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Choice and compassion at the end of life:A critical analysis of recent English policy discourse


Reference:

Borgstrom, E. and Walter, T., 2015. Choice and compassion at the end of life:A critical analysis of recent English policy discourse. Social Science and Medicine, 136-137, pp. 99-105.

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    Official URL:

    http://dx.doi.org/10.1016/j.socscimed.2015.05.013

    Abstract

    End of life care in England has recently been framed by two very different discourses. One (connected to advance care planning) promotes personal choice, the other promotes compassionate care; both are prominent in professional, policy and media settings. The article outlines the history of who promoted each discourse from 2008 to 2014, when, why and how and this was done. Each discourse is then critically analysed from a standpoint that takes account of bodily decline, structural constraints, and human relationality. We focus on the biggest group of those nearing the end of their life, namely frail very old people suffering multiple conditions. In their care within contemporary healthcare organisations, choice becomes a tick box and compassion a commodity. Informed choice, whether at the end of life or in advance of it, does not guarantee the death the person wants, especially for those dying of conditions other than cancer and in the absence of universally available skilled and compassionate care. Enabling healthcare staff to provide compassionate, relational care, however, implies reversing the philosophical, political and financial direction of healthcare in the UK and most other Anglophone countries.

    Details

    Item Type Articles
    CreatorsBorgstrom, E.and Walter, T.
    DOI10.1016/j.socscimed.2015.05.013
    Uncontrolled Keywordsengland, end of life care, choice, compassion, discourse, old age, relational ethics, governmentality
    DepartmentsFaculty of Humanities & Social Sciences > Social & Policy Sciences
    Research CentresCentre for Death and Society
    RefereedYes
    StatusPublished
    ID Code44609

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