Resisting bureau - medicalisation: The integration of 'Spaces of Compassion' with the Biomedical Healthcare Environment

同情心在提高患者满意度、帮助患者康复以及培养患者对自身健康的责任感方面提供了实质性的好处(Van der Cingel，2011)。然而，在不断加速向更高的“效率”、“工具简约主义”和“技术官僚冷漠”的转变中，证明同情的重要性是当代医疗服务提供中的一个关键挑战(duta等人，2019年；Hensman和van Bommel，2020)。拟议的项目利用“阻力的地理”文献来评估同情空间与医院服务的地方整合，作为对日益合理化和新自由主义的医疗提供的以社区为中心的回应。与英格兰西北部的NHS牧师团队合作，两名消费文化、市场和健康研究方面的资深专家将监督一名博士生的研究，研究同情空间所占据的政治和意识形态维度，以及临床环境中多种身份、价值观和实践的持续纠缠，有时甚至是相互竞争的。日益增加的预算压力、人口老龄化和全国范围内更高的疾病水平已经将英国的公共医疗转向“局部化-医学化”，内森和韦伯(2010：15)定义为“[生物]医疗模式和组织必要性的有效结合”。医疗化侧重于财政纪律和卫生净价值；主要以市场为中心的使命是通过执行大规模、高效和可推广的卫生服务来实现业务目标，并了解各种背景下的经验衡量和管理评估。然而，将护理等同于目标、评估护理提供者的表现以及衡量和概括本质上既不能量化也不能概括的护理形式的动力，破坏并限制了临床环境中同情的机会。

Compassion offers substantial benefits in terms of improving patient satisfaction, aiding patients' recovery, and engendering a sense of responsibility in patients for their own health (Van der Cingel, 2011). Nevertheless, justifying the importance of compassion amidst ever-accelerating shifts towards greater 'efficiency', 'instrumental reductionism', and 'technocratic apathy' represents a key challenge in contemporary healthcare service provision (Dutta et al., 2019; Hensmans and van Bommel, 2020).The proposed project draws upon 'geographies of resistance' literature to assess the local integration of compassionate spaces with hospital services as a community-centric response to increasing rationalisation and neoliberalisation of healthcare provision. In partnership with an NHS Chaplaincy team in the North-West of England, two senior experts in consumer culture, markets, & health studies will supervise a doctoral student's research on the political and ideological dimensions that compassionate spaces occupy and the ongoing entanglements of multiple, and sometimes competing, identities, values, and practices within clinical environments.Increasing budgetary pressures, an ageing population, and greater levels of illness nationally has shifted public healthcare in the UK towards "bureau-medicalisation", what Nathan and Webber (2010: 15) define as, "a potent combination of the [bio]medical model and organisational imperative". Bureau-medicalisation centres on fiscal discipline and net health value; a largely market-centric mission to meet operational targets through executing mass, efficient and generalisable health services informed by empirical measurement and managerial assessment across contexts. Yet the impetus to equate care with targets, to assess the performance of care providers, and to measure and generalise forms of care which, by their nature, are neither amenable to quantification nor generalisability, undermines and limits the opportunities for compassion in clinical settings.