title: The "Conflicted Dying": The Active Search for Life Extension in Advanced Cancer Through Biomedical Treatment.
abstract: Using a poststructural perspective, we examine the subjectivities that are produced when advanced cancer patients seek life extension through biomedical treatments. Seven case studies were developed that included 20 interviews with patients, family, nurses, and physicians recruited from a tertiary hospital in Canada, 30 documents, and 5 hours of participant observation. We identify seven types of subjectivity: (a) the Desperate Subject, (b) the Cancer Expert Subject, (c) the Proactive Subject, (d) the Productive Subject, (e) the Mistrusting Subject, (f) the Model Patient Subject, and (g) the Suffering Subject. We characterize the "conflicted dying," a contemporary figure who holds multiple perspectives about seeking curative treatment despite the acknowledgment of death. Using active strategies to gain access to treatment, this figure resists traditional arrangements of power/knowledge established by health care providers. We suggest that the search for life extension is a process of shaping the self to fit certain aesthetical traits associated with surviving cancer.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada shan.mohammed@utoronto.ca.
authors.forename: Shan
authors.initials: S
authors.lastname: Mohammed
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Peter
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Gastaldo
authors.affiliation: University of Toronto, Toronto, Ontario, Canada Princess Margaret Cancer Center, Toronto, Ontario, Canada.
authors.forename: Doris
authors.initials: D
authors.lastname: Howell
keywords: cancer; case studies; death and dying; decision making; discourse analysis; ethics / moral perspectives; illness and disease, life-threatening / terminal; palliative care; power / empowerment