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Sarah McGann, The Production of Hospice Space: Conceptualising the Space of Caring and Dying, Ashgate Publishing, Farnham, UK, 2013, 122 pp., hbk £60, ISBN: 9781409445791.

Published online by Cambridge University Press:  13 April 2015

GLENYS CASWELL*
Affiliation:
University of Nottingham, UK
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Abstract

Type
Reviews
Copyright
Copyright © Cambridge University Press 2015 

At the start of this book, the author claims that it will challenge the notion that hospice is not a building but a philosophy of care. This is a big claim to make and I do not think that it achieves this. However, in the final chapter the author reflects on the book's journey and concludes that hospice is a philosophy, ‘but a philosophy that is anchored by space and spatial practices' (p. 110). This is a more modest claim, and one which I think the author goes a long way towards achieving; the hospice building can contribute much to the provision of good care under the hospice ethos, but the ethos does not depend upon the space within which the care takes place.

The author is an architect and the book is largely based around her work in designing the first two phases of St Francis Hospice in Dublin, Ireland. She is most assured when she is writing about this work. She describes the building as ‘an unfolding narrative’, and describes three themes which form the ‘basis for a new conceptualisation for the production of hospice space’ (p. 74). McGann draws on the work of a number of theorists from different disciplines in order to make her case, which she does convincingly here. The third theme, for example, privacy/community and the ‘lived’ hospice (pp. 97–104), illustrates her claim of the importance of space in the hospice philosophy. The design made flexible use of space in order to meet the needs of the different users of that space, and so that outdoor spaces were as integral to the design as indoor spaces. Natural light and the flow of movement around the hospice were key elements in ensuring that the needs of patients, for example, for being both sufficiently private and also being part of the hospice community, were met.

The notion of a space which is designed specifically to meet the needs of dying people, so that they may live well until they die, is attractive and compelling. I am not clear, however, about the link which the author wants to make between hospice philosophy, space and the hospice at home service, which offers people the opportunity to die at home supported by hospice professionals.

The author is less assured in the first three chapters of the book, and appears less comfortable with her material. In these chapters she is establishing the background to her study of St Francis Hospice as building and philosophy, and necessarily engages with material about dying and death. Some of her claims here are not well set up and lack authority. For example, she states that death is still ‘a relatively taboo’ subject (p. 19), without reference or engaging with the academic discussions which have taken place about death as taboo and the nature of that taboo. Consequently, I do not know what she means by saying that death is ‘relatively taboo’ and thus find myself unconvinced. The author later states that the work to replace temporary buildings with permanent ones was ‘symbolic’ of the removal of ‘hidden death’ and a ‘wider acceptance of death and dying in modern society’ (p. 51). I found myself wondering what happened to the taboo. There are a number of instances, such as this, where the book would have benefited from a more developed discussion of the material and engagement with contemporary theorists working in the field. This would offer a more solid foundation on which to build the case for the hospice building as a key element of the hospice philosophy.

It is a shame that there are a number of typographical errors which I found detracted from my enjoyment of the text, but this book will, I think, be of use to anyone who has an interest in hospices and the work they do. It is written in a style that requires no specialist knowledge of architecture in order to understand it. For those readers, like me, who are not well versed in the ways of architecture, there will be much food for thought in this book. It did not convince me that the ideals of hospice care for those who are dying cannot exist without an appropriately designed building. However, it did make me think again about the design and planning of health-care spaces, with the recognition that when good spatial design comes together with a good ethos of care, the two can work together in harmony.