The development of the intensive care unit stands as an expression of a post war medical revolution in which the means have become available to deflect and defer death almost indefinitely. Here, cultural expectations of medical heroism are conjoined with images of the most exacting and precise application of medical science. However, the use of an arsenal of scientific and technological advances to try and pull dying people back from the very brink of death has, it might be argued, leapt ahead of our ability to deal with the professional, social, ethical and financial consequences thrown up by its use. This book explores how the withdrawal of active medical treatment is managed in intensive care units, placing this in the context of detailed patient case studies. It examines, in particular, the notion of 'natural death' in this highly technological health care setting, and explores how doctors and nurses strive to achieve this for dying people and their families. It draws extensively on the experiences of patients' families, doctors and nurses, using interview and observational data. It is a timely account of the practical, ethical and emotional difficulties of end of life care in this complex setting.The book will be of interest to nurses working with dying people in acute hospital environments, to those engaged in the sociology of death and dying, and in the conduct of ethnographic research in this field.
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