Thoresen Lisbeth, Røberg Anne-Stine Bergquist
Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Pb. 1089 Blindern, N-0318 Oslo, Norway.
The Norwegian Directorate of Health, Oslo, Norway.
Palliat Care Soc Pract. 2022 Aug 29;16:26323524221118586. doi: 10.1177/26323524221118586. eCollection 2022.
To contribute with knowledge to health policy development, this article presents a critical discourse analysis of two Norwegian official reports on palliative care published in 1999 and 2017.
We identify, describe and discuss how linguistic features in policy documents contribute to and engender a distinct change from 1999 to 2017 in how patients are framed, documenting the development of palliative care.
The analysis identifies and considers two interwoven discourses: the discourse of accountability and the discourse of complexity. The patient moves from being described as in need of care, in the 1999 report, to being described as an active and responsible patient making proper choices, in the 2017 report.
Result of this policy development might be less involvement of professionals and focus on existential questions, and more responsibility on patients for their prospective wellbeing and health: a change that we argue should be considered and counteracted in upcoming policy processes considering palliative care.
为了为卫生政策制定贡献知识，本文对1999年和2017年发布的两份关于姑息治疗的挪威官方报告进行了批判性话语分析。
我们识别、描述并讨论政策文件中的语言特征如何促成并引发了1999年至2017年期间在患者框架构建方面的明显变化，记录姑息治疗的发展情况。
分析识别并考量了两种相互交织的话语：问责话语和复杂性话语。在1999年的报告中，患者被描述为需要护理，而在2017年的报告中，患者被描述为做出恰当选择的积极且有责任感的患者。
这一政策发展的结果可能是专业人员的参与减少，对生存问题的关注增加，以及患者对自身未来福祉和健康承担更多责任：我们认为，在未来考虑姑息治疗的政策进程中，这种变化应得到考量并加以应对。
