Nicole Piemonte

Nicole M. Piemonte, PhD, is Assistant Dean for Medical Education at Creighton University School of Medicine in Phoenix. She is the author of Afflicted: How Vulnerability Can Heal Medical Education and Practice (MIT Press).

  • Death and Dying

    Death and Dying

    Nicole Piemonte and Shawn Abreu

    An examination of the contemporary medicalization of death and dying that calls us to acknowledge death's existential and emotional realities.

    Death is a natural, inevitable, and deeply human process, and yet Western medicine tends to view it as a medical failure. In their zeal to prevent death, physicians and hospitals often set patients and their families on a seemingly unstoppable trajectory toward medical interventions that may actually increase suffering at the end of life. This volume in the MIT Press Essential Knowledge series examines the medicalization of death and dying and proposes a different approach—one that acknowledges death's existential and emotional realities.

    The authors—one an academic who teaches and studies end-of-life care, and the other a physician trained in hospice and palliative care—offer an account of Western-style death and dying that is informed by both research and personal experience. They examine the medical profession's attitude toward death as a biological dysfunction that needs fixing; describe the hospice movement, as well as movements for palliative care and aid in dying, and why they failed to influence mainstream medicine; consider our reluctance to have end-of-life conversations; and investigate the commodification of medicine and the business of dying. To help patients die in accordance with their values, they say, those who care for the dying should focus less on delaying death by any means possible and more on being present with the dying on their journey.

    • Paperback $15.95
  • Afflicted

    Afflicted

    How Vulnerability Can Heal Medical Education and Practice

    Nicole Piemonte

    How medical education and practice can move beyond a narrow focus on biological intervention to recognize the lived experiences of illness, suffering, and death.

    In Afflicted, Nicole Piemonte examines the preoccupation in medicine with cure over care, arguing that the traditional focus on biological intervention keeps medicine from addressing the complex realities of patient suffering. Although many have pointed to the lack of compassion and empathy in medical practice, few have considered the deeper philosophical, psychological, and ontological reasons for it. Piemonte fills that gap, examining why it is that clinicians and medical trainees largely evade issues of vulnerability and mortality and, doing so, offer patients compromised care. She argues that contemporary medical pedagogy and epistemology are not only shaped by the human tendency to flee from the reality of death and suffering but also perpetuate it. The root of the problem, she writes, is the educational and institutional culture that promotes reductionist understandings of care, illness, and suffering but avoids any authentic confrontation with human suffering and the fear and self-doubt that can come with that confrontation. Through a philosophical analysis of the patient-practitioner encounter, Piemonte argues that the doctor, in escaping from authentic engagement with a patient who is suffering, in fact “escapes from herself.”

    Piemonte explores the epistemology and pedagogy of medicine, examines its focus on calculative or technical thinking, and considers how “clinical detachment” diminishes physicians. She suggests ways that educators might cultivate the capacity for authentic patient care and proposes specific curricular changes to help students expand their moral imaginations.

    • Hardcover $35.00