Humanitarian Palliative Care : On the threshold of concern

Abstract: Humanitarian organizations and research groups are increasingly considering the potential of integrating palliative care into humanitarian health responses. While studies on the topic frequently examine the obstacles of integrating palliative care into humanitarian action, the field is marked by notable research gaps, particularly concerning assessments of practice, the impact of guidelines, as well as critical inquiries into the moral and conceptual implications of a “humanitarian palliative care”. This thesis contributes to the latter of these research gaps by unpacking the discourses of palliative care and humanitarianism as imperatives, with attention to the ways in which the two may support or challenge each other.  The main research question, “How does humanitarian action take up palliative care as a humanitarian concern?”, is addressed through an anthropological lens. To shed light on the intangible, yet powerful, moral aspects of combining these discourses, this research method consists of a literature review approaching guidelines and studies as empirical data. While without its main ethnographic method, the use of classic anthropological theories and analysis offers apt insight into the framework of a humanitarian palliative care. The thesis paper progresses as follows: first, a literature review outlines the background of palliative care and its introduction in the humanitarian sector along with the direction of existing studies and guidelines on the topic. This outline then facilitates a comparative analysis of the moral language and principles of palliative care and humanitarianism. During this analysis, Fassin’s critique of “humanitarian reason” (2012) is used to better understand both imperatives in focus, leading to a biopolitical analysis of the implications of a combined ‘humanitarian palliative care’. This analysis suggests that palliative needs inhabit a liminal position in humanitarian healthcare – at the threshold of humanitarian concern.   The liminality of humanitarian palliative care is then explored with particular attention to the infrastructure and relevant temporal aspects of humanitarian healthcare. While addressing abstract concepts, the analysis draws upon case examples to illuminate each analytical point in practice. Finally, I conclude with a discussion reflecting on the suggestions made by this thesis, and ultimately, the – arguably ambiguous – dynamic between palliative care and humanitarian action.