Transforming the Culture of Dying: The Work of the Project on Death in America

ISBN : 9780199311613

David Clark
304 ページ
164 x 237 mm

Over a period of almost 10 years, the work of the Project on Death in America (PDIA) played a formative role in the advancement of end of life care in the United States. The project concerned itself with adults and children, and with interests crossing boundaries between the clinical disciplines, the social sciences, arts and humanities. PDIA engaged with the problems of resources in poor communities and marginalized groups and settings, and it attempted to foster collaboration across a range of sectors and organizations. Authored by medical sociologist David Clark, whose research career has focused on mapping, archiving and analyzing the history and development of hospice, palliative care and related end of life issues, this book examines the broad, ambitious conception of PDIA - which sought to 'transform the culture of dying in America' - and assesses PDIA's contribution to the development of the palliative care field and to wider debates about end of life care within American society. Chapters consider key issues and topics tackled by PDIA grantees which include: explorations of the meanings of death in contemporary American culture; the varying experiences of care at the end of life (in different settings, among different social and ethnic groups); the innovations in service development and clinical practice that have occurred in the US in response to a growing awareness of and debate about end of life issues; the emerging evidence base for palliative and end of life care in the US; the maturation of a field of academic and clinical specialization; the policy and legal issues that have shaped development, including the ethical debate about assisted suicide and the Oregon experience; the opportunities and barriers that have been encountered; and the prospects for future development. A final chapter captures developments and milestones in the field since PDIA closed in 2003, and some of the challenges going forward.


1. Brief History of the Project on Death in America
Project on Death in America: Programs and Grants, 1994-2003
Exit Strategy
2. Exploring the Meanings of Death
Contemporary Meanings and Practices Relating to Death and Dying
Arts and Humanities Grants Program
3. Highlighting Experiences of Care
Giving and Receiving Care
Community and Media Representations
4. Service Innovation and Practice Developments
Clinical Practice
5. Opportunities, Barriers, and Underserved Communities
Policy Matters
Underserved Communities
6. Ethical, Legal, and Financial issues
The Question of Assisted Suicide
Wider Ethical Issues
Legal and Financial Matters in End-of-Life Care
7. Developing the Field
A Science of Care
Professional Educational Initiatives
Specialization, Recognition, and Interdisciplinary issues
8. Assessing the Impact of the Project on Death in America
Modus Operandi
The Special Role of the Faculty Scholars
The Impact
9. A Culture Transformed? Post-PDIA Progress in Palliative and End-of-Life Care
Continuing Role of Foundations
Ongoing Work of PDIA Faculty Scholars, Leaders, and Grantees
Future Challenges


Director of Interdisciplinary Studies, University of Glasgow