Special Issue "The Socio-Political Context of Death and Dying"

A special issue of Societies (ISSN 2075-4698).

Deadline for manuscript submissions: closed (15 October 2018) | Viewed by 6837

Special Issue Editor

Dr. Panagiotis Pentaris
E-Mail Website1 Website2
Guest Editor
Department of Psychology, Social Work and Counselling, University of Greenwich, Old Royal Naval College, Park Row, Greenwich, London SE10 9LS, UK
Interests: thanatology (death, dying and bereavement); end of life care; death and health policies; social and health care
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Special Issue Information

Dear Colleagues,

This Special Issue of Societies invites scholars to examine both the social and political circumstances in which death and dying are experienced. The issue pays close attention to the abundant socio-political changes, nationally and internationally, which directly and indirectly influence how people die or experience the death of a loved one. The last ten years alone, not only in the UK, the care of the dying and bereaved has seen increasing interest by governments, while medical, clinical and technical approaches pertain. People die in hospitals, hospices or other institutions more often than they die in the comfort of their own home. The ambiguity of identifying when one is ready to die keeps medicine attuned to the task of preserving and prolonging life. This issue would like to explore in more detail the socio-political context in which death is experienced and examine how shifting societal and political attitudes influence how we die and vice versa. Finally, the issue is interested in bringing together both empirical and theoretical papers, aiming at conceptualising the current governance of death and dying, while focusing on the impact of the former on the latter.

Dr. Panagiotis Pentaris
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Societies is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • socio-political
  • death
  • dying
  • bereavement
  • care

Published Papers (4 papers)

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Research

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Article
Individualism and the Decision to Withdraw Life Support
Societies 2018, 8(4), 117; https://doi.org/10.3390/soc8040117 - 21 Nov 2018
Cited by 1 | Viewed by 1471
Abstract
The 1996 Health Care Consent Act of Ontario (Canada) is a law that regulates medical decision making. Therefore, it also gives indications on how end of life decisions should be made. The goal of the law was to ensure and protect patient’s autonomy [...] Read more.
The 1996 Health Care Consent Act of Ontario (Canada) is a law that regulates medical decision making. Therefore, it also gives indications on how end of life decisions should be made. The goal of the law was to ensure and protect patient’s autonomy and avoid medical paternalism, especially at the end of life. Throughout this article, I would like to argue that one of the consequences of the 1996 Health Care Consent Act of Ontario is to promote individualism. Therefore, this law makes it improbable to attain a shared decision model. More specifically, the way the 1996 Health Care Consent Act is currently written, a proxy is assigned as a decision-maker for someone who is deemed incompetent. However, it also ensures that the proxy will be the only one with the burden of that decision. This argument will be supported by providing a qualitative description of three cases that I have encountered during my six-month fieldwork in the Intensive Care Unit (ICU) of a hospital located in Ontario. This paper offers a reflection upon the consequences of using an alternative decision maker (proxy) to withdraw life support. Full article
(This article belongs to the Special Issue The Socio-Political Context of Death and Dying)
Article
The Location of Death and Dying Across Canada: A Study Illustrating the Socio-Political Context of Death and Dying
Societies 2018, 8(4), 112; https://doi.org/10.3390/soc8040112 - 09 Nov 2018
Cited by 1 | Viewed by 1607
Abstract
Background: Concern has existed for many years about the extensive use of hospitals by dying persons. In recent years, however, a potential shift out of hospital has been noticed in a number of developed countries, including Canada. In Canada, where high hospital occupancy [...] Read more.
Background: Concern has existed for many years about the extensive use of hospitals by dying persons. In recent years, however, a potential shift out of hospital has been noticed in a number of developed countries, including Canada. In Canada, where high hospital occupancy rates and corresponding long waits and waitlists for hospital care are major socio-political issues, it is important to know if this shift has continued or if hospitalized death and dying remains predominant across Canada. Methods: Recent individual-anonymous population-level inpatient Canadian hospital data were analyzed to answer two questions: (1) what proportion of deaths in provinces and territories across Canada are occurring in hospital now? and (2) who is dying in hospital now? Results: In 2014–2015, 43.9% of all deaths in Canada (excluding Quebec) occurred in hospital. However, considerable cross-Canada differences in end-of-life hospital utilization were found. Some cross-Canada differences in hospital decedents were also noted, although most were older, male, and they died during a relatively short hospital stay after being admitted from their homes and through the emergency department after arriving by ambulance. Conclusion: Over half of all deaths in Canada are occurring outside of hospital now. Cross-Canada hospital utilization and inpatient decedent differences highlight opportunities for enhanced end-of-life care service planning and policy advancements. Full article
(This article belongs to the Special Issue The Socio-Political Context of Death and Dying)
Article
The Socio-Political Debate of Dying Today in the United Kingdom and New Zealand: ‘Letting Go’ of the Biomedical Model of Care in Order to Develop a Contemporary Ars Moriendi
Societies 2018, 8(3), 65; https://doi.org/10.3390/soc8030065 - 10 Aug 2018
Cited by 3 | Viewed by 1904
Abstract
Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying [...] Read more.
Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer a compelling movement towards individuals seeking control of their dying trajectory to actualise the notion of individual choice. With this shifting landscape there is an opportunity to be grasped to change how we manage our dying trajectory away from the biomedical patterns of behaviour when dying, in order to balance life decisions. To achieve this prospect, we need to engage with a framework upon which to pin the changes. This paper offers a re-framing and re-presenting approach, using illustrative examples that draw upon British and New Zealand literature, together with over 50 years of professional nursing, and the Ars Moriendi to reflect upon the self-centricity of the contemporary Western individual to access a ‘good death’ of choice. Full article
(This article belongs to the Special Issue The Socio-Political Context of Death and Dying)

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Project Report
What Is the “Right” Number of Hospital Beds for Palliative Population Health Needs?
Societies 2018, 8(4), 108; https://doi.org/10.3390/soc8040108 - 02 Nov 2018
Cited by 2 | Viewed by 1481
Abstract
Healthcare services are one of the twelve determinants of population health. While all types of healthcare services are important, timely access to hospital-based care when needed is critical. For three decades, long waits and wait lists for hospital admission and inpatient care have [...] Read more.
Healthcare services are one of the twelve determinants of population health. While all types of healthcare services are important, timely access to hospital-based care when needed is critical. For three decades, long waits and wait lists for hospital admission and inpatient care have been a concern in Canada. Undersupply of hospital beds to meet population needs may be the cause of this as hospitals were downsized due to government funding cutbacks and hospital expansion has not occurred since despite population growth and aging. The availability of hospital beds for palliative population health needs may therefore be an issue, particularly as longstanding concern exists about terminally-ill and dying people being frequently admitted to hospital and having long hospital stays. A decline in hospital deaths in many developed countries, including Canada, could indicate that palliative population needs for hospital-based care are not being met. This paper compares the number of hospitals and hospital beds that exist in 9 Canadian provinces and 15 developed countries in relation to population and spatial considerations in an attempt to determine an optimal number of hospital beds for the general public and thus also palliative population health needs. Methods: Document analysis. Publicly-available hospital, population, and geographic information was sought for 9 Canadian provinces and 15 developed countries and compared. Results: Major differences in citizen to hospital bed ratios and citizen to hospital ratios across provinces and countries were found. The availability of hospitals and hospital beds clearly varies. Conclusion: Some regions may have too few hospitals and hospital beds to meet the palliative and other care needs of their citizens. Sufficient beds should exist so necessary admissions to hospital can occur without harmful delay. Full article
(This article belongs to the Special Issue The Socio-Political Context of Death and Dying)
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