The ethical landscape of home care practice, management, and funding
An ageing population and improvements in health outcomes is leading to the reconfiguration of long-term care services in the UK. This includes care provided to older adults, those with chronic health conditions, and other people with life-long impairments. In health and social care policy, a person’s own home, situated within the community in which they live alongside family and friends, is interpreted as the optimal location for care delivery. Shifting from residential to home care is viewed as offering the most personalised approach to care delivery, aligned with individuals’ preferences and improvements in patient-reported outcome measures.
Health services research has begun to shed light on the efficacy of new models of care in the domestic setting. However, in contrast to other community care settings, there has been little attention paid to the ethical issues that arise in planning, funding, managing, and delivering home care services. This project will examine these issues, and offer different avenues to explore, depending on the candidate’s experience and interests. Specific research foci within the general theme of home care ethics that could be explored include ethical challenges concerning:
- Home care in later life for older, frail adults where family relations and the home environment are modified to meet new caregiving needs
- Home care in the face of chronic illness or lifelong impairment as families and the individual adapt to supporting well-being when health interventions are incorporated into a domestic setting
- Home palliative care as a person’s own home transitions into a place where the dying process is planned and realised
- Home care that draws on novel technological interventions (for example, the use of artificial intelligence), and the relationships between the recipient of care, the human providers of care, and the technologies used in the home care setting
- The management, funding and allocation of professional home care services at a time of policy change and funding cuts
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
We intend the project to involve both ethical and qualitative social scientific methodologies, combined such that the project can contribute to the emerging field of empirical bioethics. However, we are open to applicants who wish to take a more philosophy-driven approach. Specific methods training will be provided through appropriate courses offered in the department and wider university. The successful applicant will also benefit from participating in a new skills training programme, the Orientation into Research in Bioethics Programme, for new doctoral students at the Ethox Centre.
FIELD WORK, SECONDMENTS, INDUSTRY PLACEMENTS AND TRAINING
Field work (interviews/focus groups/observations) will most likely be within Oxfordshire, and will involve data collection within domestic home settings and through domiciliary care agencies. We are also open to applicants focusing their research in other geographical settings.
A social scientist or bioethicist, ideally with training or experience in using qualitative research methods, and evidence of experience of, or an interest in, ethical questions in health and care delivery. Experience with, and knowledge of, social care settings will be advantageous.