Scholarlink

<p>Clinicians in Hospice and Palliative Medicine (HPM) specialize in caring for terminally ill patients, a population often regarded as representing the “failures” of medical intervention. This unique context challenges conventional definitions of success in medicine, which prioritize cure and longevity. Drawing on extensive qualitative data from interviews and ethnographic fieldwork, this article explores how HPM clinicians navigate these challenges by shifting their definition of success to a process rather than an outcome. These clinicians rely upon the strategy of “hewing” to achieve success, which includes discovering and crafting shared, achievable goals with clinical stakeholders—patients, families, and colleagues. By examining how these clinicians construct and negotiate their professional project, this study sheds light on how clinical practices shift when confronted by the intractable problem of death. This article introduces the concept of hewing to describe how HPM clinicians coordinate patients, families, and colleagues around shared goals under conditions where standard definitions of medical success fail.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The Operation was Successful and the Patient Died: Processes for Achieving a Good Death

  • 期刊论文

  • 发表日期：

    2026年3月21日

查看全文
  • Timothy B. Elder

摘要

Clinicians in Hospice and Palliative Medicine (HPM) specialize in caring for terminally ill patients, a population often regarded as representing the “failures” of medical intervention. This unique context challenges conventional definitions of success in medicine, which prioritize cure and longevity. Drawing on extensive qualitative data from interviews and ethnographic fieldwork, this article explores how HPM clinicians navigate these challenges by shifting their definition of success to a process rather than an outcome. These clinicians rely upon the strategy of “hewing” to achieve success, which includes discovering and crafting shared, achievable goals with clinical stakeholders—patients, families, and colleagues. By examining how these clinicians construct and negotiate their professional project, this study sheds light on how clinical practices shift when confronted by the intractable problem of death. This article introduces the concept of hewing to describe how HPM clinicians coordinate patients, families, and colleagues around shared goals under conditions where standard definitions of medical success fail.