Erkännande, makt och möten : En studie av inflytande och självbestämmande med LSS

The dissertation is about people with serious functional impairments who receive support pursuant to the Swedish LSS – the Act Concerning Support and Service for Persons with Certain Functional Impairments. LSS gives compensatory support, so that a person can enjoy the right to live a life like anyone else. The user’s right to influence and self-determination is emphasized in the Act. The overall aim of the dissertation is to describe and analyse conditions, possibilities, and limitations to influence and self-determination for people receiving LSS support. The investigation includes two interview studies. One is a study of influence and self-determination in everyday life with personal assistance. The other study focuses on people receiving some form of LSS service in combination with having a limited guardian. The thesis shows that LSS can be understood on a general level as a judicial recognition of the group’s right to support for citizenship on individual terms. In many cases LSS service give the user influence and self-determination in everyday life. The interaction between the user and the supporting persons are crucial. If it involves mutual recognition of equality and recognition of difference – the right to be compensated for restricted abilities – then the user can act autonomously. The study deals with power and recognition as essential aspects. The analysis shows that recognition and power together contribute to an understanding of the complex situation that users of LSS measures have in their day-to-day lives. The intention behind the care is to ensure the user’s best interest. Relations and encounters around the user are affected by pastoral power with a caring purpose where support and control are interwoven. Mis-directed recognition is perceived as an infringement of integrity. The dilemma is that care that aims for something good without recognition reduces the user to an object and disrespect. The studies reveal a tension between the ideal of influence and self-determination as ”subject of rights” and the user’s everyday life. Personal assistance can be designed to contribute to achieving the intentions. Among many people receiving LSS support and having a legal guardian, the personal influence and self-determination are not distinct and guardianship is unclear. Relations are characterized by dilemmas concerning the preferential right of interpretation. The individuals are seen as “objects of care” by others. Influence and self-determination depend on a fundamental recognition of the user as subject with a need for individually adapted care. This means the right to be and act as a “subject of care”. Recognition, relations and power are keys to influence and self-determination in LSS