Logic Conflicts in Community-Based Palliative Care. (4th May 2021)

• Record Type: Journal Article
• Authors: Vijay, Devi; Whitelaw, Sandy; Clark, David
• Is Part Of: Progress in palliative care. Volume 29:Number 3(2021)
• Page Start: 149
• Page End: 155
• Publication Date: 2021-05-04
• Subjects: Palliative care -- Community participation -- Kerala -- Conflicts -- Public health palliative care; Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.02905
• DOI: 10.1080/09699260.2020.1817691
• Languages: English
• ISSNs: 0969-9260

Abstract

Abstract: Community-based palliative care services and their integration with public health systems are of considerable contemporary interest. However, the conflicts that emerge in such a complex organizational field comprising multiple stakeholders with diverse interests remain under-examined. Our analysis of community-based palliative care in Kerala identifies four 'logic conflicts' that indicate competing frames of reference in an organizational field. These conflicts shape decision-making and coordination and manifest as: 1) professional versus community logics, 2) centralized versus decentralized governance logics, 3) generalist versus specialist care logics, 4) charity versus rights-based logics . We also identify two mechanisms – forming coalitions and fostering plurality – by which actors manage these conflicting logics. We discuss contributions to public health palliative care conversations and implications for nurturing and sustaining care communities.