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Ethical controversies in end of life
Ethical case study for end of life care
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The Medicalization Of Death Critical evaluation of: whether medical explanations predominate and how individuals negotiate and resist the medical model. In order to illustrate the predominance of medical explanations, a definition of the medicalisation thesis will be given and illustrated by the case of the treatment of terminally ill patients. The medicalisation of death and dying will be highlighted by a review of sociological literature from both feminist and non-feminist perspectives. The limits of medicalisation will be provided as a rationale for the resistance of the medifcal model. Finally, the ways in which individuals negotiate and resist the medicalisation of death will be discussed including the rise of pro-euthanasia groups, increasing use of complementary medicine, and the popularity of the hospice movement. The main elements of the medical model of health are the search for objective, discernable signs of disease, its diagnosis and treatment (Biswas, 1993). Therefore, by adhering to this reductionist view, the human body is seen as a biochemical machine (Turner, 1995) and health merely as an absence of disease, a commodity to be bought and sold. The rise of hospitals with their goal of curing and controlling disease has led to the marginalisation of lay medicine, and a focus upon the individual rather than society as a cause of ill health. Health education and promotion with their focus upon 'victim blaming' and individualism have extended the remit of the medical profession from the hospital into the community. With medical imperialism the power of medicina has grown and medicine has all but replaced religion as an institution of social control. Illich (1976, p53) describes medicine as a: 'moral enterprise.....[which] gives content to good and evil..... like law and religion [it] defines what is normal, proper or desirable'. Medicalisation is defined as:'a process of increased medical intervention into areas that hitherto would be outside he medical domain' (Bilton et al, 1996 p422). Areas of life which could be considered 'natural' such as pregnancy, childbirth, unhappiness, ageing and death have been brought within the medical remit (Taylor & Field, 1997) and therefore are increasingly viewed under the principles of the medical model. Indeed many of these 'ailments' cannot be cured by medical intervention but are still subjec... ... middle of paper ... ...don. Taylor, S. & Field, D. (1997) Sociology of Health & Health Care. Blackwell Science: Oxford. Thompson, D. F. (1993) Professionalism & Paternalism IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London. Turner, B.S. (1995) Medical Power & Social Knowledge (2nd ed). Sage: London. Victor, C.V. (1993) Health Services & Policy for Dying People & their Carers IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London. Voluntary Euthanasia Society (1999) The Case for Voluntary Euthanasia AT http://www.ves.org.uk/factsheets/for.htm Walter, T. (1993) Sociologists Never Die: British Sociology & Death IN Clark, D. (Ed) (1993) The Sociology of Death. Blackwell: Oxford. Walter, T. (1999) On Bereavement: The Culture of Grief. Open University Press: Buckingham. World Health Organisation (1990) cited in Dunlop, R.J. & Hockley, J.M. (1998) Hospice-based Palliative Care Teams: The Hospital-Hospice Interface (2nd ed). Oxford University Press: Oxford. Zola (1972) cited in Armstrong, D. (1989) An Outline of Sociology as Applied to Medicine (3rd ed). Wright: London.
The Dying of the Light is an article by Dr. Craig Bowron that captures the controversy surrounding the role of medication in prolonging life. The author describes that many medical advancements have become a burden to particularly elderly patients who in most instances are ready to embrace the reality of death. Dr. Bowron believes that dying in these modern times has become a tiring and unnatural process. “Everyone wants to grow old and die in his or her sleep, but the truth is most of us will die in pieces,” Bowron notes (Bowron). The article does not advocate for euthanasia or the management of health care costs due to terminal or chronic illness. Bowron faults humanity for not embracing life and death with dignity as it was in the past. He blames the emergence of modern medical advances and democracy as the sole reason why everyone is pursuing immortality or prolonging of life rather than embracing the natural course of things. The article is very articulate and comes out rather persuasive to its target audience that happens to be health-conscious. Craig Bowron uses effective rhetorical strategies such as logos, ethos, and pathos to pass on his message. The article’s credibility is impeccable due to the author’s authority in health matters as he is a hospital-based internist. A better placed individual to dissect this issue by analyzing his experiences in the healthcare profession. The article incorporates a passionate delivery that appeals to the readers’ hopes, opinions, and imagination.
The flow and organization of the topics are structured chronologically and easy for readers to have a clear depiction of the progression of the book. He explains and elaborates his ideas and assumptions on struggles with morality, through real voices of patients and his own personal encounter. The first few topics were lighthearted, more on procedural terms such as the demographics of care in the United States and India and the evolution of care. This heightens to themes that are close to one’s heart as he uncovers the relationship amongst medicine, patient, and the family. It also deliberates on the concerns after medicine becomes impotent and society is ill-equipped for the aging population, which highlight the decisions and conversations one should or might have pertaining to death. He makes
Scott, J., & Marshall, G. (2009). A dictionary of sociology (3 ed.). Oxford: Oxford University
...an, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: coming
The ethical debate regarding euthanasia dates back to ancient Greece and Rome. It was the Hippocratic School (c. 400B.C.) that eliminated the practice of euthanasia and assisted suicide from medical practice. Euthanasia in itself raises many ethical dilemmas – such as, is it ethical for a doctor to assist a terminally ill patient in ending his life? Under what circumstances, if any, is euthanasia considered ethically appropriate for a doctor? More so, euthanasia raises the argument of the different ideas that people have about the value of the human experience.
Medicine as a Form of Social Control This critique will examine the view that medicine is a form of social control. There are many theorists that have different opinions on this view. This critique will discuss each one and their different views. We live in a society where there is a complex division of labour and where enormous varieties of specialist healing roles are recognised.
There are two methods of carrying out euthanasia, the first one is active and the second one is passive. Active euthanasia means the physicians deliberately take actions which cause the death of the patients, for example, the injection of sedatives in excess amount. Passive euthanasia is that the doctors do not take any further therapies to keep the ill patients alive such as switching off the life supporting machines [1]. This essay argues that the legalization of the euthanasia should not be proposed nowadays. It begins by analyzing the problem that may cause in relation to the following aspects: ‘slippery slope’ argument, religious view, vulnerable people and a rebuttal against the fair distribution of medical resources. This essay concludes that the legalization of the voluntary euthanasia brings more harm than good.
Kevin White pp: 5-8k introduction to sociology of health and illness second edition books.goole.co.uk accessed 11-04-2014
middle of paper ... ... http://www.statistics.gov.uk/hub/release-calendar/index.html?newquery=*&uday=0&umonth=0&uyear=0&title=Social+Trends&paget Gerhardt, E. (1987) Ideas about Illness: An Intellectual and Political History of Medical Sociology.
Depending on the social contexts, there are some illnesses without diseases or the meaning of illnesses is independent from the biomedical entity. Illness is socially and culturally constructed and can reflect cultural biases or set limitations on particular groups. Historically, cultural assumptions of women’s nature have limited women’s ability to access resources and participate in the public sphere. Physicians have acted as agents of social control through defining women’s natural ability as secondary to men, and medicalizing of women’s problems, such as childbirth, menopause and premenstrual syndrome. These biased assumptions have become more complex and less visible, however they continue to limit and control women’s agency in society. Feminists have accused the medicalization of menopause as devaluing women, despite that fact that aging is a natural process. However, different cultures construct different understandings, definitions, experiences and medical practices of illness. Illness, such as anorexia can reflect the changing social expectations and roles of women in different cultures. The creation and treatment of illnesses are unequal. “Stigmatized illness”, including AIDS and epilepsy can create moral meanings that cause the perception of illness and individuals with illness stigmatized. Furthermore, factors such as whom and how many are affected
Purdy, M and Banks, D (2001) The sociology and politics of health: A Reader, Routledge Press
Medicalization is when human conditions that were not previously known as illnesses are defined and treated as a medical problem. These problems are new and call for treatment by a medical doctor or another form of medical involvement such as therapy, medication, or surgery. Peter Conrad l writes a summary of his ideas on the topic and a wide exploration of current trends and developments is society.
Many individuals are in denial about their health as a result they do not take responsibility for their health. These individuals rather have a doctor tell them that their condition is hereditary opposed to blatantly honest responses such as “Stop smoking.” or “Change your eating habits.” which imply that the individual is at fault. An article on the blog ‘Medical Malprocess’, outlines the responsibility of doctor and patient by stating that: “The providers should be held responsible for their advice and actions only. We patients should be responsible for the consequences of our decisions and actions.” This shows that while doctors may be responsible in a patient’s health that patient is also considered responsible for their actions or decisions that may have caused or worsened their condition. The blog farthest outlines and illustrates these responsibilities by giving examples such as; a regularly smoker should be responsible for getting lung cancer as this increasing their chances. However a non-smoker’s actions should not be accused if they got lung cancer.
Unorthodox systems of medicine were first developed in Europe and the United states in the late 1700s but were not completely adopted by doctors until the 1800s. Traditional, or orthodox medicine was established in the West through a process of “regulation, association, institution building and systematized medical education” (Coulter & Willis 2004) and any form of deviance threatened that. During the Revolutionary ...
To sum up, the book reminds us of the complexity and paradox of the medical profession: the limits of a medical culture that is excessively focused on curing disease and has lost sight of its equally important role in helping patients confronting death with dignity. What physicians can really do beyond cure is to open up and confront their own fears and doubts, and willing to prepare their patients for the "final exam" (Chen, 2007). Those with a career of caring for the ill have to continually confront their own human limitations if they are ever to become the type of doctors people value.