Death in the Hospital: An Examination of Patient-Centeredness and Consumerism in Hospital Design 
Christopher Thompson, MD, University of Pittsburgh Medical Center; Kristin Collier, MD, University of Michigan

Every year hundreds of thousands of Americans die in the hospital. While designed to accommodate medical and surgical modalities in the twentieth century, modern hospital design has shifted to incorporate a concept of patient-centeredness driven by consumerism. This paper aims to consider how the hospital space changes for patients, family members, staff and physicians when it becomes a dying place. Furthermore, It contrasts one author’s experience at a VA hospital with wider trends in design and considers how consumerist elements of design, such as concierge service and onstage/offstage policies, affect the hospital as a dying space. This in turn reciprocally affects a wider understanding of healthcare. Using an anthropological lens, this paper considers space, ritual, the sacred, motivations for innovation, and meaning-making. It examines the trend toward a transactional understanding of health care in the context of consumerism and death. 

Our primary question is whether current trends in hospital design adequately take into account its role as a space for dying people. And further, what alternative frameworks can move hospital design forward while lending space for patient comfort and ease, good health outcomes, community building, and the sacred?