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Methods:The studies presented in this symposium all employ qualitative methods appropriate to exploratory inquiry that seeks to understand complex phenomena surrounding communication in end of life care. Discourse analysis of public debate in the physician-assisted dying case of Britney Maynard, comparative case studies of hospital-based palliative care teams, phenomenological study of caregiver needs and grounded theory analysis of advance care planning discussions, all contribute to a nuanced and multi-level understanding of the multiplicity of challenges of communication in end of life care.
Findings:Findings from this collection of studies indicate that communication around end of life care is particularly challenging for a variety of reasons. From ethical, cultural, linguistic, role incumbency and organizational perspectives, there is still great discomfort and much room for improvement in communication necessary to plan and provide care at the end of life that honors self-determination and dignity.
Conclusions: It is incumbent on social workers to take a leadership role in end of life care research, policy and practice. We are uniquely positioned to improve care at the end of life based on our bio-psychosocial approach, scope of practice, and NASW code of ethics. At a time when the Patient Self-Determination Act has not fulfilled its promise, medicalized dying is being questioned, physician-assisted dying is increasing, and chronic eventually fatal illnesses have become the new normal for dying in America, social work leadership in this arena is more salient now than ever.