Caring for families with a family history of cancer: why concerns about genetic predisposition are missing from the palliative agenda

Care of the family is integral to palliative care, but little attention has been paid to the way nurses, or other healthcare professionals, are responding to the needs of families who are concerned about whether their family history of cancer is associated with an inherited genetic predisposition. This paper discusses how palliative care nurses perceive the care needs of patients with a family history of cancer. Data were collected through recorded, semi-structured interviews with 10 nurses who had worked in specialist palliative care. The findings show that there are cogent arguments and concerns about raising the issue of an inherited genetic predisposition at the end of life (especially when the patient is close to death and there is a lack of knowledge about genetics). Nevertheless, exemplar cases are used to illustrate the reasons why it is important that nurses working in specialist palliative care settings are aware of the needs of this patient group. The paper highlights that nurses not only need an appropriate knowledge base but also an insight of what can be achieved when supporting patients with a family history of cancer.Care of the family is integral to palliative care, but little attention has been paid to the way nurses, or other healthcare professionals, are responding to the needs of families who are concerned about whether their family history of cancer is associated with an inherited genetic predisposition. This paper discusses how palliative care nurses perceive the care needs of patients with a family history of cancer. Data were collected through recorded, semi-structured interviews with 10 nurses who had worked in specialist palliative care. The findings show that there are cogent arguments and concerns about raising the issue of an inherited genetic predisposition at the end of life (especially when the patient is close to death and there is a lack of knowledge about genetics). Nevertheless, exemplar cases are used to illustrate the reasons why it is important that nurses working in specialist palliative care settings are aware of the needs of this patient group. The paper highlights that nurses not only need an appropriate knowledge base but also an insight of what can be achieved when supporting patients with a family history of cancer

Hidden in plain sight: Constructivist treatment of social context and its limitations

This article argues that constructivism in International Relations (IR) suffers from certain important shortcomings in its analysis of the idea of social context. Specifically it is argued that constructivists fail to adequately engage with ‘social structural’ forces in world politics. While constructivists have pitched themselves as theorists who aim to account for the role of social context in world political inquiry, their conceptual focus on ideational factors – rules, norms and inter-subjective beliefs – has resulted in an inadequate, or incomplete, conceptualisation of social structure. Constructivists, it is argued here, tend to leave the role of materially embodied social structures theoretically and empirically unexplored. The limitations of constructivist treatments of social context have significant consequences for their analysis of world politics, for example, for recent constructivist attempts to deal with international law. Constructivist interventions into analysis of law remain deficient in important senses because of their failure to conceive of international law in social structural terms and because of their inability to explore in depth law's relationship with other social structures, such as patriarchy or capitalism. This entails that the structured systems of inequality and hierarchy embodied in law fail to be adequately recognised. Recognising the ‘incompleteness’ of the constructivist accounts of social context, we argue, is important in highlighting the often un-noted limitations of constructivist scholarship and in potentially redirecting constructivist scholarship towards closer engagement with ‘critical theory’ investigations into IR and law