Department of Conflict Resolution Studies Theses and Dissertations

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Date of Award

1-1-2026

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy in Conflict Analysis and Resolution

First Advisor

Ismael Muvingi

Keywords

Bereaved Parents; Coordinated Management of Meaning; Interpretative Phenomenological Analysis; Narrative Ethics; Pediatric End-of-Life Decision-Making; Pediatric Palliative Care

Abstract

Pediatric end-of-life decision-making unfolds at the intersection of medicine, ethics, and relationship, a territory that existing scholarship has examined primarily through clinical outcomes and quantitative measures. This study asked a different question: what is it actually like to be there? Using Interpretative Phenomenological Analysis, this study examined the lived experiences of 16 bereaved parents and 16 pediatric clinicians navigating end-of-life decision-making, with particular attention to how participants made meaning from those experiences. Analysis generated Group Experiential Themes across both sub-samples, revealing the same clinical spaces experienced in irreconcilably different ways. Parent themes illuminated the experience of a world turned upside down: the fight for narrative authority, the weaponization of bioethical frameworks against the families they were designed to protect, and the unexpected grace that arrived where the clinical system could not follow. Clinician themes illuminated what it means to be cast as the main character in someone else's worst nightmare: the systemic barriers that made good care harder, the daily practice of clinical courage, and the slow formation that years of proximity to dying children produced. Three theoretical frameworks, symbolic interactionism, coordinated management of meaning, and moral conflict theory, were applied as a sequential cascade rather than parallel lenses. Findings carry implications for clinical education, healthcare ethics consultation, institutional design, and policy. This study argues that dying children and their families deserve clinicians “brave enough” to meet them fully, and this dissertation documents what that bravery looks like, where it comes from, and what makes it possible.

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