Doctoral Dissertation Research: Clinicians as Culture Bearers: A Study of the Dying Process in the American Hospital

University Of Virginia Main Campus, Charlottesville VA

Investigators

Abstract

While death is not infrequent in the American hospital, a "good death" there is hard to come by. The death of the patient clearly contradicts the hospital mission of rescue, stabilization and recovery, but it is seldom described as a conflict in American cultural values. This dissertation research by a cultural anthropologist examines the conflict between two American values: the commitment to saving personal lives and the desire for a death with personal meaning. The central question is how do conflicting norms, both in American culture and within the hospital, prevent its clinicians from attending to the restoration of selfhood to the patient who is approaching death, making it impossible to achieve "death with dignity?" Using retrospective interviews and participant observation with clinicians and administrators the student will study two city hospitals in in a Mid Atlantic city who must mediate between America's contradictory ideals of rescue and "death with dignity" as they seek to treat life-threatening illness. Broader Impact: The scarcity of "death with dignity" in American hospitals receives continued public attention in end-of-life discussions. The use of diverse hospital sites and contexts in this project will generate practical findings relevant not only to clinicians in acute care institutions, but also to those in other facilities where patients die, such as hospices, long term care and rehabilitation settings. In addition the project contributes to the training of a young social scientist.