Medical Assistance in Dying (MAiD) was legalized in Canada in June, 2016. The Canadian government’s decision to legislate assisted dying, an approach that requires a high degree of obligation, precision, and delegation, has resulted in unique challenges for health care and for nursing practice. The purpose of this study was to better understand the implications of a legislated approach to assisted death for nurses’ experiences and nursing practice. The study used a qualitative approach guided by Interpretive Description. Semi-structured interviews were conducted with 59 registered nurses and nurse practitioners. Interviews were audio-recorded, transcribed, and managed using qualitative analysis software. Analysis followed a procedure of data immersion, open coding, constant comparative analysis, and the construction of a thematic and interpretive account. Nurses in this study described great variability in how MAiD had been enacted in their work context and the practice supports available to guide their practice. The development of systems to support MAiD, or lack thereof, was largely driven by persons in influential leadership positions. Workplaces that supported a range of nurses’ moral responses to MAiD were most effective in supporting nurses’ well-being during this impactful change in practice. Participants cited the importance of teamwork in providing high quality MAiD-related care; although, many worked without the benefit of a team. Nursing work related to MAiD was highly complex, largely because of the need for patient-centered care in systems that were not always organized to support such care. In the absence of adequate practice supports, some nurses were choosing to limit their involvement in MAiD. Data obtained in this study suggested that some workplace contexts still lack the necessary supports for nurses to confidently meet the precision required of a legislated approach to MAiD. Without accessible palliative care, sufficient providers, a supportive team, practice supports, and a context that allowed nurses to have a range of responses to MAiD, nurses felt they were legally and morally at risk. Nurses seeking to provide the compassionate care consistent with such a momentous moment in patients’ lives, without suitable supports, find themselves caught between the proverbial rock and hard place.

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The rocks and hard places of MAiD: a qualitative study of nursing practice in the context of legislated assisted death.

Infrastructures of survival: digital justice and black poetics in community Internet provision Chair of Supervisory Committee: Sarah Elwood-Faustino Geography This dissertation explores community wireless networks as they respond to overlapping forms of socio-spatial inequality, using a case study of the Equitable Internet Initiative in Detroit, Michigan. Where commercial Internet service is unavailable or inaccessible to the majority of Detroit’s low-income residents, community technologists and organizers are building their own last-mile Internet infrastructure. Using data from interviews, participant observation, and organizational documents, I trace how these actors build neighborhood-scale, community-owned wireless networks and rework both the material and social relations that comprise broadband provision. Rather than analyze practices of community provision as an example of neoliberal responsibilization, I draw on black geographies, digital geographies, and infrastructure studies to analyze the networks as socio-technical survival programs, rooted in traditions of black and brown liberation. I argue that community wireless networks challenge mainstream sociotechnical futuring practices and reshape the urban political struggles that take place around and through digital technologies. This dissertation fills empirical gaps in geographic research on digital infrastructures and makes theoretical contributions to contemporary urban geography, digital geographies, and black geographies. My analytical strategy of reading for difference in the socio-spatial practices of urban residents whose perspectives are illegible to the dominant political economic order enables me to advance urban geographic research on the political potential of community resilience. Theorizing community networking initiatives as infrastructural survival programs allows for a deeper and more nuanced analysis of the sociotechnical practices of these efforts and helps move debates about digital inequality beyond binary “digital divides.” Finally, I contribute to black geographic scholarship by bringing it into conversation with digital geographies and helping expand its methodological repertoire.

Infrastructures of survival: digital justice and black poetics in community Internet provision

The Essence of Desperation: Accounting for Counterinsurgency Doctrines as Solutions to Warfighting Failures in Vietnam, Iraq, and Afghanistan

Let's begin with what we know: One way or another, we all die. What we don't know precisely is when death occurs. Yet however inaccurate our definition of death may be, it plays an instrumental rol...

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Toward a Science of Brain Death

‘ “Am I Still an Artist?” Sustaining Arts Practice in an Age of Austerity’ is a preliminary investigation into artists’ narratives of struggles to sustain creative and critical professional practice in current conditions of austerity, identifying themes as concerns for enquiry The study makes a critical enquiry into discourses of the ‘artist’, ‘qualification’ and ‘economic agents’ in the contexts of the contemporary creative arts markets and considers the effects of performativity on the identity and agency of creative artists The study considers concepts of networks of ‘innovation’ and ‘knowledge economies’ to consider ‘performativity’ and ‘counter-performativity’ in the organization of networks, and the implications for artists with regard to questions of education, training and continuing professional development

Larry Snyder

Papers

Changing the conversation.