'Listening with the third ear and other expertises' : A case analysis of social work discourse in the context of the multidisciplinary palliative care team

The philosophy of palliative care is to provide holistic support to people living with a lifethreatening illness and their families, optimally delivered by a multi-disciplinary healthcare team with the patient and his/her family centralised as the prime drivers ofdecisions about support and care. We argue, however, that palliative care is in effectmore than this: it is an expression of shared cultural beliefs about the ‘right’ way to diein the context of a terminal illness with a concomitant impact on the ability of the patientto define his/her own support needs. Drawing on the work of Michel Foucault andthrough analysis of a case study of the social worker on a palliative caremultidisciplinary team, we argue that the impact of shared cultural beliefs about ways ofdying, coupled with the functioning of the multidisciplinary team, can work tomarginalise the patient and render his/her voice silent, and hence, become secondary toprofessional expertises in decisions surrounding support and care at the end of life.