I have always been fascinated by hospitals. They are spaces where some of the most intense and vulnerable moments of our lives happen, and for many of us, it is also be where we will spend our very last days of life and die.
Given the importance of the hospital in our final illness trajectories, my interest is to better understand how we – both as individuals and as a society – negotiate understandings of what it means to be nearing end of life in hospital settings, and what care practices are constructed as appropriate or inappropriate for those who are sick enough to die.
This is an important time to researching hospital end of life and palliative care as it is rapidly being reconfigured by social, economic, and professional considerations such as growth of palliative care as a speciality, innovations in medicine, aging multi-morbid populations, increasing prognostic uncertainty, championing of patient and family member involvement in care decisions, interest in physician-assisted dying, system resource considerations, and changing ideas of a good death.
These, and other considerations, place hospitals at the epicentre of debates regarding how to best care for those nearing end of life.
“Hello, my name is Marian Krawczyk”, and I am a medical anthropologist who specializes in researching palliative and end of life hospital care. I am a new post-doctoral fellow working in the School of Interdisciplinary Studies here at the University of Glasgow, in collaboration with the Glasgow End of Life Studies Group.
In my new position, my goal is twofold:
First, I will extend my knowledge about Canadian end of life hospital care by conducting research in hospitals here in Scotland. In particular I want to build on Professor David Clark and his team’s ground-breaking imminence of death studies which have been conducted in Scotland and beyond. Second, while there is a wealth of anthropological research about hospitals that now spans almost 50 years, no one has yet systematically reviewed all of these contributions.
At the same time, new methods and theories within the field are reconceptualising approaches to this kind of enquiry. Consequently, I am in the process of mapping the rich body of literature specific to anthropological approaches to hospital care. Ultimately I hope that, as worldwide rates of dying become one of the most pressing health concerns of our time, my research will facilitate critically engaged development of globally innovative and locally relevant hospital care for those are nearing the end of life.
I am from the West Coast of British Columbia, Canada. Previous to starting this position, my PhD (Negotiated practices: understanding hospital palliative care as an affective economy, 2015, Simon Fraser University) was an in-depth account of how Canadian palliative specialists, patients, and family members negotiated prognostic uncertainty to create collaborative end of life care pathways within increasingly complex health systems. I then held joint post-doctoral positions (2015-2017) with Trinity Western University (Langley, B.C.), The Centre for Health Evaluation and Outcome Evaluation (Vancouver, B.C.), and the Canadian Frailty Network.
My research focused on the impact of new technologies for enhancing person-centered care by electronically eliciting patient and family-members’ self-reports of quality of life and experiences in diverse palliative care settings. I am particularly passionate about working at the interface between interdisciplinary social studies theorizing and clinical practice, and learning how each can inform the other.
I’m tremendously excited to have this opportunity to join the University of Glasgow. In particular I extend thanks to Professor David Clark (Founder of the Glasgow End of Life Studies Group) and Professor Carol Hill (Head of the School of Interdisciplinary Studies) for their support and mentorship.
As I settle into my new role over the coming months, I plan to blog regularly about my work, and I encourage anyone interested in these ideas to contact me – I’d love to hear your thoughts and explore opportunities for collaboration.