ABSTRACT

This article approaches the theorisation of extraterritoriality through an ethnographic examination of the shaping of end-of-life experiences and trajectories through federal healthcare governance in St. Croix, an island in the unincorporated territory of the U.S. Virgin Islands. Drawing on critical phenomenological approaches to the organisation of attention, I advance disregard as a central dynamic shaping how the end of life unfolds on St. Croix through the constitution of the U.S. Virgin Islands as exceptional. I demonstrate the workings of disregard and the reproduction of exceptionality through analyses of the everyday workings of Medicare, the universal health coverage programme for American citizens 65 years old and over. Specifically, the case study examines how the bureaucratic disregard within Medicare worked to create and then maintain a situation in which the medical equipment that can support and extend the capacities of older adults’ bodies in the territory was unavailable. I suggest that this points to the broader import of disregard and the reproduction of exceptionality in constituting the extraterritoriality of the U.S.’s insular areas, and to the importance of the body as a locus of extraterritoriality.

摘要

本文通过对美属维尔京群岛非建制领土圣克罗伊岛联邦医疗治理对临终经历和轨迹的塑造进行人种学研究，探讨治外法权的理论化。借鉴对注意力组织的批判性现象学方法，我将无视作为一个核心动力，塑造生命终结如何通过美属维尔京群岛的宪法在圣克罗伊岛展开，这是例外。我通过分析医疗保险的日常运作来展示无视和复制例外的运作，医疗保险是 65 岁及以上美国公民的全民健康保险计划。具体来说，该案例研究探讨了医疗保险内部的官僚主义如何造成并维持这样一种情况，即该地区无法提供可以支持和扩展老年人身体能力的医疗设备。我认为这表明在构成美国岛屿地区的域外法权时更广泛的无视和特殊性的再现，以及身体作为域外法权场所的重要性。