The Corpse Leads, We Follow: Medical Intervention at the End of Life

Posted on January 10, 2013 by

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Those of us who labor in the techno-confused trenches of American medicine need little reminder of how the profit driven machine seems to ramp up the closer a person is to death. We’ve counted the twenty drips hung around the patient in ICU Bed 2, glittering and glowing like the control panel of a jet aircraft. Maybe we’ve been asked to participate in the futility as one organ after another disengages from the world, joining the reluctant but certain parade to the morgue.

Dr. Jeffrey P. Bishop, a practicing internist, philosophy professor and Episcopal priest, has witnessed his share of medically indulgent endings. Perhaps this is what inspired him to attempt to explain how medicine evolved to it’s current state of end-of-life futility and excessive intervention and why we can’t seem to get this misadventure under control.

In The Anticipatory Corpse: Medicine, Power and the Care of the Dying, Dr. Bishop explains that once a patient hits the doors of the ICU, he or she is caught up in a web of intertwining social, medical and legal directives that makes it nearly impossible to script a death beyond the control of the medical establishment.

“Medicine cannot let the dying be,” Dr. Bishop tells us. Medicine is obsessed with death–obsessed with preventing it in ICUs and in controlling how the final curtain falls via palliative care. The end result is that patients are treated as malfunctioning bodies, robbed of their personhood.

In trying to make death more efficient and predictable medicine has certainly overstepped its boundaries but, as Dr. Bishop acknowledges, there is no easy way to stuff this genie back in the bottle. The best start perhaps and one provided in these pages is an understanding that death is not a one-size-fits-all occasion.

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