The sequestration of sickness and death

What are now called hospitals only gradually became differentiated from the older organisations which sought to cope with the impact of `poverty'. The `hospitals' which were the forerunners of prisons and asylums, as well as of modern medical organisations, mixed together just that range of people noted in previous paragraphs. The emergence of a separate sphere of medical treatment, focused on people with distinct `physical problems', was part of the self-same processes that created the other carceral organisations.

The development of the hospital in its modern sense was closely bound up with the professionalisation of medicine. The hospital is a setting where medical technology can be concentrated and medical expertise fostered. Yet, like prisons and asylums, the hospital is also a place where those who are disqualified from participating in orthodox social activities are sequestered, and it has similar consequences in terms of the concealment from general view of certain crucial life experiences -- sickness and death. As was discussed in the previous chapter, in pre-modern societies chronic sickness was part of many people's lives and contact with death was a more or less commonplace feature of everyone's experience. Elias has pointed out that Ariès's work on the subject probably presents a somewhat slanted view of death in the pre-modern world. Aries tends to argue that, since death had not yet become hidden away, people were able to meet their end in a serene fashion, surrounded by their loved ones. As Elias says, the presence of others at the deathbed was not necessarily always comforting: sometimes in fact the dying were mocked and taunted by the survivors. ¹⁹ Whatever the truth of this may be, and though death may still have been surrounded by fundamental fears and anxieties, it was not then a phenomenon to be concealed.

The point is not just that, today, death is routinely hidden from view. In addition, death has become a technical matter, its assessment removed into the hands of the medical profession; what death is becomes a matter of deciding at what point a person should be treated as having died, in respect of the cessation of

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various types of bodily function. Death remains the great extrinsic factor of human existence; it cannot as such be brought within the internally referential systems of modernity. However, all types of event leading up to and involved with the process of dying can be so incorporated. Death becomes a point zero: it is nothing more or less than the moment at which human control over human existence finds an outer limit.

The history of capital punishment bears witness to the impulsion to convert death into a pure `event'. As Foucault and others have shown, in pre-modern settings capital punishment, often combined with other modes of inflicting pain on the body, was frequently a collective spectacle. With the coming of the prison, punishment moves `out of view' and becomes disciplinary in form. What Foucault does not pursue, although this is quite consonant with his analysis, are the changes affecting capital punishment inside the prison. Public forms of execution were often not just painful, but noisy and prolonged. The whole weight of subsequent development was towards reducing execution to as `silent' a process as possible. ²⁰ In England, for example, great care was taken to ensure that the condemned spent his or her last night in a cell very close to the place of execution, so as to minimise the duration of the final event. A sequence of technical modifications, designed to make the execution apparatus efficient and silent, was introduced. Death, in other words, was to be instantaneous and unobtrusive. Capital punishment has since been abolished in many countries -- a reform prompted by humanitarian motives, but one which also recognises that execution finally puts an individual beyond the possibility of social control.

Date: 2016-04-22; view: 690