The Social Life of Healthcare Decisions: Contexts and Consequences

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Background

This Research Topic advances the analysis of the social context and social consequences of decisions about healthcare provision. It proceeds from the premise that decisions about which procedures should be provided for which conditions, to which people, by whom, at what cost, and to what end variously presuppose, create, sustain, transform, and corrode a range of social positions and social relations. It progresses the critical sociological understanding of these positions and relations.

Decisions about providing or withholding healthcare regularly attract health-scientific, political, moral, and religious controversy. The polio vaccination programme in Pakistan, prescriptions of opioid painkillers in the United States, and decisions against offering certain cancer drugs in the British health service are only three of many recent examples. During the Covid-19 pandemic, the need for sociological analyses of such decision making has been highlighted once more, as its thorniest forms have been materialising – for instance, as doctors in several countries have been preparing for decisions about whom among a growing number of severely ill patients to grant scarce potentially life-saving interventions. The implications of decades of marketisation and austerity in healthcare are, it seems, becoming too palpable to coat or justify. Much of the post-pandemic world will witness a reorganisation of healthcare provision. What is unclear is how this will unfold. Sociological inquiries into the social context of contemporary decision making about healthcare provision and into its consequences for social relations can elucidate the immediate preconditions and ramifications of this watershed moment in human history. Thus, this Research Topic makes a unique and essential contribution to comprehending our present.

We encourage submissions on decision making in any healthcare domain. Papers should share the Topic’s distinctive focus on the social relations presupposed or shaped by such decisions. The Topic is not committed to a particular theoretical perspective. Submissions informed by a wide variety of conceptions of social relations – as interactions, figurations, exchange relations, power relationships, discriminations, or inequalities, to name only some – are welcome.

The following questions exemplify, without exhausting, potential topics of analysis:
• What are the properties of, and who has access to, the positions and systems of expertise in which the evidence for explaining and legitimising decisions about healthcare provision is identified and interpreted?
• How do decisions to offer some patient groups beneficial procedures whilst withholding beneficial procedures from others raise or avoid the problem of discrimination?
• How do such decisions sustain or change existing health inequalities?
• Which dynamics of rendering resources scarce propel such decision making?
• How do decisions to provide, notably to resource, procedures for people affect the corresponding tissue of relationships of giving and receiving, buying and selling, caring and being cared for?
• How do processes for resolving which treatments to cover through insurance plans or national health services create, maintain, or corrode market configurations such as competitive relationships between manufacturers?
• What assumptions, rationales, and operations characterise the technical devices assisting decision making? How do these order the social world they represent, write the past, and script the future?

***Due to the exceptional nature of the COVID-19 situation, Frontiers is waiving all article publishing charges for accepted articles in this Research Topic if submitted before the 11th of January 2021.***

Keywords: decision making, healthcare provision, social relations, scarcity, expertise

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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