In the shadow of "death with dignity": medicine and cultural quandaries of the vegetative state

Am Anthropol. 2000 Mar;102(1):69-83. doi: 10.1525/aa.2000.102.1.69.

Abstract

In this paper I address one site of technological development and cultural production, the permanent or persistent comatose condition and the institutions and practices that enable this life form to exist. As with other medical sites of ambiguity and change under recent scrutiny by anthropologists, the locations in which comatose bodies thrive are those in which the routinization of technology use in the clinic and a legitimating social and economic context come together to permit and create a further remapping of the notions of "life" and "person." I explore the new forms of knowledge, practice, and the body that are created at this site and how they are negotiated, and I discuss how the shifting understanding of "culture" and "nature" both have an impact on and are informed by American quandaries about approaching death. I argue that beings who are neither fully alive, biologically dead, nor "naturally" self-regulating, yet who are sustained by modern medical practice, destabilize the existing social order in ways that are different from other hybrid forms.

MeSH terms

  • Attitude of Health Personnel
  • Attitude to Death
  • Culture*
  • Decision Making
  • Family
  • Humans
  • Life Support Care* / ethics
  • Life Support Care* / psychology*
  • Medical Futility
  • Persistent Vegetative State* / diagnosis
  • Persistent Vegetative State* / therapy
  • Personhood*
  • Quality of Life
  • Sociology, Medical
  • Ventilators, Mechanical
  • Withholding Treatment / ethics