Instrumental Activism at the End of Life: Theorizing the Role of American Culture in the Provision of Aggressive Medical Care

Abstract

In this thesis, I move to situate the provision of "aggressive" end of
 life care within the broader context of Americans' cultural
 understandings of death and dying. Drawing principally from the
 works of Talcott Parsons, Victor Lidz, and Renée C. Fox, I argue that
 Americans approach death with a cultural orientation of “instrumental activism,” a pattern of action whose roots in a neo-Weberian
 conceptualization of the Protestant Ethic leads individuals to
 dedicate themselves to activities that, on rational grounds, seek “to
 maximize human control over the conditional elements of the life
 situation” (Parsons and Lidz 1967: 139). As a result, I hypothesize,
 individuals steeped in an American cultural orientation of
 “instrumental activism” are more apt to embrace aggressive care—like CPR—at the end of life even with the knowledge that such interventions might not prove successful in the meaningful extension
 of life.