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Negotiating End-of-Life Decisions

2025· article· en· W4417451342 on OpenAlexaffvenueabout
Louise Chartrand

Bibliographic record

VenueAnthropologica · 2025
Typearticle
Languageen
FieldMedicine
TopicPalliative Care and End-of-Life Issues
Canadian institutionsUniversity of Manitoba
Fundersnot available
KeywordsPalliative careNegotiationAcute careProcess (computing)Path (computing)

Abstract

fetched live from OpenAlex

When someone is very ill in Canada, the individual is taken under charge of the medical system and put on one of two distinct paths for handling the situation: either acute or palliative care. In the acute path, all available medical technology is deployed to save lives and avoid death, while the main objective of the palliative path is comfort, as death becomes inevitable and expected. The two paths are ordinarily seen as part of a linear process, wherein acute care is initially deployed and palliative care only after acute care is determined ineffective. In practice, however, the two paths are intermittent, as the reasoning repertoires that guide care practices along both paths are constantly renegotiated by care teams. This article follows the decision-making process regarding the use of the ventilator for two individuals at the end of their lives as their care teams alternate between legal, curing, and care repertoires. The entanglement of these repertoires leads to unexpected care practices as patients are shifted from one path to another. In both cases, the transition from acute to palliative care was nonlinear, and the purposes of the possible medical actions that could be taken along the two paths kept changing as events unfolded.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.032
metaresearch head score (Gemma)0.040
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Qualitative · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.032
Threshold uncertainty score0.169

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0320.040
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.001
Science and technology studies0.0140.036
Scholarly communication0.0130.013
Open science0.0030.014
Research integrity0.0060.008
Insufficient payload (model declined to judge)0.0090.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.168
GPT teacher head0.474
Teacher spread0.306 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designQualitative
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes3
Has abstractyes

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