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Symptom control is a key aim of advanced cancer and palliative care. Yet, wellbeing in this context is complex, highly contextual, and contested. The World Health Organisation’s (WHO, 2021, p. 10) recent definition of wellbeing, for example, emphasises ‘meaning and purpose’. Models of care – such as the biopsychosocial model – aim to attend to this complexity. And such models matter: if assessments of an intervention lowlight effects relating to psychological and social domains, the potential benefits of these interventions may go unrecognised. In this chapter, the authors provide the results of a review of symptom assessment scales used in advanced cancer and palliative care settings. Combining the analytic strengths of a critical review with the brevity of a rapid review (Grant & Booth, 2009), this critical rapid review asks: to what degree do scales measuring the impacts/effects of symptoms on wellbeing in advanced cancer contexts incorporate the three components of the ‘biopsychosocial’ model: biological, psychological, and social? Findings – considered in the context of conflicting evidence on the effectiveness of medicinal cannabis in supporting patient wellbeing – show that only five of the eleven scales identified through the review attend to social aspects of wellbeing. These findings reinforce critiques of the biopsychosocial model and demonstrate the dominance of dualistic, biomedical conceptualisations of wellbeing. Drawing on Barry et al.’s (2008) scholarship on interdisciplinarity, the findings underscore the limitations of numeric measures of wellbeing conducted in isolation and support calls for an ontological reimagination of wellbeing in advanced cancer and palliative care contexts.

This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.