Spiritual Transitions at the End of Life
DOI:
https://doi.org/10.18357/anthropologica67220252697Keywords:
death, dying, care, palliative, spiritual, liminality, biopsychosocialAbstract
This article considers the liminality of dying through the lens of “deathbed experiences”: reports of events occurring towards the end of life subject to multiple, potentially conflicting explanations, both medical and transcendent. Examples include a dying person reporting conversation with a deceased relative or reaching towards something unseen. While deeply meaningful and metaphysically significant to some, others explain them in material terms: as opioid toxicity, delirium or similar. These differing explanations bring an ontological liminality into the clinical realm. Based on ethnographic research within a UK hospice and 42 interviews with palliative care staff, this piece puts deathbed experiences in conversation with anthropology’s “ontological turn.” It compares the responses of clinicians to those of ethnographers confronting ontological difference. Drawing specifically on the methodological strain within this literature, it argues for care in such moments to be informed by “recursivity.” The article considers the consequences of this recursive form of care more broadly with reference to the biopsychosocial model. It ends with a discussion of how to do research about recursive care in a suitably recursive way.
Downloads
Publication Facts
Reviewer profiles N/A
Author statements
- Academic society
- Canadian Anthropology Society
- Publisher
- University of Victoria
References
Badone, Ellen. 1987. “Death Omens in a Breton Memorate.” Folklore 98 (1): 99–104. https://doi.org/10.1080/0015587X.1987.9716401. DOI: https://doi.org/10.1080/0015587X.1987.9716401
Barad, Karen. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham: Duke University Press. DOI: https://doi.org/10.2307/j.ctv12101zq
Behar, Ruth. 1996. The Vulnerable Observer: Anthropology that Breaks your Heart. Boston: Beacon Press.
Bell, Richard. 2005. “’Our people die well’: Deathbed scenes in John Wesley’s Arminian magazine.” Mortality 10 (3): 210–223. https://doi.org/10.1080/13576270500178153. DOI: https://doi.org/10.1080/13576270500178153
Bessire, Lucas, and David Bond. 2014. “Ontological Anthropology and the Deferral of Critique.” American Ethnologist 41: 440–456. https://doi.org/10.1111/amet.12083. DOI: https://doi.org/10.1111/amet.12083
Bolton, Derek, and Grant Gillett. 2019. The Biopsychosocial Model of Health and Disease. London: Palgrave Macmillan. DOI: https://doi.org/10.1007/978-3-030-11899-0
Brayne, Sue, Chris Farnham, and Peter Fenwick. 2006. “Deathbed Phenomena and their Effect on a Palliative Care Team: A Pilot Study.” American Journal of Hospice and Palliative Medicine 23 (1): 17–24. https://doi.org/10.1177/104990910602300104. DOI: https://doi.org/10.1177/104990910602300104
Broz, Ludek. 2018. “Ghosts and the Other: Dangerous Commensalities and Twisted Becomings.” Terrain: Anthropologie and Sciences Humaines 69. https://doi.org/10.4000/terrain.16623. DOI: https://doi.org/10.4000/terrain.16623
Carel, Havi, and Ian James Kidd. 2014. “Epistemic Injustice in Healthcare: A Philosophical Analysis.” Medicine, Health Care and Philosophy 17 (4): 529–540. https://doi.org/10.1007/s11019-014-9560-2. DOI: https://doi.org/10.1007/s11019-014-9560-2
Charbonnier, Pierre, Gildas Salmon, and Peter Skafish. 2017. Comparative Metaphysics: Ontology after Anthropology. London: Rowman and Littlefield International. DOI: https://doi.org/10.5040/9798881812645
Claxton-Oldfield, Stephen, and Alexie Dunnett. 2018. “Hospice Palliative Care Volunteers’ Experiences with Unusual End-of-Life Phenomena.” OMEGA - Journal of Death and Dying 77 (1): 3–14. https://doi.org/10.1177/0030222816666541. DOI: https://doi.org/10.1177/0030222816666541
Descola, Philippe. 2013 [2005]. Beyond Nature and Culture. Translated by Janet Lloyd. Chicago: The University of Chicago Press. DOI: https://doi.org/10.7208/chicago/9780226145006.001.0001
Eidson, Jacob. 2019. “Anti-Relativism since the Eighties.” Zeitschrift für Ethnologie (ZfE) / Journal of Social and Cultural Anthropology (JSCA) 144: 133–162. https://www.jstor.org/stable/27034094.
Eitel, Kathrin, and Michaela Meurer. 2021. “Introduction. Exploring Multifarious Worlds and the Political Within the Ontological Turn(s).” Berliner Blatter 84: 3–19. https://doi.org/10.18452/22952. DOI: https://doi.org/10.2307/j.ctv1h9dhxk.5
Engel, George. 1977. “The Need for a New Medical Model: A Challenge for Biomedicine.” Science 196 (4286): 129–196. https://doi.org/10.1521/pdps.2012.40.3.377. DOI: https://doi.org/10.1126/science.847460
Evans-Pritchard, Edward. 1976 [1937]. Witchcraft, Oracles, and Magic Among the Azande. Oxford: Clarendon Press.
Fenwick, Peter, Hilary Lovelace and Sue Brayne. 2007. “End of Life Experiences and Their Implications for Palliative Care.” International Journal of Environmental Studies 64 (3): 315–323. https://doi.org/10.1080/00207230701394458. DOI: https://doi.org/10.1080/00207230701394458
Fricker, Miranda. 2007. Epistemic Injustice: Power and the Ethics of Knowing. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/acprof:oso/9780198237907.001.0001
Furani, Khaled, and Joel Robbins. 2021. “Introduction: Anthropology within and without the Secular Condition.” Religion 51(4): 501–517. https://doi.org/10.1080/0048721X.2021.1971495. DOI: https://doi.org/10.1080/0048721X.2021.1971495
Griscti, Odette, Megan Aston, Grace Warner, Ruth Martin-Misener, and Deborah McLeod. 2016. “Power and Resistance within the Hospital’s Hierarchical System: The Experiences of Chronically Ill Patients.” Journal of Clinical Nursing, 26: 238–247. https://doi.org/10.1111/jocn.13382. DOI: https://doi.org/10.1111/jocn.13382
Haraway, Donna. 1997. Modest_Witness@Second_Millennium. FemaleMan_Meets_ OncoMouse: Feminism and Technoscience. New York: Routledge.
——. 2011. “Speculative Fabulations for Technoculture’s Generations: Taking care of Unexpected Country.” Australian Humanities Review, 50 [online]. Available at Speculative Fabulations for Technoculture’s Generations: Taking Care of Unexpected Country – AHR (australianhumanitiesreview.org) (accessed 27 June 2024).
——. 2016. Staying with the Trouble: Making Kin in the Chthulucene. Durham: Duke University Press.
Henare, Amiria, Martin Holbraad, and Sari Wastell. 2007. Thinking Through Things: Theorising Artefacts Ethnographically. London: Routledge. DOI: https://doi.org/10.4324/9780203088791
Heywood, Paolo. 2017. “Ontological turn, the”. In The Open Encyclopedia of Anthropology, ed. Felix Stein [online]. Available at Ontological turn, the | Open Encyclopedia of Anthropology (anthroencyclopedia.com) (accessed 25 June 2024).
Holbraad, Martin. 2012. Truth in Motion: The Recursive Anthropology of Cuban Divination. Chicago Illinois: University of Chicago Press. DOI: https://doi.org/10.7208/chicago/9780226349220.001.0001
Holbraad, Martin, and Morten Pedersen. 2017. The Ontological Turn: An Anthropological Exposition. Cambridge: Cambridge University Press. DOI: https://doi.org/10.1017/9781316218907
Hospice UK. 2021. Equality in Hospice and End of Life Care: Challenges and Change. London: Hospice UK [online]. Available at Equality in hospice and end of life care - May 2021 (accessed 28 June 2024).
Kerr, Christopher, James Donnelly, Scott Wright, Sarah Kuszczak, Anne Banas, Pei Grant, and Debra Luczkiewucz. 2014. “End-of-Life Dreams and Visions: A Longitudinal Study of Hospice Patients’ Experiences.” Journal of Palliative Medicine 17 (3): 296–303. https://doi.org/10.1089/jpm.2013.0371. DOI: https://doi.org/10.1089/jpm.2013.0371
Kessler, David. 2011. Visions, Trips and Crowded Rooms: Who and What You See Before You Die. California: Hay House.
Laidlaw, James. 2012. “Ontologically Challenged.” Anthropology of This Century, 4 [online]. Available at Ontologically challenged by James Laidlaw « Anthropology of this Century (aotcpress.com). (accessed 25 June 2024).
Lavi, Shai. 2007. The Modern Art of Dying: A History of Euthanasia in the United States. Princeton, NJ: Princeton.
Lawrence, Madelaine, and Elizabeth Repede. 2012. “The Incidence of Deathbed Communications and Their Impact on the Dying Process.” American Journal of Hospice and Palliative Medicine 30 (7): 632–639. https://doi.org/10.1177/1049909112467529. DOI: https://doi.org/10.1177/1049909112467529
Leigh Star, Susan. 2010. “This is Not a Boundary Object: Reflections on the Origin of a Concept.” Science, Technology, and Human Values 35 (5): 601–617. https://doi.org/10.1177/0162243910377624. DOI: https://doi.org/10.1177/0162243910377624
Lyckhage, Elizabeth, and Berit Lindhal. 2013. “Living in Liminality - Being Simultaneously Visible and Invisible: Caregivers’ Narratives of Palliative Care.” Journal of Social Work in End-of-Life and Palliative Care 9: 272-288. https://doi.org/10.1080/15524256.2013.846885. DOI: https://doi.org/10.1080/15524256.2013.846885
MacArtney, John, Alex Broom, Emma Kirby, Phillip Good, and Julia Wootton. 2017. “The Liminal and the Parallax: Living and Dying at the End of Life.” Qualitative Health Research 27 (5): 623–633. https://doi.org/10.1177/1049732315618938. DOI: https://doi.org/10.1177/1049732315618938
McLennan, Gregor. 2010. “The Postsecular Turn.” Theory, Culture and Society 27 (4): 3–20. https://doi.org/10.1177/0263276410372239. DOI: https://doi.org/10.1177/0263276410372239
Mol, Annemarie. 2002. The Body Multiple: Ontology in Medical Practice. Durham: Duke University Press. DOI: https://doi.org/10.1215/9780822384151
Morgan, Tessa, Robbie Duschinsky, and Stephen Barclay. 2021. “Maintenance Art: Paul Stenner’s Liminality and the Case of Older Caregiving Spouses.” In Experience on the Edge: Theorizing Liminality, edited by Brady Wagoner and Rania Zittoun, 121–135. Cham, Switzerland: Springer. DOI: https://doi.org/10.1007/978-3-030-83171-4_7
Myerhoff, Barbara, and Andrei Simic. 1979. Life’s Career-Aging: Cultural Variations on Growing Old. London: SAGE publications.
Nyatanga, Brian. 2013. “Culture, Palliative Care and Multiculturalism.” International Journal of Palliative Nursing 8 (5): 240–246. https://doi.org/10.12968/ijpn.2002.8.5.10371. DOI: https://doi.org/10.12968/ijpn.2002.8.5.10371
Open to Hope. 2015. Dr Martha Atkins: Death Bed Phenomenon. 5 May. Available at: Dr Martha Atkins: Bed Phenomenon (youtube.com) (accessed 25 June 2024).
Painter, Susan. 2021. The Meaning of White Feathers: Analyzing the Symbolism. The Meaning of White Feathers: Analyzing the Symbolism | LoveToKnow (accessed 19 June 2024).
Pedersen, Morten. 2012. “Common Nonsense: A Review of Certain Recent Reviews of the ‘Ontological Turn.” Anthropology of This Century, 5 [online]. Available at Common Nonsense: A Review of Certain Recent Reviews of the “Ontological Turn” by Morten Axel Pedersen’s Anthropology of this Century (aotcpress.com) (accessed 25 June 2024).
Porter, Douglas. 2017. “Ontological Assumptions, a Biopsychosocial Approach, and Patient Participation: Moving towards an Ethically Legitimate Science of Psychiatric Nosology.” Philosophy, Psychiatry, and Psychology 24 (3): 223–226. https://doi.org/10.1353/ppp.2017.0030. DOI: https://doi.org/10.1353/ppp.2017.0030
Puig de la Bellacasa, Maria. 2017. Matters of Care: Speculative Ethics in More Than Human Worlds. Minneapolis: University of Minnesota Press. DOI: https://doi.org/10.1017/S2753906700002096
Robinson, Fiona. 2020. “Resisting Hierarchies Through Relationality in the Ethics of Care.” International Journal of Care and Caring 4 (1): 11–23. https://doi.org/10.1332/239788219X15659215344772. DOI: https://doi.org/10.1332/239788219X15659215344772
Salmond, Amiria. 2014. “Transforming Translations (part 2): Addressing Ontological Alterity.” HAU: Journal of Ethnographic Theory 4 (1): 155–187. https://doi.org/10.14318/hau4.1.006. DOI: https://doi.org/10.14318/hau4.1.006
Springfield, Emma. 2014. Eerie Bird Superstitions. Eerie Bird Superstitions (nc-mag.com) (accessed 19 June 2024).
Stengers, Isabelle. 2010. Cosmopolitan I. Translated by R. Bononno. Minneapolis: University of Minnesota Press.
Stenner, Paul. 2021. “Theorising Liminality between Art and Life: The Liminal Sources of Cultural Experience.” In Experience on the Edge: Theorizing Liminality, edited by Brady Wagoner and Rania Zittoun 3–44. Cham, Switzerland: Springer. DOI: https://doi.org/10.1007/978-3-030-83171-4_1
Stevenson, Lisa. 2014. Life Beside Itself: Imagining Care in the Canadian Arctic. California: University of California Press. DOI: https://doi.org/10.1525/9780520958555
Stevenson, Lisa, and Eduardo Kohn. 2015. “Leviathan: An Ethnographic Dream.” Visual Anthropology Review 31 (1): 49–53. https://doi.org/10.1111/var.12062. DOI: https://doi.org/10.1111/var.12062
Strathern, Marilyn. 1980. “No Nature; No Culture: The Hagen Case.” In Nature, Culture, Gender, edited by Carol MacCormack and Marilyn Strathern, 174-222. Cambridge: Cambridge University Press.
——. 1987. “Out of Context: The Persuasive Fictions of Anthropology.” Current Anthropology 28 (3): 251–281. https://www.jstor.org/stable/2743236. DOI: https://doi.org/10.1086/203527
Sulmasy, Daniel. 2002. “A Biopsychosocial-Spiritual Model for the Care of Patients at the End of Life.” The Gerontologist 42 (3): 24–33. https://doi.org/10.1093/geront/42.suppl_3.24. DOI: https://doi.org/10.1093/geront/42.suppl_3.24
Tronto, Joan. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York: Routledge.
Turner, Victor. 1967. The Forest of Symbols: Aspects of Ndembu Ritual. Ithaca, NY: Cornell University Press.
——. 1969. The Ritual Process: Structure and Anti-structure. Ithaca, NY: Cornell University Press.
Turner, Victor, and Edith Turner. 1978. Image and Pilgrimage in Christian Culture. New York: Columbia University Press.
Vaté, Virginie, and John Eidson. 2021. “The Anthropology of Ontology in Siberia: A Critical Review.” Anthropologica 63 (2): 1–27. https://doi.org/10.18357/anthropologica63220211029. DOI: https://doi.org/10.18357/anthropologica63220211029
Viveiros de Castro, Eduardo. 1992. From the Enemy’s Point of View: Humanity and Divinity in an Amazonian Society. Chicago: University of Chicago Press. DOI: https://doi.org/10.7208/chicago/9780226768830.001.0001
——. 2004. “Perspectival Anthropology and the Method of Controlled Equivocation.” Tipiti: Journal of the Society for the Anthropology of Lowland South America 2 (1): 1–20. https://doi.org/10.70845/2572-3626.1010. DOI: https://doi.org/10.70845/2572-3626.1010
——. 2012. Cosmological Perspectivism in Amazonia and Elsewhere: Four Lectures Given in the Department of Social Anthropology, Cambridge University, February-March 1998. Manchester: HAU, Journal of Ethnographic Theory.
Williams, Bryan. 2017. The Clock Stops for Thee: On a Seemingly Anomalous Physical Effect Reported Around the Time of Death. The Clock Stops for Thee: On a Seemingly Anomalous Physical Effect Reported Around the Time of Death (psychicalresearchfoundation.com) (accessed 19 June 2024).
Willig, Carla, and Luisa Wirth. 2018. “Liminality as a Dimension of the Experience of Living with Terminal Cancer.” Palliative and Supportive Care 17: 333–337. https://doi.org/10.1017/S1478951518000536. DOI: https://doi.org/10.1017/S1478951518000536
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Rachel Cummings

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to Anthropologica agree to release their articles under the Creative Commons Attribution-Noncommercial 4.0 Unported license. This licence allows anyone to share their work (copy, distribute, transmit) and to adapt it for non-commercial purposes provided that appropriate attribution is given, and that in the event of reuse or distribution, the terms of this license are made clear.
Authors retain copyright of their work and grant the journal right of first publication.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.