The Empire of Death: How Culture and Economics Affect Informed Consent in the U.S., the U.K., and Japan

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American Society of Law and Medicine




American culture reflects a paradox: the more openly we discuss death and its inevitability, the more money we spend to postpone and deny it. Sherwin Nuland's book How We Die, a frank description of the way our bodies deteriorate with and without medical intervention, topped the New York Times best seller list in the spring of 1994. At the same time, Jack Kevorkian, arguably the world 's best known physician, was being acquitted of violating Michigan 's law against assisted suicide, while a Michigan commission was debating legislative changes to permit physicians to help their terminally ill patients kill themselves. Despite such open discussion of death and expansion of the informed consent doctrine, U.S. medical expenditures at the end of life remain astronomically high. Most of this elevated spending is attributable to new medical technology.

In J.G. Ballard 's Empire of the Sun, the United States, British and Japanese cultures are contrasted through the eyes of a young British boy incarcerated by the Japanese army in China during World War II.

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