Hospice Care: Between Existential and Medical Hope

ABSTRACT

Medicalisation of hospice care has been discussed simultaneously with the development of palliative care into a medical speciality. However empirical knowledge of the role of medicalisation in hospice practice is underexplored. This paper considers hospice managers’ perspectives on hospice care in the complex between values related to hospice philosophy and a specialised medical approach to hospice care. Focus groups and small group interviews were conducted with hospice managers from 16 out of the 19 Danish hospices. Drawing on hope as a theoretical framework, the study contributes to further understanding of the complexity of navigating hospice care in the impasse between an existential hope focused on meaning at the end of life and a medical hope for control of the dying body. Hospice care appeared as pulled between these dimensions of hope. The hospice managers took a pragmatic approach to medicalisation but their emphasis on dying as an existential event also points to a role for hospices as a critical voice against over-medicalisation of dying.

KEYWORDS:

• Hospice
• hope
• medicalisation
• hospice philosophy
• hospice care
• existential

Acknowledgments

The authors would like to thank all of the participants in our study and the Danish Organisation of Hospice Managers for funding the study. Thank you to Simon Woods for comments on an earlier draft.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Agape refers to love as a sacrificial love and not as romantic or sexual love.

Additional information

Funding

This work was supported by the Organisation of Danish Hospice Managers.

Notes on contributors

Vibeke Graven

Vibeke Graven holds a master degree in social science and philosophy and a PhD in ‘Humanistic Palliative care and Thanatology’ - a research field characterized by an interdisciplinary approach. She is post-doctoral researcher at REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care. Vibeke’s research and publications have focused on hospice practice, spiritual care and the concept of hope.

Anders Petersen

Anders Petersen is associate professor of sociology in the Department of Sociology and Social Work at Aalborg University, Denmark. His research is particularly concerned with philosophical, critical, and methodological issues in sociology and other human and social sciences. In recent years he has been studying the impact of psychiatric diagnoses on individuals and society and is now focusing on the cultural development of the phenomenon of grief. He is also engaged in cultural critique, writing extensively in Danish newspapers and journals. He has authored numerous articles and books on these issues, among them The Social Pathologies of Contemporary Civilization (ed. with Kieran Keohane) and Præstationssamfundet (The Performance Society).

Helle Timm

Helle Timm holds a MSc in cultural sociology and a PhD in health care science. Helle is professor and head of the palliative care research group at REHPA, Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark. She has published widely in the field of palliative care.