Care vs. care: 'Biomedical' and 'holistic' worldviews of palliative care

Abstract

Introduction: Scarce information has been collected regarding how the construct of palliative care is conceptualised from the physicians' perspective. Aims: The purpose of this research was to explore and describe linguistically embedded components of the Biomedical and Holistic views of palliative care, drawn from interviews with New Zealand physicians. Method: This paper reports on data from the first phase of a larger mixed methods study of palliative care management within one acute hospital in New Zealand. Employing data from 7 physicians interviews word-use patterns [in discussing palliative care issues] are explored within the context of one urban hospital, using a combination of multidimensional scaling and linguistic interpretive analysis. Results: The components of the two worldviews of palliative care are outlined, highlighting the tension that exists between a Holistic worldview focused on social connectedness and "total care" of a person, and a Biomedical worldview focused on control and mastery of disease. Profiles are constructed of the salient features differentiating Holistic and Bio-medical worldviews. Conclusion: Physicians who habitually organise their knowledge and perceptions of clinical reality according to each of these two worldviews (bio-medical, holistic), appear to be having distinctly different experiences of their clinical reality - as reflected linguistically in how they describe it.