The Spirit Ambulance is a journey into decision-making at the end of life in Thailand, where families attempt to craft good deaths for their elders in the face of clashing ethical frameworks, from a rapidly developing universal medical system, to national and global human-rights politics, to contemporary movements in Buddhist metaphysics. Scott Stonington’s gripping ethnography documents how Thai families attempt to pay back a “debt of life” to their elders through intensive medical care, followed by a medically assisted rush from the hospital to home to ensure a spiritually advantageous last breath. The result is a powerful exploration of the nature of death and the complexities arising from the globalization of biomedical expertise and ethics around the world.
"A moving ethnographic portrayal of how end of life in northern Thailand combines religious, local moral, and global motifs into a profoundly human (read, cultural) experience of end of life. A challenge to biomedical accounts of what the last period of life is about. Impressive!"––Arthur Kleinman, author of The Soul of Care: The Moral Education of a Husband and a Doctor
"Stonington’s exploration of the inseparability of biomedical technology and Buddhist practices in Thailand provides a meticulously crafted case study of the changing contours of death and dying in an increasingly medicalized world. A timely and innovative ethnography of new forms of engagement with personhood, medicine, and end-of-life ethics."––Sharon R. Kaufman, author of Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the Line
"This is a brilliant book that is at once a detailed and insightful ethnography of death and dying in northern Thailand and at the same time an in-depth reflection on how culture shapes people's understanding of the end of life. Hospitals, which are now as common in Thailand as they are in North America and Europe, still remain alien places for most Thai (and, indeed, for most people). Today, however, most in Thailand must spend some time in a hospital if they have a serious affliction. But they do not want their loved ones to remain in a hospital until death. Stonington proposes a distinctive concept, the choreographing the end of life, which should have application well beyond the world of Thai Buddhists. Although there is now a substantial literature on death and dying, no scholar or physician (and Stonington is both) has given such sustained attention to how families faced with the pending death of a loved one draw on deeply rooted cultural understandings to arrange actions to make the trauma of dying meaningful. Stonington also introduces the concept of the spirit ambulance to show how movements between the home of the dying person and the hospital are in fact orchestrated." ––Charles Keyes, Professor Emeritus, University of Washington
"Beautifully written and full of startling insights, The Spirit Ambulance paints a portrait of care for the dying as it is practiced in contemporary Thailand. Stonington shows how high-tech biomedical end-of-life care assumes distinctively local meanings and temporalities in the context of complex and shifting Thai religious and ethical understandings."–– Janelle S. Taylor, Professor of Anthropology, University of Toronto
