Enacting death: contested practices in the organ donation clinic

Area of Science:

• Medical Sociology
• Nursing Ethics
• Thanatology

Background:

• Intensive care units (ICUs) present complex ethical and practical challenges in managing patient death.
• Healthcare professionals' actions and decisions regarding death can vary significantly within these high-tech environments.

Purpose of the Study:

• To explore the inconsistencies in how death is handled, determined, and perceived by healthcare personnel in Norwegian ICUs.
• To analyze the different ways of attending to the dying and deceased, and associated professional behaviors.
• To apply theoretical frameworks, specifically Annemarie Mol's concept of multiple ontologies, to understand these practices.

Main Methods:

• Qualitative fieldwork conducted in two Norwegian Intensive Care Units.
• Observation and analysis of healthcare professionals' interactions and decision-making processes concerning death.
• Application of sociological theories, including 'ontological politics', to interpret findings.

Main Results:

• Identified discrepancies in the handling and determination of death among healthcare staff in ICUs.
• Revealed diverse perspectives on appropriate professional conduct when dealing with dying and deceased patients.
• Demonstrated how different ontologies of death are enacted and perceived as self-evident or illogical within the ICU setting.

Conclusions:

• The study highlights the variability in end-of-life care practices within ICUs, influenced by differing professional behaviors and perceptions of death.
• Utilizing concepts like 'ontological politics' provides a framework for understanding why certain practices become normalized while others are dismissed.
• Further research into these ontological differences can inform more consistent and ethically sound end-of-life care protocols in critical care settings.