“Is There Life on Dialysis?”: Time and Aging in a Clinically Sustained Existence

Abstract

ABSTRACT Increasingly, in the United States, lives are being extended at ever-older ages through the implementation of routine medical procedures such as renal dialysis. This paper discusses the lives and experiences of a number of individuals 70 years of age and older at two dialysis units in California. It considers what kind of life it is that is being sustained and prolonged in these units, the meanings of the time gained through (and lost to) dialysis for older people, and the relationship of “normal” life outside the units to an exceptional state on the inside that some patients see as not-quite-life. Highlighting the unique dimensions of gerontological time on chronic life support, the article offers a phenomenology of the end of life as that end is drawn out, deferred by technological means, and effaced by the ethos and experiential course of dialysis treatment. ANN JULIENNE RUSS is a medical anthropologist and member of the research faculty at the University of California, San Francisco. Her research has focused on end-of-life care and communication among clinicians, patients, and their families in hospice and high-tech medical environments. Her publications have appeared in Cultural Anthropology and Culture, Medicine and Psychiatry. JANET K. SHIM is assistant adjunct professor at the University of California, San Francisco. Her research in medical sociology has focused on issues at the intersections of health inequalities, biomedical science and technologies, and race, gender, and aging. Her publications have appeared in Sociology of Health and Illness, American Sociological Review, and Social Studies of Science. SHARON R. KAUFMAN is professor of medical anthropology at the University of California, San Francisco. Her recent research explores life extension, technologies of dying, and subjectification in an aging society. She is the author, most recently, of … And a Time to Die: How American Hospitals Shape the End of Life (Scribner, 2005).