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Biomedical subjects

M Holstein

Publications and source records attributed to M Holstein.

9 recordsLinked to original sources
PubMed1997

Reflections on death and dying.

Americans simultaneously worry about dying and about being tethered to machines that keep them alive beyond a point when life has any meaning. People living with terminal illness often feel isolated from life around them and a burden on those they love; they feel uncertain that their deaths will be relatively free of pain and suffering and that their dignity will be compromised as little as possible. These failings can be remedied. Traditional hospice care and integrating palliative care into the general medical setting are important, but they cannot alone occasion a better dying. The medical community must re-imagine dying and reflect about ways to transform image into reality in practice and in training colleagues and successors. Physicians and others know how to provide care and even improve living when cure is unlikely; the harder task is to respect such care as profoundly as curing. The exigencies of modern medicine, where time is a budgetable commodity, makes caring well for dying patients difficult. Medicine cannot have hegemony over dying and cannot singularly offer people a better death, but it cannot absent itself either. The almost single-minded focus on decision making that has infused conversations about dying and death may divert attention from the attentiveness and loving relationships that are as vital as life's end as at its beginning. Medicine has "colonized" death: It has transformed it into a place where progress in staving it off may appear to be unlimited, and thus it encourages forgetting that death is part of the human condition. The task before medicine, and academic medicine in particular, is to transform death back into a human scale. With all that is available to delay death--but not to make it optional--the most important task is to recover humbleness before an awesome moment and be with the patient, one human being to another, knowing that dying is not always open to solutions.

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PubMed1994

Taking next steps: gerontological education, research, and the literary imagination.

This article interprets two literary works--both about old women who have suffered strokes and are near death--and argues that literature can make essential contributions to gerontological research and education by developing sensitivity to theory, empathic understanding, and self-awareness. This article examines these fictional accounts against two theoretical perspectives--the political economy of aging and theories of personal meaning--and encourages epistemological experimentation.

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PubMed1992

Productive aging: a feminist critique.

This essay offers a feminist perspective on the call for a "productive aging" society, and says that the movement provides an answer before we have systematically asked questions about the meaning of old age. An emphasis on productivity, among other things, can devalue relational activities, often inherent in women's roles, and certain older people-older women in particular. The author proposes a number of measures for the short term, so that society can be responsible to older women who need and want jobs, as well as ideas for more far-reaching change.

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PubMed1991

The short life and painful death of the Medicare Catastrophic Coverage Act.

This article draws upon a combined political and moral economy theoretical framework to explicate the rise and fall of the Medicare Catastrophic Coverage Act (CHI). Underlying factors, including the legacy of Medicare, the politics of austerity, and the declining political legitimacy of the aged in the 1970s and 1980s, are seen to have heavily shaped the unique characteristics of the legislation, such as its unpopular self-financing mechanism. Moral economy concerns with reciprocity, fairness, and just taxation are used to help explain the intensity of the "senior revolt" against CHI, which ultimately led to the legislation's repeal. The "Catastrophic catastrophe" is seen as having further eroded the political legitimacy of the old, while at the same time demonstrating the raw political muscle of this population group. Implications of the repeal of CHI for future health coverage legislation, and the impact of repeal on the states and other stakeholders, also are discussed.

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