And a Time to Die
How American Hospitals Shape the End of Life
“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 of Medicine
Society for Medical Anthropology: New Millennium Book Award
Won
“An act of courage and a public service.”<San Francisco Chronicle>
“An outstanding, timely examination of how and why people die or are kept alive in U.S. society. . . . You finish the book with a sense that although the future remains unknown, you are at least better informed and perhaps better able to cope with the inevitable.”
“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’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.”
“This is ethnography at its best. . . . [The author's] quietly powerful book, which needs to be read by both family caregivers and medical professionals, belongs on the shelves of public, academic, and medical libraries.”
“Kaufman exposes the bureaucratic and ethical quandaries that hover over the modern deathbed.”
PART I
THE PREDICAMENT: DEATH BECOMES A NEW KIND OF PROBLEM 21
1. Death and Hospital Culture
2. Death in Life: The "Person" and the Experience of Dying
PART II
THE HOSPITAL SYSTEM: TIME AND THE POWER OF THE PATHWAY 85
3. Transforming Time: From Deathwatch to Billable Treatments 89
4. Moving Things Along 95
I. The Heroic Intervention Pathway 104
II. The Paradox of Resuscitation: Approach/Avoidance on the Heroic Pathway 116
III. The Revolving Door Pathway 131
5. Waiting 147
I. Obstructing the Order of Things 152
II. "Let's Wait and See": The Indeterminate Condition of Old Age 177
III. Agreement and Anticipation: Watchful Waiting 190
PART III
THE POLITICS AND RHETORIC OF THE PATIENT'S CONDITION: "SUFFERING," "DIGNITY," AND "THE QUALITY OF LIFE" 203
6. Death by Design 207
7. Life Support 236
8. Hidden Places: The Zone of Indistinction as a Way of Life 273
I. The Specialized Unit: Routines Without Pathways, Life with No End 275
II. The Shadow Side of "Death with Dignity"
9. Culture in the Making
Appendix A. About the Research
Appendix B. A Note on Diversity
Notes
Bibliography
Acknowledgements
Credits
Index
Anthropology: General Anthropology
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