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Hopeful dying? The meanings and practice of hope in palliative care family meetings

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  • Kirby, Emma
  • Broom, Alex
  • MacArtney, John
  • Lewis, Sophie
  • Good, Phillip

Abstract

Hope can carry considerable allure for people facing imminent mortality and for those who care for them. Yet, how hope is variously and relationally (re)produced within end-of-life care settings, remains under-researched. In this study, we aimed to better understand hope as it circulates within palliative care, drawing on video recorded family meetings and pre- and post-meeting qualitative interviews, within two hospitals in Queensland, Australia. Our findings highlight family meetings as an important site for articulations of hope and hopefulness. The results illustrate how hope is recalibrated within the transition to and through palliative care, the tensions between hope and futility, and the work of hope in discussions of goals and expectations. Through our analysis we argue that hopefulness within family meetings, and in palliative care more broadly, is collectively produced and opens up discourses of hope to the lived experience of terminality. Attending to the nuances of hope, including moving beyond the determinative (hope for more life/hope for a quick death), can elucidate the possibilities and problems of the collective negotiation of hope at the end of life, including how hope can be drawn on to express support and solidarity.

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  • Kirby, Emma & Broom, Alex & MacArtney, John & Lewis, Sophie & Good, Phillip, 2021. "Hopeful dying? The meanings and practice of hope in palliative care family meetings," Social Science & Medicine, Elsevier, vol. 291(C).
    • Handle: RePEc:eee:socmed:v:291:y:2021:i:c:s0277953621008030
    DOI: 10.1016/j.socscimed.2021.114471
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    References listed on IDEAS

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    1. Miyaji, Naoko T., 1993. "The power of compassion: Truth-telling among American doctors in the care of dying patients," Social Science & Medicine, Elsevier, vol. 36(3), pages 249-264, February.
    2. Eliott, Jaklin A. & Olver, Ian N., 2007. "Hope and hoping in the talk of dying cancer patients," Social Science & Medicine, Elsevier, vol. 64(1), pages 138-149, January.
    3. Broom, Alex & Kirby, Emma & Good, Phillip & Wootton, Julia & Adams, Jon, 2013. "The art of letting go: Referral to palliative care and its discontents," Social Science & Medicine, Elsevier, vol. 78(C), pages 9-16.
    4. Zimmermann, Camilla, 2004. "Denial of impending death: a discourse analysis of the palliative care literature," Social Science & Medicine, Elsevier, vol. 59(8), pages 1769-1780, October.
    5. McNamara, Beverley, 2004. "Good enough death: autonomy and choice in Australian palliative care," Social Science & Medicine, Elsevier, vol. 58(5), pages 929-938, March.
    6. Broom, Alex & Adams, Jon & Tovey, Philip, 2009. "Evidence-based healthcare in practice: A study of clinician resistance, professional de-skilling, and inter-specialty differentiation in oncology," Social Science & Medicine, Elsevier, vol. 68(1), pages 192-200, January.
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    1. Dellenborg, Lisen & Enstedt, Daniel, 2023. "Balancing hope at the end of life organisational conditions for spiritual care in palliative homecare in Sweden," Social Science & Medicine, Elsevier, vol. 331(C).

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