Publications by authors named "Sharon R Kaufman"

What can we learn about the experience of dementia and about ways of being human when a poet describes her forgetting? My mother, the poet Shirley Kaufman, died in 2016 at the age of 93. She had dementia for many years. By her mid-80s, many of her poems probed the experience of forgetting, including questions about the nature of self, memory, and thought, and the location of the past and the future.

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The clinical activities that constitute longevity making in the United States are perhaps the quintessential example of a dynamic modern temporality, characterized by the quest for risk reduction, the powerful progress narratives of science and medicine, and the personal responsibility of calculating the worth of more time in relation to medical options and age. This article explores how medicine materializes and problematizes time through a discussion of ethicality-in this case, the form of governance in which scientific evidence, Medicare policy and clinical knowledge and practice organize first, what becomes "thinkable" as the best medicine, and second, how that kind of understanding shapes a telos of living. Using liver disease and liver transplantation in the United States as my example, I explore the influence of Medicare coverage decisions on treatments, clinical standards, and ethical necessity.

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Purpose: This study aims to identify nurses' concerns about the clinical, ethical, and legal aspects of deactivating cardiovascular implantable electronic devices (CIEDs).

Methods: We used focus groups to discuss decision making in CIED management.

Results: Fourteen nurses described the informed consent process as overly focused on procedures, with inadequate coverage of living with a device (e.

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Data from this multiyear qualitative study of the effects of Hurricane Katrina and flooding in New Orleans suggest differences in how the elderly cope with disaster. At the time of the disaster, the elderly of New Orleans were at greater risk than other groups, and more elderly died than any other group during the storm and in the first year after. Those who did survive beyond the first year report coping with the long-term disaster aftermath better than the generation below them, experiencing heightened stresses, and feeling as if they are "aging" faster than they should.

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In this article I explore the ambiguous nature of the boundaries of authority and responsibility in medicine by discussing two dimensions of patients' response to long-term ramifications of stroke. A phenomenological examination of the chronic illness experience is employed to identify how and the extent to which medicine's power both responds to and affects the individual sufferer. Rather than interpret the illness process as a dichotomy between medical control and patient autonomy, this article presents some assumptions about the boundaries of medical authority that are held by patients and practitioners alike.

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We take the example of cardiac devices, specifically the implantable cardioverter defibrillator, or ICD, to explore the complex cultural role of technology in medicine today. We focus on persons age 80 and above, for whom ICD use is growing in the U.S.

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Life-extending interventions for older persons are changing medical knowledge and societal expectations about longevity. Today's consciousness about growing older is partly shaped by a new form of ethics, constituted by and enabled through the routines and institutions that comprise ordinary clinical care. Unlike bioethics, whose emphasis is on clinical decision-making in individual situations, this new form of ethics is exceptionally diffuse and can be characterized as an ethical field.

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Developments in clinical intervention are having a profound impact on health and health behaviors in late life and on ideas about longevity and the appropriate time for death. The fact that the timing of death is even considered to be a controllable event is a relatively new cultural phenomenon. The activities that make up life extension, like other medical practices scrutinized by social scientists, constitute a site for the emergence of new forms of subjectivity.

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Developments in clinical intervention are having a profound impact on health and health behaviours in late life and on ideas about longevity and the appropriate time for death. The fact that the timing of death is even considered to be a controllable event is a relatively new cultural phenomenon. The activities that make up life extension, like other medical practices scrutinised by social scientists, constitute a site for the emergence of new forms of subjectivity.

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An aging society, a growing array of life-extending medical interventions, Medicare policy, and an ethic of individual decision making together contribute to the deepening societal tension in the United States between controlling health care costs and enabling health consumer use of life-sustaining technologies. The activities that constitute longevity making, like so many other sociomedical practices, comprise a site for the governing of life and the emergence of new forms of ethical comportment and social participation. Those activities--including the necessity of treating risk, the difficulty of saying "no" to evidence-based interventions, and the responsibility of choosing among clinical options--also lie at the heart of debates about health care rationing and reform.

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The number of kidneys transplanted to people over age 70, both from living and cadaver donors, has increased steadily in the past two decades in the United States. Live kidney donation, on the rise for all age groups, opens up new dimensions of intergenerational relationship and medical responsibility when the transfer of organs is from younger to older people. There is little public knowledge or discussion of this phenomenon, in which the site of ethical judgment and activism about longevity and mortality is one's regard for the body of another and the substance of the body itself is ground for moral consideration about how kinship is "done.

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The treatment imperative, say the authors, refers to the almost inexorable momentum towards intervention that is experienced by physicians, patients, and family members alike.

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With the trend toward an older, sicker dialysis population in the USA, discussions of ethical issues surrounding dialysis have shifted from concerns about access to and availability of the therapy, to growing unease about non-initiation and treatment discontinuation. Recent studies report treatment withdrawal as the leading cause of death among elderly dialysis patients. Yet, the actual activities that move patients toward stopping treatment often remain obscure, even to clinicians and patients themselves.

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This article introduces the concept of clinical life to capture a form of life produced in the pursuit and wake of medically achieved longevity. Relying on the retrospective accounts of 28 individuals over age 70 who have undergone cardiac bypass surgery, angioplasty or a stent procedure, as well as interviews with their families and with clinicians, we examine three features of clinical life. First, patients do not distinguish between clinical possibility and clinical promise, and thus assume that life can and will be improved by medical intervention in late life.

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Objectives: This qualitative, ethnographic study explores the character and extent of medical choice for life-extending procedures on older adults. It examines the sociomedical features of treatment that shape health care provider understandings of the nature of choice, and it illustrates the effects of treatment patterns on patients' perspectives of their options for life extension.

Methods: By using participant observation in outpatient clinics and face-to-face interviews, we spoke with a convenience sample of 38 health professionals and 132 patients aged 70 or older who had undergone life-extending medical procedures.

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With increasing frequency, the oldest members of US society are undergoing medical interventions aimed at prolonging life. Using cardiac care as a case study, this paper explores how a discourse of risk infuses and legitimates high-tech clinical treatments in late life. In particular, we examine how the diminishing risks associated with biomedical procedures produce a sense of medical possibility regarding life extension, and push the definition of "old age" into a receding future.

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Increasingly, in the United States, lives are being extended at ever-older ages through the implementation of routine medical procedures such as renal dialysis. This paper discusses the lives and experiences of a number of individuals 70 years of age and older at two dialysis units in California. It considers what kind of life it is that is being sustained and prolonged in these units, the meanings of the time gained through (and lost to) dialysis for older people, and the relationship of "normal" life outside the units to an exceptional state on the inside that some patients see as not-quite-life.

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Studies of end-of-life communication and care have emphasized physician-patient conversations, often to the exclusion of family members' discussions and interactions with providers, or with patients themselves. Relatively little is known therefore about families' experiences of end-of-life care in the hospital, or the concrete meanings and practices through which families conceive and define communication. Yet increasingly, family members are asked to serve as surrogates and thereby to participate in the facilitation of decisions for medical procedures and the withdrawal of treatments.

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