A Question of Choice: Bioethical Reflections on a Spiritual Response to the Technological Imperative
First published in 1997, this book contributes to our understanding of the way our society responds to issues of death and dying. The trans-disciplinary research which informs this discussion is situated in the disciplines of bioethics and palliative care. Postmodern notions of discourse and power are used to explore the organizational approach of one hospice (Karuna Hospice Service) to working with the dying. In modern, Western technological societies, biomedicine is the dominant discourse which underpins our care of the terminally ill. Bioethics has recently emerged as a discipline concerned with resolving the many ethical dilemmas arising from such a physiological, technologized approach to death. Rather than add to such studies, this research looks into the direction of alternative ways of responding to the dying in our community. KHS was chosen for this research as it presented the possibility of a holistic and spiritual alternative to the positivist, reductionist hegemony of scientific medicine. The research focus is on establishing and describing this difference, and exploring how such an organization could maintain resistance to mainstream medicine. The research findings are shared with the intent of using the material and insights gained to explore important issues presently arising in bioethics and palliative care, for example the recent critique of Principalism in bioethics and the methodological difficulties restricting research into spirituality for palliative care.
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Silencing the technological imperative
making the difference
A concluding statement
death and dying
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acknowledged affirm alternative argued articulated assumption bioethical biomedical discourse biomedical model biomedicine Buddhist Buddhist philosophy bureaucratic bureaucratisation Cardiopulmonary Resuscitation central challenge chapter charismatic charismatic movements choice clients compassionate concern construction contribution death and dying deconstruction discourse of KHS discursive practices discussion dominant epistemological ethical explore expressed Fairclough focus Foucaultian health professionals hegemonic holistic hospice care hospice movement hospice/palliative ideas ideological important individual individual’s ingredient inscribed insights institutional interpretation interviews issues Karuna Hospice Service KHS’s difference KHS’s discourse KHS’s spiritual discourse language/texts Mahayana mainstream health marginalised Medical Ethics medicine members of KHS metanarratives modernist moral notion of spirituality notions of discourse Nursing one’s organisation organisation’s orientation palliative palliative care participants patient person philosophy positive possibility postmodern approach principles privileged rationality reality reductionist relationship relativism resistance response scientific seen situated social spiritual dimension suggests talk terminally ill texts underpinning understanding