title: The Liminal and the Parallax: Living and Dying at the End of Life.
abstract: Transitions to palliative care can involve a shift in philosophy from life-prolonging to life-enhancing care. People living with a life-limiting illness will often receive palliative care through specialist outpatient clinics, while also being cared for by another medical specialty. Experiences of this point of care have been described as being liminal in character, that is, somewhere between living and dying. Drawing on experiences of illness and care taken from semistructured interviews with 30 palliative care outpatients in Australia, we found that this phase was frequently understood as concurrently living and dying. We suggest that this is a "parallax experience" involving narratives of a coherent linear self that is able to understand both realities, in a way that acknowledges the benefits of being multiple. These findings have significant implications for the ways in which palliative care is understood and how the self and subjectivity might be conceptualized at the end of life.
authors.affiliation: 1 University of Oxford, UK.
authors.forename: John I
authors.initials: JI
authors.lastname: MacArtney
authors.affiliation: 2 University of New South Wales, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Broom
authors.affiliation: 2 University of New South Wales, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Kirby
authors.affiliation: 3 St. Vincent's Hospital Brisbane, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Good
authors.affiliation: 3 St. Vincent's Hospital Brisbane, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Wootton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D013727:Terminal Care / Q000523:psychology*
keywords: Australia, Australians; cancer; death and dying; end-of-life issues; experiences; health care, users’; narrative inquiry, storytelling; qualitative conceptual analysis; sociology