ABSTRACT
According to David Barnard, the former chair of the Department of Humanities at Pennsylvania State University College of Medicine, we are the cusp of the change from the unconditional acceptance of the biomedical model (see Chapter 2) to insistence on a more person-centered approach to care that has come about in response to three conditions (Barnard, 1998):
1. The effects of medical technology that has blurred the line between life and death, making the end-of-life an expensive time that is often lived out in pain, with intrusive medical procedures, and an increasing sense of helplessness
2. The devaluation of symptom control in medicine in favor of treatments intended to cure disease and prolong life
3. The loneliness of dying arising out of the awkward, distant, and evasive relationships between dying people and their loved ones with their care givers
One way to conceptualize this shift is to contrast the modern biomedical model with the newer wellness philosophy, which reflects the dying-well ethos that has been emerging within the past couple decades (see Table 9.1).
