title: Employing imaginative rationality: using metaphor when discussing death.
abstract: The prevalence of metaphors in medicine is widely acknowledged. In a qualitative study exploring expectations of longevity, we observed repeated recourse to the imaginative rationality provided by metaphors to express perspectives on longevity and death. Bafflement, acceptance, uncertainty and distress were conveyed through metaphors, providing valuable insight into the internal healthcare frameworks of participants. Skilful use of imaginative rationality in the healthcare setting may illuminate the elusive and often eschewed topic of death in a way that fosters clarity and new understandings, and pave the way towards a better life, and death for patients. By becoming aware of the nuances contained within patients'-as well as their own-metaphors, clinicians may enhance patients' overall healthcare experience and avert unintended miscommunication.
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Llewellyn
authors.affiliation: Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
authors.forename: Chrystal
authors.identifier: http://orcid.org/0000-0002-7071-7774
authors.initials: C
authors.lastname: Jaye
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Egan
authors.affiliation: Royal College of Surgeons in Ireland-Medical University of Bahrain, Adilya, Bahrain.
authors.forename: Wayne
authors.initials: W
authors.lastname: Cunningham
authors.affiliation: Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
authors.forename: Jessica
authors.identifier: http://orcid.org/0000-0002-8173-0552
authors.initials: J
authors.lastname: Young
authors.affiliation: Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Radue
mesh_terms: D001293:Attitude to Death; D003142:Communication; D003405:Creativity; D003643:Death; D003695:Delivery of Health Care; D004644:Emotions; D005260:Female; D006801:Humans; D007092:Imagination; D008136:Longevity; D008297:Male; D019365:Metaphor; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life