From personal challenge to technical fix: the risks of depersonalised care

Health Soc Care Community. 2012 Mar;20(2):145-54. doi: 10.1111/j.1365-2524.2011.01026.x. Epub 2011 Aug 16.


Our research focuses on the complexity of needs associated with distress in people with advanced cancer. We have recently completed a large longitudinal survey exploring the interplay between a number of components of distress, including depression, demoralisation, debility and spirituality, amongst a cohort of people living with terminal cancer. Participants were recruited from 25 hospices across the Northwest of England between 2007-2009. A purposive subsample of 27 people was invited to take part in a qualitative interview to explore in greater depth their personal experiences of living with illness and related distress. Holistic-content analysis revealed two emerging themes: 'personal or personalised care' and 'expectations of truth and certainty'. We discuss these themes in the light of Illich's critique of health care as a 'technical response to a personal challenge'. We highlight the need for further work to explore the impact of organisation of care on personalised need and suggest looking to the chronic illness self-management literature for help in developing future palliative care approaches.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • England
  • Female
  • Hospice Care
  • Humans
  • Interviews as Topic
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Patient Satisfaction*
  • Terminal Care / psychology*