From Publishers Weekly
Starred Review. 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."
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Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Booklist
Medical anthropologist Kaufman says that only within the last few hundred years has death become a medical concern. Previously, people looked upon death as a private, personal rite of passage that took place within the confines of the home and surrounded by one's loved ones: a spiritual journey. Enter the medical professional, who takes prolonging life--hence, delaying death--as a mission, and dying is transformed into a last gasp for hope, a medical failure. It gets worse. Only within the last half-century has the number of people who die in hospitals come to vastly outnumber that of those dying at home. Moreover, recent scientific research has only served to broaden and more often blur the definition of death and life. Death as a personal experience has pretty much been erased and instead has become an institutional nightmare, one contorted by hospital politics, "bureaucratic logic without logical purpose," and the law. Kaufman exposes, with all its complexities, the clash of dying patients and their families with the only institutional resources available to them. Donna Chavez
Copyright © American Library Association. All rights reserved
Copyright © American Library Association. All rights reserved
