Abstract / Summary
As death in the United States is increasingly managed within biomedical institutions, end-of-life doulas (EOLDs) have emerged as non-medical practitioners who support dying people and their families through education, advocacy, companionship, ritual, and vigil care. Drawing on 18 semi-structured interviews with practicing EOLDs across the United States, this qualitative study examines how these doulas conceptualize a good death, navigate emotionally intensive care work, and sustain themselves in a largely unregulated field. These interviews suggest that EOLDs challenge dominant biomedical models of dying by organizing care around client autonomy, relational presence, and personalization of treatment rather than cure, intervention, and control. According to the interviews, central to their practices are death-positive worldviews, emotionally intimate approaches to care, and strong peer networks. For these EOLDs, lower reported burnout and compassion fatigue were linked not only to self-care, but to a broader relational framework in which death is understood as a meaningful life passage rather than a professional defeat.