Governing Through Intimacy: Sharing Meanings in Health Care Policy Formulations

26 Pages Posted: 26 Sep 2010

See all articles by Anna Durnova

Anna Durnova

affiliation not provided to SSRN

Date Written: 2010


‘Governing through meaning’ has become a prevalent paradigm in post-positivist policy analysis. The article suggests that meanings are “shared” in the first place and illustrates this point through the notion of “intimacy“, which can be observed in the field of inpatient care for dying fellows (“dying care”). Intimacy is a deep personal knowledge about body and mind, that changes during the dying process. Intimacy is shared through emotions and implies a process of acknowledging patient’s emotional requirements by family and care staff.

I describe how the Czech online assessment agenda “” supporting dying fellows and their family in the dying care practices has put in place a contract of communication that has been built on sharing of emotions and has boosted in that way specific meaning of dying. I therefore understand intimacy as a “contract of communication” that uncovers how collective interpretations (discourses) emerge through specific sharing of emotions (anxieties, wishes, imaginations).

Against this example, I discuss “governing through intimacy” as a key factor of policy formulation. This factor becomes particularly important when controversial, unpopular or uncertain policies are at stake as the recent health care policies tend to be.

Suggested Citation

Durnova, Anna, Governing Through Intimacy: Sharing Meanings in Health Care Policy Formulations (2010). APSA 2010 Annual Meeting Paper, Available at SSRN:

Anna Durnova (Contact Author)

affiliation not provided to SSRN ( email )

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