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Forecasting and foreclosing futures: The temporal dissonance of advance care directives

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  • Zivkovic, Tanya

Abstract

Advance care directives situate persons as rational and self-determining actors who can make anticipatory plans about their futures. This paper critically examines how people interpret individual and future-oriented approaches to medical decision-making with limited access to information and knowledge, and reduced opportunities to prepare and document their care preferences. Based on ethnographic research with Asian migrant families living in Adelaide, South Australia (August 2015–July 2018), it reveals a discord between planning for a finite future and the contingencies and continuities of social life. It unsettles the detached reasoning that is privileged in end-of-life decision-making and reveals limitations to “do-it-yourself” approaches to advance care directives which, it will be argued, not only forecasts potential futures but also forecloses them. Taking Derrida's critique of death and decision-making as a point of departure, it develops the concept of temporal dissonance as a theoretical framework to articulate the tensions that are constituted in advance care directives. The paper suggests that attention to temporal incongruities may help to shed light on the many complex interpretations of advance care directives and the difficulties of promoting them in diverse contexts.

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  • Zivkovic, Tanya, 2018. "Forecasting and foreclosing futures: The temporal dissonance of advance care directives," Social Science & Medicine, Elsevier, vol. 215(C), pages 16-22.
    • Handle: RePEc:eee:socmed:v:215:y:2018:i:c:p:16-22
    DOI: 10.1016/j.socscimed.2018.08.035
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    References listed on IDEAS

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    1. Borgstrom, Erica & Walter, Tony, 2015. "Choice and compassion at the end of life: A critical analysis of recent English policy discourse," Social Science & Medicine, Elsevier, vol. 136, pages 99-105.
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    4. Sinclair, Craig & Smith, Jessica & Toussaint, Yann & Auret, Kirsten, 2014. "Discussing dying in the diaspora: Attitudes towards advance care planning among first generation Dutch and Italian migrants in rural Australia," Social Science & Medicine, Elsevier, vol. 101(C), pages 86-93.
    5. Warin, Megan & Zivkovic, Tanya & Moore, Vivienne & Ward, Paul R. & Jones, Michelle, 2015. "Short horizons and obesity futures: Disjunctures between public health interventions and everyday temporalities," Social Science & Medicine, Elsevier, vol. 128(C), pages 309-315.
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    Cited by:

    1. Carter, Celina & Mohammed, Shan & Upshur, Ross & Kontos, Pia, 2021. "Biomedicalization of end-of-life conversations with medically frail older adults - Malleable and senescent bodies," Social Science & Medicine, Elsevier, vol. 291(C).
    2. Koen Gaast & Jan Eelco Jansma & Sigrid Wertheim-Heck, 2023. "Between ambitions and actions: how citizens navigate the entrepreneurial process of co-producing sustainable urban food futures," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 40(3), pages 1287-1302, September.
    3. Zivkovic, Tanya, 2021. "About face: Relationalities of ageing and dying in Chinese migrant families," Social Science & Medicine, Elsevier, vol. 291(C).

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