And a Time to Die

About this book

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.