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The interweaving of pharmaceutical and medical expectations as dynamics of micro-pharmaceuticalisation: Advanced-stage cancer patients' hope in medicines alongside trust in professionals

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  • Brown, Patrick
  • de Graaf, Sabine
  • Hillen, Marij
  • Smets, Ellen
  • van Laarhoven, Hanneke

Abstract

Existing pharmaceuticalisation research denotes the salience of expectations in novel medicines and in the medical contexts through which these may be accessed. Specific processes of expectation such as hope and trust, alongside their shaping of patients' lifeworlds around pharmaceutical use, remain neglected however. Considering data from in-depth interviews and observations involving thirteen patients with advanced-stage cancer diagnoses who were or had recently been involved in clinical trials, we develop an interpretative phenomenological analysis of the influence of hope and trust upon the accessing of novel medicines through trials, illuminating the depth and texture of pharmaceuticalisation at the micro-level. Trust in clinicians and hope in trial medicines, for self and future patients, were important in the reconfiguring of patients' horizon of possibilities when accessing new medicines. Interwoven processes of trust and hope, embedded within heightened vulnerability, sustained the bracketing out of doubts regarding medicines, trials and professionals. The need to maintain hopes, and trusting relations with professionals who facilitated these hopes, generated meaning and momentum of medicines use which inhibited disengagement from trials. Findings indicate the taken-for-granted, as well as more reflexive, pursuit of solutions through medicines, which in this case-study enabled the generation of evidence through trial involvement. Analyses of micro-level dynamics within both downstream-consumption and upstream-substantiation of pharmaceutical solutions assist more nuanced accounts of interests, agency and expectations within pharmaceuticalisation.

Suggested Citation

  • Brown, Patrick & de Graaf, Sabine & Hillen, Marij & Smets, Ellen & van Laarhoven, Hanneke, 2015. "The interweaving of pharmaceutical and medical expectations as dynamics of micro-pharmaceuticalisation: Advanced-stage cancer patients' hope in medicines alongside trust in professionals," Social Science & Medicine, Elsevier, vol. 131(C), pages 313-321.
    • Handle: RePEc:eee:socmed:v:131:y:2015:i:c:p:313-321
    DOI: 10.1016/j.socscimed.2014.10.053
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    1. Sinding, Christina & Hudak, Pamela & Wiernikowski, Jennifer & Aronson, Jane & Miller, Pat & Gould, Judy & Fitzpatrick-Lewis, Donna, 2010. ""I like to be an informed person but..." negotiating responsibility for treatment decisions in cancer care," Social Science & Medicine, Elsevier, vol. 71(6), pages 1094-1101, September.
    2. Snowdon, Claire & Elbourne, Diana & Garcia, Jo, 2006. ""It was a snap decision": Parental and professional perspectives on the speed of decisions about participation in perinatal randomised controlled trials," Social Science & Medicine, Elsevier, vol. 62(9), pages 2279-2290, May.
    3. Bell, Susan E. & Figert, Anne E., 2012. "Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward," Social Science & Medicine, Elsevier, vol. 75(5), pages 775-783.
    4. Lupton, Deborah, 1997. "Consumerism, reflexivity and the medical encounter," Social Science & Medicine, Elsevier, vol. 45(3), pages 373-381, August.
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    Cited by:

    1. Bröer, Christian & Besseling, Broos, 2017. "Sadness or depression: Making sense of low mood and the medicalization of everyday life," Social Science & Medicine, Elsevier, vol. 183(C), pages 28-36.

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