Christopher Justice

The rapidly changing location of death in Canada, 1994-2004.

This 2008 study assessed location-of-death changes in Canada during 1994-2004, after previous research had identified a continuing increase to 1994 in hospital deaths. The most recent (1994-2004) complete population and individual-level Statistics Canada mortality data were analyzed, involving 1,806,318 decedents of all Canadian provinces and territories except Quebec. A substantial and continuing decline in hospitalized deaths was found (77.7%-60.6%). This decline was universal among decedents regardless of age, gender, marital status, whether they were born in Canada or not, across urban and rural provinces, and for all but two (infrequent) causes of death. This shift occurred in the absence of policy or purposive healthcare planning to shift death or dying out of hospital. In the developed world, recent changing patterns in the place of death, as well as the location and type of care provided near death appear to be occurring, making location-of-death trends an important topic of investigation. Canada is an important case study for highlighting the significance of location-of-death trends, and suggesting important underlying causal relationships and implications for end-of-life policies and practices.

Cross-cultural simulation to advance student inquiry

This article reviews how and why the authors have used the cross-cultural simulation BAFA BAFA in a 1styear social sciences inquiry course on social identity. The article discusses modifications made to Shirts’s original script for BAFA BAFA, how the authors conduct the postsimulation debriefing, key aspects of the student-written reflection of the simulation, and research results on how students perceive and rate BAFA BAFA relative to their learning. Students enrolled in the course find the simulation to be important to various aspects of their learning, including helping them to understand cultural diversity. This is particularly true for students who score highly on measures of deep learning, that is, the ability to connect course content with meanings in other situations and experiences in reflective ways.

Planning and Providing for a Good Death Using Rural French-Canadian and English-Canadian Insights

Little is known about what constitutes a good death, although palliative care is broadly aimed at enabling the good death. Good deaths could vary considerably across populations. A two-stage ethnographic study was conducted in rural Canada, involving English-speaking Albertans and French-Canadians in Quebec, to establish a conceptual understanding of the good death from a rural perspective. This study identified four common bicultural elements, as well as a conceptual model focusing on quality of life through four dimensions: physical, spiritual, social, and emotional/psychological. Rurality was identified as a dominant consideration for further study.