title: Caring for quality of care: symbolic violence and the bureaucracies of audit.
abstract: BACKGROUND
  This article considers the moral notion of care in the context of Quality of Care discourses. Whilst care has clear normative implications for the delivery of health care it is less clear how Quality of Care, something that is centrally involved in the governance of UK health care, relates to practice.
  
  
  CONCLUSIONS
  This paper presents a social and ethical analysis of Quality of Care in the light of the moral notion of care and Bourdieu's conception of symbolic violence. We argue that Quality of Care bureaucracies show significant potential for symbolic violence or the domination of practice and health care professionals. This generates problematic, and unintended, consequences that can displace the goals of practice.
  
  
  CONCLUSIONS
  Quality of Care bureaucracies may have unintended consequences for the practice of health care. Consistent with feminist conceptions of care, Quality of Care 'audits' should be reconfigured so as to offer a more nuanced and responsive form of evaluation.
authors.affiliation: School of Politics, International Studies and Philosophy, Queen's University Belfast, Belfast, UK. n.emmerich@qub.ac.uk.
authors.forename: Nathan
authors.initials: N
authors.lastname: Emmerich
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK. d.swinglehurst@qmul.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: Swinglehurst
authors.affiliation: The King's Fund, London, UK. j.maybin@kingsfund.org.uk.
authors.forename: Jo
authors.initials: J
authors.lastname: Maybin
authors.affiliation: Research Department of Primary Care and Population Health, UCL Medical School, London, UK. sophie.park@ucl.ac.uk.
authors.forename: Sophie
authors.initials: S
authors.lastname: Park
authors.affiliation: University of Cambridge, School of Clinical Medicine, Cambridge, UK. saq23@medschl.cam.ac.uk.
authors.forename: Sally
authors.initials: S
authors.lastname: Quilligan
mesh_terms: D003695:Delivery of Health Care / Q000941:ethics* / Q000592:standards; D004645:Empathy; D006801:Humans; D009014:Morals; D011787:Quality of Health Care / Q000941:ethics*; D013561:Symbolism; D006113:United Kingdom; D014754:Violence