Abstract as per original application
(English/Chinese): |
Following over three decades of market reforms and stringent birth planning policies, the People's Republic of China is undergoing a dramatic demographic and cultural transformation that has significant ramifications for the care of older people and the critically ill. By focusing on fraught debates over the use and termination of costly medical technologies in Chinese hospitals, this research project will provide fresh data on emerging caregiving practices and health-seeking strategies. The project will produce the first research monograph on the culture and ethics of critical care in urban China, linking transformations in family-based caregiving with the growing medicalization of death in Chinese hospitals. The interdisciplinary impact of this project is far-reaching, with important insights for understanding the role of medical technology in the context of a rapidly ageing society and an unevenly privatized health care system.
Drawing on approaches from sociocultural anthropology and the medical humanities, the principal investigator will utilize mixed methods (including ethnographic observation, interviewing, surveys, and archival work) to collect comparative data on end-of-life treatment in tertiary care hospitals located in Beijing, Shanghai, Shenzhen, and Zhengzhou. With over half of all deaths in urban China now occurring in medical facilities, these sites for critical care offer a crucial window on how the medicalization of dying is transforming the ways in which Chinese patients, families, and medical professionals confront mortality. The project will integrate qualitative and quantitative data to provide a rigorous analysis of the challenges involved in caring for the critically ill in urban China.
This research project builds upon the principal investigator's previous work on the culture and ethics of transnational biomedical technologies. While the principal investigator's first book (Biomedical Odysseys, Princeton 2017) focuses on the efforts of terminally ill patients and their families around the world to pursue experimental stem cell therapies in urban China, this new research study goes beyond the pursuit of curative medicine to examine what happens when technological interventions are no longer able to restore health. By shifting the focus from cure to care, this project will illuminate the ways in which Chinese patients, family members, and health care providers negotiate the practical and moral challenges of care at the limits of medicine.
這是一項關於中國重症監護的文化實踐和倫理道德觀的研究項目。經過三十多年的改革開放和計劃生育政策，中華人民共和國正在經歷一場巨大的人口和文化轉型。人口高速老齡化和醫療衛生系統的改革對老年人和重症病人照顧的理念和技術產生了深遠的影響和改變。通過對醫療技術使用中人們面臨的問題和挑戰的調查，本研究將探討中國有關護理技術以及健康策略的趨勢和變化，並進一步對家庭護理、醫院臨終照顧、以及中國城市的重症照顧理念和倫理的轉變等方面提供新的見解。
本項目將採用社會科學和醫學人文的研究方法，包括深度訪談、問卷調查、檔案研究、參與觀察等來收集、比較和分析位於北京、上海、深圳和鄭州四地醫院的臨終治療方式。對重症監護中臨終治療的研究為理解醫技術的發展和應用是如何影響重症患者、其家庭以及醫療專業人員應對死亡的挑戰提供了一個重要的窗口。通過量化與質化的綜合分析，本研究將深刻探討對重症患者的照護過程中人們所面臨技術選擇、生存挑戰及道德困境。
本研究將以主研究者之前關於跨國生物醫學技術的文化和倫理的研究著作為基礎 (2017 年由普林斯頓大學出版社出版專著 Biomedical Odysseys: Fetal Cell Experiments from Cyberspace to China)，將研究重點從有藥可醫的疾病治療進一步轉移到無法挽救的臨終護理，以闡明中國重症患者、家庭成員和醫療人員，是如何在醫學技術的限制下就護理的實際需要和道德挑戰與死亡進行艱難交涉的。
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