The expression of ‘policy’ in palliative care: A critical review

Whitelaw, S. , Bell, A. and Clark, D. (2022) The expression of ‘policy’ in palliative care: A critical review. Health Policy, 126(9), pp. 889-898. (doi: 10.1016/j.healthpol.2022.06.010) (PMID:35840439)

Abstract

The importance of ‘policy’ within palliative care has steadily increased over the past 25 years. Whilst this has been welcomed within the palliative care field and seen as a route to greater recognition, we focus here on a more critical perspective that challenge the effectiveness of a ‘policy turn’ in palliative care. Applying Bacchi's “What's the Problem Represented to Be?” (WPR) framework to data from a systematic search, we address the research question, “in what ways has ‘policy’ been articulated in palliative care literature?”. The paper describes the construction of ‘the problem’ context and reflects critically on the robustness and pragmatic utility of such representations. In particular, we identify five elements as prominent and problematic: (1) a lack of empirical evidence that connects policy to practice; (2) the dominance of ‘Global North’ approaches; (3) the use of a policy narrative based on ‘catastrophe’ in justifying the need for palliative care; (4) the use of idealistic and aspirational ‘calls to action’; and (5) a disengaged and antagonistic orientation to existing health systems. We conclude by suggesting that the efficacy of palliative care policy could be enhanced via greater emphases on ‘Global South’ perspectives, ‘assets-based’ approaches and attention to pragmatic implementation.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Clark, Professor David and Bell, Mr Anthony and Whitelaw, Dr Alexander
• Authors: Whitelaw, S., Bell, A., and Clark, D.
• College/School: College of Social Sciences > School of Social & Environmental Sustainability
• Research Group: Glasgow End of Life Studies Group
• Journal Name: Health Policy
• Publisher: Elsevier
• ISSN: 0168-8510
• ISSN (Online): 1872-6054
• Published Online: 30 June 2022
• Copyright Holders: Crown Copyright © 2022
• First Published: First published in Health Policy 126(9): 889-898
• Publisher Policy: Reproduced under a Creative Commons licence