Something That Cannot Be Put into Words? Intensive Care, Secularity and the Sacred
Issue: Vol 20 No. 2 (2017)
Journal: Implicit Religion
Subject Areas: Religious Studies
DOI: 10.1558/imre.34379
Abstract:
Drawing on ethnographic research conducted in intensive care units in three European countries, the aim of this article is to engage with issues of secularity and the sacred in contemporary biomedicine. Contemporary biomedicine plays well into the narrative of secularization. At the same time, faced with criticism for its one sided and reductionist scientific focus, healthcare has moved in a supposedly more holistic direction, making space for the spiritual needs of patients. I suggest however, that some of the clinical practices that at face value appear to contradict the narrative of secularization, may just as much be interpreted within this framework and not as points of challenge. A second argument concerns the creed of biomedicine itself. Here, I draw on Durkheim’s understanding of religion as a collective, moral project founded in the distinction between the sacred and the profane. These are collectively maintained categories, and the sacred according to Durkheim inspires in us a sense of deep-seated respect. It is socially determined, but its value and truth appear undeniable. Drawing on my own ethnographic experiences of being an observer in intensive care, as well as on social-scientific literature about the moral project of medicine, I suggest that contemporary biomedicine represent not only a disenchantment of human life in line with typical secularization theory. Rather, I suggest, we find in the practices and implicit moral stances of this field, evidence of what our society holds to be sacred.
Author: Gitte H. Koksvik
References :
Alasad, Jafar. 2002. “Managing technology in the intensive care unit: The nurses’ experience.” International Journal of Nursing Studies 39: 407–413. https://doi.org/10.1016/S0020-7489(01)00041-4
Almerud, Sofia, Richard L. Alapack, Bengt Fridlund and Margaretha Ekebergh. 2008. “Beleaguered by technology: Care in technologically intense environments.” Nursing Philosophy 9: 55–61. https://doi.org/10.1111/j.1466-769X.2007.00332.x
Ariès, Philip. 1975. Essais sur la mort en occident, du moyen âge à nos jours. Paris: Editions du Seuil. https://doi.org/10.14375/NP.9782757850060
Bergé, Christine. 2010. “Fluides organiques et pesée de l’âme ou le calcul des humeurs en réanimation.” Dilecta, corps 2010/1(8): 65–72. https://doi.org/10.3917/corp.008.0065
Bergé, C. and Jacqueline Salmon. 2006. La Vie entre Chien et Loup. Paris: Jauze.
Boch, Anne-Laure. 2009. Médecine technique, médecine tragique. Le tragique, sens et destin de la médecine moderne Paris: Editions Seli Arslan.
Cannell, Fenella. 2010. “The anthropology of secularism.” Annual Review of Anthropology 39: 85–100. https://doi.org/10.1146/annurev.anthro.012809.105039
Carkner, Gordon E. 2012. “Charles Taylor and the immanent frame of the secular.” https://ubcgcu.files.wordpress.com/2012/08/taylor-and-immanent-frame.pdf
Cassell, Eric J. 1993. “The sorcerer’s broom: Medicine’s rampant technology.”
The Hastings Center Report 23(6): 32–39. https://doi.org/10.2307/3562922
Collins, Peter. 2013. “Acute ambiguity: Toward a heterotypology of hospital chaplaincy.” In Social Identities between the Sacred and the Secular. Edited by Abby Day, Giselle Vincent and Christopher R. Cotter, 39–61. London: Routledge.
Durkheim, Émile. 1976 [1915]. The Elementary Forms of Religious Life. Introduction by Robert Nisbet. London: George Alien & Unwin.
———. 1995 [1915]. The Elementary Forms of Religious Life. Translation and
introduction by Karen E. Fields. New York: Free Press.
Fassin, Didier. 2011. Humanitarian Reason. A Moral History of the Present. Berkeley: University of California Press. https://doi.org/10.1525/california/9780520271166.001.0001
Foucault, Michel. 1966. La Naissance de la Clinique. Paris: PUF.
Frank, Arthur W. 1995. The Wounded Storyteller. Body, Illness, and Ethics.
Chicago, IL: The University of Chicago Press. https://doi.org/10.7208/chicago/9780226260037.001.0001
Girard, Marc. 1988. “Technical expertise as an ethical form: Towards an ethics of distance.” Journal of medical ethics 14: 25–30. https://doi.org/10.1136/jme.14.1.25
Hadders, Hans. 2007. “Dealing with the dead patient at the intensive care unit.” Mortality 12(3): 207–222. https://doi.org/10.1080/13576270701430726
Halvorsen, Kristin. 2009. “The ethics of bedside priorities in intensive care: Value choices and considerations, a qualitative study.” Unpublished PhD thesis, Faculty of medicine, University of Oslo.
Illich, Ivan. 1976. Medical Nemesis: The Expropriation of Health. New York: Pantheon Books.
Jennett, Bryan. 2002. The Vegetative State: Medical Facts, Ethical and Legal Dilemmas. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511545535
Karsoho, Hadi, Jennifer R. Fishman, David Kenneth Wright and Mary Ellen MacDonald. 2016. “Suffering and medicalization at the end of life: The case of physician assisted dying.” Social science & Medicine. 170: 188–196. https://doi.org/10.1016/j.socscimed.2016.10.010
Knott, Kim. 2013. “The secular sacred: In between or both/and?” In Social Identities between the Sacred and the Secular. Edited by Abby Day, Giselle Vincent and Christopher R. Cotter, 145–161. London: Routledge.
Komesaroff, Paul. 2008. Experiments in Love and Death. Austin: River Grove Books.
Koksvik, Gitte H. 2015. “Dignity in practice: Day-to-day life in intensive care units in Western Europe.” Medical Anthropology 34(6): 517–532. https://doi.org/10.1080/01459740.2015.1037391
Lavi, Shai. 2007. The Modern Art of Dying : A History of Euthanasia in the United States. Princeton, NJ: Princeton University Press.
Le Breton, D. 2011. Anthropologie du corps et modernité. Paris: Quadrige/PUF.
Lock, Margaret. 2002. Twice Dead. Organ Transplants and the Reinvention of Death. Berkeley: University of California Press.
Lock, Margaret and Vinh-Kim Ngyen. 2010. The Social Anthropology of Biomedicine. Oxford: Wiley Blackwell.
Lupton, Deborah. 2012. Medicine as Culture: Illness, Disease and the Body London: SAGE Publications.
Lynch, Gordon. 2012. The Sacred in the Modern World: A Cultural Sociological
Approach. Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199557011.001.0001
Marin, C. 2008. Violences de la maladie, violence de la vie. Paris: Armand Colin.
Mol, Annemarie. 2002. The Body Multiple: Ontology in Medical Practice. Durham, NC: Duke University Press. https://doi.org/10.1215/9780822384151
Pierron, Jean-Philippe. 2010. Vulnérabilité. Pour une philosophie du soin. Paris:
Collection La nature humaine, PUF.
Price, Ann M. 2013. “Caring and technology in an intensive care unit: an ethnographic study.” British Association of Critical Care Nurses 18(6): 278–288. https://doi.org/10.1111/nicc.12032
Redfield, Peter. 2013. Life in Crisis: The Ethical Journey of Doctors without Borders. Berkeley: University of California Press.
Scheper-Hughes, Nancy and Margaret Lock. 1987. “The mindful body:
A prolegomenon to future work in medical anthropology.” Medical
Anthropology Quarterly, New Series 1(1): 6–41. https://doi.org/10.1525/maq.1987.1.1.02a00020
Seymour, J. E. 2001. Critical Moments: Death and Dying in Intensive Care. Facing Death series. Buckingham: Open University Press.
Sharp, Lesley A. 2006. Srange Harvest. Organ Transplants, Denatured Bodies, and the Transformed Self. Berkeley: University of California Press.
Taylor, Charles. 2007. A Secular Age. Cambridge, MA: The Bellknap Press of Harvard University Press.
Weber, Max. 1993 [1922]. The Sociology of Religion. Boston, MA: Beakon Press.
———. 1975 [1918]. “Science as a vocation.” In Essays in Sociology, 129–156 London: Routledge & Kegan Paul.
Wikström, Ann-Charlott, Ann-Christin Cederborg and Marita Johanson. 2007. “The meaning of technology in an intensive care unit—an interview study.” Intensive and Critical Care Nursing 23: 187–195. https://doi.org/10.1016/j.iccn.2007.03.003
Zussman, Robert. 1992. Intensive Care: Medical Ethics and the Medical Profession. Chicago, IL: University of Chicago Press.
Internet resources
World Health Organization. Preamble to the Constitution of the World Health Organization, 1946 http://www.who.int/about/definition/en/print.html