Routledge No Place For Dying: Hospitals and the Ideology of Rescue

The U.S. hospital embodies society’s hope for itself―a technological bastion standing between us and death. What does the gold standard of rescue, as ideology and industry, mean for the dying patient in the hospital and for the status of dying in American culture? This book shows how dying is a management problem for hospitals, occupying space but few billable encounters and of little interest to medical practice or quality control. An anthropologist and bioethicist with two decades of professional nursing experience, Helen Chapple goes beyond current work on hospital care to present fine-grained accounts of the clinicians, patients, and families who navigate this uncharted, untidy, and unpredictable territory between the highly choreographed project of rescue and the clinical culmination of death. This book and its important social and policy implications make key contributions to the social science of medicine, nursing, hospital administration, and health care delivery fields. Review "[S]he combined her study results with extensive supporting material from relevant research to present a convincing case for her conclusions. This is an aspect of the book that I particularly enjoyed--Chapple thoroughly reviews the literature (references run to 20Þ pages), provides a theoretical view and makes it ''real'' with case studies. She achieves a good mix of presenting hospital procedures with the human results of those procedures. I highly recommend it and hope it reaches a wide audience." -Jeanne Boland, Death Studies"Helen Stanton Chapple does a masterful job of portraying the ways that rescue minimizes death and contributes to death denial in our culture. In hospitals where almost every aspect of care has a code or label, dying patients are uncategorized. Moreover, dying does not have an International Classification of Diseases Clinical Modification, Ninth Revision (ICD-9-CM) code. Clinicians in the acute care setting often feel helpless when a person is dying and see themselves as being held hostage to the dying instead of feeling a sense of honor. Acute and high tech care can support vital signs and delay death, but it also promotes the illusion that death can be infinitely postponed. Chapple argues that society's complacent confidence in its agents' ability to perform life-saving miracles distracts us from death's inevitability. When hospitalized dying patients are minimized, each member of society is shortchanged." -Gerontologist "While rooted in an ethnographic study of staff in two quite different hospitals, her analysis embraces insights into the roles of economics, bioethics, the hospice and palliative care movement, and iconic American cultural beliefs. This volume would be rewarding reading for any student of American health care, including hospital administrators and board members as well as clinicians and change agents frustrated by the epidemic of over-treatment of hospitalized patients at the end of life. This volume would be rewarding reading for any student of American health care, including hospital administrators and board members as well as clinicians and change agents frustrated by the epidemic of over-treatment of hospitalized patients at the end of life. Th[e] book is loaded with serious, intellectually strenuous material, making some popular books on dying in America seem downright breezy by contrast. Because Dr. Chapple is a good writer and her volume is well organized, the book is dense only in the best sense. Most importantly, clearly told patients' stories and direct quotations from interviews with those who cared for them keeps the analysis grounded in hospital realities." -Patricia A. Murphy and David M. Price, Journal of Palliative Medicine "Readers familiar with the inner workings of hospital care will instantly empathise with the 'ritual' described in all its guises in the text. Chapple's skill is in deploying such a description that raises awareness of the tacit cultural a