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The institutionalization of the good death
B McNamara1, C Waddell, M Colvin
1Department of Anthropology, University of Western Australia, Nedlands.
Social Science & Medicine (1982)
|December 1, 1994
Summary
Institutionalization of hospice care challenges its founding ideals. This study reveals five key issues, including medical encroachment and organizational demands, impacting the
Area of Science:
- Palliative Care
- Sociology of Health and Illness
- Healthcare Management
Background:
- Concerns exist regarding the institutionalization of hospice care potentially undermining its core principles.
- The influence of mainstream medicine and a focus on treatment pose challenges to hospice philosophy.
Purpose of the Study:
- To investigate the compatibility of the 'Good Death' ideal with the institutionalization of hospice care.
- To explore challenges faced by hospice care in Australia.
Main Methods:
- Qualitative study utilizing interviews with nurses.
- Participant observation in an inpatient hospice unit and a community-based hospice service.
- Analysis of Australian hospice care data.
Main Results:
- Identified five key challenges: medical encroachment, competing motivations, intellectual delimitation, organizational maintenance, and routinization of the 'Good Death'.
- Demonstrated tension between maintaining hospice ideals and organizational needs.
- Highlighted strategies used by healthcare professionals to navigate daily demands.
Conclusions:
- The institutionalization of hospice care presents significant challenges to its founding ideals.
- Balancing organizational demands with the philosophical tenets of hospice care is crucial.
- Further research is needed to address the identified challenges and preserve the essence of hospice care.