Of deaths in the US, an increasing proportion occur within hospital intensive care units amidst miraculous medical technology. A positivist ethos dominates, despite the severe philosophic criticisms levelled at its axiomatic foundations. As patients are transformed into ‘cases’, they lose social identity, and their dying becomes a medical defeat, rather than a natural and social process. Families encounter sedated intubated specimens rather than social persons from whom they wish ceremonially to depart. In response to these problems, there are ongoing efforts at transformation and remediation. Viewing biomedicine in relationship to phronesis, this article explores the dilemmas.
Alvord, Lori Arviso
and Van Pelt, E.C. (2000) The Scalpel and the Silver Bear. New York: Bantam.
2.
Anspach, Renée R.
(1987) ‘Prognostic Conflict in Life-and-Death Decisions: The Organization as an Ecology of Knowledge’, Journal of Health & Social Behavior28 (September): 215-231.
3.
Baer, Hans A.
(ed.) (1987) Encounters with Biomedicine: Case Studies in Medical Anthropology. New York: Gordon & Breach.
4.
Bauer, Henry H.
(1992) Scientific Literacy and the Myth of the Scientific Method. Urbana, IL: University of Illinois Press.
5.
Baynes, Kenneth
, Bohman, James and McCarthy, Thomas (eds) (1994) After Philosophy: End or Transformation. Cambridge, MA: MIT Press.
6.
Bohme, Gernot
and Stehrs, Nico (eds) (1986) The Knowledge Society: Sociology of the Sciences Yearbook. Norwell, MA: D. Reidel.
7.
Bosk, Charles L.
(1979) Forgive and Remember: Managing Medical Failure. Chicago, IL: University of Chicago Press.
8.
Buchman, Timothy
, Cassell, Joan, Ray, Shawn and Wax, Murray (2002) ‘Who Should Manage the Dying Patient? Rescue, Shame, and the Surgical ICU Dilemma’, Journal of the American College of Surgeons194: 665-673.
9.
Buckingham, R. W. III
, et al. (1976) ‘Living With the Dying: Use of the Technique of Participant Observation’, Canadian Medical Association Journal115: 1211-1215.
10.
Carlton, Wendy
(1978) In Our Professional Opinion: The Primacy of Clinical Judgment over Moral Choice. Notre Dame, IN: Notre Dame University Press.
11.
Cassell, Joan
(1991) Expected Miracles: Surgeons at Work. Philadelphia, PA: Temple University Press.
12.
Cassell, Joan
(2000) The Woman in the Surgeon’s Body. Cambridge, MA: Harvard University Press.
13.
Cassell, Joan
(2002) ‘Perturbing the System: “Hard Science”, “Soft Science”, and Social Science: The Anxiety and Madness of Method’, Human Organization61(2): 177-185.
14.
Cassell, Joan
(nd) ‘Stories, Moral Judgment, and Medical Care in an ICU’. Unpublished.
15.
Chambers, Tod
(1999) The Fiction of Bioethics: Cases as Literary Texts. New York: Routledge.
16.
Chambliss, Daniel F.
(1996) Beyond Caring: Hospitals, Nurses, and the Social Organization of Ethics. Chicago, IL: University of Chicago Press.
17.
Cicourel, Aaron
(1986) ‘The Reproduction of Objective Knowledge: Common Sense Reasoning in Medical Decision Making’, in Gernot Bohme and Nico Stehr (eds) The Knowledge Society: Sociology of the Sciences Yearbook, pp. 87-122. Norwell, MA: D. Reidel.
18.
Coleman, James S.
(1966) Equality of Educational Opportunity. Washington, DC: US Government Printing Office.
19.
Coombs, Robert H.
and Goldman, Lawrence J. (1973) ‘Maintenance and Discontinuity of Coping Mechanisms in an Intensive Care Unit’, Social Problems20(3): 342-355.
20.
Curtis, J. Randall
and Rubenfeld, Gordon D. (eds) (2001) Managing Death in the Intensive Care Unit: The Transition from Care to Comfort. New York: Oxford University Press.
21.
Dallmayr, Fred
(2000) ‘The Enigma of Health: Gadamer at Century’s End’, in Schmidt (ed.) Language and Linguisticality in Gadamer’s Hermeneutics, pp. 155-170. Lanham, MD: Lexington Books.
22.
Dewey, John
(1976) ‘Logical Conditions of a Scientific Treatment of Morality’, in Jo Ann Boydston (ed.) Middle Work, 1899-1924, pp. 3-39. Carbondale, IL: Southern Illinois University Press [orig. pub. 1903].
23.
Di Giacomo, Susan M.
(1987) ‘Biomedicine as a Cultural System: An Anthropologist in the Kingdom of the Sick’, in Baer, Hans A. (ed.) Encounters with Biomedicine: Case Studies in Medical Anthropology, pp. 315-346. New York: Gordon & Breach.
24.
Di Giacomo, Susan M.
(1995) ‘A Narrative Deconstruction of “Diagnostic Delay”’, Second Opinion20(4): 21-35.
25.
Fadiman, Anne
(1997) The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Strauss & Giroux.
26.
Field, Marilyn J.
and Cassel, Christine K. (eds) (1997) Approaching Death: Improving Care at the End of Life. Washington, DC: National Academy Press.
27.
Flyvbjerg, Bent
(2001) Making Social Science Matter: Why Social Inquiry Fails and How it Can Succed Again. Cambridge: Cambridge University Press.
28.
Fox, Renée
and Swazey, Judith P. (1978) The Courage to Fail: A Social View of Organ Transplants and Dialysis, 2nd edn.Chicago, IL: University of Chicago Press.
29.
Fox, Serena J.
(2001) Night Shift (unpublished poems).
30.
Gadamer, Hans-Georg
(1976) ‘Hermeneutics as Practical Philosophy’, in Baynes, Kenneth, Bohman, James and McCarthy, Thomas (eds) (1994) After Philosophy: End or Transformation, pp. 325-338. Cambridge, MA: MIT Press.
31.
Gadamer, Hans-Georg
(1981) Reason in the Age of Science. Cambridge, MA: MIT Press.
32.
Gadamer, Hans-Georg
(1996) The Enigma of Health. Translated by Jason Geiger and Nicholas Walker. Stanford, CA: Stanford University Press.
33.
Geertz, Clifford
(1973) ‘Thick Description’, in Clifford GeertzThe Interpretation of Cultures, pp. 3-30. New York: Basic.
34.
Geertz, Clifford
(2001) ‘Empowering Aristotle’, Science293 (6 July), p. 53.
35.
Goffman, Erving
(1959) The Presentation of Self in Everyday Life. New York: Anchor.
36.
Greenberg, Gary
(2001) ‘As Good as Dead: Is Brain Death Just a Noble Lie?’, The New Yorker, 13 August, pp. 36-41.
37.
Greenhaigh, Trisha
(1998) ‘Narrative Based Medicine in an Evidence Based World’, in Trisha Greenhaigh and Brian Hurwitz (eds) Narrative Based Medicine, pp. 247-265. London: BMJ Books.
38.
Greenhaigh, Trisha
and Hurwitz, Brian (eds) (1998) Narrative Based Medicine. London: BMJ Books.
39.
Groopman, Jerome
(2000) Second Opinions. New York: Penguin.
40.
Hempel, Carl G.
(1965) Aspects of Scientific Explanation. New York: Free Press.
41.
Hunter, Kathryn M.
(1991) Doctors’ Stories: The Narrative Structure of Medical Knowledge. Princeton, NJ: Princeton University Press.
42.
Irwin, Alan
(1995) Citizen Science. London: Routledge.
43.
Johnson, Nancy
, Cook, Deborah, Giacomini, Mita and Willms, Denis (2000) ‘Towards a “Good” Death: End of Life Narratives Constructed in an Intensive Care Unit’, Culture, Medicine, and Psychiatry24(3): 275-295.
44.
Kaufman, Sharon R.
(1998) ‘Intensive Care, Old Age, and the Problem of Death in America’, The Gerontologist38(6): 715-724.
45.
Kaufman, Sharon R.
(2000) ‘In the Shadow of “Death with Dignity”: Medicine and Cultural Quandaries of the Vegetative State’, American Anthropologist102(1): 69-83.
46.
Kessels, J. P.
and Korthagen, Fred A.J. (1995) ‘The Relationship Between Theory and Practice: Back to the Classics’, Educational Researcher25(3): 17-23.
47.
Kleiber, Charmaine
, et al. (1994) ‘Emotional Responses of Family Members During a Critical Care Hospitalization’, American Journal of Critical Care3 (1): 70-76.
48.
Kurosawa, Akira
(1950) Rashomon. Japan: Daiei.
49.
Lakatos, Imre
and Feyerabend, Paul (1999) For and Against Method. Matteo Motterlini (ed.). Chicago, IL: University of Chicago Press.
50.
Lawton, Julia
(2000) The Dying Process: Patients’ Experiences of Palliative Care. London: Routledge.
51.
Levy, Mitchell M. and Carlet, Jean M. (eds) (2001) ‘Compassionate End-of-Life Care in the Intensive Care Unit’, Supplement toCritical Care Medicine29(2): N1-N61.
52.
Luce, John M.
and Lemaire, Francois (2001) ‘Two Transatlantic Viewpoints on an Ethical Quandary’, American Journal of Respiratory Critical Care Medicine163(4): 818-821.
53.
MacIntyre, Alasdair
(1966) A Short History of Ethics. New York: Macmillan.
54.
MacIntyre, Alasdair
(1971) Against the Self-Images of the Age: Essays on Ideology & Philosophy. Notre Dame, IN: University of Notre Dame Press.
55.
MacIntyre, Alasdair
(1984) After Virtue: A Study in Moral Theory. Notre Dame, IN: University of Notre Dame Press.
56.
Marinker, Marshall
(1998) ‘Sirens, Stray Dogs, and the Narrative of Hilda Thomson’, in Greenhaigh, Trisha and Hurwitz, Brian (eds) Narrative Based Medicine, pp. 103-109. London: BMJ Books.
57.
Mead, George Herbert
(1912) ‘The Mechanism of Social Consciousness’, Journal of Philosophy9: 401-406.
58.
Miller, Peggy
, Forbes, Sarah and Boyle, Diane K. (2001) ‘End-of-Life Care in the Intensive Care Unit: A Challenge for Nurses’, American Journal of Critical Care10(4): 230-237.
59.
Mizrahi, Terry
(1986) Getting Rid of Patients: Contradictions in the Socialization of Physicians. Rutgers, NJ: Rutgers University Press.
60.
Moskowitz, Ellen H.
and Nelson, James Lindemann (eds) (1995) Dying Well in the Hospital. Special supplement to Hastings Center Report (November-December).
61.
Murray, John F.
(1999) Intensive Care: A Doctor’s Journal. Berkeley, CA: University of California Press.
62.
Nagel, Ernst
(1961) The Structure of Science. New York: Harcourt, Brace & World.
63.
New York Times(2001a) ‘Coming to Blows Over How Valid Science Really Is’, Saturday, 21 July, A15.
64.
New York Times(2001b) ‘Florida Judge Rules Man May Let Wife Die’, Thursday, 9 August, A14.
65.
New York Times(2001c) ‘California Justices Limit Families’ Right to End Life Support’, Friday, 10 August, A10.
66.
Paget, Marianne A.
(1987) The Unity of Mistakes: A Phenomenological Interpretation. Philadelphia, PA: Temple University Press.
67.
Paget, Marianne A.
(1993) A Complex Sorrow: Reflections on Cancer and an Abbreviated Life, Marjorie DeVault (ed.). Philadelphia, PA: Temple University Press.
68.
Park, Robert Ezra
(1950) ‘Behind Our Masks’, in Everett C Hughes (ed.) Race and Culture, pp. 244-255. Glencoe, IL: The Free Press.
69.
Polanyi, Michael
(1959) The Study of Man. Chicago, IL: University of Chicago Press.
70.
Polanyi, Michael
(1967) The Tacit Dimension. New York: Anchor.
71.
Popper, Karl R.
(1963) Conjectures and Refutations: The Growth of Scientific Knowledge. New York: Harper.
72.
Putnam, Hilary W.
(2002) The Collapse of the Fact/Value Dichotomy and Other Essays. Cambridge, MA: Harvard University Press.
73.
reprinted in William v. O. Quine (1961) From a Logical Point of View. Cambridge, MA: Harvard University Press.
74.
Robert Wood Johnson Foundation
(nd) ‘Promoting Excellence in End-of-Life Care: An Interim Report’.
75.
Roscoe, Paul B.
(1995) ‘The Perils of Positivism in Cultural Anthropology’, American Anthropologist97: 492-504.
76.
Scheibe, Karl E.
(2000) The Drama of Everyday Life. Cambridge, MA: Harvard University Press.
77.
Schmidt, Lawrence K.
(ed.) (2000) Language and Linguisticality in Gadamer’s Hermeneutics. Lanham, MD: Lexington Books.
78.
SUPPORT Principal Investigators
(1995) ‘A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients’, Journal of the American Medical Association274(20): 1591-1636.
79.
Tempels, Rev. Placide
(1945) Bantu Philosophy. Translated by Colin King. Paris: Presence Africaine.
80.
Timmermans, Stefan
(1999) Sudden Death and the Myth of CPR. Philadelphia, PA: Temple University Press.
81.
Tulsky, James A.
(2001) ‘“Comment” on “Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care Units”’, Journal of General Internal Medicine16(5): 283-289. Cited in Reuters Health.
82.
Turner, Victor
(1974) Dramas, Fields, & Metaphors: Symbolic Action in Human Society. Ithaca, NY: Cornell University Press.
83.
Wax, Murray L.
(1995-96) ‘Method as Madness: Science, Hermeneutics and Art in Psychoanalysis’, Journal of the American Academy of Psychoanalysis23(4): 525-544.
84.
Wax, Murray L.
(1997) ‘On Negating Positivism: An Anthropological Dialectic’, American Anthropologist99(1): 17-23.
85.
Wax, Murray L.
(1999) Western Rationality and the Angel of Dreams. Lanham, MD: Rowman & Littlefield.
86.
Wax, Murray L.
(2002) ‘The School Classroom as Frontier’, Anthropology & Education Quarterly33(1): 118-130.
87.
Wax, Murray L.
and Ray, Shawn E. (2002) ‘Dilemmas Within the Surgical Intensive Care Unit’, Journal of the American College of Surgeons.
88.
Wax, Murray L.
, Wax, Rosalie. H. and Dumont, Robert V. (1989) Formal Education in an American Indian Community. Prospect Heights, IL: Waveland Press.
89.
Zussman, Robert
(1992) Intensive Care: Medical Ethics and the Medical Profession. Chicago, IL: University of Chicago Press.
