This chapter develops a brief paradigmatic analysis of palliative care using the same framework that was derived for care in general, in Chapter 2. It also identifies the key problems arising from the transference into palliative care of the detrimental effects of the paradigm of care. The main detrimental effect of the paradigm is to establish and validate the distinction between a socially valued class of care providers, such as doctors or philanthropists, and a socially devalued class of care recipients and people excluded from care. As the social organisation of care becomes more modern and industrialised, this distinction becomes increasingly pronounced. The wide-ranging institutionalisation of devalued people becomes the preferred form of social management in modern times. The social devaluation of people who receive care becomes more pronounced and systematised with the increasing dominance of the institutional model of care.
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