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"Dying is not easy, but it needn't be this hard": Contemporary narratives of good and bad deaths

Hansen, Chloe (2020) "Dying is not easy, but it needn't be this hard": Contemporary narratives of good and bad deaths. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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The 21st century has seen a surge of discourses critiquing discussion of and approaches to end of life in the U.S. In this dissertation, I perform a conceptually-oriented rhetorical analysis of the concept of the good death in narratives published in ‘The End’ (2015-2016), The New York Times op-ed series about end of life, and Atul Gawande’s bestselling book Being Mortal (2014). Grounded in rhetorics of health and medicine, I conduct an in-depth analysis of narratives of patient deaths told by healthcare practitioners in order to uncover images of good and bad dying constructed within, some ideological investments of those images and the historical contexts that shaped them. Taking seriously the idea that public narratives surrounding health and medicine impact how medical situations are approached, I argue that a narrative shift away from decision-making and the dying person as primary agent at end of life may shift standards of judgment with regard to dying, enabling instead the circulation of narratives with a networked view of agency and that take seriously the importance of ending the dying person’s life story. I find that the narratives in my archive are told through the logic of choice, which focuses on the dying individual as autonomous agent in a context that is increasingly out of their control. This narrative construction often functions as a barrier to the good death. I speculate that a shift toward narrating end of life through the logic of care instead – which centers on ending the dying person’s story and on distributed care, agency and responsibility – would shift the concept of the good death and, thus, standards of judgment for evaluating end of life. The question of how we might live a good life until the end and what discourses and structures might enable the most people to achieve that goal is worth exploring precisely because death is something everyone will experience. Shifting end of life rhetorics would allow us to tell different stories and may shift interactions with medical institutions, judgments about end of life, preparations for dying and our identities as (future) dying people and their loved ones.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Hansen, Chloeclh116@pitt.educlh1160000-0003-0064-9929
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee CoChairClarke, Lynn
Committee CoChairKuchinskaya, Olga
Committee MemberOlson, Lester
Committee MemberParker, Lisa
Committee MemberJohnson, Paul
Date: 16 September 2020
Date Type: Publication
Defense Date: 17 April 2020
Approval Date: 16 September 2020
Submission Date: 25 July 2020
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 182
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Communication: Rhetoric and Communication
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: end of life, death, dying, rhetorics of health and medicine, logic of care, narrative, public discourse
Date Deposited: 16 Sep 2020 13:58
Last Modified: 16 Sep 2020 13:58


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