Paper short abstract:

This paper explores the complex and shifting ‘doings’ and ‘goods’ of medical treatments and pharmaceuticals in shaping care assemblages and everyday living with multimorbidity in Denmark

Paper long abstract:

In welfare states like Denmark, public health problems of multimorbidity, polypharmacy and ‘treatment burden’ have sparked campaigns and discourses that are increasingly concerned with how patients and healthcare professionals can ‘choose wisely’, to avoid ‘unnecessary’ treatments and prioritize those treatments that benefit patients. In clinical discourse, risk related to phenomena such as polypharmacy and overtreatment is mainly assessed by quantitative measures, such as the number of medications, the doses, and the amount of time a drug is taken. Less attention is given to concrete effects and what pharmaceuticals ‘do’ in the shaping of everyday life. At the same time, ethnographic studies of clinical consultations in the context of multimorbidity and polypharmacy have shown the detrimental effects of overmedication. In this paper, I explore the complex role of medical treatments and pharmaceuticals in shaping the care assemblages that make life liveable with severe and life-limiting diseases in Denmark. Based on 20 months of fieldwork, and especially 24 months of diary-writing by one interlocutor, I analyze concrete examples from a single care trajectory over an extended period. The paper raises discussions on the shifting roles and ‘doings’ of pharmaceuticals in shaping care assemblages and how they become part of the daily negotiations about how to handle complex diseases in homes and clinics. Finally, the paper discusses how researchers can study the ‘goods’ of medical treatments and make room for complexity in discourses on ‘avoidable’, ‘unnecessary’ and ‘detrimental’ treatments in ethnographic writing, public discourse and clinical consultations.