Death and the Maiden: End-of-Life Legislation and the Semiotics of the Female Body
Regis A. de Silva
Associate Professor of Medicine, Harvard Medical School, Boston, MA, USA

She bestows the idea. And the idea withdraws, becomes transcendent, inaccessible, seductive. It beckons from afar…..The dream of death begins. It is woman.
Jacques Derrida

Until the last 30 years, death was largely a matter between the patient and the physician. Since then, end-of-life care has become rather more complex, and clinical decision-making has undergone significant changes. Such decisions now involve lengthy, and sometimes contentious, discussions with families, legal disputes, and the involvement of ethics committees, the state and public advocacy groups. In the United States, three end-of-life cases resulted in contentious litigation that reached the Supreme Court, with a major impact on how clinical care is rendered.  All 3 cases involved young white women in the third decade of life, and in all cases, there were protracted legal proceedings. There were escalating levels of media attention, and public and legislative involvement with each case. These cases raise questions about the hidden role young white women play in American society and the public imagination. I will draw on the possible roles symbolism, semiotics and mythology play in an analysis of these cases in making public policy.

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