democracy”. Is it
organized like a democratic government? To what extent and under what
circumstances can school pupils be entrusted with self-government or given a
share in the maintenance of discipline?
7. To what extent can public opinion be relied upon to enforce the rules (a) in
athletics; (b) in the class-rooms; (c) in business; (d) in government? Would laws be
effective if there were no penalties but the censure of public opinion to enforce
them? If not, why not?
8. What is the value of a high school or college education in training young men
and women (a) to make a living; (b) to become leaders; (c) to help their fellow-
citizens; (d) to hold public office? Towards which of these things does education
contribute the most?
9. Can any one be a good citizen without knowing how government is carried
on? Without knowing American history? Without belonging to any social or civic
organization? Without voting at elections? Without being at all interested in social
or political questions?
Topics for Debate
1. No one who is not a citizen should be permitted to become a voter.
2. The obligation of military service ought to be imposed upon aliens as well as
upon citizens.
3. The teaching of civics should be made compulsory in all grammar and high
schools.
CHAPTER VI
POPULAR CONTROL OF GOVERNMENT
The purpose of this chapter is to explain how the people, both directly and
indirectly, control all branches of government in the United States.
Public Opinion and Representative Government
How the People Rule.—In free governments The ultimate
the will of the people prevails in the decision of sovereignty of the
all important matters. This does not mean, of people.
course, that the people decide every question directly, but merely
that when a substantial majority of them have reached a decision
upon any point their will prevails through one channel or another.
The wishes of the American people have at times been thwarted by
their government; but in the long run, when the people have made
up their minds, their will has brushed aside every obstacle and has
become the supreme law of the land. This popular control of
American government is exerted in four ways, namely, by the
pressure of public opinion upon all officials, by the periodic election
of representatives, by direct law-making through the initiative and
referendum, and by the action of the people in amending their state
constitutions.
The pressure of public opinion is continuous, and it is exerted in
various ways. The government cannot proceed very far in defiance
of it. The election of representatives, on the other hand, takes place
at stated intervals, and in the period between elections the people do
not have direct control over those whom they elect. But where
provision for the initiative and referendum exists, the people may
frame and enact laws without the intervention of their representatives
and thus may exercise direct control. Finally, the ultimate agency of
popular sovereignty is the power of the people to amend their
constitutions. So far as the state constitutions are concerned they
accept or reject proposed changes by their own votes; in the case of
the national constitution they act through their representatives in
Congress and in the state legislatures. By these four methods of
control we maintain what is known as the sovereignty of the people.
Popular Rule through Public Opinion.—We What is public
hear a good deal nowadays about public opinion?
opinion. What is it? How is it ascertained? How does it make itself