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The influence of neoliberalism on non-beneficial high-intensity life sustaining treatments near the end of life

Anatomy Museum, London

15 Jan End of life1 Part of Global Health & Social Medicine seminar series

Speaker: Dr Elizabeth Dzeng (University of California)

Abstract: Non-beneficial high-intensity life-sustaining treatments (LST) near the end of life have the potential to create ethical challenges where treatments induce harm and suffering, with little chance of benefit. There is a need to understand the broader macro-sociological factors that influence institutional culture and individual behavior that impact burdensome care.

One such macro-sociological phenomenon is the culture of neoliberalism in the United States. This talk will describe the ongoing analysis of a qualitative project at one high and one low-intensity California hospital for the intensity of end-of-life care.

Interviews reveal different patterns of practices and behavior in response to ethical challenges around high-intensity LST. These patterns reflect different support structures that mitigate the influences of neoliberalism at an institutional level. Stronger systems-level support structures at the low-intensity hospital appear to support clinicians in making decisions in a patient’s best interest, which appear to modulate aggressiveness of end-of-life care.

About the speaker

Elizabeth Dzeng

Dr Elizabeth Dzeng is a sociologist and hospitalist physician conducting research at the nexus of sociology, medical ethics, palliative and end-of-life care, and human-centered design.

She is an Assistant Professor at the University of California, San Francisco (UCSF) in the Division of Palliative Medicine and Social and Behavioral Sciences, Sociology programme. She is also a Senior Atlantic Fellow for Equity in Brain Health, based at the Global Brain Health Institute at UCSF's Memory and Aging Center.

She completed her PhD in Medical Sociology and an MPhil in Development Studies at the University of Cambridge at King’s College London as a Gates Cambridge Scholar and was a General Internal Medicine post-doctoral clinical research fellow and palliative care research fellow at the Johns Hopkins School of Medicine. 


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