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

Borgstrom, Erica and Walter, Tony (2015). Choice and compassion at the end of life: A critical analysis of recent English policy discourse. Social Science & Medicine, 136-137 pp. 95–105.

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DOI (Digital Object Identifier) Link: https://doi.org/10.1016/j.socscimed.2015.05.013
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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 early 2015, 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.

Item Type: Journal Item
Copyright Holders: 2015 Elsevier Ltd.
ISSN: 0277-9536
Keywords: England; End of life care; Choice; Compassion; Discourse; Old age; Relational ethics; Governmentality
Academic Unit/School: Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care > Health and Social Care
Faculty of Wellbeing, Education and Language Studies (WELS) > Health, Wellbeing and Social Care
Faculty of Wellbeing, Education and Language Studies (WELS)
Item ID: 46828
Depositing User: Erica Borgstrom
Date Deposited: 18 Aug 2016 08:57
Last Modified: 10 Jun 2019 20:08
URI: http://oro.open.ac.uk/id/eprint/46828
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