Making normative structures visible: The British National Health Service and the hospice movement as signifiers of compassion and hope

Abstract

Compassion and hope are vital to individual and societal flourishing, not least through the solidarity and change that they facilitate. This article considers the importance of these two social phenomena for welfare institutions, and in particular for the hospice movement and the National Health Service in Britain. Compassion and hope are enacted due to the normative structures in which citizens are embedded. From here it is argued that a dialectical process exists whereby compassion and hope spur the creation of, and are embedded within, healthcare and hospice institutions. In turn, these institutions encourage and give rise to the practice of these emotions across society by virtue of making normative structures more visible. However, the role of these institutions as signifiers of compassion and hope is not straightforward. Tensions exist between the instrumentalism required to provide expansive healthcare access for all, and the communicative action through which hope and compassion are practised at the interpersonal level. More positive norms, such as compassion and hope, intersect with a range of other frameworks which may constrain or undermine their outworking across society. Future research and policy-making needs to acknowledge institutions’ broader influence and value when appraising their role and effective management.