Feeling Rule Management and Relational Authority: Fostering patient compliance in palliative care consultations

Abstract

Once conferred by jurisdictions, hierarchies, or credentials, professional authority is now considered relational and probabilistic, drawing attention to actions that professionals can take to encourage client compliance. In this paper, we use ethnographic observations of palliative care consultations to show that professionals suggest feeling rules that correct patients’ lay understandings and in doing so facilitate compliance. Palliative care professionals suggested three corrective feeling rules that validate patients’ emotions and reattribute them to circumstances aligned with professionals’ expert recommendations for care: that patients should fear curative treatment, that patients should hope for pain relief, and that patients and family members should feel guilty for prolonging misery. We argue that authority depends, in part, on professionals’ ability to manage broader feeling rules instead of individual emotions. Given that feeling rule management involves altering meanings of what is considered appropriate, we contend that professionals’ symbolic power and emotional capital underpin their authority in the professional–client encounter.