Public lecture Sharon Kaufman
On October 19 2010 the Leyden Academy on Vitality and Ageing organised a public lecture by the well known American anthropologist Sharon Kaufman. The lecture was entitled "Making longevity: technology, policy and ethics in US health care".
During this lecture Sharon Kaufman, PhD, professor at the University of California, Institute for Health and Aging, presented her views on how technologies, clinical evidence and medical procedures influence and shape expectations, practices and knowledge of people in late life.
Below an impression of the lecture:
Let's imagine an older man, who has experienced cardiac rest. He has a do-not-resuscitate wish that is documented in a piece of paper that he carries around. But when he experiences his cardiac rest there is no time to waste looking for such a paper. Thus the man is rushed to the hospital, put on a respiratory machine and then his family members are called. The relatives rush into hospital, worried and watch their beloved one. The physicians tell them what has happened in medical terms and explain that he is now on a machine to breath. The family members are thrown in limbo. Immediate questions such as how will he be if he wakes up? What if he doesn't wake up? What about his do-not-resuscitate wish? are lingering in their minds. Two weeks later their beloved one does not show any change in status and the physicians pose the family for a dilemma, should we stop the machine? The family members are confronted with even more confusing questions if I stop the machine, will I kill him? Can he actually still be considered alive?
This and other stories were the ones that Prof. Sharon Kaufman related to us during her lecture in the late afternoon of the 19th of October. She let us ponder about some of the issues that older people and their relatives worldwide are faced with today as a result of technological advances.
She compellingly described how it is not simply healthcare technology that is being influenced by these developments, but also the effects it has on definitions of life and death. Boundaries between when someone can be considered alive blur and people's understanding becomes equally confused. Also people are posed with very different choices than in the past. Newer technologies and continuously new clinical trials give (renewed) hope upon life extension. In some sense it is now up to a patient when to say that life has been enough, when to choose death instead of a try for another clinical trail or a new technology. Paradoxically, death is less and less part of life and seems less discussed by physicians, patients and relatives alike. Prof. Sharon Kaufman even observed that often enough the word death was avoided in conversation between relatives and doctors.
These issues became strikingly clear when she gave us a glimp in to the future with a replacement heart (LVAD). An artificial heart that can be implanted, carried around on a batter pack that can be recharged and replaces the patient's real heart. The ethical issues and questions that are thrown up by this can be remarked by everyone. The debate how longevity shapes technology was well-addressed by Prof. Sharon Kaufman and is one that will occupy us for the coming decades.