Decision-Making and End-of-Life
Life and death are closely linked in health care settings where questions regarding the quality of life and death, the pursuit (or not) of disease directed treatments and the legitimacy of those who make these decisions shape these crucial moments. As therapeutic possibilities seem never-ending, when to stop or when to embrace a palliative perspective is a complex issue. The boundaries between the social categorizations that separate the curable from the incurable, the sick from the dying and impending of death are often uncertain. Grounded in two ethnographic studies, one conducted in a pediatric hospital setting (hematology-oncology unit-bone marrow transplant) and the other with elderly people in a hospital setting as well as a long-term care facility in Montreal, the authors discuss the diversity of end-of-life trajectories. When can we stop? Who can answer? These questions are recurrent without being new. They are, however, the daily reality of “major illness.” The authors draw upon the notions of “care” and the “duty of non-abandonment” in their quest of answers while questioning the contemporary status of (bio)medicine.