Within the debate between medical and health geographers there are often calls for methodological and philosophical conciliation. The purpose of this paper is to detail some of the epistemological difficulties in ever achieving that aim. We do so by offering a foundational scientific analysis of home death in Washington State, and then turning to a postmedical deconstruction of that scholarship within the space of a single paper. Although the result is a reflexive self-critical paper on how we know the geography of home death, it is by no means a resolution of the debate. A key epistemological impasse is identified between the foundationalism in our quantitative analysis and our poststructural critique. This impasse leads to different and irreconcilable aims between the two halves of the paper. In our reflections we stress the need to recognize explicitly this epistemological irreconcilability in order to temper the promise of an easy solution to the debate between medical and health geography. We nevertheless suggest that scholarly, ethical, and political insights can be gained from this project.
Get full access to this article
View all access options for this article.
References
1.
AikenS, 1998Family Fantasies and Community Space (Rutgers University Press, New Brunswick, NJ).
2.
BarnesT J, 1998, “A history of regression: Actors, networks, machines, and numbers” Environment and Planning A30203–223.
3.
BarnesT J, 2000, “Quantitative methods”, in The Dictionary of Human Geography4th edition, Eds JohnstonRGregoryDPrattG (Blackwell, Oxford) pp 663–665.
BoothC, 1999, “Taking care of our aging parents” Time Magazine154(9) 30 August, 62–67.
6.
BowlingACartwrightA, 1982Life After Death: A Study of the Elderly Widowed (Tavistock Publications, London).
7.
BradshawP, 1993, “Characteristics of clients referred to home, hospice, and hospital palliative care services in Western Australia” Palliative Medicine7101–107.
8.
BrimOFreemanHLevineSScotchN (Eds), 1970The Dying Patient (Russell Sage Foundation, New York).
9.
BrownM, 1995, “Ironies of distance: An ongoing critique of the geographies of AIDS” Environment and Planning D: Society and Space13159–183.
10.
BrownM, 1997Replacing Citizenship: AIDS Activism and Radical Democracy (Guilford Press, NY).
11.
BuckinghamR, 1982, “Hospice care in the United States: The process begins” Omega13159–171.
12.
ByockI, 1997Dying Well: Peace and Possibilities at the End of Life (Riverhead Books, New York).
13.
CartwrightAHockeyLAndersonJ, 1973Life Before Death (Routledge Kegan Paul, London).
14.
CliffordCJolleyDGilesC, 1991, “Where people die in Victoria” Medical Journal of Australia155446–456.
15.
ConnellyR, 1998, “The medicalization of dying: A Positive turn on a new path” Omega36331–341.
16.
ConstantiniMCamoiranoEMadedduLBruzziPVerganelliEHenrigquetF, 1993, “Palliative home care and place of death among cancer patients: A Population-based study” Palliative Medicine7323–331.
17.
CorlessI, 1988, “Settings for terminal care” Omega18319–340.
18.
CraddockS, 2000City of Plagues (University of Minnesota Press, Minneapolis, MN).
19.
CurtisJ RRubenfeldG, 2000Managing Death in the I. C U.: The Transition from Cure to Comfort (Oxford University Press, Oxford).
20.
DixonDJonesJ, 1998, “My dinner with Derrida: Or spatial analysis and poststructuralism do lunch” Environment and Planning A30247–260.
21.
DornMLawsG, 1994, “Social theory, medical geography, and body politics” Professional Geographer46106–110.
22.
DunphyKAmesburyB, 1990, “A comparison of hospice and home-care patients: Patterns of referral, patient characteristics, and predictors of place of death” Palliative Medicine4105–111.
23.
EveASmithATebbitP, 1997, “Hospice and palliative care in the UK 1994–1995, including a summary of trends 1990–1995” Palliative Medicine1131–43.
24.
FieldMCassellC, 1997Approaching Death: Improving Care at the End of Life (National Academic Press, Washington, DC).
25.
FisherI, 1998, “Families provide medical care, tubes and all” New York Times 7 June, page A-1.
26.
GouldP, 1970, “Is statistix inferens a wild goosechase?” Economic Geography46439–448.
27.
GrandeGAddington-HallJToddC, 1998, “Place of death and access to home care services: Are certain patient groups at a disadvantage?” Social Science and Medicine47565–579.
28.
GreerDMorVMorrisJSheerwoodSKidderDBirnbaumH, 1986, “An alternative in terminal care: Results of the National Hospice Study” Journal of Chronic Disease399–26.
29.
HarawayD, 1991Simians, Cyborgs, and Women (Routledge, London).
30.
HosmerDLemeshowS, 1989Applied Logistic Regression (John Wiley, New York).
31.
HuntRRoderDMacHarperT, 1989, “The impact of hospice services on places of death in South Australians” Cancer Forum13110–113.
32.
HuntRBondMGrothMKingM, 1991, “Place of death in South Australia: Patterns from 1910 to 1987” Medical Journal of Australia155549–553.
33.
HuntRBonettARoderD, 1993, “Trends in the terminal care of cancer patients: South Australia 1898–1900” Australia and New Zealand Journal of Medicine23245–251.
34.
HuntRMcCaulK, 1996, “A population based study of the coverage of cancer patients by hospice services” Palliative Medicine105–12.
35.
JaroszLLawsonV, 2001, “Mapping the red, white, and blue: Rural landscapes and class relations in America'sWest” Antipode forthcoming.
36.
JohnsonHOliverD, 1991, “The development of palliative care services and the place of death of cancer patients” Palliative Medicine540–45.
37.
KastenbaumRNormanC, 1990, “Deathbed scenes as imagined by the young and experienced by the old” Death Studies14201–217.
38.
KearnsR, 1993, “Place and health: Towards a reformed medical geography” The Professional Geographer45139–147.
39.
KearnsR, 1994, “Putting health and health care into place: An invitation accepted and declined” The Professional Geographer46111–115.
40.
KearnsR, 1995, “Medical geography: Making space for difference” Progress in Human Geography19144–152.
41.
KearnsRGeslerW, 1998Putting Health into Place: Landscape, Identity, and Well-being (Syracuse University Press, Syracuse, NY).
42.
KingM, 1999, “Home-care agencies feeling the squeeze” The Seattle Times 8 April, page B1.
43.
KircherTAndersonR, 1987, “Cause of death: Proper completion of the death certificate” Journal of the American Medical Association258349–352.
44.
KomesaroffPMossCFoxR, 1989, “Patients' socioeconomic background: Influence on selection of inpatient of domiciliary hospice terminal-care programmes” Medical Journal of Australia151196–201.
45.
KriegerN, 1992, “The making of public health data: Paradigms, politics, and policy” Journal of Public Health Policy13412–427.
46.
Kubler-RossE, 1970On Death and Dying (Macmillan, New York).
47.
LawsonV, 1995, “The politics of difference: Examining and quantitative/qualitative dualism in post-structuralist, feminist research” The Professional Geographer47449–457.
48.
LernerM, 1970, “When, why, and where people die”, in The Dying Patient Eds BrimOFreemanHLevineSScotchN (Russell Sage Foundation, New York) pp 5–29.
49.
McCluskerJ, 1983, “Where cancer patients die: An epidemiologic study” Public Health Reports92170–176.
50.
McCluskerJ, 1985, “The use of home care in terminal care” American Journal of Preventative Medicine142–52.
51.
McCluskerJStoddardA, 1987, “Effects of an expanding home care program for the terminally ill” Medical Care25373–385.
52.
McCormickWInuiTDeyoRWoodR, 1991, “Long-term care preferences of hospitalized patients with AIDS” Journal of General Internal Medicine6524–528.
53.
McDowellL, 1995, “The problem of/for theory”, in Geographies of Global Change Eds JohnstonRTaylorPWattsM (Blackwell, Oxford) pp 280–294.
54.
MayerJMeadeM, 1994, “A reformed medical geography reconsidered” The Professional Geographer46103–105.
55.
MeadeMEricksonR, 1999Medical Geography2nd editionGuilford Press, New York).
56.
MeslerM, 1995, “The philosophy and practice of patient control in hospice: The dynamics of autonomy versus paternalism” Omega30173–189.
57.
MilliganC, 2000, “Bearing the burden: Towards a restructured geography of caring” Area3249–58.
58.
MillerPMikeP, 1995, “The medicare hospice benefit: Ten years of federal policy for the terminally ill” Death Studies19531–542.
59.
MoinpourCPolissarL, 1989, “Factors affecting place of death of hospice and non-hospice cancer patients” American Journal of Public Health791549–1551.
60.
MorVHirisJ, 1983, “Determinants of site of death among hospice cancer patients” Journal of Health and Social Behavior24375–385.
61.
MorrillRCromartieJHartG, 2000, “Metropolitan, urban and rural commuting and statistical areas: Toward a better depiction of the US settlement system” Urban Geography20727–748.
62.
MortonLOmarRCarrollSBeirneMHallidayDTaylorK, 2000, “Incomplete and inaccurate death-certification: The impact on research” Journal of Public Health and Medicine22133–137.
63.
NashN, 1977, “Dignity of the person in the final phase of life—an exploratory study” Omega871–80.
64.
PalmerG, 1993Death: The Trip of a Lifetime (Harper Collins, San Francisco, CA).
65.
PhiloC, 1998, “Reconsidering quantitative geography: The things that count” Environment and Planning A30191–201.
66.
PolissarLSeversonRBrownN, 1987, “Factors affecting place of death in Washington State, 1968–1981” Journal of Community Health1240–54.
67.
PorterT, 1986The Rise of Statistical Thinking: 1820–1900 (Princeton University Press, Princeton, NJ).
68.
PorterT, 1995Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton University Press, Princeton, NJ).
69.
PowersJBurgerM, 1987, “Terminal care preferences: Hospice placement and severity of disease” Public Health Reports102444–449.
70.
PrattG, 1988, “Quantitative techniques and humanistic-historical materialist perspectives”, in Rethinking Human Geography Eds KobayashiAMcKenzieS (Unwin Hyman, Winchester, MA) pp 100–115.
71.
PritchardRFisherETenoJSharpSRedingDKnausW, 1998, “Influence of patient preferences and local health system characteristics on the place of death” Journal of the American Geriatric Society461242–1250.
72.
RodderDBonettAHuntRBeareM, 1987, “Where patients with cancer die in South Australia” Medical Journal of Australia14711–13.
73.
RosenauP, 1992Postmodernism and the Social Sciences (Princeton University Press, Princeton, NJ).
74.
RosenbergM, 1998, “Medical or health geography?” International Journal of Population Geography4211–226.
75.
RosenbergEShortC, 1983, “Issues of institutionalization: 5% facilities and terminal care” International Journal of Aging and Human Development1743–55.
76.
SankarA, 1991Dying at Home: A family Guide for Caregiving (Bantam Books, New York).
77.
SatelS, 2001, “The indoctrinologists are coming” The Atlantic Monthly287(1) 59–64.
78.
SealeC, 1991, “Death from cancer and death from other causes: The relevance of the hospice approach” Palliative Medicine512–19.
79.
SealeCCartwrightA, 1994The Year Before Death (Avebury, Aldershot, Hants).
80.
SeamarkDThorneCLawrenceCGrayD, 1995, “Appropriate place of death for cancer patients: Views of general practitioners and hospital doctors” British Journal of General Practice45359–363.
81.
SimsARadfordJDoranKPageJ, 1997, “Social class variation in place of cancer death” Palliative Medicine11369–373.
82.
StaceyJ, 1990Brave New Families (Basic Books, New York).
83.
ThompsonL, 1994, “Cultural and institutional restrictions on dying styles in a technological society” Death Education8223–235.
84.
ThorpeG, 1993, “Enabling more dying people to remain at home” British Journal of Medicine307915–918.
85.
TolleSRosenfeldATildenVParkY, 1999, “Oregon's low in-hospital death rates: What determines where people die and satisfaction with decisions on place of death?” Annals of Internal Medicine130681–685.
86.
VitzezM, 1997, “Long-distance care: Families struggle to provide for ill and aging parents far away” Seattle Times 17 June.
87.
WebbS, 1997The Good Death: The New American Search to Reshape the End of Life (Bantam Books, New York).
