Creating Discursive Order at the End Of Life: The Role of Genres in Palliative Care Settings

This article investigates an emerging practice in palliative care: dignity therapy. Dignity therapy is a psychotherapeutic intervention that its proponents assert has clinically significant positive impacts on dying patients. Dignity therapy consists of a physician asking a patient a set of questions about his or her life and returning to the patient with a transcript of the interview. After describing the origins of dignity therapy, the authors use a rhetorical genre studies framework to explore what the dignity interview is doing, how it shapes patients’ responses, and how patients improvise within the dignity interview’s genre ecology. Based on a discourse analysis of the interview protocol and 12 dignity interview transcripts (legacy documents) gathered in two palliative care settings in Canadian hospitals, the findings suggest that these patients appear to be using the material and genre resources (especially eulogistic strategies) associated with dignity therapy to create discursive order out of the...