Dying

Alex Broom's new book on dying takes a sociological analysis to the end of life creating what he calls a ‘sociology of dying’ (p. 3). The book covers topics from communicating and managing transitions at the end of life, the normativity of the hospice, and the embodied experiences of dying. Throughout the text, Broom seeks to draw out different perspectives - those of the patient, family and carers, and the professionals - to describe end of life and dying as inter-subjective and relationally experienced. Most of the book is based on qualitative fieldwork and in-depth interviews conducted in Australian hospices since the late 2000s, although Broom also includes insights from his previous UK-based research with people who had cancer. He is clear that these studies focus the book on life-limiting illness. Nevertheless, by positioning this research within the wider social shifts in how the end of life is managed, Broom is able to articulate the ways in which dying (particularly from life-limiting illness) has become morally bounded and situated within particular socio-cultural contexts. Similar to Clive Seale's work in the late 1990s about constructing death, Broom's analysis highlights the different expectations that are placed on dying individuals to live and die in certain ways, under what he calls the ‘evolving culturally-located normativity of dying’ (p. 155). What is interesting about Broom's analysis is that he holds up the ‘multiple truths’ (his term) that can represent what dying is like, where contradictions and uncertainty are negotiated and not always resolved. For Broom, this approach requires situating end of life in a sociological context that takes into consideration the time (e.g. twenty-first century, when in someone's life-span, how long decisions take, timing of transition towards palliative care depending on various factors and actors), place (e.g. hospice, home, hospitals and the interpersonal and inter-professional dynamics within these), moralities (e.g. the Anglo-Christian logics within hospice), and politics of hospice care. He also explores issues of gender and family dynamics and experiences - areas of research that are becoming more popular in this sub-field. Through his analysis, he has come to see the hospice as offering a particular kind of dying and end of life which, although often represented as an alternative to a medicalised death and allowing for more personalisation, itself can marginalise alternative ways of dying. Readers familiar with articles written by Broom and his colleagues may recognise some of the main arguments and studies since several of the chapters borrow from previous publications. What this book does, that those papers in isolation cannot do, is present a coherent and consistent example of how dying is a ‘social occasion’ (his phrase) in the contemporary settings he discusses. Not only is dying something that happens in a social setting, but Broom illustrates the ways in which various actors are constrained and enabled, and highlights the tensions between choice and obligation that make dying in the twenty-first century Australian (hospice) context what it is. This goes further than Allan Kellehear's ‘death as a social relationship’ in that it alludes to timing, settings, potential ritualistic natures, and the relational elements. This is a helpful addition to the field in terms of broadening the lens beyond relationships and can also be used in non-death related studies. I see this book being positioned amongst other similar monographs that describe in detail how dying - and living towards the end of life - is experienced, constructed, and negotiated. This book updates the field, and by introducing the concept of dying as a social occasion, it presents a way in which other researchers can analytically mobilise this way of framing the subject in their own accounts both in death studies and more broadly in medical sociology. In the last chapter, readers are invited to think where studies of end of life care could go further, addressing the many gaps Broom and others have identified in the field. He speculates that more research will and should be done on the experiences of dying across cultures, differing biographies (i.e. class and ethnicity), including people not dying from cancer, and critically examining access to informal care and the diminishing role of the state. Crucially, Broom sees the need to investigate dying as a potential site for disadvantage and social justice. To add to this, I would suggest critical examinations considering the intersecting ways in which these dimensions affect when, how, and where someone dies and the meaning made from this. This book reminds readers that a study of the end of life is about living as much as it is about death and dying. It can be read as how life is lived towards the end, that is, the ways in which it is socially structured and experienced. Whilst the field of death studies is growing, and a lot of interesting research is being done on new socialities at the end of life, this book provides well structured and thought-through accounts that theorise and exemplify how living - and caring - at the end of life can be today

Aesthetics · Art · Broom · Embodied cognition · End-of-life care · Epistemology · Invisibility · Limiting · Palliative care · Perspective (graphical · Qualitative research · Situated · Social science · Sociology · Gender Studies · History · Medicine · Nursing · Palliative Care and End-of-Life Issues · Philosophy

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