Business and Management INK

Love and Justice at the End of Life: Studying Palliative Care in India

May 7, 2021 2014
touching moment in hospital

The article “The Conflicting Conventions of Care: Transformative Service as Justice and Agape,” currently in press in the Journal of Service Research, examines the transformative service provided by a community palliative care initiative in Kerala, India.  In the community-based approach, teams of doctors, nurses, and community volunteers provide free home-based palliative care, including medical, social, financial, bereavement, and rehabilitation support. This model is thus distinct from the conventional hospice and hospital-based palliative care services that are anchored around professional care delivery.

Rohit Varman Devi Vijay Per Skålén
Rohit Varman, left; Devi Vijay, and Per Skålén

In this ethnographic study, the authors — Rohit Varman,  a professor at University of Birmingham; Devi Vijay, an associate professor at Indian Institute of Management Calcutta; Per Skålén, a professor at Karlstad University (Sweden) examine the conflicts and unintended consequences that arise from the diverse social conventions constituting such a transformative service. They draw on convention theory to argue that a transformative service system cannot be monochromatically based on markets. Accordingly, a transformative initiative requires a broad interface reflective of society and its various conventions and conflicts.

This study contributes to transformative service research by developing a dialectical transformative service system framework that is a synthesis of the calculative conflict-ridden and calculative regime of justice and the non-calculative regime of agape in which persons actively cooperate out of a sense of love and abandon calculations of reciprocity. In our transformative service system framework, the regime of justice has civic conventions at its core and industrial, inspired, market, domestic, and fame conventions as ancillaries. The framework provides a micro-level understanding of disputes and their reconciliation, advances a diffused understanding of worth that ruptures the binary of legitimate or illegitimate actions, and delineates the significance of morality in transformative service. The study also contributes by explaining agape’s role in community-based palliative care.

This study offers several implications for policy development and practice. The spread of COVID-19 during the writing of this article and the dramatic rise in serious health-related suffering, particularly in low- and middle-income countries, have cast in high relief the need for community healthcare models. The pandemic is a sharp reminder that collective consciousness and actions are crucial for human survival. There is thus an urgent need to explore service delivery models beyond the prevailing hospital or hospice-based approaches and the neoliberal market-based models that are limited in coverage and affordability. Kerala’s community model is one exemplary model that offers an alternative by remodeling health services through empowered communities. This study shows the centrality of the civic conventions and agape in such an intervention that prioritizes civic/political rights, solidarity, and love, with several other worlds playing a supportive role. Moreover, designing compromises between different conventions can be central to the working of such transformative service systems.

Furthermore, public health offerings cannot strategically design agape into interventions because this would introduce calculations. Agapic love cannot be forced, edified, or brought about intentionally. However, service systems that encourage caregiver interactions that shun or renounce calculated exchanges and reciprocity may gradually create spaces where caregivers can transition, even momentarily, to a regime of agape.

Thus, the study shows that transformative service systems have to transcend the narrow confines of markets and seamless resource integration to embrace a dialectic of justice and agape that is marked by unintended consequences, conflicts, and compromises. Our emphases on civic conventions and love as central features of a transformative service help to imagine a common frontier that is becoming imperative for  human survival.

Business and Management INK puts the spotlight on research published in our more than 100 management and business journals. We feature an inside view of the research that’s being published in top-tier SAGE journals by the authors themselves.

View all posts by Business & Management INK

Related Articles

Boards and Internationalization Speed
Business and Management INK
November 18, 2024

Boards and Internationalization Speed

Read Now
Deciphering the Mystery of the Working-Class Voter: A View From Britain
Insights
November 14, 2024

Deciphering the Mystery of the Working-Class Voter: A View From Britain

Read Now
How Managers Can Enhance Trust
Business and Management INK
November 11, 2024

How Managers Can Enhance Trust

Read Now
Doing the Math on Equal Pay
Insights
November 8, 2024

Doing the Math on Equal Pay

Read Now
Julia Ebner on Violent Extremism

Julia Ebner on Violent Extremism

As an investigative journalist, Julia Ebner had the freedom to do something she freely admits that as an academic (the hat she […]

Read Now
The Role of Place in Sustainability

The Role of Place in Sustainability

In this article, co-authors Arno Kourula, Panikos Georgallis, Irene Henriques, and Johanna Mair reflect on the inspiration behind their research article, “Introduction to the Special Issue […]

Read Now
The Conversation Podcast Series Examines Class in British Politics

The Conversation Podcast Series Examines Class in British Politics

Even in the 21st century, social class is a part of being British. We talk of living in a post-class era but, […]

Read Now
0 0 votes
Article Rating
Subscribe
Notify of
guest

This site uses Akismet to reduce spam. Learn how your comment data is processed.

0 Comments
Newest
Oldest Most Voted
Inline Feedbacks
View all comments