Religiosity, Biopower and Comprehensiveness in Palliative Care: A Field of Tension

The development of Western medicine, based on the positivist scientific paradigm, distanced medical epistemology from experiences of spirituality, delegitimizing practices and epistemologies considered non-scientific. Palliative Care (PC) emerged proposing a recomposition of the medical perspective on the human person and a revaluation, in the health field, of the experience of illness, especially at the end of life. The discourse of comprehensive health care promoted by PC repositions subjectivity, spirituality and religiosity with the same centrality given to the physical care of the sick person. This study uses an analytical and critical approach to examine the discourse of the comprehensive approach in Palliative Care. The objective is to problematize the discourse of comprehensive care, investigating how it may reflect a normativity influenced by religious values. The methodology adopted involves a critical and discursive analysis of the reference literature on PC and spirituality and religiosity. The research focuses on the intersections between medicine, religiosity and biopower, questioning how the rhetoric of integrality can be linked to a normative religious model. The results indicate that the modern hospice movement, inspired by the Christian charity of Victorian hospices, and the influence of the religiosity of Cicely Saunders, its main founder, suggest that the discourse of integrality in PC is strongly permeated by Christian values. These values shape practices such as the rejection of euthanasia, imposing a certain normativity and attitude towards illness and death. We conclude that, although integrality in PC offers a more holistic approach to care, it can also extend medical control over personal aspects, such as spirituality. Religious influence on this care can act in a normative way, informing practices through values of Christian virtues, limiting other expressions of spirituality and religiosity and reinforcing certain attitudes towards suffering and death.