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- W2478536420 abstract "AbstractPurposeMillions of people die of chronic diseases within inpatient settings annually in the United States, despite patient preferences for dying at home. This medicalization of dying has received social and economic critiques for decades. This chapter offers a further analysis to these critiques by examining the ecological impacts of inpatient end-of-life care on the natural environment and occupational and public health.MethodologyWe compare the ecological health outcomes of medical care in three inpatient units (conventional cancer unit, palliative care ward, and hospice facility) using ethnographic observations, semi-structured interviews, and institutional records on medical supply use, waste generation, and pharmaceutical administration and disposal.FindingsCare provided on all three medical units had significant socioecological impacts. Cumulative impacts were greatest on the conventional unit, followed by palliative care, and lowest on the hospice unit. Variations in impacts mirrored differences in dependence on material interventions, which arose from variations in patient needs, institutional policies, and nursing cultures between the three units.Practical implicationsSocial and economic concerns have been major drivers in reforming end-of-life medical care, and our analysis shows that ecological concerns must also be considered. Transitioning terminal patients to less materially intensive modes of care when appropriate could mitigate ecological health impacts while honoring patient preferences.OriginalityThis chapter describes how the medicalization of dying has converged with institutional policies, practices, and actors to increase the negative consequences of medical care, and recognizes that the far-reaching impacts of clinical decisions make the provision of medical care a socioecological act." @default.
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- W2478536420 date "2013-10-01" @default.
- W2478536420 modified "2023-09-27" @default.
- W2478536420 title "The Ecology of Dying" @default.
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- W2478536420 doi "https://doi.org/10.1108/s1057-6290(2013)0000015013" @default.
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