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This introduction serves several important goals. It lays out both the research objective and theoretical framework placing this study on an interdisciplinary foundation that combines work from political science, American political development, mass communication, history, and diffusion studies. It introduces the core concepts of the book, concentrated around a recurring multistage process called the political communication cycle (PCC). The three stages of the PCC, detailed in the following chapters, include the information and communications technology (ICT)–focused technological imperative phase; the political choice phase, which emphasizes the behavioral process central to innovation; and stabilization through the establishment of new norms, regulations, and institutions. This process has repeated throughout history, where long periods of relative stability, known as political communication orders (PCOs), are disrupted by shorter periods of permanent change, identified as political communication revolutions (PCRs). The introduction concludes by introducing the three claims that are used throughout the book and outlining the chapters that follow.

This book concludes by focusing on Emerson due to the fact that his work exemplifies two major ideas central to the author's argument. The first of these ideas is that the phenomenon we experience as time emerges out of the efforts of human beings to make productive use of the nonhuman world. We might think of temporal modes such as deep time or clock time as facts of nature or technological imperatives, aspects of the world to which we must adapt ourselves. However, while time may be anchored in the nonhuman world, always partly beyond reach, Emerson's writings demonstrate how we bring time within human culture through our labor. As we perform work with time, as we strive to shape ourselves and our social worlds into new forms, we create the temporal modes that we inhabit.

This chapter discusses system design issues in end-of-life care. Two basic approaches to system design have prevailed since the 1970s—an autonomy and patient empowerment strategy and a quality of life model of palliative and holistic care. The chapter examines practical and conceptual problems arising in these two strategies. It discusses an emerging alternative system design with emphasis on relationality and communication concerning the goals of end-of-life care. In this relational and communicative design, the use of life-sustaining medical treatments may not fall prey to the technological imperative. Caregiving services can be appropriately managed and provide continuity of care across the trajectory of incurable, progressive chronic illness, especially during the last year or two of life. Hospice and palliative care programs, suitably reorganized and financed, will play a key role in that new system design.