The purpose of my paper is to offer an understanding of home hospice from a perspective of political geography. Informed by critical political theories of care, and recent work on the geographies of public and private spheres, I explore one set of consequences of the spatial shift towards home death in metropolitan Seattle, Washington. Terminal hospice care done in the home creates an especially paradoxical home space. By blurring public–private boundaries, hospice care produces a political geography of home interpretable through four spatial paradoxes: a normative paradox of home being a good and bad place to die, a territorial paradox of control itself changing the home, a constitutive paradox between heart and welfare politics, and a relational paradox between autonomy and dependency. The implications for political and health geography, as well as political theory and hospice work itself are discussed as a consequence of recognizing these spatial paradoxes.
Get full access to this article
View all access options for this article.
References
1.
BrimOFriedmanHLevineSScotchN, 1970The Dying Patient (Russell Sage Foundation, New York)
2.
BrownM, 1997RePlacing Citizenship: AIDS Activism and Radical Democracy (Guilford, New York)
3.
BrownMColtonT, 2001“Dying epistemologies: an analysis of home death and its critique”, Environment and Planning A33799–821
4.
BuschA, 2000Geography of Home: Writings on Where We Live (Princeton University Press, Princeton, NJ)
5.
ButlerJScottJ (Eds), 1992Feminists Theorize the Political (Routledge, London)
6.
CalifanoJ, 1997, “Death management”, in The Grim Reader: Writings of Death, Dying and Living On Eds SpiegelMTristmanR (Anchor Books, New York) pp 370–376
DudaD, 1987Coming Home: A Guide to Dying at Home with Dignity (Aurora Press, New York)
9.
DyckI, 1998, “Women with disabilities and everyday geographies: home space and the contested body”, in Putting Health into Place Eds KearnsRGeslerW (Syracuse University Press, Syracuse, NY) pp 102–119
10.
FieldMCassellC, 1997Approaching Death (American Academic Press, Washington, DC)
11.
FraserNGordonL, 1997, “A geneology of ‘dependency’: tracing a keyword of the US welfare state”, in Justice Interruptus: Critical Reflections on the Post-socialist Condition Ed. FraserN (Routledge, London) pp 121–149
12.
GatrellA, 2001Geographies of Health: An Introduction (Blackwell, Oxford)
13.
GeslerWKearnsR, 2001Culture, Health, and Place (Routledge, London)
14.
GleesonBKearnsR, 2001, “Remoralising landscapes of care”Environment and Planning D: Society and Space1961–80
15.
GottschalkM, 2000The Shadow Welfare State: Labor, Business, and the Politics of Health Care in the United States (Cornell University Press, Ithaca, NY)
16.
HarringtonM, 1999Care and Equality: Inventing a New Family Politics (Knopf, New York)
17.
Harrington MayerM (Ed.), 2000Care Work: Gender, Labor, and the Welfare State (Routledge, London)
18.
Harrington MayerMKesterke StorbakkenM, 2000, “Shifting the burden back to families”, in Care Work: Gender, Labor, and the Welfare State Ed. Harrington MayerM (Routledge, London) pp 217–228
19.
HarrisK, 1971, “The political meaning of death”Omega2227–239
20.
HauptB, 1998, “Characteristics of hospice care users: data from the 1996 National Home and Hospice Care Survey”, Advance Data #299, National Home and Hospice Care Survey, National Center for Health Statistics, Hyattsville, MD
21.
Hospice Association of America, 2002, “Hospice facts and statistics”, unpublished report; available from Hospice Association of America, 228 Seventh Street SE, Washington, DC 20003
22.
HoyerT, 1998, “A history of the medicare hospice benefit”Hospice Journal1361–69
23.
HumphreyH, 1967“The welfare state—a state of general welfare”, in The Welfare State Ed. SchottlandC (Harper Torchbooks, New York) pp 179–183
24.
KatzM, 2001The Price of Citizenship: Redefining the American Welfare State (Metropolitan Books, New York)
25.
KidderD, 1992, “The effects of hospice coverage on Medicare expenditures”Health Services Research 117 pp 599–606
26.
KnijnT, 2000, “Marketization and the struggling logics of (home) care in the Netherlands”, in Care Work: Gender, Labor, and the Welfare State Ed. Harrington MayerM (Routledge, London) pp 167–187
27.
MackA (Ed.), 1993Home: A Place in the World (New York University Press, New York)
28.
MasseyD, 1993Space, Place, and Gender (University of Minnesota Press, Minneapolis, MN)
29.
MesslerM, 1995, “The philosophy and practice of patient control in hospice: the dynamics of autonomy versus paternalism”Omega30173–189
30.
MilliganC, 2000, “Bearing the burden: toward a restructured geography of caring”Area3249–58
31.
NAHC, 2001, “Basic statistics about hospice”, National Association of Hospice Care, 1700 Diagonal Road, Suite 300, Alexandria, VA 22314, http://www.nahc.org/consumer/hpcstats.html (July)
32.
NHPCO (no date) “Facts and figures about hospice”, National Hospice and Palliative Care Organization, http://www.nhpco.org
33.
PalmerG, 1993Death: The Trip of a Lifetime (HarperCollins, New York)
34.
PatemanC, 1989The Disorder of Women: Democracy, Feminism, and Political Theory (Stanford University Press, Stanford, CA)
35.
PeavyF, 1996Heart Politics (Black Rose Books, Montreal)
36.
PeckJ, 2001Workfare States (Guilford, New York)
37.
SealeC, 1998Constructing Death: The Sociology of Dying and Bereavement (Cambridge University Press, Cambridge)
38.
SeeryJ, 1996Political Theory for Mortals (Cornell University Press, Ithaca, NY)
39.
StaeheliL, 1994, “Restructuring citizenship in Pueblo, Colorado”Environment and Planning A26849–871
40.
StaeheliL, 1996, “Publicity, privacy, and women's political action”Environment and Planning D: Society and Space14601–619
41.
StaeheliL, 2001, “Of possibilities, probabilities, and political geography”Space and Polity5177–189
TrontoJ, 1994Moral Boundaries: A Political Argument for an Ethic of Care (Routledge, London)
44.
US DoHHS, 2000, “National Home and Hospice Care Survey”, CD-Rom Series 13, (27 July), National Center for Health Statistics, United States Department of Health and Human Services; available from National Center for Health Statistics, Division of Data Services, 6525 Hyattsville Road, Hyattsville, MD 20782
45.
WebbM, 1997The Good Death: The New American Search to Reshape the End of Life (Bantam, New York)
46.
WhiteJ, 2000Democracy, Justice, and the Welfare State: Reconstructing Public Care (Penn State Press, College Park, PA)
47.
YoungI, 1997, “House and home: feminist variations on a theme”, in Intersecting Voices: Dilemmas of Gender, Political Philosophy, and Policy (Princeton University Press, Princeton, NJ) pp 134–164
48.
YoungI, 2000, “Political theory: an overview”, in A New Handbook of Political Science Eds GoodinRKlingemannH (Oxford University Press, Oxford) pp 479–502
