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.
1. Introduction. 2. The Postmodern Lens. 3. Engaging in the Research. 4. Setting the Stage by Stating the Difference. 5. Buddhism: The Difference Within the Difference. 6. Connecting the Discourses: Spirituality. 7. A Changing Discourse: Death and Dying. 8. Silencing the 'Technological Imperative'. 9. Coming into Existence: The Threats. 10. Coming into Existence: Success. 11. Maintaining Existence. 12. Spirituality: Making the Difference. 13. Bioethical Reflections. 14. A Concluding Statement.