| abstract | Death in America has evolved from a communal family setting, in which the dying individual and family members had control over the
process of dying, into a completely different way of dealing with death. Twenty-first century death now takes place in a private, hospital/institutional environment,
in which doctors and other medical professionals dictate, while the patient and family members have little or no control. The focus has shifted from the dying person's
concerns and comfort to those of the standardized medical procedures in which the doctors, nurses, medical and administrative staff rule.
This dissertation begins with a discussion of the cultural, social, and emotional implications of a natural death through a sixty-eight year period in American history.
This work analyzes and evaluates death's unfortunate antagonistic relationship with conventional medical treatment. The emphasis is on death choices made by terminally
ill patients and families and the healthcare professional's disregard for those choices. The methodology of activity surrounding the cultural, social, and emotional
preparation for the patient is explored along with the activity related to the patient's last days among the living and the effect it has on those who remain.
The research suggests the there is a time to accept the inevitability of death and a right time for healthcare professionals to stop the dramatic rescue-treatment-cure
strategy, comfort the patient and refer the patient to palliative care, alternative care or a hospice or home care.
This work encourages the creation and development of a new branch of American medicine called "End of Life Care", specialization focused on the dying patient and
family. Research highlights similar characteristics of a branch of the UK national healthcare system which has shown to be extremely successful in this aspect of medical
support and patient centered care for the dying.
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