In my last post I wrote about an article published in a British medical journal that admitted that medically futile care — care that is not expected to increase a sick or dying patient’s health or prolong their life — has ritualistic intent and effect on the population at large. I did not pay to access the full article and the abstract did not detail the ritualistic intent/effect so I was left to surmise for myself what the intent and effects are on society as a whole when Western medicine in particular flogs corpses with no reasonable chance of being revived; prolongs the dying process with aggressive and violent transplants and surgeries, resuscitation attempts and so-called “life support” including intravenous nutrition and hydration, mechanical breathing and filtration and the like; artificially delivers and maintains genetically or congenitally nonviable infants instead of letting them die naturally and so on.
I have observed previously that Western medicine attempting to treat untreatable, incurable and progressive disease is also ritualistic and does not benefit the patient except to function as a means of compliance and confession where sick people, especially sick women, are expected to confess their sins of and accept a flogging for being failed producers/consumers under capitalism and patriarchy. Thus I would include such ineffective care under the heading of ritualistic medically futile care although the article I was responding to did not address or include that type of futility. As a radical feminist I reject patriarchal rituals on their face and refuse to participate in them at all where and when I have a choice. I have resisted using the capitalistic patriarchal (Western) medical doctor’s office as confessional, and refused to accept the flogging of brutal treatments that will not increase my overall quality of life or even reliably delay my death, instead choosing to treat my otherwise intractable pain and symptoms with medical cannabis.
So the existence of medically futile care as (capitalistic, patriarchal) ritual does not seem to be at issue, being freely admitted to by researchers who frame these rituals as having a positive effect on society — an effect which transcends the abuse and pain suffered by individual patients who are subjected to it but do not themselves directly benefit from it in terms of an increased quality or even quantity/length of life. So what exactly is the specific ritualistic intent and effect on society at large of flogging corpses, creating and maintaining zombified “undead” and/or profoundly impaired patients on so-called life support, artificially reducing natural levels of infant mortality and so on?
In my research for this follow-up post I noted that there is distinction made in the study of the creation of “political leader cults” between ritual and propaganda both of which are tools used to bring people under persuasive (mind) control. In the case of essentially brainwashing people into these cults, ritual refers to “forms of participation that make possible the construction of charismatic authority in micro-interaction contexts” while propaganda refers to “communication[s] that make possible the transformation of bureaucratic state power into charismatic (extra-bureaucratic) authority.” For our purposes, I think it is obvious enough that “society” is essentially a patriarchal cult that brainwashes women to accept patriarchal authority and advance male interests instead of and in fact directly oppositional to our own, so a cult-creation language and framework seems to work.
I also found the cult-creation framework helpful where ritual and propaganda are seen as different but not “mutually exclusive, since leader-focused propaganda and rituals of leader worship can interact and amplify each other.” In fact, I wrote this post starting with ritual which naturally segued into propaganda where medical-themed dramas and reality-based television programming are so widespread. In analyzing the intent and effect of media images I borrowed from my previous work identifying and describing the “gears” of the patriarchal propaganda machine. One can easily apply nearly every (or every) facet of that analysis to the effects of media propaganda supporting Western medicine including end-of-life and other medically-futile care. I will leave the list and links here for women to make the connections and perform any additional analysis themselves.
The following are core radical feminist concepts that have been created over the last several decades of feminist work and compiled into a well-honed list that is easily applied in radical feminist critiques of media images specifically and of patrarichal policy and practice generally. I am frankly astonished at the nearly blanket-applicability of these concepts to the issue of medically futile care but I shouldn’t be. That is the hallmark of radical feminist work which is fact/reality based, demonstrably true and generally applicable across time and place. Each concept is linked to an additional description and application of that concept for those who wish to explore further:
Fetishize female vulnerability
Handmaidens of the patriarchy
Harm reduction/refusal to name the agent
Joke’s on women
Male bonding over misogyny
Mansplaining/women’s perspective is wrong
— Goal is to “land a man”
— Normalize exaggerated/simulated female pleasure
— Normalize reproductive stress and pain
— Pathologize menstruation
— Pathologize older women and menopause/fetishize female youth
— Rape and rape culture
Pornify girl children/infantilize adult women
Primacy of the nuclear family
Support patriarchal institutions (medicine/religion/law)
Woman as “useful object”
As an attorney/JD as opposed to a Ph.D I am relatively uneducated in this type of social and medical analysis so writing about it conclusively is beyond my pay-grade. Yet, as a chronically ill person, a female and a radical feminist I have everything to gain and nothing to lose by trying to figure it out anyway. In this Part II I will further parse the specific effects on “society” of so-called medically futile care, including input I have received in private conversations with readers and followers of this blog. Thanks to those who have contributed to this second part by discussing it with me and offering their insight. For anyone who would like to revisit Part I as an introduction/context for this Part II, that post can be found here.
I. Separating the sick from the well/divide and conquer as a political tactic. To recap, the article I am responding to identified the use of medically-futile care as having ritualistic intent and effect that affected society at large and not just the patients normally thought to be the primary or sole beneficiaries of the “care” visited on their sick and dying bodies. But thinking about this more deeply, it seems as if there may not even be a homogenous “population at large” when it comes to the intent and effect of the ritualistic use of medically futile care. Rather, there will be different effects on seriously ill people versus those who are, or who believe they are or identify as, relatively well. In the case of people who are already ill, predestined to become ill through familial or social history, or even those tasked with caring for seriously ill people including infants and children, the rituals and propaganda of medically futile care directly and viscerally affect us so will be like a dog-whistle that only they/we can properly “hear” or perhaps even perceive at all.
In this way the population will tend to self-select into political/class divisions of well versus sick based on whether these issues directly affect us. Since class division and divide-and-conquer seems to be a critical tool in the belt of the oppressor class I don’t suppose the divisive and self-sorting function here is unintentional and that point probably stands on its own: the population at large is actually being divided along political lines where such division normally does not benefit us.
Interestingly, liberal SJW (social justice warrior) types at least superficially reject the sick/well political division instead encouraging well people to identify as “temporarily able-bodied” so as to recognize that good physical health, mobility, independence and whatnot are only temporary states which can be removed at any time and which tend to disappear with age. But since SJWs themselves are aggressively consumerist and uncritically accepting of Western medical care as a rule (including medically futile care implicated in medical transition for transgender-identifying people) this seems to be a distinction without a difference, at least within the context of accepting or rejecting medically futile care where everyone is expected to accept all conventional medical care uncritically. Here, the divide and conquer intent and function of separating people based on health and ability — temporary or not — remains intact no matter what SJWs imagine they are doing to stop it. Such ineffectualism is par for the course with liberal feminism of course, which seems based in resistance for its own sake and/or soliciting political crumbs rather than resistance designed to or actually affecting the root of male power.
I only mention that here because many of my readers are probably aware of the SJW distinction and thus that activists’ attempts to resist and/or remove the class division between sick and well have so far failed. There is probably a reason for that (that sick-versus-well is a distinction that’s critical to maintaining capitalism and patriarchy) but a full discussion of divide and conquer is beyond the scope of this post. Importantly to a feminist discussion of the ritualistic intent and effects of medically futile care, the sick/well divide will tend to separate sick and well women from each other and to therefore undermine and destabilize female-only groups and space and feminist activating. To wit, actual and perceived ableism within feminist groups and the damage it causes would be irrelevant but for the capitalistic, patriarchal division at the sick/well line which creates issues that are largely arbitrary (like unequal/disparate access to “community resources” aka. accumulations and other patriarchal goodies) and not based in natural law.
Of course, not all sick/well distinctions are socially constructed and those distinctions that are based in natural (rather than man-made) law are not acknowledged or respected, for example the physical, material reality of serious, untreatable illness or injury. If any natural sick/well distinction were respected, disabled and seriously ill people would be given what they need without having to aggressively fight (or beg and otherwise be degraded and humiliated) for it. And intractable and/or terminally ill people including infants would have a natural right to die rather than being forced to feign wellness (meaning “well enough to produce/consume”) with conspicuous consumption of Western medical goods and services pushed on them even after they are “clinically” dead and often following an unnaturally
extended life prolonged dying process.
II. Collective trauma and trauma-based mind control. Again, there is a very general intent and effect of medically-futile care as ritual which has to include the creation of collective trauma, leaving everyone exposed to it vulnerable to trauma-based mind control. While a full exploration of trauma-based mind control is beyond the scope of this post, and above my paygrade, I believe it is worth mentioning in the context of an admittedly ritualistic effect and intent of medically futile care including emergent and end-of life-care which almost always implicates violence, issues of consent, heightened emotional states including extreme fear and pain, and perceived and actual grief and loss among other things. Indeed, the widespread use of corporate media to disseminate images of both real and fictional medicalized violence guarantees that most of us will be exposed to it and that particularly women will become traumatized or retraumatized by it and everything that traumatic exposure entails. Here, everyone knows about the medical rituals that occur largely behind closed doors and we are obviously meant to know.
To be clear, mainstream media is rife with images of medically futile care such as with television medical dramas and medical-based reality programming (“St. Elsewhere” and “Rescue 911” in the 1980s and their contemporary progeny including medical examiner and medical mystery shows etc.) which all include the traumatic thematic imagery referenced above: flogging corpses (“We did all we could”), creating and maintaining zombified/undead people through invasive so-called life support (“We are doing everything we can”) refusing to let nature self-select for healthy and viable infants (“neonatal intensive care” or NICU) and so on. Medically futile care is also represented in news and legal programming, such as the recent case of the Native American woman who gave birth 10 years into a persistent vegetative coma and while on so-called “life support” that obviously left her vulnerable to abuse including sexual assault and rape. Issues of medically futile care are also implicated in relationship, marriage (including same-sex relationships and marriage) and elder-related programming where people contemplate issues of medical visitation and decision-making like Powers of Attorney, Living Wills and the like.
The ritual of medically futile care — that which is not intended to increase the comfort, health or longevity of the patient — is also widely disseminated in psychiatric and prison-related content where pharmaceutical medications are administered against the patient’s will including sedation and otherwise “treating” people who do not consent to it, execution by lethal injection and having medical doctors oversee executions and examine the executed dead.
This violent and (therefore) traumatic imagery is everywhere in the so-called developed world, we are all exposed to it, and the ritualistic intent and effect of these practices is beyond debate (they admit it) so what does it do to the people who watch it including those who cannot avoid exposure to media representations of medicalized rituals even if they wanted to?
For those who are unsure whether anyone can be affected by representations of something that they did not personally experience, I would refer them to the original journal article entitled “Rituals, death and the moral practice of medical futility” which admitted the ritualistic intent and effect of medically futile care on the public at large which did not experience such “care” firsthand. I would also recommend researching vicarious trauma which is a known work-related psychological injury suffered by those in the helping professions who are constantly exposed to the trauma of others. And “triggering” of course refers to “something read, seen, or heard causing someone emotional distress, typically as a result of arousing feelings or memories associated with a particular traumatic experience.” Women, as oppressed people, are routinely victimized which causes trauma and are known to become “distressed” at hearing accounts of other’s victimization and trauma whether those depictions are based in reality or fiction. Of course, just because any particular depiction of violence is based in “fiction” doesn’t mean the exact same thing doesn’t also happen for real.
Of particular note to radical feminists will be the effect of trauma-induced altered states of consciousness including dissociation and emotional numbing where people appear to be more susceptible to cultural messages and to passively accepting everything that’s going on around them at the time. In women’s case, that means being more susceptible to messages of our own inferiority/otherness and male supremacy, and accepting both the exceptional and the banal, everyday violence all women are exposed to as targets for male aggression and oppressed people who are mined for our individual and collective resources. Men, of course, need no additional coaxing to accept patriarchal messages and norms which directly and obviously benefit them.
III. Asserting a pro-life value system where “life” is (re)defined to mean something very specific and degraded. In the case of so-called “life support” which is actually a policy and practice of zombification, creating and maintaining a state of undead, and perpetual vulnerability and potential (and actual) victimhood this type of medically-futile care serves to literally define “life” including what can be expected of “life” by those who are living it. In the context of capitalism and patriarchy, life itself is inherently degraded to refer to (essentially) renewable resources that can be exploited for as long as possible. Trees, livestock and so-called “human resources” are all alive and live only to be exploited; women are doubly-exploited as both public and private resources, first for men in general (in public including as laborers for pay and consumers of goods and services) and then for individual men in private as unpaid sexual, reproductive and domestic laborers. Generational and inherited wealth is also passed along paternal, not maternal lines so women are never able to accumulate anything and are forced to give everything over to men for them to share amongst themselves.
Here, as long as a patient’s heart is beating they are considered to be alive because they can still be forced to consume medical goods and services as near-perpetual consumers of “life support” which must be the very definition of medically-futile care (that which cannot restore the patient to health and does not increase the patient’s quality of life at all). A person in such a degraded condition can also be consumed as a resource themselves — defenseless victims are extremely valuable resources within the abusive economic framework of capitalism and patriarchy. Here, for example, vegetative females can be raped and impregnated and otherwise abused, even having their abuse broadcast to others who will be traumatized by it creating more zombified consumers and defenseless victims and so on.
Similarly, only when a person is unable to ever consume/be consumed again is that person considered to be dead. Such a person will have a stopped heart and be subject to imminent decomposition; only then is a person absolved of their duty to consume or to be consumed. Of course, this redefinition of “life” as essentially “alive enough to consume and/or be consumed” will have implications for both the sick and the well. For the well, who under capitalism and patriarchy live a “healthy” yet nonetheless vastly degraded life consisting only of production and consumption, they will be unable to imagine anything more so will have no chance of acting on those thoughts, in this case escaping the “rat race” in favor of a truly meaningful or healthful life. Nor are they likely to seek a meaningful inner life that exists only or primarily for themselves because if it cannot be exploited by others (sold for money) then what’s the point?
For the sick, so long as Big Medicine keeps their hearts beating they will continue to consume medical goods and services uncritically and without regard to whether such medical consumption does what it says on the tin: improving their quality of life by decreasing pain and symptoms and/or increasing their ability to experience pleasure, joy, peace, novelty, companionship and the things that make life worth living.
In no case is any person, as either producers or consumers, given legitimated or ultimate control over what “life” means including when and how to end it once that life becomes so degraded as to be unrecognizable. Where “life” is defined as a still-beating heart and nothing more, both suicide and euthanasia even in the case of intractable physical and mental pain are considered exactly as immoral as causing the untimely death of a completely healthy person; such outcome is so taboo it is unthinkable even, and it is impossible to act without first having the thought. When we manage to think about it anyway, we often find more goods and services to be consumed such as in the case of medically-assisted suicide which is prohibitively resource-intensive in terms of time, money, energy and health and therefore impossible for most sick people to achieve.
Predictably considering their conditions, people become bored, restless or insane but so long as they can still be used they will be, whatever that means and however they can, depending on how sick (or well) they are, and they will be used that way forever and there is pretty much nothing they can do about it. In fact, the more bored, restless and insane you become the more patriarchal institutions will be able to control you starting with pharmacological solutions for anxiety, depression and the like and terminating in psychiatric or criminal incarceration for being unable to control our behavior and affect due to intractable physical and mental pain and where we are only valued in either context as the consumers and/or the consumed. And on it goes. This is “life” under capitalism and patriarchy and Big Medicine aggressively enforces this degraded definition and experience of life for everyone.
IV. Normalizing the experience of sick and dying people being funneled and coerced into accepting Western medical care while preventing and/or invisiblizing dissent. Another effect of medically-futile care as ritual would seem to be to normalize what is happening to sick people as we are funneled and coerced into the Western medical machine which cannot or will not effectively treat our pain and symptoms or even reliably delay our deaths. Here I am suggesting that “treating” or attempting to treat or unsuccessfully treating conditions that are essentially untreatable (being notoriously unresponsive to conventional care like Crohn’s is) and which are incurable and progressive qualifies as medically-futile care and I believe it does. This type of care does not and is not intended to benefit the patient but rather serves a ritualistic function in the same way as medically futile emergent and end-of-life care does.
This horrific situation of having to accept ineffective medical care is the situation faced by hundreds of thousands if not millions of people in the so-called developed world suffering from confounding incurable and progressive diseases like MS, RA, Crohn’s disease and others but who are forced to consume ineffective Western medical goods and services anyway. Normalizing and ritualizing emergent and end-of-life medically-futile care also normalizes what is happening to us. Authority-worship under the guise of legitimate medical care equals medical care and this is always acceptable where there is no hope of effective treatment or cure.
In practice, this means that sick people learn early and well what “disability” means under capitalism and patriarchy, where we are no longer able to perform our function as producers/consumers by working for pay and instead are forced to earn our keep by consuming medical goods and services in order to collect disability-based benefits. In other words, if they want to survive, untreatable and otherwise “failed” patients have to let doctors hurt us for money. Because medically-futile care is normalized, our accepting it in exchange for money and the necessities of life is not seen as coercion and even extreme violence even though it is. Patients who are unable or unwilling to be coerced and violated this way, including those whose treatments are likely to worsen or kill them, are ineligible for disability-based benefits and collect nothing.
Medically-futile care as ritual also relieves us of our opportunity to give informed consent, or to dissent, where we think we are being presented with a treatment plan that is at least in our best interests even where we know it cannot treat or cure us. In reality, medically futile care is admittedly used ritualistically in order to send messages to other people (society at large) and is not intended to benefit us primarily or at all. The patient and their family are never told about that part when asked to consensually submit to various treatments for everyone’s alleged benefit excepting any benefit to the patient’s actual health. According to the original article identifying medically-futile care as ritual, patients themselves and even the patients’ own friends and family benefit from Western medicine “facilitating the dying process” but the sick and dying person is not made better from the treatments that are inflicted on them nor are they asked if they want their “dying process” facilitated in this way or at all.
Sometimes medically-futile care is the gold standard (meaning, normalized) where effective treatments exist but are less socially acceptable or unavailable (not-normalized). In my case, I gave my “informed” consent to treatment with 2 years of Big Pharma poisons which were not helping and I was only getting worse. At some point my GI specialist told me somberly that I needed to use my intelligence and research skills as an attorney in order to find out what treatments were available to me. In retrospect I believe he was trying to tell me that the care he was offering me was not going to help and that I needed to try something else, likely medical cannabis. Cannabis has been used all over the world for thousands of years specifically to treat digestive and gut issues and there is contemporary peer-reviewed medical literature proving its efficacy in treating Crohn’s but it was illegal in the state in which I was living and treating. My GI doctor never discussed cannabis with me directly even though I now believe he knew it would help, probably because he was afraid of being punished by his medical licensing board or worse.
I was lied to by omission so how can my consent to treat with Big Pharma poisons be considered informed? I wonder now how much of my pervasive pain and symptoms are due to iatrogenic illness and injury caused by my treatments which included invasive and radiologic procedures, high doses of dangerous drugs and other things I’ve blocked out or been too sick to remember. Of course, because Crohn’s disease in particular is so relentlessly painful and predictably disabling, most outright dissent/nonconsent to any and all medical care for this disease would be insane. Still, I might’ve dissented to Western medical care and sooner had I known there was a reasonable alternative. But medically-futile treatments for my condition were (and are) the norm instead. Medically-futile care has been made to be completely normal wherever and whenever Western medical doctors deem to inflict it.
V. Supporting male power and patriarchal institutions/deliberately harming women physically, mentally, economically, politically and reversing it to seem as if it’s beneficial to us. I suppose I should end this analysis of the intent and effect of medically-futile care as ritual by acknowledging the intent and effect of patriarchy itself which appears to be sadistic and to relieve primarily females of their individual and collective resources. Thus patriarchal institutions also are intended to and do sadistically harm and relieve females of our resources. And Big Medicine is a foundational patriarchal institution. The ultimate purpose and intent of patriarchy and its institutions is not to make money, or to further knowledge or to treat people fairly or reduce suffering or anything except to cause primarily females sadistic and material harm for the direct or indirect benefit of all men. Not coincidentally, females are exceptionally vulnerable to being subjected to medically-futile care at the end of life as we tend to live exceptionally long lives and to outlive male companions, male children and others who may reasonably care for us outside of a medical institutional setting. And internalized, interpersonal and institutionalized misogyny ensures that our care and comfort is no one’s priority even if there is someone around who could care for us if they only wanted to.
Females are also most frequently diagnosed with autoimmune diseases which are very serious, confounding, incurable and progressive conditions that Western medicine cannot effectively treat. Whereas males would seem to be exceptionally vulnerable to medically futile care as nonviable infants and accident- and violence-prone adolescents and young adults if I’m putting the pieces together correctly. Can we deduce then that the effect and intent of medically-futile care as ritual is also directed primarily at women as opposed to primarily men or equally to both?
A radical feminist understanding of patriarchy would seem to suggest that, yes. Which also means that there is something more sadistic and more materially oppressive about normalizing medically futile care where and when we receive it — as the untreatably chronically ill and as vulnerable, unprotected and exceedingly elderly adults at the end of life. And that does seem to make sense, where flogging a young, healthy male on a single occasion following an accident (for example) would seem to be less-wrong than the same “treatment” inflicted likely multiple times on a frail and exceedingly elderly woman who has outlived everyone she knows and who has probably already been routinely over (or under) medicated, futilely treated, and sexually assaulted in the course of her long-term care. An injured young male may also be both more likely to be successfully revived than an extremely elderly woman and to have a meaningful “life” to return to as compared to someone who is incurably chronically ill. Perhaps.
Thankfully, tricky comparisons like that last one are not really necessary since we know, because they do it, that medically futile care and its admittedly ritualistic intent and effect is worse for us than it is for them. What they do to us — to women — is more sadistic and more effectively relieves women of our resources than anything they will ever do to themselves/other men. Always. If it were otherwise they wouldn’t do it.