Out-of-hospital cardiac arrest (OHCA) is a major public health crisis in the United States and a leading cause of death, with a mortality rate of 90%. Immediate layperson cardiopulmonary resuscitation (CPR), delivered by someone who is not part of an organized emergency response, can double or even triple the likelihood of survival. Fewer than half of those affected receive layperson intervention, despite decades of widespread training efforts. This thesis argues that layperson CPR is a culturally mediated practice shaped by moral expectations, bodily norms, and social anxieties rather than knowledge deficits alone. The thesis employs a mixed-methods approach, including ethnographic fieldwork at CPR training events across North Carolina and Maine, archival research, analysis of CPR training materials, interviews with instructors and cardiac arrest survivors, and a survey of Duke undergraduates. The study conceptualizes CPR as a “moral inversion,” in which acts typically understood as violent are redefined as care. It examines how cultural assumptions surrounding race, gender, and the normative body are reproduced through CPR training infrastructure, reflecting systemic inequities in the distribution of emergency care. Through analysis of manikin design, certification protocols, and public health campaigns, the thesis demonstrates how CPR training constructs a “default patient” who is white, lean, and flat-chested, rendering non-normative bodies less legible as subjects of care. It further shows how American ideologies of individualism recast a fundamentally collective act as an exceptional exercise of personal will. This work contributes to scholarship in medical anthropology, the anthropology of the body, and cultural analysis of emergency care.
