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Biomedicalization of end-of-life conversations with medically frail older adults - Malleable and senescent bodies

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  • Carter, Celina
  • Mohammed, Shan
  • Upshur, Ross
  • Kontos, Pia

Abstract

The common practice of delaying and/or avoiding end-of-life conversations with medically frail older adults is an important clinical issue. Most research investigating this practice focuses on clinician training and developing conversation skills. Little is known about the socio-political factors shaping the phenomenon of end-of-life conversations between clinicians and medically frail older patients. Using the critical lens of biomedicalization we consider how two dominant discourses, successful aging and frailty, and subsequent constructions of bodies as malleable or senescent, shape patient subjectivities and influence normative expectations about appropriate healthcare conversations and the consumption of biomedicine for medically frail adults. We highlight the uneven ways medically frail older adults are clinically positioned as successful or frail agers and briefly discuss how gender, class, and race may impact this tension and ambiguity. We conclude by arguing that end-of-life conversations with medically frail older adults is constrained by the pervasiveness of the successful aging discourse and the tendency within medical institutions to construct older bodies as malleable and in need of medical intervention to promote health and longevity.

Suggested Citation

  • Carter, Celina & Mohammed, Shan & Upshur, Ross & Kontos, Pia, 2021. "Biomedicalization of end-of-life conversations with medically frail older adults - Malleable and senescent bodies," Social Science & Medicine, Elsevier, vol. 291(C).
  • Handle: RePEc:eee:socmed:v:291:y:2021:i:c:s027795362030647x
    DOI: 10.1016/j.socscimed.2020.113428
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    References listed on IDEAS

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    1. Ferlie, Ewan & Mcgivern, Gerry & FitzGerald, Louise, 2012. "A new mode of organizing in health care? Governmentality and managed networks in cancer services in England," Social Science & Medicine, Elsevier, vol. 74(3), pages 340-347.
    2. Zivkovic, Tanya, 2018. "Forecasting and foreclosing futures: The temporal dissonance of advance care directives," Social Science & Medicine, Elsevier, vol. 215(C), pages 16-22.
    3. Sharon R. Kaufman & Janet K. Shim & Ann J. Russ, 2006. "Old Age, Life Extension, and the Character of Medical Choice," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 61(4), pages 175-184.
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