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The social meanings of choice in living-with advanced breast cancer

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  • Lewis, Sophie
  • Kenny, Katherine
  • Broom, Alex
  • Kirby, Emma
  • Boyle, Frances

Abstract

Individual choice is valorised as a core social value; yet the necessity and desirability of making choices takes on new significance for people living with incurable cancer who are required to make often difficult decisions about treatment, care and family life, amidst considerable vulnerability and precariousness. There has been comparatively little exploration of how choice is negotiated and made meaningful under the spectre of incurability and a contracted future. In this paper, drawing on multiple qualitative interviews with 38 women with metastatic breast cancer, we explore how they experience and give meaning to choice in relation to their health (and beyond) in their daily lives. Our analysis highlights that while exercising choice was sometimes a concealed or silent pursuit, choice was always a socially negotiated and temporally unfolding process, nested within relational and interpersonal dynamics. Choices were also often constrained, even foreclosed, due to situational and relational dynamics. Yet even in the absence of choice, the idea of choice-as-control was discursively embraced by women. We argue that greater attention is needed to the affective, temporal and economic dimensions of choice, and how treatment decisions are asymmetrically structured when considered within the normative context of cancer.

Suggested Citation

  • Lewis, Sophie & Kenny, Katherine & Broom, Alex & Kirby, Emma & Boyle, Frances, 2021. "The social meanings of choice in living-with advanced breast cancer," Social Science & Medicine, Elsevier, vol. 280(C).
  • Handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621003798
    DOI: 10.1016/j.socscimed.2021.114047
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    References listed on IDEAS

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    1. Lupton, Deborah, 1997. "Consumerism, reflexivity and the medical encounter," Social Science & Medicine, Elsevier, vol. 45(3), pages 373-381, August.
    2. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
    3. Bell, Kirsten, 2014. "The breast-cancer-ization of cancer survivorship: Implications for experiences of the disease," Social Science & Medicine, Elsevier, vol. 110(C), pages 56-63.
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    Cited by:

    1. Footman, Katy, 2024. "The illusion of treatment choice in abortion care: A qualitative study of comparative care experiences in England and Wales," Social Science & Medicine, Elsevier, vol. 348(C).

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