What is a ‘good death’? Narratives, metaphors and professional identities in interviews with hospice managers

Semino, Elena; Demjén, Zsófia; Hardie, Andrew; Koller, Veronika; Payne, Sheila and Rayson, Paul (2013). What is a ‘good death’? Narratives, metaphors and professional identities in interviews with hospice managers. In: A Narrative Future for Healthcare, 19-21 Jun, London, UK.

URL: http://ucrel.lancs.ac.uk/melc/Narrative_Health2013...

Abstract

In this presentation we discuss the metaphors and narratives that fifteen hospice managers produced during semi-structured interviews in response to the following questions: ‘How would you describe a good death? Can you provide any examples from your experience?’ Metaphor involves talking and, potentially, thinking about one thing in terms of another. It is often used to communicate about experiences that are subjective, complex and sensitive, including the emotions around death (e.g. Kövecses 2000). As part of an ESRC-funded project on ‘Metaphor in End-of-Life Care’, we apply a well-established analytical method (Pragglejaz Group 2007) in order to identify the metaphors that were used by several interviewees in order to describe the characteristics of a good death. These include: metaphors to do with freedom and control (‘pain-free’, ‘their symptoms are under control’); metaphors to do with openness (‘open discussions’); metaphors to do with vision (‘what the patient sees as a good death’); and a variety of metaphors to do with journeys (‘at peace with the journey as it’s going’, ‘reached an understanding that the death is going to come’, ‘went down quite quickly’). When interviewees told stories about specific cases, they produced what we call ‘narratives of successful intervention’ which, in Labov’s (2010) terms, have the following characteristics: a lengthy orientation phase which outlines a problematic situation; a narrative core in which the problems are successfully addressed by hospice staff; a brief reference to the person’s death; and a wealth of evaluation devices, often clustering towards the end of the story. We discuss the ways in which these metaphors and narratives are linked to the interviewees’ professional views, challenges and identities.

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