Doctoral Dissertation Research: Cultural, Economic, and Technological Contexts of End-of-Life Care

New York University, New York NY

Investigators

Abstract

New York University graduate student Dwaipayan Banerjee, under the supervision of Dr. Emily Martin, will undertake research on how economic constraints, religious beliefs, and variable medical practices affect end-of-life ethics and care. His research will be conducted in India where the presence of three different institutional forms of care make possible a comparative case study. In recent years, the Indian Supreme Court has been inconsistent on the question of whether the right to life in the constitution can be understood as the right to die. Because of this context of legal uncertainty, doctors at private hospitals in India suggest that they allow a higher rate of life-support use than almost anywhere in the world. But in addition to private hospitals, India offers public hospitals, where resources are more limited; and a new, less medicalized third option of religious and secular hospice care. Thus India provides an appropriate context for studying and creating general theory to understand how social, economic, and cultural factors affect the changing landscape of end-of-life care ethics and decision making. The research will be carried out at some of these sites of care for the terminally ill in Delhi. The researcher will compare private and public health care facilities as well as religious and secular hospices, examining how these varied contexts differently shape end-of-life situations. He will employ a combination of appropriate social science research methods. These will include interviews with doctors, retrospective interviews with patient families, interviews with hospital and nursing staff, observations at hospice and intensive-care sites, and archival research on the colonial and post-colonial development of end-of-life law. The importance of this research is that it will contribute to the social scientific understanding of the relationship between religion, medicine, and the cultural contexts through which understandings of human dignity, particularly at the end of life, are shaped. Part of its contribution will be to reveal the effects of religious and cultural differences on understandings of human dignity, which is more discernible and available to observation during end-of-life decisions. Findings from this research also will elucidate the effects of everyday practices of care giving on the emergence of new moral and ethical understandings. Funding this research also supports the training of a social scientist.