nature of goods dealt in splah
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In many ways Sherwin Nuland is at the opposite end of the spectrum from Kubler-Ross, who is often accused of being a nineteenth-century romantic. She seems to suggest that if people have enough time and are helped by a sensitive counselor they will (and should) peacefully accept their dying. What I find surprising and intriguing is that a common theme is found in On Death and Dying and How We Die, namely, that death is "natural." Neither author tries to prove the point; the naturalness is a given.
It should be noted that what seems so obvious now was not the case before the l960s. Physicians were trained to fight against death as an enemy that stalks human beings. Despite always eventually losing, physicians were never to surrender to the enemy. Many physicians today are understandably confused by a quick shift in the public attitude toward death. The new stance is represented in a line that Nuland regularly repeats: "Death is not the enemy, disease is." Were physicians wrong in always refusing to give up the battle with death? I think the answer is yes. But the alternative to fighting death as an external enemy may be more complex than saying "death is natural."
Medical science until very recently was the most dramatic expression of the enlightenment philosophy that pitted "man" against "nature." Death may belong to nature but it is outside "man." The death of the human individual comes from the outside, an invader from the real enemy (nature) that still waits to be conquered. Sigmund Freud was a product of this enlightenment mentality, even if in other ways he was bringing the era to a close. In The Future of an Illusion, Freud writes: "The principal task of civilization, its actual raison d'etre, is to defend us against nature....No one is under the illusion that nature has already been vanquished." Freud was at that moment introducing a "death instinct" into his anthropology, an admission that death is not an external enemy but an inner component of the human being.
In the eighteenth-century language that still bedevils us, "man" was to conquer and dominate nature. Scientific and technological progress was imagined to be the result of this conquest. And indeed until recently there seemed to be much progress; nature was in retreat and "man" saw himself as master of the earth. The dirty little secret behind the victory communiques was that although "man" was succeeding, men and women kept dying every minute of every day. The individual's death, in the middle of man's triumphs, became more galling. The stricken person inevitably felt "how come if man is so powerful, I am so weak?"
It should be noted that what seems so obvious now was not the case before the l960s. Physicians were trained to fight against death as an enemy that stalks human beings. Despite always eventually losing, physicians were never to surrender to the enemy. Many physicians today are understandably confused by a quick shift in the public attitude toward death. The new stance is represented in a line that Nuland regularly repeats: "Death is not the enemy, disease is." Were physicians wrong in always refusing to give up the battle with death? I think the answer is yes. But the alternative to fighting death as an external enemy may be more complex than saying "death is natural."
Medical science until very recently was the most dramatic expression of the enlightenment philosophy that pitted "man" against "nature." Death may belong to nature but it is outside "man." The death of the human individual comes from the outside, an invader from the real enemy (nature) that still waits to be conquered. Sigmund Freud was a product of this enlightenment mentality, even if in other ways he was bringing the era to a close. In The Future of an Illusion, Freud writes: "The principal task of civilization, its actual raison d'etre, is to defend us against nature....No one is under the illusion that nature has already been vanquished." Freud was at that moment introducing a "death instinct" into his anthropology, an admission that death is not an external enemy but an inner component of the human being.
In the eighteenth-century language that still bedevils us, "man" was to conquer and dominate nature. Scientific and technological progress was imagined to be the result of this conquest. And indeed until recently there seemed to be much progress; nature was in retreat and "man" saw himself as master of the earth. The dirty little secret behind the victory communiques was that although "man" was succeeding, men and women kept dying every minute of every day. The individual's death, in the middle of man's triumphs, became more galling. The stricken person inevitably felt "how come if man is so powerful, I am so weak?"
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in many ways Sherwin nuland is the opposite end of the spectrum from kubler Ross,who is often accused romantic.
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