Critical compassion:Affect, discretion and policy-care relations

Open Access

Abstract

Care has become a focus of debate in feminist technoscience studies, with a recent call for researchers to be care-full about the politics of research and theorising and also to challenge 'care' as a taken-for-granted good. Care is a current focus of concern in Britain, where a crisis has been declared in national health and social care, and where previous policy has focused on quantity at the expense of quality. The influential government-commissioned Francis Report documents 'appalling and unnecessary patient suffering' and calls for action to put 'compassion at the heart of healthcare'. The report's conclusions are widely supported, and there are new policy interventions to promote compassionate care. Hence, this policy can be seen as a specific form of care. However, current debates frequently cite policy and care as in tension with one another: ; for example, legislative responses are critiqued as meaningless to the realities of clinical practice and as attempting to control rather than to support practitioners. In order to explore how compassion is being done differently in diverse instantiations and enactments, in this article the authors juxtapose feminist technoscience studies on the politics of care with an analysis of health policy and with vignettes of located practices. The vignettes articulate affects, materials and relations of compassion in clinical locations and explore not only the good of what is considered compassion, but also possible harms, contestation and vulnerabilities. Thereby, the analytical approach aligns with Martin et al.'s call for 'critical care' research that understands care as an affectively charged and selective mode of attention and that exposes the dark side of care. The authors reflect on the relationship between policy and care as a process of contestation, shifts and stabilisation and explore possibilities for formulating policy-care relations as forms of care that especially attend to, and promote, affective and discretionary aspects of compassion.