Lifelines and end-of-life decision-making: an anthropological analysis of advance care directives in cross-cultural contexts

Abstract

This paper examines interrelated dichotomies in social anthropology and cross-cultural research on advance care directives (ACDs). It aims to recast the disjuncture between individual (Western) selves and collectivist (non-Western) Others that has impeded understandings of the cultural complexities of decision-making at the end of life. Based on research conducted with Chinese, Vietnamese and Indian communities living in Adelaide, South Australia, it explores how ACDs can obscure the vicissitudes of bodies and social life, decontextualising and detracting from our emplacement in relational worlds. Drawing on Ingold’s approach to living beings as a bundle of lines that join together, a ‘meshwork’ that carries on, I trace the continuities and points of tension, or ‘knots’, interwoven in movements and metaphors of writing up advance care directives, signing consent, opening doors and caring through touch.