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Communication at the End of Life


Jon F. Nussbaum, Howard Giles and Amber Worthington

Communication is at the heart of any complete understanding of the end of life. While it is true that individuals physically die as a single entity, the process of ending an individual life is located within a complex system of relationships and roles connected and constructed through communicative processes. In this volume, top scholars from numerous disciplines showcase the latest empirical investigations and theoretical advances that focus on communication at the end of life. This multi-contextual approach serves to integrate current findings, expand our theoretical understanding of the end of life, prioritize the significance of competent communication for scholars and practitioners, and provide a solid foundation upon which to build pragmatic interventions to assist individuals at the end of life as well as those who care for and grieve for those who are dying. This book is suitable for undergraduate and graduate courses in Death and Dying, Communication and Aging, Health Communication, Life Span Development, Life Span Communication, Long term care, Palliative care and Social Work.
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Chapter Two: Discourse “On or About’” Dying: Palliative Care



Discourse “On OR About’” Dying: Palliative Care


Language inevitably arrives at the limits of expression. For example, in medical and legal discourses, when a precise time or location cannot be isolated, then one must resort to the less specific phrase “on or about.” In light of this limited aspect of language, the present chapter admits to addressing discourses merely “on or about” death through palliative care literature. In addition to the endeavor to show the limits of language, the phrase “on or about” was also chosen to emphasize the multiplicity of discourses surrounding end of life and the inability to represent death, and therefore dying, as an immutable, singular, and definitive entity or phenomenon.

We begin with the presupposition that death is not inherently problematic, and that the appropriation of death through the assigning of meaning(s) is epochally contingent. Despite the feeling that our own relationships to death are individualized and extremely personal, our responses to death and dying are “greatly influenced by the beliefs of society which seep into the fabric of institutional power” (Powell, 2011, p. 359). In this way, end-of-life discourses are not mere reflections of individual thoughts and choices, nor are they simply representative of meaning and culture; “they are the very elements that produce meaning and culture surrounding the end of life by becoming routine, naturalized, institutionalized, and accepted” (Candrian, 2013, p. 57).

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