2003 volume 35(5) pages 833 – 851

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Brown M, 2003, "Hospice and the spatial paradoxes of terminal care" Environment and Planning A 35(5) 833 – 851

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Hospice and the spatial paradoxes of terminal care

Michael Brown

Received 26 April 2002; in revised form 27 August 2002

Abstract. 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.

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