Abstract
This paper discusses the metaphors used by sixteen palliative healthcare professionals from around the United Kingdom in semi-structured interviews to describe what they see as ‘good’ and ‘bad’ deaths. The interviews, conducted for the large-scale “Metaphor in End-of-Life Care” project, are set against the background of contemporary practices and discourses around end-of-life care, dying and quality of death. To date, the use of metaphor in descriptions of different types of deaths has not received much attention. Applying the Metaphor Identification Procedure (Pragglejaz Group, 2007) we find that the difference between good and bad deaths is partly expressed via different frequencies of contrasting metaphors, such as ‘peacefulness’ and ‘openness’ as opposed to ‘struggle’ and ‘pushing away’ professional help. We show how metaphors are used to: evaluate deaths and the dying; justify those evaluations; present a remarkably consistent view of different types of deaths; and promote a particular ‘framing’ of a good death, which is closely linked with the dominant sociocultural and professional contexts of our interviewees. We discuss the implications of these consistent evaluations and framings in broader end-of-life care contexts, and reflect on the significance of our findings for the role of metaphor in communication about sensitive experiences.
Highlights
This paper focuses on metaphors used to describe ‘good’ and ‘bad’ deaths in semistructured interviews with sixteen UK-based healthcare professionals in hospice or palliative care
The project investigated how healthcare professionals, patients and unpaid family carers use metaphor to talk about their experiences, attitudes and expectations of end-of-life care, and what this might suggest about their needs, challenges, and emotions, as well as potential causes of anxiety and/or misunderstanding
In this paper we discussed the metaphors used by sixteen UK-based hospice professionals to describe good and bad deaths
Summary
This paper focuses on metaphors used to describe ‘good’ and ‘bad’ deaths in semistructured interviews with sixteen UK-based healthcare professionals in hospice or palliative care. 100) argue that the construction of a good death in late-modern Western societies relies on the notions of “control, autonomy, dignity, awareness, and heroism” This, they suggest, reflects a social context that is individualistic, increasingly secular, values independence, self-mastery, self-care, and believes in the power of medicine. Cipolletta and Oprandi (2014) for example, point out that patient autonomy is considered important in countries like the Netherlands, Switzerland, and Australia, but less so in Italy and Sweden Despite such acknowledgements of the sociocultural variability of what counts as a good or bad death, the medical-revivalist discourse seems to dominate. After a more detailed description of our data and methods, we focus on the metaphors they used to describe good and bad deaths and discuss the unified professional view that emerges
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