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Open Access Couldn’t care less? A psychosocial analysis of contemporary cancer care policy as a case of borderline welfare

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This article is Open Access under the terms of the Creative Commons CC BY licence.

This article engages with recent shifts in public healthcare policy in Norway through a psychosocial analysis of contemporary cancer care, which evokes the hope of cure and reparation in the psychosocial imaginary. With increasing incidence and prevalence, cancer is a persistent challenge for public health services. Policy makers therefore emphasise that resources must be prioritised while ensuring good-quality care for vulnerable citizens. In 2015, Norway implemented integrated patient pathways as national guidelines to standardise clinical assessment and medical treatment for patients with a suspected cancer diagnosis. In a text analysis of ‘the integrated breast cancer pathway’ as a framework for practice, we found the concept and practice of care absent. There were sparse descriptions of the relational responsibilities of health professionals, beyond informing and communicating. From a psychosocial care understanding, we problematise how the emphasis on information delivery presupposes a universally autonomous, competent, resilient and rational patient, rather than a particular human being with complex thoughts, feelings, needs and vulnerabilities in the face of a life-threatening illness. We refer to wider issues effected by neoliberal governance, which may profoundly impact on the relationship between professionals and patients. We raise the concern that integrated cancer care is a case of borderline welfare, characterised by a fear of feelings associated with mutual vulnerabilities and dependencies. We identify values and ethical pressures at stake in an emerging careless policy in Norwegian welfare, in light of the government’s stated ambition to become an international role model for good patient trajectories.

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Keywords: cancer care; ethical pressure; healthcare policy; psychosocial care; psychosocial imaginary

Document Type: Research Article

Affiliations: 1: University of Stavanger, Norway 2: University of Southern Denmark, Denmark

Publication date: October 2020

This article was made available online on September 17, 2020 as a Fast Track article with title: "Couldn’t care less? A psychosocial analysis of contemporary cancer care policy as a case of borderline welfare".

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  • The Journal of Psychosocial Studies publishes work that falls within the broad transdisciplinary area of Psychosocial Studies, defined by a commitment to understanding the significance of the links between internal and external worlds.

    Psychosocial Studies draws on a range of disciplines to explore the interactive relationships between self, culture and society. Whilst often focusing on affect and emotion it explores the complexities of subjectivity and experience as it is lived and shaped in different contexts and settings. This approach is defined by a commitment to exploration of the links between the internal and external worlds; both the deeply personal and profoundly social.

    We are interested in publishing papers that bring a psychosocial perspective that might help us understand a range of contemporary social phenomena. This might be work on family life, welfare practices, criminal justice issues, youth work, cultural products (such as film, art and literature).

    As the adopted journal of the Association for Psychosocial Studies (APS) we especially seek to promote work that is interdisciplinary and considers issues of practice. The Journal of Psychosocial Studies provides space for research and writing that crosses the traditional boundaries between disciplines in the social sciences, humanities and the arts. We also publish work that emerges from and reflects on practice (that might include for example: social work, education, law, business studies, psychotherapy, group analysis and counselling) that draws on these theoretical frames.

    The Journal provides both a supportive and an academically rigorous space for new and established researchers to disseminate ideas, and hence stimulate debate in the psychosocial field. We welcome submissions from across the globe. Our strong International Editorial Board ensures that the Journal of Psychosocial Studies provides a publishing platform that transcends international boundaries. All published academic articles undergo our thorough double-blind peer review process. Please see the instructions for authors to find out how to submit an article.

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