Revisiting the Violence Metaphor in End-of-Life Care

Koller, Veronika; Demjen, Zsofia; Demmen, Jane; Hardie, Andrew; Payne, Sheila; Rayson, Paul and Semino, Elena (2014). Revisiting the Violence Metaphor in End-of-Life Care. In: 5th International Conference on Critical Approaches to Discourse Analysis Across Disciplines (CADAAD 2014), 1-3 Sep 2014, Budapest, Hungary.



In the project ‘Metaphor in End-of-Life Care’ we investigate metaphor use in a 1.5 million-word corpus of interviews and online forum contributions by terminally ill patients, family carers and health professionals. In this paper we revisit the controversial ‘WAR metaphor’ in relation to terminal illness by exploring how it is used by patients.
Sontag (1978) famously argued against the use of WAR metaphors in relation to terminal illness. Since then such metaphors have frequently been criticised for their potential to harm and disempower patients, and have been systematically avoided in official documents such as the 2008 End-of-Life Care Strategy for England and Wales.
However, the analysis of our patient data shows that there is no one WAR metaphor and that the continuing use of metaphors to do with war, battles and violence deserves detailed attention. We discuss the different types of WAR metaphors and explore the various situations, interactions and attitudes they describe, including patients’ attempts to recover from illness, their hospital stays and their interactions with health professionals (e.g. ‘health professionals have to provide the armoury’, ‘arming oneself with knowledge to talk to the professionals’). We note that WAR metaphors sometimes have a positive function, such as expressing personal determination, self-empowerment and solidarity (e.g. ‘you are such a fighter’).
We reflect on the implications of these metaphors for the extreme imbalances of power that come with the end-of-life care context and consider our project in relation to CDA's 'emancipatory agenda'.

Sontag, S. (1978): Illness as Metaphor. New York: Farrar, Straus and Giroux.

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