Skip to main content
Log in

Phenomenology in End-of-Life Care: Implications for Philosophy and Clinical Practice

  • Original Paper
  • Published:
Clinical Social Work Journal Aims and scope Submit manuscript

Abstract

Care of the terminally ill and dying in the hospice setting is a growing practice field for social workers. Support to family, as well as the patient, is implicit in hospice care, adding to the reach and impact of the hospice social worker’s role. As people age and approach the end of life, they may encounter changes in their experience of time, space and of the material world. They often have to redefine the role of hope in their day to day lives. Based on these changing experiences and perceptions, phenomenology, with its focus on a patient’s subjective, lived experience, has implications for end-of-life care. The role of empathy and compassion are also explored in relation to existential experiences of the terminally ill through the lens of phenomenology and Eastern philosophy. To complement the Western biomedical model of care for the dying, insight from Eastern philosophical traditions, which view living and dying on the same continuum, and provide an expanded view of suffering bring comfort and understanding to how living and dying are processed within the phenomenology of patient experience and the hospice model of care. Case vignettes demonstrate social work theory and practice at the intersection of various interrelated phenomena when caring for those facing the end of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Berzoff, J. (2008). Working at the end of life: Providing clinically based psychosocial care. Clinical Social Work Journal, 36(2), 177–184. doi:10.1007/s10615-007-0119-z.

    Article  Google Scholar 

  • Bruce, A. (2007). Time(lessness): Buddhist perspectives and end-of-life. Nursing Philosophy, 8(3), 151–157. doi:10.1111/j.1466-769X.2007.00310.x.

    Article  PubMed  Google Scholar 

  • Cheng, F. K., & Tse, S. (2015). Applying the Buddhist four immeasurables to mental health care: A critical review. Journal of Religion & Spirituality in Social Work: Social Thought, 34, 24–50. doi:10.1080/15426432.2014.921128.

    Article  Google Scholar 

  • Clark, D. (1999). ‘Total pain’, disciplinary power and the body in the work of Cicely Saunders, 1958–1967. Science and Medicine, 49, 727–736.

    Article  Google Scholar 

  • Ellenberger, H. (1958). A clinical introduction to psychiatric phenomenology & existential analysis. In R. May, E. Angel, & H. Ellenberger (Eds.), Existence (pp. 92–124). NY: Simon & Schuster.

    Google Scholar 

  • Ellingsen, S., Roxberg, Å., Kristoffersen, K., Rosland, J. H., & Alvsvåg, H. (2013). Entering a world with no future: A phenomenological study describing the embodied experience of time when living with severe incurable disease. Scandinavian Journal of Caring Sciences, 27(1), 165–174. doi:10.1111/j.1471-6712.2012.01019.x.

    Article  PubMed  Google Scholar 

  • Englander, M. (2014). Empathy training from a phenomenological perspective. Journal of Phenomenological Psychology, 45(5), 5–26. doi:10.1163/15691624-12341266.

    Article  Google Scholar 

  • Erickson, E., & Erickson, J. (1997). The life cycle completed extended version. New York: Norton and Company.

    Google Scholar 

  • Erickson, E., Erickson, J., & Kivnick, H. (1986). Vital involvement in old age. New York, NY: Norton & Co.

    Google Scholar 

  • Fracasso, C. (2012). Paving a new frontier: Near-death experiences and the unspoken aspect of what researchers have faced, and continue to face. NeuroQuantology, 10(2), 210–215.

    Google Scholar 

  • Fremantle, F. (2001). Luminous emptiness understanding the tibetan book of the dead. Boston, MA: Shambala.

    Google Scholar 

  • Fulton, P. R. (2014). Contributions and challenges to clinical practice from Buddhist psychology. Clinical Social Work Journal, 42(3), 208–217. doi:10.1007/s10615-013-0469-7.

    Article  Google Scholar 

  • Gustin, L., & Wagner, L. (2012). The butterfly effect of caring-clinical nursing teachers’ understanding of self-compassion as a source to compassionate care. Scandanavian Journal of Caring Sciences, 27(1), 175–183. doi:10.1111/j.1471-6712.2012.01033.x.

    Article  Google Scholar 

  • Halifax, J. (2009). Being with dying cultivating compassion and fearlessness in the presence of death. Boston, MA: Shambhala.

    Google Scholar 

  • Halifax, J. (2012). A heuristic model of enactive compassion. Current Opinion in Supportive and Palliative Care, 6(2), 228–235.

    Article  PubMed  Google Scholar 

  • Hanson, R. (2009). Buddha’s brain the practical neuroscience of happiness, love and wisdom. Oakland, CA: New Harbinger.

    Google Scholar 

  • Hollan, D. (2008). Being there: On the imaginative aspects of understanding others and being understood. Ethos, 30(4), 475–489. doi:10.1111/j.1548-1352.2008.00028.x.

    Article  Google Scholar 

  • Husserl, E. (2012). Ideas: General introduction to pure phenomenology. New York: Routledge.

    Google Scholar 

  • Inada, K. (1974). Time and temporality—A Buddhist approach. Philosophy East and West, 24(2), 171–179.

    Article  Google Scholar 

  • Kessler, D. (2010). Visions, trips, and crowded rooms who and what you see before you die. New York: Hay House Inc.

    Google Scholar 

  • Leung, P., Chan, C., Ng, S., & Lee, M. (2009). Towards body-mind-spirit integration: East meets west in clinical social work practice. Clinical Social Work Journal, 37(4), 303–311.

    Article  Google Scholar 

  • National Hospice and Palliative Care Organization (NHPCO). (2014). History of hospice care. Retrieved from http://www.nhpco.org/history-hospice-care

  • National Hospice and Palliative Care Organization (NHPCO). (2013). NHPCO’s Facts and Figures Hospice Care in America. Retrieved from www.nhpco.org/sites/default/files/public/Statistics_Research/2013

  • Olsen, C. (2009). The human body as a boundary symbol: A comparison of Merleau-Ponty and Dogen. In J. Park & G. Kopf (Eds.), Merleau-Ponty and Buddhism (pp. 83–94). Plymouth: Lexington Books.

    Google Scholar 

  • Olver, I. (2012). Evolving definitions of hope in oncology. Current Opinion in Supportive and Palliative Care, 6(2), 236–241. doi:10.1097/SPC0b013e3283528d0c.

    Article  PubMed  Google Scholar 

  • Park, J., & Kopf, G. (Eds.). (2009). Merleau-Ponty and Buddhism. Plymouth: Lexington Books.

    Google Scholar 

  • Raheim, S., & Lu, J. (2014). Preparing MSW students for integrative mind-body-spirit practice. Clinical Social Work Journal, 42(3), 288–301. doi:10.1007/s10615-014-0484-3.

    Article  Google Scholar 

  • Ratcliffe, M. (2012a). Phenomenology as a Form of Empathy. Inquiry: An Interdisciplinary Journal of Philosophy, 55(5), 473–495. doi:10.1080/0020174X.2012.716196.

    Article  Google Scholar 

  • Ratcliffe, M. (2012b). Varieties of temporal experience in depression. Journal of Medicine and Philosophy, 37, 114–138. doi:10.1093/jmp/jhs010.

    Article  PubMed  Google Scholar 

  • Ratcliffe, M. (2013). What is it to lose hope? Phenomenology and the Cognitive Sciences, 12, 597–614. doi:10.1007/s111097-011-9215-1.

    Article  Google Scholar 

  • Redding, K. (2005). When death becomes the end of an analytic treatment: Necessary parameters. Clinical Social Work Journal, 33(1), 69–79. doi:10.1007/s10615-005-2620-6.

    Article  Google Scholar 

  • Richardson, K., MacLeod, R., & Kent, B. (2011). A Steinian approach to an empathic understanding of hope among Patients and clinicians in the culture of palliative care. Journal of Advanced Nursing, 68(3), 686–694. doi:10.1111/j.1365-2648.05793.x.

    Article  PubMed  Google Scholar 

  • Sanders, S., Bullock, K., & Broussard, C. (2012). Exploring professional boundaries in end-of-life care: Considerations for hospice social workers and other members of the team. Journal of Social Work in End- Of-Life & Palliative Care, 8(1), 10–28.

    Article  Google Scholar 

  • Sass, L., & Pienkos, E. (2013). Space, time and atmosphere a comparative phenomenology of melancholia, mania and schizophrenia. Part II. Journal of Consciousness Studies, 20(7–8), 131–152.

    Google Scholar 

  • Smith, D. W. (2013). Phenomenology, the stanford encyclopedia of philosophy. Retrieved from http://plato.stanford.edu/entries/phenomenology/

  • Tharakan, K. (2013). Heritage of the yoga philosophy and transcendental phenomenology: The interlocution of knowledge and wisdom across two traditions of philosophy. Retrieved from http://philpapers.org/bbs/thread.pl?tId=842

Download references

Conflict of interest

The author declares that the author has no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joan Ordille.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ordille, J. Phenomenology in End-of-Life Care: Implications for Philosophy and Clinical Practice. Clin Soc Work J 44, 170–178 (2016). https://doi.org/10.1007/s10615-015-0536-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10615-015-0536-3

Keywords

Navigation