Show simple item record

dc.contributor.advisorJaye, Chrystal
dc.contributor.advisorEgan, Richard
dc.contributor.advisorWinters, Janine
dc.contributor.advisorEgan, Tony
dc.contributor.authorYoung, Jessica Esther
dc.date.available2020-09-21T22:18:46Z
dc.date.copyright2020
dc.identifier.citationYoung, J. E. (2020). Agency, uncertainty and power: Why people consider assisted dying at the end of life (Thesis, Doctor of Philosophy). University of Otago. Retrieved from http://hdl.handle.net/10523/10395en
dc.identifier.urihttp://hdl.handle.net/10523/10395
dc.description.abstractAssisted dying is a significant issue in Aotearoa New Zealand given the continued controversy over the End of Life Choice Bill (2017), Act (2019) and forthcoming referendum. However, the views of people approaching the end of life are largely missing from the public debate and New Zealand research. My PhD research is an open enquiry into the perspectives of people with approximately one year’s life expectancy who would have considered an assisted death (if it were available). Fourteen participants and six family members were interviewed. My thesis focuses on the socio-cultural values that dying people used to explain their views on assisted dying. The conceptual framework incorporates both the sociology of death and dying and the ‘wish to hasten death’ literatures. The discursive and assemblage methodological approaches were chosen because of their analytic power to illuminate the dynamism, the contextual and relational elements of the wish to hasten death, overlooked by much of the literature. Identifying an assemblage of medicalised dying demonstrated that participants were not passive recipients of medicalisation; rather they rejected, co-opted and embraced it. I illustrate how participants strategically re-medicalised dying by framing their dying, death and suffering as activities that require medical intervention to achieve the good death that ‘medicine’ had promised them. Assisted dying appealed because it offered individual control and mitigated the risk of dying badly. Yet any regime of assisted dying reinforces health professionals as in control of dying and increasingly controls freedom. Within this paradox of control, I argue there is still scope for choice, activism and an ethical making of the self, although limited by the biopolitical regime, that equates to a degree of freedom for participants. Participants contested normative discourses about life, dying and death. I show how participants sought to expand the boundaries of acceptable dying and to normalise assisted dying. Foucault’s principles of exclusion, rarefaction and games of truth shed light on the power structures that privilege some discourses, ideologies and groups over dying persons’ experiences. Participants described being disenfranchised by medicine’s rejection of assisted dying as a legitimate option at the end of life. In the face of this perceived epistemic injustice and uncertainty, assisted dying offered a technique of certainty against the risk that dying badly posed for their ontological security. My research suggests participants exercise agency through their attempts to ‘strategically negotiate’ and re-medicalise dying, and contest normative discourses of dying and longevity for their own aims. These three concepts—strategic negotiators, contesting normative dying, and freedom within the paradox of control—constitute the original contributions of this research. If the debate in Aotearoa New Zealand on assisted dying is to be moved forward, attention must be paid to the contextual reasons people would consider choosing assisted dying. The wish to have the option of assisted dying is a manifestation of a new paradigm of dying that reflects changing individual, societal and ideological concepts about: what is a good life, what is a good death and importantly in between, what is undesirable dying.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherUniversity of Otago
dc.rightsAll items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjectend of life choice choice
dc.subjectassisted dying
dc.subjecteuthanasia
dc.subjectterminal illness
dc.subjectend of life
dc.subjectwish to hasten death
dc.subjectNew Zealand
dc.subjectsociology
dc.subjectmedical sociology
dc.subjectbioethics
dc.subjectpalliative care
dc.subjectdiscourse analysis
dc.subjectassemblage theory
dc.subjectsociology of death and dying
dc.titleAgency, uncertainty and power: Why people consider assisted dying at the end of life
dc.typeThesis
dc.date.updated2020-09-21T04:43:09Z
dc.language.rfc3066en
thesis.degree.disciplineGeneral Practice and Rural Health
thesis.degree.nameDoctor of Philosophy
thesis.degree.grantorUniversity of Otago
thesis.degree.levelDoctoral
otago.openaccessOpen
otago.evidence.presentYes
 Find in your library

Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record