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    --And a time to die : how American hospitals shape the end of life / Sharon R. Kaufman.

    • Title:--And a time to die : how American hospitals shape the end of life / Sharon R. Kaufman.
    •    
    • Author/Creator:Kaufman, Sharon R., author.
    • Published/Created:New York : Scribner, [2005]
    • Holdings

       
    • Library of Congress Subjects:Terminal care--United States.
      Hospital care--United States.
      Death--Social aspects--United States.
    • Medical Subjects: Terminal Care.
      Attitude to Death.
      Hospitals.
      Anthropology, Cultural.
      United States.
    • Description:x, 400 pages ; 23 cm
    • Summary: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. 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.
    • Notes:"A Lisa Drew book."
      Includes bibliographical references (pages 371-386) and index.
    • ISBN:0743264762
      9780743264761
      9780226426853
      0226426858
    • Contents:Introduction
      pt. I. The predicament : death becomes a new kind of problem
      Death and hospital culture
      Death in life : the "person" and the experience of dying
      pt. II. The hospital system : time and the power of the pathway
      Transforming time : from deathwatch to billable treatments
      Moving things along : The heroic intervention pathway ; The paradox of resuscitation: approach/avoidance on the heroic pathway ; The revolving door pathway
      Waiting : Obstructing the order of things ; "Let's wait and see": the indeterminate condition of old age ; Agreement and anticipation: watchful waiting
      pt. III. The politics and rhetoric of the patient's condition : "suffering," "dignity," and the "quality of life"
      Death by design
      Life support
      Hidden places : the zone of indistinction as a way of life : The specialized unit: routines without pathways, life with no end ; The shadow side of "death with dignity"
      Culture in the making.
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