Session Three: Vision--Confronting the Margin
Editor's Note

How we look at the dying and at the dead is the focus of Session III, "Vision: Confronting the Margin." LaVera Crawley, M.D., from the Stanford Center for Biomedical Ethics, introduces this portion of the institute by providing her own example of how an individual may or may not see the imminence of death: where the purely visual cues may be inadequate to what Jodi Halpern has called (in Session I) "acknowledgement."

The tension between the scientific gaze and compassionate or empathic looking dominates the presentations and ensuing discussion in Session III. Historian Tom Cole, from the Institute for Medical Humanities at the University of Texas Medical Branch at Galveston, draws on Adam Smith's Theory of Moral Sentiments to argue that we have a "relationship with [the dead] which is imaginative and no less real for that." He then goes on to discuss--and show clips from--a film he is producing about that relationship; it shows the experience of medical students encountering the cadaver for the first time. How, the film asks, can one learn compassion in the anatomy lab? Can such experience help prepare medical students for the realization that, despite the powerful tools of their profession, there is no cure for mortality, the "inescapable condition of being human"?

Pathologist Frank Gonzalez-Crussi, from the Northwestern University School of Medicine and Children's Memorial Hospital in Chicago (emeritus), is also concerned with the body in death. Describing the role of the pathologist as emblematic of the "excessive reliance on optics to obtain knowledge," Dr. Gonzalez-Crussi goes on to offer other notions of "seeing" in other cultural spaces and historical moments. The sight of the cadaver also poses a riddle, he says--particularly in Western cultures, it is a presence that is also an absence.

Commenting on Session III, Patricia Benner, Professor of Physiological Nursing at the University of California, San Francisco, remarks on the contrast between the clinical entity of death and death as a "human passage," labeling it a "dialogue between the Cartesian body and the social sentient body that dwells in real, finite, risky worlds." Professor Benner recounts examples of "grief stories" from the world of critical care to argue for the importance of social relationships and personal interactions in the dying process, and for the limitations imposed by what she calls "choice" language in the discourses of death and dying as currently practiced.

Issues of discussion in Session III include: the risks of engagement for health professionals; a historical development that saw the rise of the power of the hospital and the instantiation of the medical (and funerary) establishment--over the family and community--as those who are "intimate with the dead"; the limited role of humanistic education in medical training; and contrasting notions of the body in death, especially as seen in literary traditions. --CMG

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