Kaufman Sharon R And A Time To Die How American Hospitals Shape The End Of Life
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And a Time to Die
Most Americans, when pressed, have a vague sense of how they would like to die. They may imagine a quick and painless end or a gentle passing away during sleep. Some may wish for time to prepare and make peace with themselves, their friends, and their families. Others would prefer not to know what's coming, a swift, clean break. Yet all fear that the reality will be painful and prolonged; all fear the loss of control that could accompany dying. That fear is justified. It is also historically unprecedented. In the past thirty years, the advent of medical technology capable of sustaining life without restoring health, the expectation that a critically ill person need not die, and the conviction that medicine should routinely thwart death have significantly changed where, when, and how Americans die and put us all in the position of doing something about death. In a penetrating and revelatory study, medical anthropologist Sharon R. Kaufman examines the powerful center of those changes -- the hospital, where most Americans die today. In the hospital world, the deep, irresolvable tension between the urge to extend life at all costs and the desire to allow "letting go" is rarely acknowledged, yet it underlies everything that happens there among patients, families, and health professionals. Over the course of two years, Kaufman observed and interviewed critically ill patients, their families, doctors, nurses, and other hospital staff at three community hospitals. In...And a Time to Die, her research places us at the heart of that science-driven yet fractured and often irrational world of health care delivery, where empathetic yet frustrated, hard-working yet constrained professionals both respond to and create the anxieties and often inchoate expectations of patients and families, who must make "decisions" they are ill-prepared to make. Filled with actual conversations between patients and doctors, families and hospital staff,...And a Time to Die clearly and carefully exposes the reasons for complicated questions about medical care at the end of life: for example, why "heroic" treatment so often overrides "humane" care; why patients and families are ambivalent about choosing death though they claim to want control; what constitutes quality of life and life itself; and, ultimately, why a "good" death is so elusive. In elegant, compelling prose, Kaufman 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 itself -- its rules, mandates, and daily activity -- in shaping death and our individual experience of it. ...And a Time to Die is a provocative, illuminating, and necessary read for anyone working in or navigating the health care system today, providing a much-needed road map to the disorienting territory of the hospital, where we all are asked to make life-and-death choices.
Ordinary Medicine
Author: Sharon R. Kaufman
language: en
Publisher: Duke University Press
Release Date: 2015-05-29
Most of us want and expect medicine’s miracles to extend our lives. In today’s aging society, however, the line between life-giving therapies and too much treatment is hard to see—it’s being obscured by a perfect storm created by the pharmaceutical and biomedical industries, along with insurance companies. In Ordinary Medicine Sharon R. Kaufman investigates what drives that storm’s “more is better” approach to medicine: a nearly invisible chain of social, economic, and bureaucratic forces that has made once-extraordinary treatments seem ordinary, necessary, and desirable. Since 2002 Kaufman has listened to hundreds of older patients, their physicians and family members express their hopes, fears, and reasoning as they faced the line between enough and too much intervention. Their stories anchor Ordinary Medicine. Today’s medicine, Kaufman contends, shapes nearly every American’s experience of growing older, and ultimately medicine is undermining its own ability to function as a social good. Kaufman’s careful mapping of the sources of our health care dilemmas should make it far easier to rethink and renew medicine’s goals.
At the End of Life
What should medicine do when it can’t save your life? The modern healthcare system has become proficient at staving off death with aggressive interventions. And yet, eventually everyone dies—and although most Americans say they would prefer to die peacefully at home, more than half of all deaths take place in hospitals or health care facilities. At the End of Life—the latest collaborative book project between the Creative Nonfiction Foundation and the Jewish Healthcare Foundation—tackles this conundrum head on. Featuring twenty-two compelling personal-medical narratives, the collection explores death, dying and palliative care, and highlights current features, flaws and advances in the healthcare system. Here, a poet and former hospice worker reflects on death’s mysteries; a son wanders the halls of his mother’s nursing home, lost in the small absurdities of the place; a grief counselor struggles with losing his own grandfather; a medical intern traces the origins and meaning of time; a mother anguishes over her decision to turn off her daughter’s life support and allow her organs to be harvested; and a nurse remembers many of her former patients. These original, compelling personal narratives reveal the inner workings of hospitals, homes and hospices where patients, their doctors and their loved ones all battle to hang on—and to let go.