Iatrogenic uncertainty: the hidden challenge in psychosocial supportive care

Background: Health policy directives have increasingly stressed the inclusion of patient voices and lived experiences, and co-produced knowledge, as vital to mainstream health care. An outcome of this direction is the gradually amassed ‘knowledge’ of the experiences of people affected by cancer (PABC). Despite such intention, nonetheless, there is little evidence of knowledge translation with regard to implementation of psychosocial supportive care services.Methods: In this paper we draw together a body of research from the University of Lincoln, UK, and La Trobe University, Victoria, Australia, and reanalyse our collective findings using a modified form of Foucauldian discourse analysis. Our research triangulates a range of qualitative methods and designs, with participants recruited from rural and regional communities.Results: An unexpected but important finding was the perceived emotional disconnection of the treating health and social care practitioners toward their patients. We posit that this is a result of unacknowledged professional emotional toil. A significant theoretical outcome, we suggest, is the concept of iatrogenic uncertainty and concomitant mortality salience. Combined, these profound existential responses present significant barriers in the patient-professional relationship. In particular, there is an increased risk of poor mental health outcomes for both PABC and their treating practitioners.Conclusion: Further research is recommended to explore how health and social care professionals use and resist patient experience, as well as their own existential dilemmas. We offer the concept of iatrogenic uncertainty as a way of reconceptualising such challenges in psychosocial supportive care.