Agency and Communion in End-of-Life Decision-Making

Abstract

Both the assisted suicide and the hospice or palliative medicine movements are alike in that each weighs the wishes of the patient and family for end-of-life medical decisions. The balancing of agency and communion within small communities of support may provide the opportunity to inform end-of-life decision-making and acceptance of the dying process. In this sense, the spirit of "communitas" may instill faith that the ending of one's life journey is both reasonable and meaningful. The role of the small community of support may be akin to that of the guide who assists the aging or dying person through the dialectic of being an autonomous agent and a communicant in the end-of-life transition.Research and social policy for aging and dying should deal with such important concepts as integrity, quality of life, happiness, competence or autonomy, and social support. One perspective that may inform decision making for end-of-life is Bakan's (1966) theory for the balancing of agency (autonomy) and communion tendencies and Meador's and Henson's (2003) trenchant critique of aging and dying within a "therapeutic culture" (p. 90), as conceived by Rieff (1966) in his classic work, The Triumph of the Therapeutic. This article will consider the Illness, Crisis & Loss 0(0) 1-20 ! The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav