This Is What a Clinical Death Looks Like

Abstract

Sickness, dying, and ageing are increasingly medicalized, focusing elder quality of life on interventions, that I argue, progressively strip autonomy, dignity, and privacy. For elders aged 70 plus years, personal autonomy, or the ability to “author” one’s circumstances, is poorly understood, and in clinical settings, often ethically vexatious. What matters to elders, as they approach end-of-life I argue, could be more meaningfully understood and supported via an experiential conception of autonomy. This autoethnographic case study, based in an Australian sub-acute geriatric rehabilitation hospital, explores what happens when the author’s 86-year-old mother, Marie, challenges clinical culture. Institutional barriers to explore a collaborative and empathic care practice, regarding sleeping arrangement, exercise, and nursing, resulted in Marie’s decision to die on her own terms—and highlights a need to expand institutional understandings of personal autonomy, the sanctity of life, and elder care beyond the pathological.