Abstract
When hospital clinicians care for dying patients, they are often on their own,
practicing with few or no specific guidelines in a way that typifies virtually
no other hospital clinical practice. The move toward standardizing most of
the care of patients in hospitals has deep roots. Near the beginning of the
twentieth century, hospitals in the United States insisted that all patients
have standardized medical records. One consequence of this standardization was that patients perceived to be from lower classes (people of color,
immigrants, the poor and indigent) benefited from this more democratic
treatment. Physicians treating well-to-do patients had to open their private
notebooks, so that patient care methods used for the wealthy and powerful became accessible to clinicians and accountants (Timmermans and Berg
2003).