Provocations on privilege in palliative care: Are we meeting our core mandate?

Abstract

While increasingly recognized as a human right, access to hospice and palliative care is still not a given. Even though palliative care as a concept seems to be unanimously supported, that is what it remains: an idea that only becomes reality for people privileged enough to access it. Those who do benefit tend to also benefit from high socio-economic status and family support. People who are facing the end-of-life who also face social and structural inequities like poverty, homelessness, racism, and stigma, are not so privileged. Modern day hospice and palliative care services are vital to ensuring high-quality care for those who are dying but such services may, albeit unintentionally, serve to privilege some people in need of palliative care while rendering ‘others’ invisible. In doing so, inequities in the provision of palliative care have been created that challenge the very root structure from which early hospice care originated.

Keywords:

• Palliative care
• structural vulnerability
• privilege
• equity
• homelessness

ORCID

Kelli I. Stajduhar http://orcid.org/0000-0003-2381-4712

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1 An individual’s vulnerability to suffering is viewed as the product of their location within the hierarchical social order within society, which encompasses not only political and economic inequalities but also a wider range of cultural determinants (e.g., the medicalization/pathologization of ‘at-risk’ populations, cultural views on the ‘worthiness’ of particular groups, etc.). For the purpose of this paper I am concerned with populations that are made structurally vulnerable due to housing instability, mental illness, substance use, street involvement, or racialization and colonization.