Over the past thirty years, the way Americans experience death has been dramatically altered. The advent of medical technology capable of sustaining life without restoring health has changed where, when, and how we die. In this revelatory study, medical anthropologist Sharon R. Kaufman examines the powerful center of those changes: the hospital, where most Americans die today. She deftly links the experiences of patients and families, the work of hospital staff, and the ramifications of institutional bureaucracy to show the invisible power of the hospital system in shaping death and our individual experience of it. In doing so, Kaufman also speaks to the ways we understand what it means to be human and to be alive.
“An act of courage and a public service.”—San Francisco Chronicle
“This beautifully synthesized and disquieting account of how hospital patients die melds disciplined description with acute analysis, incorporating the voices of doctors, nurses, social workers, and patients in a provocative analysis of the modern American quest for a ‘good death.’”—Publishers Weekly
“Kaufman exposes the bureaucratic and ethical quandaries that hover over the modern deathbed.”—Psychology Today
“Kaufman’s analysis illuminates the complexity of the care of critically ill and dying patients [and] the ambiguity of slogans such as ‘death with dignity,’ ‘quality of life,’ and ‘stopping life support.’ . . . Thought-provoking reading for everyone contemplating the fate of us all.”—New England Journal ofMedicine
This beautifully synthesized and disquieting account of how hospital patients die melds disciplined description with acute analysis, incorporating the voices of doctors, nurses, social workers and patients in a provocative analysis of the modern American quest for "a good death." In a series of case studies, Kaufman (The Ageless Self: Sources of Meaning in Life), a professor of medical anthropology at UC-San Francisco, shows how hospitals, by focusing on life-saving treatments, can indefinitely prolong the life of the critically ill patient, who may drift into an indeterminate zone, suspended between life and death. "[D]ying has become a technical endeavor, a negotiated decision and a murky matter biologically," she notes. Writing with penetrating clarity and detached compassion, and with respect for hospital staff and families alike, Kaufman reveals the dilemmas of hospital death in America today: the shift to patients' control of decision making despite the doctors' greater knowledge; the ethics and practical effects of resuscitation versus pain relief; the complexities of assessing "quality of life" while guessing at the desires of an unconscious patient. Kaufman's unwavering account reveals a culture of clinical practice that seems to have trouble acknowledging the inevitability of death, and that moves awkwardly from curative to palliative treatment. This deeply probing study lays bare the cultural and institutional assumptions and rhetoric that frame our search for "a good death." Agent, Liza Dawson. (Apr.) Copyright 2005 Reed Business Information.