School of Nursing, San Diego State University, San Diego, California, USA.
Department of Nursing Research and Education, University of California, San Diego, La Jolla, California, USA.
Nurs Philos. 2023 Oct;24(4):e12458. doi: 10.1111/nup.12458. Epub 2023 Jun 18.
This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of the power dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to 'bare life' in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a 'regime of death', and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises.
本文从紧急和危重病医学干预的生活描述开始,其中无家可归者因心脏骤停被带到急诊室。该案例是通过生物政治和死刑政治操作将生命还原为赤裸生命的程度,在护理和医疗保健中具有突出影响的戏剧性表现。本文借鉴了米歇尔·福柯、乔治·阿甘本和阿克希勒·姆贝布的学术研究,对影响陷入新自由主义资本主义医疗保健体系的患者的医疗保健和临终关怀的权力动态进行了理论分析。本文分析了在殖民后资本主义体系中,那些被视为一般无法获得医疗保健的人明显受到生物权力的影响的方式,以及在他们临终之际,人类如何被降格为“赤裸生命”。我们通过阿甘本对死亡政治的描述来分析这个案例研究,即“死亡政权”,以及伴随死亡过程的技术,特别是在神圣不可侵犯的人身上。此外,本文还说明了在理解最先进和最昂贵的医疗干预如何使医疗保健系统的政治价值观变得明显,以及护士和医疗保健在这些死亡世界中如何发挥作用时,生物政治和死刑政治是不可或缺的。本文的目的是在急性和危重病环境中进一步了解生物政治和死刑政治的运作,并为这些领域的护士提供指导,因为他们在一个日益非人性化的系统中努力维护道德责任。