Acceptance of dying: A discourse analysis of palliative care literature
- 作者：Camilla Zimmermann camilla.zimmermann@uhn.on.ca
- 关键词：Acceptance ; Death ; Dying ; Palliative care ; Terminal care ; Hospice ; Discourse analysis
- 刊名：Social Science and Medicine
- 出版年：2012
- 期刊代码：242_02779536
- 类别：med
- 出版时间：July, 2012
- 卷：75
- 期：1
- 页码：217-224
- 文件大小：185 K
摘要
The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its 鈥渙pposite鈥? the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term 鈥渁cceptance鈥?of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words 鈥渁ccept or acceptance鈥?with the subject headings 鈥渢erminal care or palliative care or hospice care鈥? and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die.