“Whether normal aging is a disease, whether senility in old age is normal, and whether aging per se leads inevitably to death are all questions that persisted long before recent forms of medicocultural negotiation emerged” (Kaufman 25). With the sophistication of biomedical knowledge, a constant shift of ideas and debates continue to surface in our health care system. In Dementia-Near Death and “Life Itself,” Sharon Kaufman discusses the politics behind a “diminishing life,” the “quality of life,” and what comprises a normal decline towards the final moments of life (23). The value of life and the body of the person becomes normalized in our health care system in ways that enable more clinical approaches to control the time of death and to medicalizing aging. Kaufman points out that “life, health, illness categories, and death were objects to be acted on via the instrumentalization techniques that the biological sciences and clinical medicine offered” (24). These biomedical advancements shape our understanding of how a person with dementia and other diseases affecting the brain are bodily represented. The frameworks that are placed around healing, intervening and diagnosing conditions that slowly destroy the brain, continue to convert living bodies into “victims, patients, and research subjects” (Kaufman 25). The medicalized body therefore becomes a product of changing knowledge within our cultural belief system.
What then is considered a normal way to age, or a natural, “good” death? Our western culture is consumed and obsessed with youth, and in denial of aging and death. Even after all the wonderful advances that modern medicine has offered, 100% of people will still die. Science might help delay, post-pone or interrupt the process of dying, but eventually everyone dies. The youth today are infatuated with sex appeal and looking “older,” while the “older” population are trying to emulate the young. After reading through the articles for this week, it seems that when “we” want something from someone, and can use “them” in our society, then we consider them alive and living. However, if they can’t contribute mentally or physically, then we deem them unusable and sometimes even dead. Margaret Lock discuses this issue in her article Living Cadaver and the Calculation of Death. “Because a brain-dead body is entirely dependent upon ventilator support, its very existence is determined by technology…” (Lock 136). While many believe that this person is no longer alive, organs can still be transplanted and the body is therefore treated as if it were going to wake up one day. The body is kept “functioning as close to normal as is possible,” resembling what would be done if they were actually going to survive (Lock 140). This is similar to the way the elderly, the terminally ill and the aging population is viewed in our culture. If a person is unable to give back to the community and powerless, they are viewed to be more of a problem then a productive part of society. If the “essence” is gone, is the person gone? Some cultures believe that the concept of brain death was mainly created to help aid organ transplants, where brain dead bodies are still considered living people and basic “human rights remain attached” (Lock 138). Although different cultures have variations in belief systems around death and dying, in North America a body that is brain dead “is biologically alive in the minds of those who work closely with it, but it is no longer a person” (Lock 150). Again, this goes back to the questions of what constitutes a natural, good death especially if the body is considered not even to be a person anymore.
I believe that we fear death because we are not as familiar with it. Because death is controlled by our medical institutions we fear that we will no longer have control over our own body and mind when death approaches. Hospitals replace the home, physicians replace religious function, private rooms with curtains replace small gatherings of friends and family. Margaret Lock calls this the “new dying,” death occurring not as it will “naturally but delayed, managed, and timed” (Green 47). Death is hidden and put away until the very last moment. We live life in ways to avoid aging, to postpone death, and forget that as we are working so hard planning on how to live, life has already moved forward. Most Americans seem afraid not just of dying, but also of thinking and talking about death. Our culture influences the way we recognize, accept and identify with experiences throughout our lives.
For terminally ill patients a big question arises around supportive care when there is no cure for their disease. In the video below, the lives of 4 terminally ill people are followed throughout their journey of dying. This documentary touches on many aspects concerning what is a “good death,” and attempts to bring the viewer closer to the dying process. Sacred Heart Palliative Care Center is a thirty-nine bed clinic that serves terminally ill patients that are dying. They provides services to the ill that help them deal with the symptoms and suffering that comes with their disease. Palliative medicine approaches each person without having an agenda; listening to individuals and helping them achieve a good death. In the documentary it becomes easier to understand what is important in each of the individuals lives. Sharon Kaufman points out that “staff and family must respond to the life that is being maintained at the threshold of death enacting what they perceive to be the most respectful and lease painful passage to death or the best methods for continued maintenance of life” (Kaufman 40). This is clearly something that Sacred Heart is able to offer, and is seen through the chosen interventions that the staff provides for the patients. I feel that each person has meaning and value until the very last breath they take. With more people living longer, the task of finding high-quality care for the terminally ill, or the aging population who can no longer look after themselves is getting harder. Every life has value, and every person has meaning.
Sacred Heart Palliative Care Center
While the human body ages, changes shape and form, the importance and value of that person does not diminish, but if anything becomes priceless. The photo of the hands below visually represent a life of meaning. This aging body shows the shifts and changes in the skin, and tells a unique story of a women who has lived a meaningful life. Each crease and groove in the fingers give an idea about a life that was fully lived, and one that has left an imprint for others to carry on into the next generation.
Works Cited:
Green, James W. Beyond The Good Death, The Anthropology of Modern Dying. Philadelphia: University of Pennsylvania Press, 2008.
Lock, Margaret. “Living Cadavers and the Calculation of Death.” 2004 Body and Society 10(23): 135-152.
Kaufman, Sharon R, Ann J Russ, and Janet K Shim. “Dementia-Near-Death.” 2006 Body and Society.
Lafforgue, Eric. (Very) old Borana women hands. 2 March 2011 <http://www.flickr.com/photos/tywak/galleries/72157622422969995/>.
Health Awards Category 2 A Good Death You Tube. <http://www.youtube.com/watch?v=vLYMUdiUIrs>.
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