Bridget Taylor

Interviewing Separately or as Couples? Considerations of Authenticity of Method

Heideggerian researchers recognize that people and their worlds are coconstructed; people make sense of their world from within it, not detached from it. The presence of one’s partner in a joint interview will therefore influence the experience of participants, and will also influence the descriptions they provide. In this article, we present a reflexive discussion of two studies in which we used Heideggerian hermeneutic phenomenology to explore people’s experiences of sexuality and intimacy within the context of their illness. We present the Heideggerian concepts of Dasein, authenticity and truth, and draw on extracts from our interview transcripts to exemplify the different effects of joint and one-to-one interviews. We also discuss ethical considerations regarding these different interview approaches. Heidegger’s philosophy does not preferentially support either method, but helps us to be clearer about the merits and limitations of each approach. Combining both approaches provides richer understanding of phenomena.

Parental autonomy and consent to treatment

Parental autonomy and consent to treatment ¶This paper discusses the principle of autonomy in relation to minors and considers the complexities of parental responsibility regarding consent to treatment. The author considers the case of a child with leukaemia and draws on her own experiences as a parent to highlight the ethical dilemmas for health care professionals who may be in a position to support parents in consenting to treatment on behalf of their child.

Experiences of sexuality and intimacy in terminal illness: A phenomenological study:

Background: There is a paucity of research considering sexuality and intimacy in palliative care. It is therefore unclear whether palliative care professionals have a role in addressing these issues with patients and their partners. Aim: To understand people’s experiences of sexuality and intimacy when living with a terminal illness. Design: A Heideggerian hermeneutic (interpretive) phenomenological study was undertaken. Data were collected using one-to-one conversational interviews. An iterative approach to analysing the narratives was used to reveal shared meanings. Setting/participants: A total of 27 patients and 14 partners of patients with either cancer or motor neuron disease were recruited from outpatient, community and hospice inpatient units. All participants were aware that the illness was life-limiting. Findings: When someone is living with a life-limiting illness, their coupled relationship is also dying. In their being-towards-death-of-the-couple, patients and partners of patients with motor neuron disease and terminal cancer experienced connecting and disconnecting within their coupled relationship. Becoming-apart-as-a-couple was experienced as loss of spontaneity, as lack of reciprocity and as rejection. This was influenced by a range of factors including medical treatments, disfigurement and the disabling effects of equipment. Some participants experienced re-connecting through becoming-closer-as-a-couple, although this was not always sustained. Conclusions: This study sheds new light on people’s experiences of sexuality and intimacy when living with a terminal illness. The ethos of holistic care requires palliative care professionals to provide opportunities for patients and their partners to discuss any concerns they might have about their coupled relationship and to understand the meanings symptoms have for them.

The Impact of Assistive Equipment on Intimacy and Sexual Expression

Introduction: Sexuality is a holistic concept that involves more than the sexual act. Despite being a quality of life domain that promotes meaningful existence, it is an aspect of life that is often avoided by health care practitioners. Method: In this Heideggerian phenomenological study, conversational interviews were conducted with 13 people with motor neurone disease, and 10 of their partners, in order to understand their experiences of sexuality and intimacy. Findings: The findings provide evidence for the value of touch in peoples lives and shed light upon the impact that assistive equipment has on intimacy, sexual expression and maintaining emotional and physical connection between couples. None of the people interviewed had previously been given the opportunity to discuss these issues with their occupational therapist. Conclusion: There is a place in occupational therapy practice for discussing the value of emotional and physical connection for individuals in the context of any equipment provided.

Whose baby is it? The impact of reproductive technologies on kinship

Birth is not merely a biological event; it is also a social event in that it creates relationships. As a consequence of reproductive technologies, the boundaries between the biological and social basis of kinship have become blurred. Reproductive technologies challenge previously held cultural constructions of kinship and bring about new kinds of social relations in that kinship boundaries are redefined. This paper discusses the societal effects that reproductive technologies have had in challenging previously held notions of parenthood, kinship and relatedness.

We must give children a voice in advance care planning

Advance care planning (ACP) has become a key component of end of life care, but it involves far more than just conversations about whether or not to resuscitate. The wishes and preferences of the person concerned must be identified before they are too unwell to be involved in decision making. However, insufficient research and guidance exist on involving children and adolescents in advance care planning. Retrospective interviews with the parents of children who had an advance care plan found the process helpful in assuring that the best care was obtained for their child, and in avoiding unnecessary suffering and preserving quality of life.1 Perhaps unsurprisingly, these plans focused exclusively on medical interventions, covering decisions around resuscitation, artificial feeding, intubation and ventilation, antibiotic use, and admission to hospital. Parents reported “having peace of mind” and retaining a sense of control once they had signed the plan, but it is unclear whether their children experienced …

Sexuality at end of life: the silent bedfellow

Background Sexuality is a holistic concept that includes physical, psychological and social aspects of peoples well-being. As the aim of palliative care includes supporting patients to live as actively as possible until death, as well as supporting those that are significant to them, it would seem reasonable to expect that sexuality would be included. However, what is not clear is whether sexuality continues to be important for people in the UK who are dying. Aim To understand the experiences of patients and partners of patients living with a life-limiting illness in relation to sexuality and intimacy. Method This qualitative study used a Heideggerian hermeneutic methodology. One-to-one interviews were conducted with 27 patients and 14 partners of patients who had either motor neurone disease or terminal cancer. Each person was interviewed twice and couples were interviewed separately. Audio-recorded data were analysed using Diekelmann and Ironsides seven-stage process to uncover shared meanings. This iterative process is fundamental to Heideggers hermeneutic circle of interpretation. Findings This paper presents one of the themes, ‘the silent bedfellow’. Participants described times ‘when words fail’ and they experienced ‘disconnecting’ within their coupled relationship. In contrast, ‘when words speak’ brought about ‘connecting’, even though this was not always in ways that had been expected. It was rare for people to be given opportunities to discuss their fears or concerns about sexuality with palliative care professionals. Participants gave practical suggestions for ways that professionals can broach this aspect of peoples relationships. Conclusions Palliative care professionals who support holistic care and promote quality of life have a role in providing opportunities for discussing these issues with patients and their partners.