Situating end-of-life decision making in a hybrid ethical frame
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Ellen Barton
Ellen Barton, Ph.D., is a Professor in the Linguistics Program at Wayne State University. Her work on medical communication has appeared in the collections
Advances in Medical Discourse Analysis andThe Discourse of Hospital Communication and in the journalsCommunication & Medicine, Qualitative Health Research, Journal of Applied Linguistics , andJournal of Business and Technical Communication .
Abstract
Good communication in EOL (end-of-life) discussions is described at a general level in the literature, but there are few studies of EOL discussions at the level of interaction, with data drawn from the actual talk between physicians and families. In this article I present a discourse analysis of EOL discussions from an American ICU (intensive care unit) where the decision to withdraw life support is situated in a hybrid ethical frame co-constructed as the final phase of the EOL discussion. In Mishler's (1984) terms, the final phase of the EOL discussion merges the voice of medicine and the voice of the lifeworld, with both physicians and families initiating, developing, and repeating particular topics that encompass not only the logistics of death but also the ethics of the end-of-life decision. Physicians index their ethical accountability in terms of medical futility, and families express their accountability in terms of an ethics of consciousness. The hybrid ethical frame that is co-constructed ultimately centers upon consensus that the ‘right’ decision has been made from both ethical perspectives.
About the author
Ellen Barton, Ph.D., is a Professor in the Linguistics Program at Wayne State University. Her work on medical communication has appeared in the collections Advances in Medical Discourse Analysis and The Discourse of Hospital Communication and in the journals Communication & Medicine, Qualitative Health Research, Journal of Applied Linguistics, and Journal of Business and Technical Communication.
© Walter de Gruyter
Articles in the same Issue
- Editorial
- Situating end-of-life decision making in a hybrid ethical frame
- Professional-patient communication in the treatment of mental illness: A review
- Community as a key to healing after the death of a child
- Whiteboards: Mediating professional tensions in clinical practice
- Negotiating frame ambiguity: A study of simulated encounters in medical education
- Lexical conflation and edible iconicity: Two sources of ambiguity in American vernacular health terminology
- Index of articles in Volume 4 (2007)
Articles in the same Issue
- Editorial
- Situating end-of-life decision making in a hybrid ethical frame
- Professional-patient communication in the treatment of mental illness: A review
- Community as a key to healing after the death of a child
- Whiteboards: Mediating professional tensions in clinical practice
- Negotiating frame ambiguity: A study of simulated encounters in medical education
- Lexical conflation and edible iconicity: Two sources of ambiguity in American vernacular health terminology
- Index of articles in Volume 4 (2007)
