Toward a better death: applying Burkean principles of symbolic action to interpret family adaptation to Karen Ann Quinlan's coma.

This article considers the manner that families come to accept the collapse of identity in a family member who has entered a medical crisis with no hope of returning from it. The transformation is regarded as a "right of passage" and is characterized in terms of both the conditions that bring about resistance to the passage as well as the sorts of symbolic activities that ultimately allow the transformation to occur. The theoretical source that is used to discuss both these issues is Kenneth Burke's (1969) theory of Dramatism, regarded herein as a template that guides both interpersonal action and experience. The primary text used to illustrate these points is the story of Karen Ann Quinlan, a young woman who fell into persistent vegetative state in 1975, as told by her parents. A general goal of this article is to illustrate some of the characteristics of Dramatism as a theory of interpersonal action, especially after the collapse of routine. More particularly, it is hoped that the analysis will aid health professionals in sense making and interacting with families in crisis.