The revival of death: expression, expertise and governmentality

Foucault at the bedside: a critical analysis of empowering a healthy lifestyle

Since quite a few years, philosophy is heading towards the bedside of the patient: the practice of philosophy has stepped out of its ivory tower, it seems, to deal with empirical or practical questions. Apart from the advantages, we should keep in mind the importance of a critical analysis of medical or clinical practice as such. If ethics partakes the clinical stage, it runs the risk only to discuss the how question and to forget the more fundamental what or why questions: what are we doing exactly and why is it good for? Starting from the principle of the empowerment of the patient, we will demonstrate how the discourse on empowerment in health care seems to forget a profound reflection upon this principle as such. By rehearsing some basics from the governmentality theory of Michel Foucault and the actualization of it by Nicolas Rose, we will argue how philosophical investigation in medical-ethical evolutions such as empowerment of the patient is still needed to understand what is really going on in today's clinical practice.

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

End of life care in England has recently been framed by two very different discourses. One (connected to advance care planning) promotes personal choice, the other promotes compassionate care; both are prominent in professional, policy and media settings. The article outlines the history of who promoted each discourse from 2008 to early 2015, when, why and how and this was done. Each discourse is then critically analysed from a standpoint that takes account of bodily decline, structural constraints, and human relationality. We focus on the biggest group of those nearing the end of their life, namely frail very old people suffering multiple conditions. In their care within contemporary healthcare organisations, choice becomes a tick box and compassion a commodity. Informed choice, whether at the end of life or in advance of it, does not guarantee the death the person wants, especially for those dying of conditions other than cancer and in the absence of universally available skilled and compassionate care. Enabling healthcare staff to provide compassionate, relational care, however, implies reversing the philosophical, political and financial direction of healthcare in the UK and most other Anglophone countries.

Taboo and the different death? Perceptions of those bereaved by suicide or other traumatic death

Views differ on how far the subject of death has ever been taboo in Western Society. Walter (1991) criticised the way the 'taboo thesis' has been presented, arguing that it has often been 'grossly overdrawn and lacking in subtlety'. Research suggests that suicide and other traumatic death may be particularly difficult for people to talk about or even acknowledge. We interviewed 80 people bereaved due to suicide, or other traumatic death and used interpretative thematic analysis to consider whether the 'death taboo' is evident in these bereavement narratives. People referred to suicide as a different, even stigmatised, death but we also found that those bereaved through other traumatic death felt that their reactions had to be contained and relatively silent. The exception was those bereaved through terrorism or train crash, who were encouraged to grieve openly and angrily: reactions to deaths which are seen as 'private troubles' differ from reactions to deaths which are seen as 'public issues'. Using a symbolic interactionist approach we conclude that the shock and suddenness of the death is tied up both with the circumstances of the death (suicide, murder, accident, terrorism) and the attendant consequences for the social acceptance of public displays of mourning.

Surviving death-anxieties in liquid modern times: examining Zygmunt Bauman's cultural theory of death and dying

Despite his prominence as a leading contemporary social theorist, Zygmunt Bauman's long-term writing on the cultural theory of death and dying has largely been overlooked in the sociological literature of death and dying, particularly in the United States. Bauman uniquely theorizes how we survive death-anxieties today: Contemporary, liquid modern culture has engaged us in ceaseless pursuit of the unattainable consumer sensation of bodily fitness as a way to suppress and thus survive our death-anxieties. Bauman also argues that the prevalence of this cultural formula to survive death-anxieties has simultaneously increased, more than ever before in social history, the volume of individual responsibility for restlessly coping with existential anxieties in the societies of consumers. While unique and insightful, his theoretical argument has a limitation; largely succeeding Freud's classic view of mortality, Bauman's contemporary theory may lead us to neglect potentially important social, cultural, and historical variations in how mortality has been understood.

Bereavement and bereavement care in health and social care: provision and practice in Scotland

The interview study described here aimed to explore current views of and practice in bereavement care and identify priorities for service development in Scotland. Fifty-nine participants who worked with the bereaved in some way, or whose interest was in bereavement or bereavement care, were interviewed. They represented National Health Service organizations, chaplaincy departments, educational institutions, academic departments, voluntary groups, and other related bodies, such as funeral directors. Transcripts were read repeatedly and initial emerging themes were identified, coded and shared between research team members to reach a consensus for key themes. Priority areas for development were related to raising public awareness, coordination of services, guidance, and professional education.