Social Death as Self-Fulfilling Prophecy: David Sudnow's Passing On Revisited

It is demonstrated that the recent changes in the health care system did not weaken but instead fostered social inequality in death and dying.

Abstract

In his classic Passing On, David Sudnow described how the presumed social value of patients affects whether the staff will attempt to revive them. Since this study was published, the health care field has undergone dramatic changes and commentators have questioned whether the social rationing described by Sudnow is still relevant. Specifically, critics point to the increased rationalization of medical practice via protocols, a widely accepted resuscitation theory, and legal initiatives to promote resuscitative efforts and protect patient autonomy. Based on observations of 112 resuscitative efforts and interviews with forty-two health care workers, I demonstrate that the recent changes in the health care system did not weaken but instead fostered social inequality in death and dying.