Paper long abstract:

Health care in Britain has been seen to be failing. Several recent reviews of care of patients describe unnecessary suffering in clinical settings. (Francis, 2013; Berwick, 2013; Keogh, 2013) One widely used explanation for the documented poor care is that there has been a loss of values causing lack of 'compassion in healthcare'. (Hunt, 2013; de Zulueta, 2013) In response a new set of Common Values have been written into the National Health Service Constitution. However, while the pursuit of Common Values holds the promise of better care, can Common Values be done in clinical locations where care enacts and reflects negotiations and interferences between multiple, potentially conflicting, situated practices of valuing? I will draw on observations and interviews from an ethnographic study of the care of patients with Alcoholic Liver Disease to offer a preliminary exploration of how one of these Values might relate to situated caring. Specifically, the paper explores the shifts in distribution of expertise, values and responsibilities performed through the pursuit of the Common Value 'Respect and Dignity'. 'Respect and Dignity' values patients as individuals with aspirations, commitments, needs and desires and at the same time promises to shift responsibility for care from the State to the individual patient and his/her practitioner. Values (and compassionate care) are performed as individual expressions rather than effects of relations between heterogeneous actors. The result may be denial of a collective responsibility to alleviate suffering and reduced capacities for care.