Interviewees were aware that both interviewers were linguists, rather than specialists in end-of-life care, and therefore ‘outsiders’ whom they may have felt in need of convincing of the importance of hospices in end-of-life care and of the value of their profession. When a child has poor resilience, this can stem from a parent’s inflexibility, inability to handle change well or failure to cope with negative emotions in a healthy manner. These devices implicitly evaluate the events that actually did occur in the hospice by comparing them with potential undesirable events or outcomes that the hospice staff were able to prevent. . This politicization of death, whether ‘good’ or ‘bad’, can affect the range of ‘acceptable’ choices that patients and families are presented with. In a few cases, the interviewees mentioned lack of adequate resources for the provision of optimal care, or unfortunate circumstances such as patients being admitted at particularly busy times. Get a free, no obligation case review today. The collaborative nature of end-of-life care is reinforced in the use of we and as a team to refer to the agents who bring about the successful intervention: the interviewee presents himself as part of a group of professionals that acts as one. Some of the ‘good’ death narratives in our interviews are less prototypically structured than Example 1, but perform the same function in terms of argumentation and identity construction. When somebody simply tells you bad news, you hear it once, and that’s the end of it. Everyday English Speaking Course. It was difficult for her family because I think they ended up feeling . By and large, however, the failure of professional intervention was explained as the result of the attitude of the people involved, namely, the patient’s close relatives or, in most cases, the patient him- or herself, who either rejected help or was unable to benefit from it due to the way they had lived up to that point. In 1972, the Supreme Court declared that under then-existing laws \"the imposition and carrying out of the death penalty… constitutes cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments.\" (Furman v. Georgia, 408 U.S. 238). . Many Americans spent much of 1994-95 glued to their televisions watching the double-murder trial of former professional football player and actor O.J. Moreover, the notion of the ‘good’ death in particular is one that hospice managers regularly encounter and discuss in their professional practice. In the discussion that follows, we reflect on how these relate to the elements in Labov’s (1972) framework. couldn’t physically get her comfortable, wouldn’t accept any pain relief). Breaking news and analysis on politics, business, world national news, entertainment more. Since she had to leave by midnight, she ran and lost one slipper. de Fina and Georgakopoulou, 2012: 97; Schubert, 2010). And he’d been suicidal at one stage, he was so depressed that he couldn’t enjoy his wife’s cooking. The first two clauses (beginning with nothing) implicitly attribute to the patient a totally dismissive assessment of and attitude towards the hospice setting and services. Due to its affordability, the Ford Pinto was an extremely popular motor vehicle in the 1970’s. A marketing studio working with artists and organizations to tell their stories through media, product, and experience. The Deprivation Account originates from Nagel, who suggested that death is bad because it deprives one of future goods (for example, pleasures) which one could enjoy if one died later (1970, p. 75). Injury or illness (oneself or a family member). In Labov’s terms, however, this brief reference to the timing of the patient’s death in relation to the core action arguably counts as the story’s resolution. It shows that one instance of worst customer service failure can have serious consequences. . but if he hadn’t have been, if his wife hadn’t have been, if he’d have stayed in the hospital acute setting, his wife probably wouldn’t have been told wouldn’t have realized and he might have just died on his own behind some curtains. A particularly relevant aspect of identities for our purposes is that of ‘professional’ identities, which are linked to the teller’s workplace and their role within it. Your wife has done something that hurts your feelings or, there is a problem in the marriage that you wish to discuss with her. not only died vomiting. Currently, capital punishment is considered a legal penalty in 31 US states. However, recent research has undermined the notion of a stark dichotomy between ‘elicited’ and ‘spontaneous’ story-telling (Koven, 2011). For more information view the SAGE Journals Article Sharing page. The following four independent clauses arguably constitute the core of the narrative: the setting is now the hospice, and the focus is on the patient and the hospice staff in the period leading up to the patient’s death. As we have shown, most interviewees use narratives to exemplify their points and to support their claims that hospices can play a central role in making it possible for people to experience a ‘good’ death. The story begins with a description of the patient and his family, including some details indicative of a difficult situation: young patient, young children. The team are presented as acting as a coherent collective agent, referred to either by a semi-generic use of the second-person pronoun ‘you’, as in Example 3, or by the first-person plural pronoun ‘we’ elsewhere. Death penalty, also called capital punishment, is when ... Mexico and all members of Council of Europe are examples of countries that have abolished the death penalty. FundingThe research presented in this article was supported by the UK’s Economic and Social Research Council (ESRC grant number: ES/J007927/1). . Resolution: an indication of the final event. Death is an inevitable, universal process that eventually occurs in all living organisms. When pronouns are used for the agent(s) of the intervention, the interviewees opt for collective reference via the first-person plural pronoun ‘we’ or for partly generic reference via the second-person pronoun ‘you’ (see de Fina and Georgakopoulou, 2012: 75–80, for collective narratives in immigrants’ discourse). Example 3 below is representative of our interviewees’ responses to the ‘bad’ death questions. 4.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212452/Press_notice_-_Liverpool_Care_Pathway.pdf (accessed April 2014). In this article we show how hospice managers’ perspectives on ‘good’ and ‘bad’ deaths, expressed in the narratives they told in response to interview questions, revolve around the success or failure of professional intervention in difficult circumstances. The staff’s descriptions showed greater uniformity and emphasized ‘adequate symptom control, family involvement, peacefulness and lack of distress’ (Payne et al., 1996: 307). We then consider examples of ‘good’ and ‘bad’ death narratives in turn, before concluding with reflections on the implications of our findings. At the same time, the interviewees’ stories show how much one’s (professional) perspective can affect the representation and evaluation of different ways of dying. This situation is addressed by professional intervention in the hospice, and changed to such an extent that the patient has a ‘good’ death. Hank Stout co-founded Sutliff & Stout, Injury & Accident Law Firm, to protect and pursue the rights of people who were harmed by the carelessness of others. However, they also claimed that hospice care can actually provide patients and their families with a better overall experience, thus making a case for the importance of end-of-life care and their profession. Consider a famous example. Leech’s, 1983, ‘Modesty Maxim’), it is clear that he here constructs his profession as both necessary and positive. The famous airlines miserably failed to fulfill the two core elements of customer service i.e. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. She then uses a series of ‘battle’ metaphors to describe the attitudes and feelings on the part of patients that make it impossible for hospice staff to intervene successfully: for some people their life is a struggle or a battle or a series of conflicts; there’s [. In particular, the narratives that the interviewees told to exemplify their views share several distinctive characteristics. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. Second, story-telling can function, among other things, as an argumentation device: stories can be used to provide ‘evidence’ from one’s own or others’ experiences to support one’s claims, views and judgements (e.g. A bad example would include the Salem Witch Trials, the Spanish Inquisition, etc. 2.For ease of readability, we lay out our extracts from the interviews as continuous text and use orthographic marks to provide minimal information about intonation contours: a full stop indicates falling or final intonation; a comma indicates continuing intonation, whether within or across clause boundaries; three full stops indicate a significant pause. The LCP was intended to ensure the comfort and dignity of dying patients. Some of the more common examples of "bad" event stressors include: Losing your job: No one needs a detailed explanation of why losing your job, and the prospect of not being able to support yourself, or family is enough to keep anyone awake at night. Takata has already faced several wrongful death suits that allege the company knew of the possible defect nearly a decade before the recall was issued, thereby disregarding the safety of motorists. Following is a preliminary example of a ‘good’ death narrative from one of our interviews:2. somebody that comes to mind is somebody that was very very anxious, came into the hospice and they couldn’t sit down, they were so anxious they were just pacing and pacing and gradually we started to have discussions about what their worries are, what they frightened about and we started to relieve that anxiety. At trial, a jury found that Simpson was responsible for deaths and awarded the families $33.5 million. While the palliative care movement associates a ‘good’ death with control, autonomy and dignity, the right-to-die movement associates it with awareness and heroism. We therefore also classified as narratives a variety of stretches of text that depart in different ways from the prototypical cases described by Labov, particularly by not including a section that straightforwardly corresponds to the definition of ‘complicating action’. This involves a different kind of heroic dimension to (nearly) dying than the one that applies to the right-to-die discourse discussed by van Brussel and Carpentier (2012). (see Emma's letter for an example of a well-written appeal) Brett's Academic Dismissal Appeal Letter To Whom It May Concern: I am writing because I would like to appeal my dismissal from Ivy University for poor academic performance. As previous studies have also found (e.g. We suggest that these characteristics reflect and support a strong sense of professional worth and identity, which is undoubtedly helpful for hospice staff performing their difficult roles. Simpson. This is not an example of the work written by professional essay writers. The evaluative devices used by our interviewees include particularly negative and hypothetical structures. In both ‘good’ and ‘bad’ death narratives, evaluation plays a central role. Indeed, other data show that, in some cases, patients and their families may feel invaded in their privacy or overwhelmed by the hospice staff’s intervention. An example is provided by the artificial hand being developed by Newcastle University. . This is obviously cued by the situational context, as we interviewed people in their role as hospice managers, and mostly conducted the interviews in their workplaces. As in the previous example, the interviewee uses the first-person plural pronoun to refer to himself and his colleagues, although they are represented as less directly involved by the use of passive clauses (wouldn’t have been told) and nominalization (attention) instead of active clauses. The narratives’ function of constructing and enhancing a sense of professional identity and worth, as well as conveying loyalty and team spirit, have to be seen against this wider social background. (1996) conducted interviews with patients and staff in a palliative care unit in order to compare their views of a ‘good’ death. As a result of the semi-structured nature of the interviews, interviewees were allowed enough flexibility to express themselves freely in response to open-ended questions in a relaxed atmosphere (Dörnyei, 2007). The actions that constitute a successful professional intervention tend to be attributed to a collective agent (the speaker and his/her colleagues), primarily by means of the first-person plural pronoun ‘we’. No one had the heart to inform Annerose von Grünwald about Siegfried Kircheis's death in Legend of Galactic Heroes. Her family then filed a wrongful death claim against Zoloft’s manufacturer, Pfizer Pharmaceuticals, alleging that the drug caused Brynn to go insane and its effects led her to commit the shootings. Communicating the news of a patient’s death to a relative can be likened to breaking bad news to a patient with a terminal diagnosis. Discover recipes, home ideas, style inspiration and other ideas to try. We will see that professional face and identity are mostly enhanced by emphasizing the role of hospice staff in deaths valenced as ‘good’, while downplaying it in those seen as ‘bad’. Georgakopoulou, 2007: 37–40; Ryan, 2007). the patient’s admission to a hospice) or be implied via hypothetical and negative structures that also function as evaluative devices. The notion of a ‘good’ death, and communication around the topic of death, have been studied from several different perspectives. Our interview questions about ‘good’ and ‘bad’ deaths required the 13 hospice managers to address issues that are central to their profession, sensitive and personal for the people they serve, and increasingly visible and controversial in media and public debates. In the hospice. The image that emerges is of staff who act in beneficial ways for the patient and family unless circumstances or the latter’s attitude prevent(s) them from doing so, and who face emotional issues of their own as a result of the difficulties and demands of their profession. There is no conclusive evidence (although much speculation) an innocent has been executed since States took over duties of executing from the local counties (circa 1900), and especially since the post-Furman era (1976) began. It is at this point that hospice staff become involved in ways that provide tellable material for our interviewees in response to a question about ‘good’ deaths. Say “I’m so sorry to hear that” when you hear about sickness, death, divorce, job loss, financial trouble, big disappointment, and other serious problems or pieces of bad news that can make a person very sad. In the extract above, this reference occurs within a series of reflections on this patient’s death, which, in Labov’s terms, function as ‘external’ evaluation (Labov, 1972: 371). Nonetheless, Labov’s framework proved consistently useful in our analyses in order to account for the distinctive structural characteristics of the stories told by our interviewees. Death warmed up. His wife had been told, [‘Reflections on death as “good”: Alternative hypothetical scenario’], and he died the next morning, and it was quick we weren’t expecting it to be that quick. The pathway became publicly controversial after numerous media reports that it was not always correctly implemented. Three main aspects of narratives are particularly relevant to the discussion of our data. More recently, Labov (2013) has restated that death is one of ‘three universal centers of interest’, alongside sex and moral indignation (Labov, 2013: 4). In the next section, we present our approach to identifying and analysing ‘narratives’ in our data, and briefly discuss previous relevant work on narratives in relation to evaluation, argumentation and (professional) identities. Willy has high expectations for himself and for his children. And we went to see him as a team and did some acupuncture, and the recurrent hiccoughs erm reduced considerably, in the first instance and then and then stopped and he was able to go home. In Labov’s terms, our interviewees use ‘narrative techniques to shape and transform [. Login failed. Example 1 is typical of narratives that were told to exemplify a ‘good’ death. Dealing with death and bereavement on a daily basis can take its toll (as evidenced by frequent references to staff distress), and collectivizing/distributing responsibility when things go wrong can be seen as a coping mechanism. For example:-An eccentric British pilot cheated death after crash-landing in the shark-infested waters of the Caribbean. People who openly talk about death when they are in good health have a greater chance of facing their own deaths with equanimity. Herman, 2007). Even if a prosecutor does not have enough evidence to convict someone of homicide, there may be enough evidence to sufficiently prove liability for wrongful death. In our interviews the hospice managers express their views about ‘good’ and ‘bad’ deaths in three main ways: a) general statements about the characteristics of a ‘good’ or a ‘bad’ death, often including metaphorical expressions; b) generic narratives about types of people and experiences; and c) narratives about specific (but unnamed) individuals. In terms of positioning and linguistic features, this description corresponds to Labov’s ‘orientation’ phase (e.g. Criminologists claim they have statistically proven that when an execution is published more murders occur in the days and weeks that follow. This works through what in social cognition research is called ‘attributional asymmetry’ (Augoustinos et al., 2006: 164), a phenomenon that involves people accepting credit for success, that is, attributing it to their own actions or personality traits, but denying responsibility for failure, that is, attributing it to external factors. . You couldn’t physically get her comfortable. The following is a list of every character and extra that has died over the series. Being abused or neglected. Feeling lucky: hierarchies of suffering and stories of endometrial can... View or download all content the institution has subscribed to. We suggest that the interviewees use these narratives to construct particular professional roles and identities for themselves, that is, to define, elaborate and justify their role in end-of-life care. In contrast with the previous example, however, Example 2 does not include a separately identifiable core or ‘complicating action’ that would provide an account of the main actions and events that the story is about: the patient was moved from elsewhere (a hospital) to the hospice just in time for his wife to be told what was happening and for him to die with comfort and dignity. Reports indicate that even the pilot commented that the plane was overloaded. This website should not be taken as legal advice. Additionally, we point out that, as noted by Payne et al. So I think her life how she’d lived it played out right into the very last moment. . While the mother had not been a suspect regarding the disappearance, Grace–a former prosecutor–interrogated her about the child, insinuating that the mother knew where he was and even that she may have killed him. While Ford ultimately recalled all Pintos due to the dangerous design, this recall did not occur until after many people lost their lives in explosions and fires. The interviewee introduces a difficult situation that has the potential to result in a ‘bad’ death. A ‘location’ metaphor is also used to express the impossibility of providing psychological help for the patient (couldn’t kind of get in a good place to meet her psychologically). Therefore, it is best to break the news face-to-face. In contrast, a bad death is described as involving problems ‘in the background’ or in a ‘place’ inside the patient that hospice staff are not allowed to ‘reach’. Georgakopoulou, 2007), a strict application of Labov’s definition and framework does not do justice to the different ways in which our interviewees engaged in story-telling in response to our questions. 1 Season One - … • Death of a person where the body is not claimed by a relative or a friend. In 2012, one particular approach to the care of the dying, the ‘Liverpool Care Pathway for the Dying Patient’ (LCP), became the focus of public and media attention. .] The story opens with a reference to the patient and to the main event that transforms his experience of end of life: came to the hospice. Examples of Bad Stressors. In this context, it is important to distinguish between valence – which is to do with whether and how a death is seen as ‘good’ or ‘bad’ in itself, and evaluation – which signals tellability. These negative assessments function as signals of evaluation and set up a contrast with the positive outcome of the staff’s intervention, as they suggest that the patient was in a situation that was likely to result in a ‘bad’ death. So gradually we worked through those things with them. Presenting dying at a hospice as the best option is a particular construction of the story world that supports the professional identity the speaker wishes to project (Bamberg and Georgakopoulou, 2008). Virgin Records hired the airway company even though it had been cited four times within four years; The pilot was both unqualified and inexperienced, the crash occurred on the pilot’s first day with the company, and the pilot was not registered with or approved by the Federal Aviation Administration (FAA) to fly the plane; Traces of cocaine and alcohol were found in the pilot’s system and he had prior criminal charges related to cocaine; The aircraft was 700 pounds overloaded and was carrying one more passenger than it was supposed to carry. But, if Shiavo and Munoz are examples of a bad death, is there any better way? She is co-editor of the forthcoming Routledge Handbook of Metaphor and Language, together with Veronika Koller and Zsófia Demjén. And did battle with everyone. As with other narratives in our data, in Example 1 the patient’s death is mentioned briefly and almost as an afterthought, as it is an obligatory and predictable part of the story. The patient’s actual death is usually mentioned only briefly, since its occurrence was assumed by the interviewer’s question and the end-of-life/hospice context. And he’d had recurrent hiccoughs for about five months. In 2001, the entertainment industry was shocked when 22 year-old R&B singer and actress Aaliyah died in a plane crash along with eight other individuals following a music video shoot. Talk, small stories, and adolescent identities, Small stories as a new perspective in narrative and identity analysis, Stance, positioning and alignment in narratives of professional experience, On the contingency of death: A discourse-theoretical perspective on the construction of death, Introduction: Interviews vs. ‘natural’ contexts – A false dilemma, The role of second person narration in representing mental states in Sylvia Plath’s Smith Journal, Teachers, students and ways of telling in classroom sites: A case of out-of (work) place identities, Story-telling at work: A complex discursive resource for integrating personal, professional and social identities, Comparing stories told in sociolinguistic interviews and spontaneous conversations, Narrative analysis: Oral version of personal experience, The good and bad death perceptions of health professionals working in palliative care, From naked emperor to count zero: Tracking knights, nerds and cyberpunks in identity narratives of freelancers in the IT-field, Perceptions of a ‘good’ death: A comparative study of the views of hospice staff and patients, Narrative sequences in political discourse: Forms and functions in speeches and hypertext frameworks, The discursive construction of the good death and the dying person: A discourse-theoretical analysis of Belgian newspaper articles on medical end-of-life decision making, The media critique of the Liverpool Care Pathway: Some implications for nursing education. Euphemisms are intended to make a bad situation look less offensive and a bit tolerable, or outright hilarious. the site you are agreeing to our use of cookies. Both of the example obituaries below are fictional. Examples of negative personal stressors include: The death of a spouse. In addition, the staff characterized a ‘bad’ death in terms of ‘uncontrolled symptoms, lack of acceptance and being young’ (Payne et al., 1996: 307). In response to our question about what constitutes a ‘good’ death, the hospice managers pointed out that a ‘good’ death is a matter of perspective, and emphasized that it is essential to give patients options, and to try to fulfil their wishes. to. de Fina and Georgakopoulou, 2012: 18; Herman, 2007: 3). This adds another facet to the professional identity at stake, namely vulnerability. They mostly took place at the interviewees’ place of work, while a few were recorded at a university where the interviewees were attending classes related to their profession. Overall, the narratives argue for the role of hospices and professional hospice staff in facilitating a ‘good’ death, and, by presenting a relatively unified view, may potentially preclude alternative perspectives. Generally speaking, however, death and dying are still taboo topics: most people find them embarrassing, uncomfortable and potentially distressing to talk about. For example:-She was so pale she looked like death warmed up. The interviewee’s use of ‘you’, as well as the general reflections before the specific narrative, therefore potentially suggest that anyone would have had the same difficulties if dealing with the particular patient (see Labov, 2013: 41, on the self as ‘generalized other’). In our case, the agents involved are not the hospice managers as individuals, but the staff teams that the interviewees identify with and feel responsible for. Coda: an indication that the story is finished and potentially some general observations on the effects of the event on the narrator. For the purposes of our study, we regard narratives as a situated practice (Potter and Hepburn, 2008: 284), the situation here being the semi-structured interview. Bamberg and Georgakopoulou, 2008; de Fina and Georgakopoulou, 2012: 105–190; Georgakopoulou, 2007). What is characteristic of this kind of narrative, however, is that the main action provides an example of successful professional intervention, which involves removing some of the undesirable aspects introduced in the description of the patient: the hospice staff intervene to solve one of the main problems that affected the patient’s quality of life, and that would potentially prevent a ‘good’ death. Professor Kagan invites students to contemplate the possibility of death-free … Modern hospice care in the UK developed from the pioneering work of Dame Cicely Saunders in London’s St Christopher’s Hospice in the 1960s. And the family were with them. This can be seen to some extent in Example 3, while in other cases the interviewees talk about their colleagues being paralysed or overwhelmed by a ‘bad’ death, or needing support themselves afterwards. She has authored four monographs, including Metaphor in Discourse (Cambridge University Press, 2008) and Figurative Language, Genre and Register (Cambridge University Press, 2013, with Alice Deignan and Jeannette Littlemore). Wrongful death cases arise after an individual dies as a result of another party’s negligence or violent act. . Disclaimer: The information on this website is for informational purposes only. Narratives, professional identities and our data, A ‘good’ death and narratives of successful intervention, A ‘bad’ death and narratives of frustrated intervention, ‘Good’ and ‘bad’ deaths: Narratives and professional identities in interviews with hospice managers, http://www.creativecommons.org/licenses/by-nc/3.0/, http://www.uk.sagepub.com/aboutus/openaccess.htm, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212452/Press_notice_-_Liverpool_Care_Pathway.pdf, http://www.eapcnet.eu/Themes/Policy/PragueCharter.aspx, Interactive patterns of the opening statement in criminal trials: A historical perspective. For example, the character wakes up and the narrator talks about how this is going to be the longest day of his life. We are rewarded for "sticking it out" and are scolded by our society if we don't. This kind of explanation for a ‘bad’ death is rhetorically delicate, as it involves implicit or explicit criticisms of vulnerable people whose care is the main task of the hospice team. . In ‘bad’ death narratives, the hospice staff’s attempts to intervene are frustrated by circumstances outside their control, and particularly by lack of acceptance and cooperation on the part of patients. A ‘bad’ death was associated with the inability to deal with the patient’s negative emotions, resulting in lack of acceptance of death… Her way of avoiding conflict is to refuse to participate in the conversation. It involves a holistic approach to the needs of patients with life-limiting or terminal illnesses: within this approach, the social, emotional and spiritual aspects of the patient’s needs are taken into account alongside the physical dimension. Even when this is not possible - relatives may, for example, be abroad - be sensitive to the impact that the news ma y have on the person at the other end of the telephone. The difficulty of this particular death is conveyed explicitly by describing the death itself (traumatic), by providing distressing details (vomiting, bowel obstruction, wouldn’t accept any pain relief), and by attributing negatively valenced emotional states to the patient (very fearful and very anxious).
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