Dying, death and end-of-life practice of care

This Doctoral Thesis on Professional Practice, Dying, Death and End-of-Life Practices of Care, has explored dying not as medical or body failure but as a relational, collective experience that is part of the whole cycle of life in which acceptance, relationship, compassion, and community are valued (Epstein & Back, 2015; Gergen, 2009; Hedtke, 2020; Raboin & Uhlig, 2020). This research study extends research on relational and collaborative forms of care at end-of life that invite patients, families, clinicians, and community into more productive, respectful, and engaging ways to relate to one another, to find alternatives, to interact, and co-create supportive, comforting, and dignified treatment and care (Mills, 2021; Oldfield, 2019).

This study provides a portfolio of five chapters of research that focusses on dying, death, and end-of-life practices of care. Within the social constructionist framework of this research, knowledge unfolds in the process of the research with the goal of creating new, innovative, and transformative possibilities and practices (Camargo-Borges & McNamee, 2020). Overall, this research seeks to move beyond the 'mirroring” metaphor of “what is”, to participate in shaping or forming future practices in care at end-of-life, practices that can be more engaging, collaborative and responsive to the lived experiences of patients and families facing end-of-life and the health care practitioners traversing end-of-life with them (Gergen, 2014).

Initially, a literature review explored concepts and practices of care on the topic of death, dying and end-of-life, addressing implications for patients, caregivers and medical practitioners. The literature review investigated the dominant discourses in this topic in the Western parts of the world, as well as the growing dialogic and collaborative approaches in the relational dimension of care. Specifically, this study is situated within the Canadian context. Subsequent chapters of the research study indicated the relevance of exploring more than one perspective in palliative and end-of-life care, the relevance of going beyond the medical model, acknowledging and lifting up the voices and lived experiences of patients, family members and marginalised.

I believe that this research is particularly relevant in the current context of a fragile health care system that requires strategies, responses, and vision to support its post-pandemic recovery, and the recovery and building of new and innovative practices of care. Specifically, this research contributes significantly to knowledge as it names relational and collaborative forms of care at end-of-life in the areas of caregiver and clinician suffering, advocacy for the dying and their families, grief and bereavement practices, social justice practices and relationship building practices in which relational intelligence is fundamental and contributes to knowledge. Critical Indigenous, feminist, queer, Black and people of colour insights have provided an important framework for understanding care in all its spheres including care at end of life. This framework for understanding care in all its dimensions including end-of-life is a significant original contribution to knowledge.