ABSTRACT
Today the American public is confronting mortality in ways that were unthinkable when Jessica Mitford was writing and improbable even to Ari&s. The emphasis is on rational planning for one's death that goes far beyond buying a burial plot. As death re-enters the American household, it is tamed only by the resources a family or perhaps only a single relative or friend can muster. The impact of the intensive care unit on the American way of dying has been profound, for it is there that contemporary medicine routinely eliminates the primary actor, the patient, from the ritual of dying. The role of the physician in treating the very sick patient is problematic, in part because doctors are only apparently disinterested in advising about medical treatment options. Recalling a time, long gone, when people died at home, Michel Foucault describes the family's gaze fixed on the sick person as full of "the vital force of benevolence and the discretion of hope".
