Neoliberally framed suffering in professionals and patients in palliative care settings – ’telling cases’ from an ethnographic multi-sited field study in Denmark

ABSTRACT

In western countries, palliative care is a part of the formal healthcare system, ruled by neoliberal, organisational ideas. This Danish study illuminates how nurses and patients with non-western immigrant backgrounds (inter)act in relation to encounters in palliative care settings. Two ‘telling’ cases were selected, based on interviews and participating observations from a multi-sited ethnographic field study in Denmark. The results showed different care consequences of the structural framework, referring to, for example, political healthcare logics, strategies, and priorities, and illuminated how neoliberally organised healthcare systems inflicted suffering on patients and frustration amongst professionals. It did not seem that the immigrant background per se induced the challenges. The understandings of care and treatment conflicted as nurses often represented a medical, neoliberal logic of disease, treatment, and care, and patients often represented a non-medical logic of disease, formed by their lives. When palliative care took place in a general setting, (inter)actions were also influenced by a curative agenda of treatment and care. The study added to the evidence of the power of neo-liberal rationality across different forms of care and populations, regardless of ethnicity or location of that care.

KEYWORDS:

• Encounters
• healthcare professionals
• immigrants
• neoliberalism
• palliative care

Acknowledgments

Thanks to all participants in the study. Thanks to the Danish Cancer Society (R13-A662-09-S3), Helsefonden (2011B146), and the University of Southern Denmark for financial support for the project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Sample CRediT author statement

• Stinne Glasdam: Conceptualisation, Methodology, Formal analysis, Writing- Original draft preparation, Writing – Review & Editing.

• Hanne Bess Boelsbjerg: Methodology, Formal analysis, Investigation, Writing- Original draft preparation, Writing – Review & Editing.

• Sigrid Stjernswärd: Conceptualisation, Methodology, Formal analysis, Investigation, Writing- Original draft preparation, Writing – Review & Editing.

Additional information

Funding

The work was supported by the University of Southern Denmark; Danish Cancer Society [R13-A662-09-S3]; Helsefonden [2011B146].

Notes on contributors

Stinne Glasdam

Stinne Glasdam is Associate Professor at Department of Health Sciences, Lund University and teaches at the bachelor, master, and doctoral level, primarily in oncology and qualitative research methods. Glasdam was educated as a nurse in 1987 (Odense, Denmark), master in Nursing Science in 1996 (Aarhus University, Denmark), and PhD in 2003 (Faculty of Art, Copenhagen University, Denmark). Glasdam has worked at university colleges and universities since 2002. Research interests are primarily sociological medicine within the areas: oncology, gerontology, antimicrobial resistance, COVID-19, media, relatives, and professions. Glasdam has extensive experience in interdisciplinary collaborations nationally and internationally. Glasdam has edited and written several textbooks primarily for undergraduate students in health sciences and the pedagogy field. In addition, Glasdam has published several scientific and popular scientific articles. Glasdam is part of several (inter)national research and professional networks related to oncological care, medical sociology, and more.

Hanne Bess Boelsbjerg

Hanne Bess Boelsbjerg is postdoctoral researcher at the project “Heart openings: The experience and cultivation of love in Buddhism, Christianity, and Islam” at the Interacting Minds Centre, the Faculty of Medicine, Aarhus University, Denmark. Boelsbjerg has a MA, Study of Religion (2008, Aarhus University) and a PhD (2017) from the Faculty of Health Sciences, University of Southern Denmark. Research interests are primary: death and dying, religion, relations, professional competencies. In addition, Boelsbjerg has published several scientific and popular scientific articles. Boelsbjerg has experience of national and international interdisciplinary collaborations and is a member of several (inter)national research networks.

Sigrid Stjernswärd

Sigrid Stjernswärd is Associate Professor at the Department of Health Sciences, Lund University. She teaches at the bachelor, master, and doctoral levels, primarily in qualitative research methods, e-health, and psychiatry. Stjernswärd has a Bachelor of Arts (1996, Lund University, Sweden), a nursing degree (2000, Malmö University, Sweden) with a specialisation in psychiatry (2019, Lund University, Sweden), a master in Nursing Sciences (2005, Malmö University, Sweden), and a PhD (2009) from the Faculty of Health & Society, Malmö University, Sweden. Stjernswärd has worked at university colleges and universities since 2010. Research interests are primarily: mental health and psychosocial interventions, trauma, family support, e-health, mindfulness and compassion, social media and COVID-19, and interdisciplinary research endeavours. In addition, Stjernswärd has published several scientific and popular scientific articles. Stjernswärd has extensive experience of national and international interdisciplinary collaborations and is a member of several (inter)national research networks.