The Anticipatory Corpse

Medicine, Power, and the Care of the Dying

Jeffrey P. Bishop

Notre Dame Studies in Medical Ethics

In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the “right to die”—or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault’s genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion—people as, in effect, temporarily animated corpses with interchangeable parts—has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual “medicine.”

The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to “spiritual surveys,” to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo’s, The Anticipatory Corpse explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change.

This book is a ground-breaking work in bioethics. It will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy.

Jeffrey P. Bishop is Tenet Endowed Chair in Health Care Ethics and director of the Albert Gnaegi Center for Health Care Ethics at Saint Louis University.

“With extraordinary philosophical sophistication as well as knowledge of modern medicine, Bishop argues that the body that shapes the work of modern medicine is a dead body. He defends this claim decisively and with urgency. I know of no book that is at once more challenging and informative as The Anticipatory Corpse. To say this book is the most important one written in the philosophy of medicine in the last twenty-five years would not do it justice. This book is destined to change the way we think and, hopefully, practice medicine.” — Stanley Hauerwas, Duke Divinity School

“Jeffrey Bishop’s book constitutes a public ethical bombshell. For the first time, certain common mainline medical practices are thoroughly exposed to view as questionable, because grounded in the normativity of the dead body. And Bishop unerringly explains why they are the consequence of a secular nonrecognition of the reality of life and a liberal ethics of mere rights and utility, which fails to value personhood. I would imagine that many readers horrified by the former exposure will then listen sympathetically to the latter exposition.” — John Milbank, University of Nottingham

“Jeffrey Bishop carefully builds a detailed, scholarly case that medicine is shaped by its attitudes toward death. Clinicians, ethicists, medical educators, policy makers, and administrators need to understand the fraught relationship between clinical practices and death, and The Anticipatory Corpse is an essential text. Bishop’s use of the writings of Michel Foucault is especially provocative and significant. This book is the closest we have to a genealogy of death.” — Arthur W. Frank, University of Calgary

“Jeffrey Bishop has produced a masterful study of how the living body has been placed within medicine’s metaphysics of efficient causality and within its commitment to a totalizing control of life and death, which control has only been strengthened by medicine’s taking on the mantle of a bio-psycho-socio-spiritual model. This volume’s treatment of medicine’s care of the dying will surely be recognized as a cardinal text in the philosophy of medicine.” — H. Tristram Engelhardt, Jr., Rice University, Baylor College of Medicine


“In this brilliant book, Jeffrey Bishop, who is both a physician and a philosopher, turns his clinical and analytical gaze on medicine. His diagnosis is bleak: ‘There is something rotten in the heart of medicine.’ Nine of the ten chapters are devoted to the diagnosis, showing the source and history of the disease and some of its symptoms, always focusing on how medicine approaches death and care for the dying. . . . In the last chapter, he turns his attention to therapeutic possibilities for medicine and raises a series of provocative questions, the most provocative of which is the last line of his book: Might it not be that only theology can save medicine?” — The Christian Century

“In The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, Jeffrey P. Bishop not only articulates what is the most thorough, eloquent, and creative Foucauldian critique of bioethics to date, but also provides a means of imagining bioethical institutions that can draw on and extend the insights of Foucault’s corpus.” — Foucault Studies

“In this evocatively titled book, physician Bishop joins his Catholic sensibility with a Foucaldian analysis of medicine and power to expose the ambiguities and complexities of contemporary end-of-life issues. . . . Bishop examines issues such as how the need for donated organs since the 1950s has shaped care of the dying in troubling ways, the contesting passions surrounding the Terri Schiavo case, and the trivialization of the religious lives of caregivers and dying patients as wrought by the professionalization of palliative care.” — Library Journal

“This book will prove to be a seminal, conversation-changing monograph especially in bioethics and philosophy of medicine. . . . It will challenge the fundamental presuppositions that structure most courses in bioethics or death and dying. It is certainly a must-read for scholars and graduate students in these fields, but with guidance, it is an accessible and important text to use with undergraduates interested in bioethics or theology and medicine as well.” — Modern Theology

“Physician/philosopher Bishop explores the philosophical, medical, and ethical imperatives that structure contemporary end-of-life care in this sophisticated, provocative book. . . . Bioethicists, health care professionals, and those concerned with the care of the dying should read this work.” — Choice

“The Anticipatory Corpse: Medicine, Power, and the Care of the Dying [is] a compelling read and a groundbreaking work in philosophy and bioethics. Written by physician, bioethicist, and philosopher Jeffrey P. Bishop, the book presents an eloquent argument as to how the profession’s care of dying persons has evolved as well as a provocative and insightful critique of the present state of such care. . . . The Anticipatory Corpse . . . is engaging, provocative, and difficult to put down. . . . For physicians, lawyers, philosophers, chaplains, nurses, and other professionals whose work is centered on life’s final chapter, I wholeheartedly recommend this book.” — Journal of the American Medical Association

“This is a genuinely novel approach that invites one to completely reassess why health-care institutions and professionals function as they do. It also invites us to question how our lives are shaped by our anticipated deaths. . . . This is not an easy book, but it is worth devoting time to reading it and thinking about the questions it poses. It is beautifully written and carefully argued, and instead of shying away from difficult and potentially disruptive issues in modern medicine it exposes them and challenges us to think again.” — Times Higher Education

“Jeffrey Bishop . . . takes the reader on a journey into the past to provide insight into how the dead body plays an integral and unrecognized role in the present state of medicine in his book . . . . He argues that the corpse is the end of the practice of medicine.” — Journal of Medical Humanities (online)

“It is hard to overestimate the importance of Bishop’s book, not least because of the unchallenged, well-nigh hegemonic place occupied by medicine in western culture . . . . The theological acuteness and pastoral warmth that flow through Jeffrey Bishop’s book make it the most compelling argument for the superiority of this type of humane medicine over the ubiquitous and utterly flaccid ‘biopsychosociospiritual’ pretensions of modern medical practice. But as a challenge to the story of western liberalism, and the central place of medicine within it, The Anticipatory Corpse is also the most important book of 2011.” — ABC Religion and Ethics

“The Anticipatory Corpse is interesting, provocative and important—one of the most novel contributions to the field of bioethics of the last several decades. Bishop has many illuminating new things to say about the ethics of medical care for the dying. In the process, he helps to explain why bioethics itself is in such a sad state.” — America

“The book’s interdisciplinary nature, along with its careful analyses combined with concrete stories of real human struggles with death and dying, no doubt, will be of interest to those engaged in medicine, bioethics, philosophy, theology, and debates concerning public health policies; but all those interested in the place of the body in modern technoscientific culture will find it engaging and cogent.” — Per Caritatem

“Jeffrey P. Bishop, the author of the scholarly, literate, and clinically well-informed treatise . . . is a practicing physician, ethicist, philosopher, and humanist. He is also a vocal critic of modern medicine’s ‘metaphysics,’ especially of medicine’s negative and mechanistic approach to death and dying. Here, he follows in the footsteps of Foucault, Kübler-Ross, Becker, and others, but particularly historian and philosopher Michael Foucault.” — PsycCritiques

“Bishop joins others in critiquing contemporary medicine for giving in to a scientific reductionism that turns the patient from subject to object, turns the clinician from concern to detachment, and thereby alienates patient and clinician from each other and alienates both from contemporary practices of medicine. . . . Yet Bishop makes a deeper, more difficult, and more consequential claim: namely, that because medicine has given up formal and final causes for human beings, even its efforts to overcome scientific reductionism fall prey to the metaphysics of efficient causation, which includes a kind of nihilism regarding what it means to live and die well.” — The Public Discourse

“Bishop straddles both philosophy and medicine . . . and is acutely sensitive to, and critical of, the ways in which our social understandings of death structure medical practice. . . . Bishop’s book . . . is a powerful critique of modern medicine, rich in philosophical ideas, critical themes, historical case studies, and observations from his medical practice.” — Theoretical Medicine and Bioethics

“The Anticipatory Corpse is a tour de force laying out philosophical thought, history, and modern medical practice to present how medicine today teachers practitioners to trace liturgical lines of death over living bodies.” — Word and World

“Part of Bishop’s diagnosis is that modern medicine does not believe it has any moral strangers toward whom to practice hospitality in the way that particular communities do. Thus, it is not conscious of a time when its relentless drive to restore functionality is not salutary, or of a time when it would do well to get out of the way and allow more important people to attend to the patient.” — The Hedgehog Review

“The Anticipatory Corpse has the potential to become a classic in the field of medicine. . . . Bishop’s critique of contemporary medical practices and the fundamental philosophical questions underlying them are a stark reminder that the practices of medicine—many of them very good indeed—should not become ends in themselves.” — Ethics and Medicine

“A powerful critique of modern medicine, rich in philosophical ideas, critical themes, historical case studies, and observations from his medical practice. . . This valuable book certainly provides the philosophical analysis that would enable medicine to reflect critically on its practices and think philosophically about how medicine might be understood and practiced differently.” — Theoretical Medicine and Bioethics

“Despite its technological prowess, contemporary medicine often leaves patients with a sense of alienation, particularly in its approach to death and dying. . . . It is the ministering of theologians that Bishop prescribes—though hesitantly—to potentially save medicine and cure the existential crisis of death and dying in the twenty-first century.” — World Medical and Health Policy