“Disorders of discourse” – practices
that constitute “barriers to communication”
– can be subjected to critique, and critique can
lead to the suggestion of different practices. Such changes
in discourse may contribute to changes in the “structures
of organizations.” However, in the absence of such
structural changes, changes in discourse may actually result
in more subtle, and thus more effective, forms of domination.
That is the central problem raised in this book. Interaction
between doctors and patients, teachers and pupils, politicians
and publics, etc., can change in ways that eliminate the
more obvious forms of interactional asymmetry, domination,
or manipulation; yet whether such changes contribute to
substantive democratization – or only give an appearance
of democracy, which can make relations of domination more
effective because less obvious – depends on how such
new forms of interaction fit within the overall network
of practices that constitutes the institution concerned.