The article is based on ethnographic observation and semistructured interviews with personnel in three European adult intensive care units. Intensive care is a domain of contemporary biomedicine centered on invasive and intense efforts to save lives in acute, critical conditions. It echoes our culture’s values of longevity. Nevertheless, mortality rates are elevated. Many deaths follow from nontreatment decisions. Medicalized dying in technological medical settings are often presented as unnatural, impersonal, and undesirable ways of dying. How does this affect the way in which death is experienced by intensive care professionals? What might the enactment of dying in intensive care reveal about our cultural values of good and bad dying?
AlasadJ. (2002) Managing technology in the intensive care unit: The nurses’ experience. International Journal of Nursing Studies39: 407–413.
2.
AlmerudS.AlapackR. J.FridlundB.EkeberghM. (2007) Caught in an artificial split: A phenomenological study of being a caregiver in the technologically intense environment. Intensive and Critical Care Nursing24: 130–136.
3.
AnspachR. R. (1993) Deciding who lives. Fateful choices in the intensive-care nursery, Berkeley and Los Angeles, CA: University of California Press.
4.
ArièsP. (1975) Essays sur l’histoire de la mort en Occident du Moyen Âge à nos jours [Western attitudes toward death from the Middle Ages to the present], Paris, France: Seuil.
5.
AzoulayE.ChaizeM.Kentish-BarnesN. (2014) Involvement of ICU families in decisions: Fine-tuning the partnership. Annals of Intensive Care4: 37.
6.
Bird-DavidN. (1999) ‘Animism’ revisited: Personhood, environment and relational epistemology. Current Anthropology40(S1): S67–S91.
7.
Bird-DavidN.IsraeliT. (2010) A moment dead, a moment alive: How a situational personhood emerges in the vegetative state in an Israeli hospital unit. American Anthropologist112(1): 54–65.
8.
CallahanD. (1990) What kind of life. A challenging exploration of the goals of medicine, New York, NY/London, England: Touchstone.
9.
ChappleH. S. (2010) No place for dying. Hospitals and the ideology of rescue, Walnut Creek, CA: West Coast Press.
10.
Del Veccio GoodM. J.GadmerN.RuoppR.LakomaM.SullivanA.RedinbaughE.BlockS. (2004) Narrative nuances on good and bad deaths: Internists’ tales from high-technology work places. Social Science and Medicine58: 929–953.
11.
Domingo MarcoJ.Badia CastellóM.Servia GoixartL.Trujillano JavierJ.Gavilán RabellR.Vilanova CorsellasJ.Sandiumenge CampsA. (2014) Mortalidad del paciente crítico. Factores relacionados con limitación de terapias de soporte vital [Mortality of patients in critical condition. Factors related to withholding life sustaining treatment]. Medicina Intensiva38: 365.
12.
DresserR. (2004) Death with dignity: Contested boundaries. Journal of Palliative Care20(3): 201–206.
13.
DupontB.-M. (2007) Epistémologie du raisonnement médical contemporain [The epistemology of contemporary medical reasoning]. In: HirschE. (ed.) Ethique, médecine et société. Comprendre, réfléchir, décider[Ethics, medicine and society. Understand, think, decide], Paris, France: Espace Ethique, Vuibert, pp. 119–130.
14.
GedgeE.GiacominiM.CookD. (2007) Withholding and withdrawing life support in critical care settings: Ethical issues concerning consent. Journal of Medical Ethics33: 215–218.
15.
Gómez RubíJ. A. (2002) Ética en medicina crítica [Ethics in critical care medicine], Madrid, Spain: Triacastela.
16.
GreenJ. W. (2008) Beyond the good death. The anthropology of modern dying, Philadelphia, PA: University of Pennsylvania Press.
17.
HalvorsenK.FørdeR.NordtveitP. (2008) Professional challenges of bedside rationing in intensive care. Nursing Ethics15(16): 715–728.
18.
HelandM. (2006) Fruitful or futile: Intensive care nurses’ experiences and perceptions of medical futility. Australian Critical Care19(1): 25–31.
19.
HofmannB. (2002) Technological medicine and the autonomy of man. Medicine, Health Care and Philosophy5: 157–167.
20.
JoxR. J.SchaiderA.MarckmanG.BorasioG. D. (2012) Medical futility at the end of life: The perspectives of intensive care and palliative care clinicians. Journal of Medical Ethics38: 540–545.
21.
KasmanD. L. (2004) When is medical treatment futile? A guide for students, residents, and physicians. Journal of General Internal Medicine19(10): 1053–1056.
22.
KaufmanS. R. (2000) In the shadow of “death with dignity”: Medicine and cultural quandaries of the vegetative state. American Anthropologist102(1): 69–83.
23.
Kentish-BarnesN. (2007) Mourir à l'heure du médecin. Décisions de fin de vie en réanimation [Dying on the doctor’s time. End-of-life decisions in intensive care]. Revue Française de Sociologie3(48): 449–475.
24.
KlepstadP. (2008) Palliasjon på en intensivavdeling [Palliation in an intensive care unit]. In: KaasaS. (ed.) Palliasjon. Nordisk lærebok, 2. utgave [Palliation, Nordic teaching manual, 2nd edition], Oslo, Norway: Gyldendal Norsk Forlag, pp. 229–239.
25.
KlepstadP.GisvoldS. E. (2003) End-of-life care in intensive care units: Save lives that can be saved, offer the dying a peaceful and dignified death. Acta Anaesthesiologica Scandinavica47: 499–500.
26.
LafontaineC. (2008) La société postmortelle. Mort, l’individu et le lien social à l’ère des technosciences [The post-mortal society. Death, the individual, and social ties in the era of technosciences], Paris, France: Editions du Seuil.
27.
La MarneP. (2005) Vers une mort solidaire [Towards a solidary death], Paris, France: PUF.
28.
MaterstvedtL. J.BosshardG. (2009) Deep and continuous palliative sedation (terminal sedation): Clinical-ethical and philosophical aspects. Lancet Oncology10(6): 622–627.
29.
MollerD. W. (1996) Confronting death: Values, institutions, and human morality, New York, NY: Oxford University Press.
30.
Nimmo, G. R., & Singer, M. (Eds.). (2011). ABC of critical care medicine, 2nd edition. Oxford, England: Wiley Blackwell.
31.
PuriN.PuriV.DellingerR. P. (2009) History of technology in the intensive care unit. Critical Care Clinics Volume25(1): 185–200.
32.
RomainM.SprungC. L. (2014) End-of-life practices in the intensive care unit: The importance of geography, religion, religious affiliation, and culture. Rambam Maimonides Medical Journal5(1): e0003.
33.
SchallerC.KesslerM. (2006) On the difficulty of neurosurgical end of life decisions. Journal of Medical Ethics32: 65–69.
34.
RustomC. T.PalmerJ.ThomasG. L. (2010) Ethical issues in resuscitation and intensive care medicine. Anesthesia and Intensive Care Medicine11(1): 1–5.
35.
SealeC. (2004) Media constructions of dying alone. A form of ‘bad death.’. Social Science & Medicine58(5): 967–974.
36.
SeymourJ. E. (1999) Revisiting medicalisation and ‘natural’ death. Social Science & Medicine49: 691–704.
37.
SeymourJ. E. (2000) Negotiating natural death in intensive care. Social Science & Medicine51(8): 1241–1252.
38.
Sprung, C. L., Carmel, S., Sjokvist, P., Baras, M., Cohen, S. L.Maia, P., … ETHICATT study group. (2007). Attitudes of European physicians, nurses, patients, and families regarding end-of-life decisions: The ETHICATT study. Intensive Care Medicine, 33, 104–110.
39.
TimmermansS. (1998) Resuscitation technology in the emergency department: Toward a dignified death. Sociology of Health & Illness20(2): 144–167.
40.
WilkinsonD. J. C.SavulescuJ. (2011) Knowing when to stop: Futility in the intensive care unit. Current Opinion in Anaesthesiology24(2): 160–165.
