Between March 2002 and August 2003 as part of the research project "Patients as partners -- tumour patients and their participation in medical decisions" tumour patients undergoing palliative therapy (n=272) were interviewed and asked about their level of information, their desired place to die and whether they had prepared an advance directive. Furthermore, 72 relatives of deceased patients who had been looked after by the project's palliative care team were given a similar questionnaire including questions concerning their knowledge about disease and prognosis, the actual place of death and the relevance of advance directives. According to patients and relatives, information particularly about prognosis is unsatisfactory. Of the inter-viewed patients, 75% said they wanted to die at home and 15% in a hospital. According to their relatives, 36% of the patients looked after by the palliative care team had an advance directive. The survey of the relatives showed a significant relation between the preparation of an advance directive and dying at the desired place. According to the relatives, medical and health reasons, hope for an improvement up to the very end,acute worsening of the condition and deficits in medical care were important reasons for dying in hospital against the patient'swish. In future, advance directives should be used as an aid for communication and the planning of care. Therefore, cooperation between doctors and patients based on a partnership is necessary. The required competence in communication should be improved.
The discovery of mirror neurons opens new doors for ethnography. By attending to these advancements in cognitive science, ethnographers are provided firmer ground for investigating perceptual and emotional dynamics that are outside the realm of conscious deliberative processes. In this article, we explore these extra-deliberative processes in order to posit a new way to collect, analyze, and present findings. By examining how extra-deliberative dynamics shape action in systematic ways, we endeavor to bring together two aspects of sociological practice that have been assumed to be incompatible: (1) analytic efforts to build general theory and (2) a focus on emotions and other extra-deliberative dynamics. We conclude by suggesting that insights garnered through the analysis of extra-deliberative processes are optimally communicated using emotionally evocative writing.
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