Contemporary hospice care: the sequestration of the unbounded body and 'dirty dying'

This paper is based on a IO-month participant observation study within an inpatient hospice in Southern England. I highlight the difficulties of using homogenous categories such as 'the dying patient' and 'the dying process' in exploring the marginalisation of patients within the physical space of contemporary hospices and similar institutions. In opposition to such categories, my findings indicate the importance of focusing upon the body of the patient, and the disease processes taking place within it and upon its surfaces, in understanding why some patients are now sequestered within hospices whereas others are not. I argue that a significant proportion of patients are admitted to hospices because of the way in which their disease spread and subsequent deterioration affects the boundedness of their bodies and undermines their identities as persons. I suggest that conceptualising a hospice as a 'no place' - i.e. a space within which the taboo processes of bodily deformation and decay are sequestered - allows it to be understood as a central part of contemporary Western culture. Setting the disintegrating body apart from mainstream society, as hospices appear to do, enables certain ideas about 'living', personhood and the hygienic, sanitised, bounded body to be symbolically enforced and maintained.