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Over the past thirty years, the way Americans experience death has been dramatically altered. The advent of medical technology capable of sustaining life without restoring health has changed where, when, and how we die. In this revelatory study, medical anthropologist Sharon R. Kaufman examines the powerful center of those changes: the hospital, where most Americans die today. She deftly links the experiences of patients and families, the work of hospital staff, and the ramifications of institutional bureaucracy to show the invisible power of the hospital system in shaping death and our individual experience of it. In doing so, Kaufman also speaks to the ways we understand what it means to be human and to be alive.

“An act of courage and a public service.”—San Francisco Chronicle

“This beautifully synthesized and disquieting account of how hospital patients die melds disciplined description with acute analysis, incorporating the voices of doctors, nurses, social workers, and patients in a provocative analysis of the modern American quest for a ‘good death.’”—Publishers Weekly

“Kaufman exposes the bureaucratic and ethical quandaries that hover over the modern deathbed.”—Psychology Today

“Kaufman’s analysis illuminates the complexity of the care of critically ill and dying patients [and] the ambiguity of slogans such as ‘death with dignity,’ ‘quality of life,’ and ‘stopping life support.’ . . . Thought-provoking reading for everyone contemplating the fate of us all.”—New England Journal of Medicine

A powerful account of the everyday experiences and challenges of nursing in American hospitals

Vividly documenting the real world of the contemporary hospital, its nurses, and their moral and ethical crises, Dan Chambliss offers a sobering revelation of the forces shaping moral decisions in our hospitals.

Based on more than ten years' field research, Beyond Caring is filled with eyewitness accounts and personal stories demonstrating how nurses turn the awesome into the routine. It shows how patients, many weak and helpless, too often become objects of the bureaucratic machinery of the health care system and how ethics decisions, once the dilemmas of troubled individuals, become the setting for political turf battles between occupational interest groups. The result is a compelling combination of realism and a powerful theoretical argument about moral life in large organizations.

Hospital Time is a memoir about friendship, family, and caregiving in the age of AIDS. Amy Hoffman, a writer, lesbian activist, and former editor of Gay Community News, chronicles with fury and unflinching honesty her experience serving as primary caretaker for her friend and colleague, Mike Riegle, who died from AIDS-related complications in 1992. Hoffman neither idealizes nor deifies Riegle, whom she portrays as a brilliant man, devoted prison rights activist, and very difficult friend.
Hoffman became central to Riegle’s caregiving when he asked her to be his health-care proxy, and although she willingly chose to do this, she explores her conflicting feelings about herself in this role and about her involvement with Riegle and his grueling struggle with hospitalization, illness, and, finally, death. She tells of the waves of grief that echoed throughout her life, awakening memories of other losses, entering her dreams and fantasies, and altering her relationships with friends, family, and even total strangers.
Hoffman’s memoir gives voice to the psychological and emotional havoc AIDS creates for those in the difficult role of caring for the terminally ill and it gives recognition to the role that lesbians continue to play in the AIDS emergency. A foreword by Urvashi Vaid, former executive director of the National Gay and Lesbian Task Force, offers a meditation on the politics of AIDS and the role of family in the lives of lesbians and gay men.

Emphasizing the importance of the psychosocial and cultural background of the individual patient, the final study suggests methods of acquiring this information and the ways in which the staff can then utilize these findings to best advantage both in initial contact and in planning comprehensive patient care.