ABSTRACT
In addition to natural powerlessness, artificially induced impotence abounds for the modern dying person. The structural realities of the hospital frame of reference and the broader cultural meaning sets which shape the realities of modern dying fail to adequately relieve and explain the patient's quandary, driving the senselessness of dying deeply into the life experience and perceptions of the dying patient. The alienation of dying patients in twentieth century America is a self-exacerbating blend of naturally and societally rooted powerlessness. While some of the forms of the total institutional control over the dying process are changing, the substantive forces of alienation loom very large. Alvin Goffman's discussion of total institutions depicts not just how efficient the physical and social organization for totality is in accomplishing a multitude of tasks, but also the potential for dehumanization of the forms of life that are administered by total institutions.
