Health States of Exception: unsafe non-care and the (inadvertent) production of 'bare life' in complex care transitions.

agamben bio-power care transitions homo sacer hospital discharge neglect patient safety

Journal

Sociology of health & illness
ISSN: 1467-9566
Titre abrégé: Sociol Health Illn
Pays: England
ID NLM: 8205036

Informations de publication

Date de publication:
01 2020
Historique:
pubmed: 19 9 2019
medline: 29 12 2020
entrez: 19 9 2019
Statut: ppublish

Résumé

This paper draws on the work of Giorgio Agamben to understand how the social organisation of care transitions can reduce people to their 'bare' life thereby making harmful and degrading treatment seemingly legitimate. The findings of a 2-year ethnographic study show how some people experience hospital discharge as undignified, inhumane and unsafe process, expressed through their lack of involvement in care planning, delayed discharge from hospital and poorly coordinated care. Our analysis explores how these experiences stem from the way patients are constituted as 'unknown' and 'ineligible' subjects and, in turn, how professionals become 'not responsible' for their care. The result being that the person is reduced to their 'bare' life with limited value within the care system. We suggest that the social production of 'bare life' is an inadvertent consequence of reconciling and aligning multiple disciplines within a complex care system.

Identifiants

pubmed: 31531886
doi: 10.1111/1467-9566.12993
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

171-190

Informations de copyright

© 2019 Foundation for the Sociology of Health & Illness.

Références

Aase, K., Waring, J., Schibevaag, L. (eds) (2017) Crossing boundaries: quality in care transitions. In Research Quality in Care Transitions. London: Palgrave.
Agamben, G. (1998) Homo Sacer: Sovereign Power and Bare Life. Standford: Stanford University Press.
Agamben, G. (2005) State of Exception. London: University of Chicago Press.
Allen, D. (2014) The Invisible Work of Nurses. London: Taylor-Francis.
Bauman, Z. (1992) Mortality. Immortality and Other Life Strategies, London: Stanford University Press.
Bishop, S. and Waring, J. (2019) From boundary object to boundary subject: the role of the patient in coordination across complex care systems in care transitions, Social Science and Medicine, 325, 113270.
Colebrook, C. and Maxwell, J. (2016) Agamben. Cambridge: Polity.
Corbin, J. and Strauss, A. (2014) Basics of Qualitative Research. London: Sage.
DeForge, R., VanWyk, P., Hall, J. and Salmoni, A. (2011) Afraid to care; unable to care: a critical ethnography within a long-term care home, Journal of Aging Studies, 25, 4, 415-26.
Department of Health (2012) Transforming Care: National Response to Winterbourne View Hospital. London: Department of Health.
Dixon-Woods, M. and Pronovost, P. (2016) Patient safety and the problem of many hands, BMJ Quality and Safety, 25, 7, 485-8.
Durkheim, E. (1992) Professional Ethics and Civic Morals. London: Routledge.
Fiskesjö, M. (2012) Outlaws, barbarians, slaves: critical reflections on Agamben's homo sacer. HAU: Journal of Ethnographic Theory, 2, 1, 161-80.
Foucault, M. (1994) The Birth of the Clinic. London: Vintage Books.
Foucault, M. (1998) History of Sexuality, vol 1: The Will to Knowledge. London: Penguin.
Francis, R. (Chair). (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: TSO.
Genel, K. (2006) The question of biopower: Foucault and Agamben, Rethinking Marxism, 18, 1, 43-62.
Glasby, J. (2003) Hospital Discharge. Oxford: Radcliffe.
Healthwatch (2015) Safely Home. London: Healthwatch.
Heavey, E., Waring, J., De Brun, A., Dawson, P., et al. (2019) Patients' conceptualisation of responsibility for healthcare: a typology for understand differing attributions in the context of patient safety, Journal of Health and Social Behavior, 60, 2, 188-203.
Hesselink, G., Schoonhoven, L., Plas, M., Wollersheim, H., et al. (2012) Quality and safety of hospital discharge: a study on experiences and perceptions of patients, relatives and care providers, International Journal for Quality in Health Care, 25, 1, 66-74.
Humphreys, S. (2006) Legalizing lawlessness: on Giorgio Agamben's state of exception, European Journal of International Law, 17, 3, 677-87.
Kirkup, B. (2015) The Report of the Morecombe Bay Investigation. Morecombe Bay: Morecombe Bay Investigation.
Kripalani, S., Jackson, A., Schnipper, J. and Coleman, E. (2007) Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists, Journal of Hospital Medicine, 2, 5, 314-23.
Laugaland, K., Aase, K. and Waring, J. (2014) Hospital discharge of the elderly-an observational case study of functions, variability and performance-shaping factors, BMC Health Services Research, 14, 1, 365.
Lemke, T. (2011) Bio-Politics. London: New York University Press.
Mandelstam, M. (2011) How We Treat the Sick. London: JKP Publishers.
Mol, A. (2002) The Body Multiple. London: Duke University Press.
Morello, R., Lowthian, J., Barker, A., McGinnes, R., et al. (2013) Strategies for improving patient safety culture in hospitals, BMJ Quality and Safety, 22, 1, 11-8.
Nancarrow, S.A. and Borthwick, A.M. (2005) Dynamic professional boundaries in the healthcare workforce, Sociology of Health & Illness, 27, 7, 897-919.
Neuberger, J. (Chair). (2013) More Care, Less Pathway: Review of the Liverpool Care Pathway. London: Independent Review of the Liverpool Care Pathway.
Norris, A. (2000) Giorgio Agamben and the politics of the living dead, Diacritics, 3, 38-58.
O'Hara, J., Aase, K. and Waring, J. (2019) Scaffolding our systems? Patients and families ‘reaching in’ as a source of healthcare resilience BMJ Quality and Safety, 28, 3-6.
Parsons, T. (1975) The sick role and the role of the physician reconsidered, Milbank Quarterly, 53, 3, 257-78.
Ritzer, G. (ed) (2006) Precursors: Bureaucracy and Max Weber's Theory of Rationality, Irrationality and the Iron Cage. In McDonaldization: The Reader. London: Pine Forge.
Rosenthal, M. (1995) The Incompetent Doctor. Milton Keynes: Open University Press.
Schmitt, C. (1985) Political Theology. Cambridge: MIT Press.
Walshe, K. and Shortell, S. (2004) When things go wrong: how health care organizations deal with major failures, Health Affairs, 23, 3, 103-11.
Waring, J. (2005) Patient safety: new directions in the management of health service quality, Policy & Politics, 33, 4, 675-92.
Waring, J., Marshall, F. and Bishop, S. (2015) Understanding the occupational and organizational boundaries to safe hospital discharge, Journal of Health Services Research & Policy, 20(1_suppl), 35-44.
Waring, J., Allen, D., Braithwaite, J. and Sandall, J. (2016a) Healthcare quality and safety: a review of policy, practice and research, Sociology of Health & Illness, 38, 2, 198-215.
Waring, J., Bishop, S. and Marshall, F. (2016b) A qualitative study of professional and carer perceptions of the threats to safe hospital discharge for stroke and hip fracture patients in the English National Health Service, BMC Health Services Research, 16, 1, 297.

Auteurs

Justin Waring (J)

Health Services Management Centre, University of Birmingham, Birmingham, UK.

Simon Bishop (S)

Nottingham University Business School, University of Nottingham, Nottingham, UK.

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