(De)medicalization and the Dying Body: Sallekhanā, Kinship, and the Limits of Liberal Bioethics

In this talk, Miki Chase (U of Wisconsin-Madison) explores how trajectories of illness and care, such as terminal cancer or anticipated cognitive decline, are reinterpreted through Jain doctrinal frameworks in the narratives of adult children of women who undertake the Jain ritual fast to death (sallekhanā or santhāra). Drawing on ethnographic accounts of women’s deaths in contemporary urban Jain households, Chase traces how narratives of bodily decline are reframed not as losses to be managed through medical intervention but as conditions of spiritual possibility that invite ascetic detachment and renunciation. Rather than resisting biomedical or bioethical paradigms outright, these narratives inhabit a complex zone of overlap where cognitive clarity is both a medical and religious ideal; the attenuation of pain is karmically elevated rather than clinically managed; and the logic of institutionalized care is subtly displaced not by the absence of obligation but by alternate forms of care. In tracing the limits of bioethical paradigms that presume the necessity of medicalization and institutional oversight, this talk describes how “illness narratives” and “santhāra narratives” coalesce to challenge prevailing understandings of what it means to die well, and how suffering, pain, and the medicalized body is accounted for in the lives—and deaths—of Jain women.

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Miki Chase is Assistant Professor in South Asian Studies and holds the Śrī Anantnāth Endowed Chair in Jain Studies. Her research and teaching focuses on intersections of religion, law, and gender in questions of care around death and dying in India, with a specific focus on Jainism.

Dr. Chase received her PhD from the Department of Anthropology at Johns Hopkins University, and her doctoral work received the Mohini Jain Presidential Chair in Jain Studies Best Dissertation Prize (2024). Her research focuses on the contemporary practice of the legally contested Jain voluntary ritual fast until death known variably as sallekhanā, santhāra, or samādhi-maraṇa, examining how lay Jains reconcile ideals and concepts outlined in scripture with the interreligious pressures of urban life and modernization of death, foregrounding the centrality of women’s moral subjectivities in such negotiations. Her research has been funded by the Wenner-Gren Foundation for Anthropological Research and the American Institute for Indian Studies (AIIS), including the Rachel F. and Scott McDermott Junior Research Fellowship. Her book in progress is tentatively titled The Ambiguity of the Vow: Law, Kinship, and Gender in Pathologizing the Jain Fast Until Death.