Demystifying death: The necessarily expansive role of the end-of-life doula
Date
2026
Authors
Dow, Bethany
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Abstract
This thesis explores the multifaceted role of the contemporary End-of-Life-Doula (EOLD). The increased medicalization of death in the past 100 years has led to an increased need for emotional, mental, spiritual and educational support in end-of-life-care, a gap filled by EOLDs throughout the last decade. Interviews conducted with three EOLDs from the Vancouver Island region confirmed the necessity of this work in supporting people and communities ethically while also emphasizing the need for flexibility in role enactment to fulfill this work. EOLD services span from bedside vigiling to educational roles based in increasing community death literacy and end-of-care planning, yet all facets of care can be understood as being ethically driven by the upholding of individual and community values. The current structure of this work produces a moral economy of exchange between the doulas and their communities, with feminist constructions of care substantiating the work of doulas collectively. While some EOLDs seek a standardization of the role in hopes of decreasing ambiguity and increasing legitimacy of their work, many others argue that this standardization risks a loss in the role’s necessary diversity in practice. This thesis seeks to explain how this loss of diversity poses a threat to the moral economy of death, as the legal boundaries of the practice would inevitably disconnect the ethical basis from this extensive role.
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Keywords
end-of-life doula, death literacy, community, moral economy, gendered care, standardization