Article Text

Download PDFPDF
Employing imaginative rationality: using metaphor when discussing death
  1. Rebecca Llewellyn1,
  2. Chrystal Jaye2,
  3. Richard Egan1,
  4. Wayne Cunningham3,
  5. Jessica Young2,
  6. Peter Radue2
  1. 1Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  2. 2Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
  3. 3Royal College of Surgeons in Ireland—Medical University of Bahrain, Adilya, Bahrain
  1. Correspondence to Associate Professor Chrystal Jaye, General Practice and Rural Health, University of Otago, PO Box 56, Dunedin 9054, New Zealand; chrystal.jaye{at}


The prevalence of metaphors in medicine is widely acknowledged. In a qualitative study exploring expectations of longevity, we observed repeated recourse to the imaginative rationality provided by metaphors to express perspectives on longevity and death. Bafflement, acceptance, uncertainty and distress were conveyed through metaphors, providing valuable insight into the internal healthcare frameworks of participants. Skilful use of imaginative rationality in the healthcare setting may illuminate the elusive and often eschewed topic of death in a way that fosters clarity and new understandings, and pave the way towards a better life, and death for patients. By becoming aware of the nuances contained within patients'—as well as their own—metaphors, clinicians may enhance patients’ overall healthcare experience and avert unintended miscommunication.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This project was funded by a University of Otago Research Grant.

  • Competing interests None declared.

  • Ethics approval University of Otago Human Health Ethics Committee: (H14/144).

  • Provenance and peer review Not commissioned; externally peer reviewed.