In This Article Death, Dying, and Communication

  • Introduction
  • Core Texts
  • Journals
  • Families
  • The Family Meeting or Conference
  • Spirituality and Religion
  • Cultural Awareness and Sensitivity
  • Fear of Death/Death Anxiety
  • Avoidance of the Dying
  • Ongoing Bad News
  • Prognosis
  • Final Conversations
  • Hope versus Openness at End of Life
  • Ethics

Communication Death, Dying, and Communication
by
Teresa Thompson, Louis P. Cusella
  • LAST MODIFIED: 29 May 2014
  • DOI: 10.1093/obo/9780199756841-0148

Introduction

Besides birth, there is nothing more inherent to life than death and the process of dying—despite the off-quoted aphorism including taxes in that list. Although that notion of inherency seems obvious, there is much evidence to indicate that many human beings go to considerable effort to avoid the reality of the naturalness of death. On one level, that is understandable, as we are indeed born with a struggle to survive for as long as we can. But a more reasoned level should remind us that recognition of the inherency of death requires a different approach and an ability to confront reality and be able to talk about it. The research on dying and death issues from a communication perspective focuses on the struggle to move to that level of acceptance and to dialogue about it. That is the focus of this bibliography. It should be noted that much of the medical literature that addresses the topic culminates in the same exhortation: We need more communication at end of life. This simplistic conceptualization that “more” is “better” does little to expand our understanding of the process of communication during the terminal stages of life. An attempt has been made to include as little of the “more is better” writing as possible. Death, like health and illness, is socially constructed. What we come to see as “natural” is instead a construction based on language and culture, which becomes relevant not only to historically changing views of death but also to cultural differences. Historically, a good life was associated with a good death. That conceptualization is still true in some cultures, but that association has disappeared in many modern views. Instead, death avoidance has become predominant, and there is frequently a general desire for death to be seen as being separate from life, rather than a natural part of life. After covering some core texts, journals, theoretical perspectives, and methodological approaches, this bibliography moves to a focus on palliative team care and related processes. This emphasis reflects the dominance of palliative team care (simultaneous with curative care, in most cases) in the dying process. Some processes related to palliative team care follow, including hospice, children, families, spirituality/religion, cultural issues, death fear/avoidance, the tension between maintaining hope and allowing openness, advance directives, bad news/prognosis, and issues focused particularly on care providers. This bibliography culminates with a discussion of ethical concerns, although ethics are inherent in all work on this topic.

Core Texts

Unlike some of the topics covered in this bibliography series, there are relatively few texts on dying and death that are written from a communication perspective. The exceptions to that generalization are found in the works of Maureen Keeling and Julie Yingling on Final Conversations; the contributions of scholars Elaine Wittenberg-Lyles, Joy Goldsmith, and Sandra Ragan, whose focus is on communication and palliative care teams (see Ragan, et al. 2008, cited under Narrative Paradigm, as well as their more recent books with Betty Ferrell in Wittenberg-Lyles, et al. 2012 and Sandra Sanchez-Reilly in Wittenberg-Lyles, et al. 2010 in this section); and Beach 2009, a discourse analytic series of studies that provide detailed examination of a family discussing the mother’s cancer. Several ethnographic studies of dying are also of interest, including Sudnow 1967 (Passing On: The Social Organization of Dying) and The 2002 (Palliative Care and Communication: Experiences in the Clinic, cited under Methods). There are numerous books on more psychological approaches to dying, primarily beginning with Kubler-Ross 1969. Albom 1997, whose author wrote the popular Tuesdays with Morrie, also had a strong impact on how dying and death are viewed in many areas of Western culture; the book focuses on celebrating life while accepting and approaching death.

  • Albom, Mitch. 1997. Tuesdays with Morrie: An old man, a young man, and life’s greatest lesson. New York: Broadway.

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    Written by an acclaimed sports journalist and based on weekly conversations with a terminally ill former professor and mentor, the book not only focuses on important lessons in life but does so while helping the reader understand dying and death. A poignant, long-time best-seller.

  • Beach, Wayne. 2009. A natural history of cancer. Cresskill, NJ: Hampton.

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    An unusually detailed examination of sixty-one phone conversations among the family of a mother/wife/sister who is diagnosed and deals with cancer. Traces the interactions of the family from diagnosis to death to determine interactional patterns relating to emerging news and troubles, being stoic, claiming and defending knowledge, and commiserating.

  • Kubler-Ross, Elisabeth. 1969. On death and dying. New York: Scribner.

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    Generally regarded as the book that opened the eyes of many in Western culture to the processes of dying and grieving. Offers stages of grieving, which are applied to both anticipated death and the aftermath of death. Focuses on humane care for the dying and the importance of unconditional love.

  • Lawton, Julia. 2000. The dying process: Patients’ experiences of palliative care. New York: Routledge.

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    Focuses on how patients experience the decline prior to death. Argues that the concept of “a good death” is open to interpretation. Emphasizes the effects of bodily deterioration on a patient’s sense of self. More ethically contentious and controversial than most other work in this area.

  • Monroe, Barbara, and David Oliviere. 2004. Patient participation in palliative care: A voice for the voiceless. New York: Oxford Univ. Press.

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    Focuses on an alliance between the “person” and the “patient” and active partnerships between patients and care providers. Authors from medicine, nursing, psychology, social work, and the ministry contribute to an understanding of bereavement issues and cultural differences. Patient contributions regarding palliative team care are also included.

  • Sudnow, David. 1967. Passing on: The social organization of dying. New York: Prentice Hall.

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    Unusually detailed ethnography of those who are dying. Insightful anecdotes about families facing impending death, how one employee wears a particular uniform indicating that he is getting ready to handle a dead body and is thus socially ignored, and announcements of impending death when it has actually already occurred.

  • Wittenberg-Lyles, Elaine, Joy Goldsmith, Betty Ferrell, and Sandra Ragan. 2012. Communication in palliative nursing. Oxford: Oxford Univ. Press.

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    Brings together a communication and a nursing perspective to outline the COMFORT curriculum for teaching palliative team care to nurses. Focuses on practicing self-care, and emphasis is placed on mindful presence, orientation, looking for opportunities and openings, relating, team communication, and dealing with family.

  • Wittenberg-Lyles, Elaine, Joy Goldsmith, Sandra Ragan, and Sandra Sanchez-Reilly. 2010. Dying with comfort: Family illness narratives and early palliative care. Cresskill, NJ: Hampton.

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    Presents the stories of several families facing terminal illness with and without palliative team care. The narratives focus on the deficits in current communication practices as patients approach terminality, evidencing the increased suffering of both patients and families when palliative team care is delayed. Integrates literature with narratives and communication with medical research.

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