BioethicsWalk addresses
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Summer Reading
Sociologist Raymond de Vries taught me that the sociologist’s goal is to observe a culture, then describe it so clearly that a member of that culture can say, yes, I recognize my life. Sharon R. Kaufman, a medical anthropologist, has done just this for anyone who counts themselves as a member of the culture called “end of life care.” Her book, . . . And a Time to Die: How American Hospitals Shape the End of Life (University of Chicago, 2005) is a must-read for chaplains. Kaufman spent several years minutely observing the ICU, the ethics committee, and long-term care. Nothing escaped her notice, including the presence of chaplains, their role in the care of dying patients and their families, and their struggles with how end of life decisions may be framed or carried out under the cultural and economic pressure to make individual cases conform to established story lines: the “heroic” pathway of technology; the “revolving door” pathway of the chronically ill. She also describes two states – “waiting” for death, and “life with no end,” when technology is life-saving but not life-restoring – that exist in tension with the drive to “move things along” toward resolution and reimbursement. Go find this book. It may not suggest itself as ideal vacation reading, but it is a page-turner.
More on sociologists and reading: I’ve just finished co-editing a set of six essays collected under the title, “Chaplains in health care: What is their role in improving quality?” This essay set is the final product of The Hastings Center’s research collaboration with The HealthCare Chaplaincy, made possible by the Arthur Vining Davis Foundations, in which we explored the relationship between the “professionalizing” profession of chaplaincy and the quality improvement movement in health care. Authors include Ray de Vries and fellow sociologist Wendy Cadge, on what is gained – and lost – when an occupation decides to become a profession; medical educator and religious studies scholar Margaret E. Mohrmann, on the challenge of “ethical grounding” for a health care profession that is also a ministry; and clinical ethicist Martin L. Smith, on the parallels between chaplaincy and clinical ethics as professionalizing professions whose members may benefit from more frequent and conscious collaboration. Chaplains Martha R. Jacobs and George Fitchett, and other scholars who study chaplaincy, also contributed to this essay set. It will be published in the November-December issue of the Hastings Center Report and will be available online; watch this space for details.
Nancy Berlinger is Deputy Director and Research Associate at The Hastings Center. Her research interests focus on clinical ethics and include end of life care; ethics in health care chaplaincy; conscientious objection and moral distress in health care; and patient safety and the resolution of medical harm. Her broader interests include bioethics issues in cancer care, narrative ethics, and medical humanities.
As Deputy Director, she manages the Center’s organizational capacity-building initiative, Bioethics and the Public Interest, which has received major support from the Ford Foundation.
Berlinger is the author of After Harm: Medical Error and the Ethics of Forgiveness
(Johns Hopkins, 2005), which will be released in paperback in fall 2007. She serves on the ethics research group of the Joint Commission, the ethics faculty of the American Society of Healthcare Risk Managers (ASHRM), the bioethics committees at Montefiore Medical Center, Bronx, New York and at Richmond of New York, and the editorial board of Medical Ethics Advisor
. She is a frequent presenter at grand rounds and other ethics education programs for health care professionals. She volunteers on the Chaplaincy Service at Memorial Sloan-Kettering Cancer Center in New York City.
She is a graduate of Smith College and holds the Ph.D. in English Literature from the University of Glasgow and the M.Div. in Christian Ethics from Union Theological Seminary.
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