Researcher Explores Ethics and End-of-life Care

July 23, 2007 -- Helen Chapple is not someone who fits easily into a slot.  She worked as a nurse and stock broker before deciding to continue her education at U.Va.  Chapple became interested in the ethical questions surrounding dying patients and the medical care they receive while pursuing a master’s degree in clinical ethics. 

As a part of that program, Chapple became intrigued with patients’ end-of-life decision-making.  She was curious about why dying patients didn’t discover options such as hospice. Chapple had contact with an anthropology professor through one of her courses and was influenced to continue on to pursue a Ph.D. in anthropology.  “Anthropology provided a better opportunity to ask the questions that I wanted to ask,” she says. 

As part of Chapple’s dissertation, “Dying to be Rescued: American Hospitals, Clinicians and Death,” she interviewed clinicians, nurses, and doctors about patients who had died and about the circumstances surrounding their deaths. What Chapple learned during her exploration of these issues was that our health system places a great deal of emphasis into initially trying to save critically ill patients. However, once these saving rituals have taken place and patients are deemed no longer rescuable, with the exception of those patients who come under palliative care, a different — and arguably lower — standard of care emerges for dying patients.

“Our culture is not interested in things that can’t be fixed,” Chapple explains. “We want to fix things.”  But she views this phenomenon as a cultural problem rather than the fault of health care providers. In addition, Chapple notes that hospitals face undue pressures under our current system as they try to fulfill their social contract while simultaneously competing with one another.

Chapple recently graduated and sees herself transitioning not into academia but to work directly with clinicians, possibly as a nurse ethicist or consultant.  She wants to share the knowledge she has gained from her research with doctors to help them understand that they have more to offer their dying patients.

Written by Melissa Maki, research communications coordinator for the Office of the Vice President for Research and Graduate Studies.