Facing Death

Watching the Frontline documentary Facing Death was very informative for me. It was helpful to see a lot of concepts we have been learning in class live in action; such things like patient-doctor relationships, communication, family involvement in decision making, and autonomy. As I reflected on the topic of technology and caregiving, two questions stood out to me: how far will I go to prolong my life or the life of a loved one? And would I have the courage to let go when the time comes? I have been sitting with these questions and wondering what my family will think of these questions since culturally they will be involved in any health care decision making. In addition to my above lingering thought, I think technology has become the major form of “caregiving” in the biomedical project for two reasons: time and persistence. These two things stood out to me throughout the readings and the media assignment for this week. Chapple (2010) mentioned heroism, and technology as a tool for “buying time” and “rescue, stabilization and speed”. She mentions that there is an ever-present worry that things aren’t going fast enough for both patient and health care providers. Sandelowki (1991) also mentions the element of time and infers that technology facilitates our persistence to fix—in the case of infertility, the technology of IVF could rescue women from the stigma of infertility. Callahan (2009) offers twenty-two carrots that presently entice the use of technology. The four “carrots” that stood out to me in explaining how technology has become the major form of “caregiving” in the biomedical project are: “American love of technology”, “defensive medicine”, “aggressive promotion and marketing of medical technologies to hospitals and physicians”, and “consumer demand and expectation”(Callahan, 2009). Lawler (2004) brings up an important reason of caregiver compensation been better if connected to technology, and also brings up the idea of “freedom from physical limitations” and the desire of curing the disease and prolonging life taking precedence over caregiving. Any possibility of living as long as possible is more enticing even to a society that is aging and living longer than ever.
There are positive impacts of this development, such as: hope for the patients and their families, competition between hospitals to be ahead of the curve (Callahan, 2009), and a kind of division of labor between technology and physician on behalf of the patient. Some negative impacts are: cost, dependency on said technology, and the illusion that there is a possibility that death can be defeated. Callahan (2009) explains that it seems that despite the expense of technology, there is a resistance to spend less. It is seen as a reasonable and necessary cost and therefore worth the price because life is priceless. Lawler (2004) states that “the inability to think clearly about caregiving—and so the inability to provide as well as we could and should for a basic human need—may be a price to be paid for all the undeniable and wonderful technological success that characterizes our time” (Lawler, 2004).
In facing death (Navasky & O’Connor, 2010), one of the physicians mentioned that technology creates an illusion that they have some control over life and death, but it just prolongs the inevitable. Another physician stated that “there is nothing wrong with pushing the envelope”, but when is it time to stop. Technology has brought many amazing opportunities to diagnose and treat diseases that were once untreatable, and we are living longer than ever, but have we inevitably lost a certain lesson in letting go? Has our fears about dying increased even more as a society? When the technology fails us, and we are riddled with disappointed, how can we die gracefully?

References
Callahan, D. (2009). Chapter 2: Taming the beloved beast: Medical technology. Taming the beloved beast: How medical technology costs are destroying our health care system (pp. 37-66). Princeton, NJ: Princeton University Press.


Chapple, H. S. (2010). Rescue, stabilization, and speed. No place for dying: U.S. hospitals and the ideology of rescue(pp. 53-78). Walnut Creek, CA: Left Coast Press.


Lawler, P. A. (2004). Caregiving and the American individual.Retrieved 10/7/05, 2005, from http://www.bioethics.gov/background/lawler_paper.html


Sandelowski, M. (1991). Compelled to try: The never-enough quality of conceptive technology. Medical Anthropology Quarterly, 5(1), 29-47.


Navasky, Miri; O’Connor, Karen. (2010, November 23). Facing Death.Frontline. Retrieved fromhttp://www.pbs.org/wgbh/pages/frontline/facing-death/

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