Death’s Disparities.

Illustration: Andrew Zbihlyj
Illustration: Andrew Zbihlyj

I have a new piece in the Summer/Autumn issue of Harvard Divinity Bulletin called “Death in America,” in which I examine the inequalities inherent in our current end of life care. Here’s an excerpt (in which I quote the amazing domestic workers’ rights advocate, Ai-Jen Poo):

Domestic work, whether it is tending children, caring for elders, or performing household tasks, has always been seen as women’s work, and therefore as less worthy of pay and regulation than types of work that take place outside the home. “Often these individual employment arrangements involve no written contracts, and neither the employer/client nor the worker has clarity around hours, safety standards, responsibilities, and rights,” Ai-Jen Poo, co-founder of Domestic Workers United, writes in The Age of Dignity. “In fact, many individual employers don’t consider themselves formal employers at all—they just think of themselves as paying for ‘a little help.’ ” In Evelyn’s case, that diminished view of Maria’s employment is compounded by prejudices that are common to her socioeconomic class. Maria and those like her are invisible, their lives unseen, their labor undervalued, their stories unheard.

Why does Maria not protest? Ask for a raise? Refuse to work long, inconsistent hours? Why doesn’t she quit? In part, she is professional enough in her skills to recognize that dying patients are struggling with all kinds of loss that can sometimes be enacted on those around them. At the same time, she can little afford to push back.

“I’m scared. I don’t want to say something and get in trouble,” Maria confides to me. She desperately wants to keep her job. Like many domestic care workers, she is not a legal citizen. Poo writes that one-quarter of all domestic caregivers were born outside the United States, and 50 percent of this group are undocumented. When Maria began working with Evelyn, she was paid $13 an hour in cash. Four years later she is paid the same amount but by check, an arrangement that she worries will get her in another kind of trouble.

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