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Philip Reed (2023) argues that discrimination against (non-acutely) dying patients constitutes a unique kind—which he calls terminalism—because their status as persons with terminal illness marks them with a socially salient identity which, by means of direct and indirect discrimination, limits their sets of choices and resources, such as in hospice care or organ transplant policies.1 Importantly, Reed also argues that while terminalism is an increasingly prevalent normative phenomenon, it has been overlooked in the literature, ‘hiding in plain sight’ as even though we are ‘aware of it at some level’.”1
What could explain this paradox? Drawing from Jeffrey Bishop, Giorgio Agamben, and T. Kenny Fountain, I argue that an institutional episteme and operating assumption of medicine, from the training of medical students, discursively disciplines terminally ill persons as bare life, between medicine’s dichotomy of bodies: neither ‘biovaluable’ (the surplus value of separated human bodily material in technology) as a dead body from which to study anatomy and physiology through one’s senses2 nor a living patient with whom to understand a particular pathology and learn in longitudinal, dialectical relationships. Starting at the trainee level, healthcare professionals internalise and socially reproduce a biopolitical understanding that the terminally ill, in an awkward zone of distinction between dead/living, …
Contributors I am the sole author and contributor for my commentary proposal to the JME.
Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.