Kathleen Stassen Berger
Epilogue
Death and Dying
Death and Hope
Dying and Acceptance
Bereavement
Prepared by Madeleine Lacefield
Tattoon, M.A.
1
Death and Dying
• “Death mirrors the complexity of life
as death highlights cultural
differences and ethical dilemmas.”
– thanatology is the study of death and
dying, especially social and emotional
aspect.
2
Death and Hope
• What is death?
– a end or a beginning
– a private and personal event
– a part of the larger culture
– something to deny or avoid
– something to welcome
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Death and Hope
4
Death Through the Life Span
“In order to understand what death
means to people, we begin with
developmental differences. The
meaning assigned to death—either
the person’s own death or the death
of another person—depends partly
on cognitive maturation and personal
experience.”
5
Death in Childhood
• children as young as 2 have some
understanding of death, but their
perspective differs from that of older
family members
• children have some comprehension
of death—adults cannot assume that
children share their perceptions
6
Death in Adulthood
• a major shift in attitude about death
occurs when adults become
responsible for work and family
• death is not romanticized, but
dreaded as something to be avoided
or at least postponed
7
Death in Late Adulthood
• in late adulthood, anxiety about death
decreases
• a sign of mental health in older adults is
acceptance of their mortality
• older people write their wills, designate
health proxies---performing these actions
does not mean that they have given up on
life
8
Many Religions, Many Cultures
• Views of Death in Major Religions
– Buddhism
– Hinduism
– Native American Traditions
– Judaism
– Christianity
– Islam
9
Many Religions, Many Cultures
• Respect for Ancestors
• Spiritual and Cultural Affirmation
– near-death experience
• an episode in which a person comes
close to dying but survives and reports
having left his or her body and having
moved towards a bright, white light while
feeling peacefulness and joy
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Dying and Acceptance
• A good death is one
that is peaceful and
quick and occurs at
the end of along life,
in familiar surrounding
with family and friend
present and without
pain, confusion, or
discomfort
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Dying and Acceptance
• Attending to the Needs of the Dying
– Honest Conversation
– The Hospice
• an institution in which terminally ill patients
receive palliative care
– Comfort Care
• palliative care
– care designed not to treat an illness but to relieve the
pain and suffering of the patient and his or her family
• double effect
– an ethical situation in which a person performs an
action that is good or morally neutral but has ill effects
that are foreseen, though not desired
12
Dying and Acceptance
• Choices and Controversies
– When is a Person Dead?
• passive euthanasia
– a situation in which a seriously ill person is allowed to
die naturally, through the cessation of medical
intervention
• do not resuscitate (DNR)
– a written order from a physician (sometimes initiated
by a patient’s advance directive or by a health care
proxy’s request) that no attempt should be made to
revive a patient if he or she suffers cardiac or
respiratory arrest
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Dying and Acceptance
• Choices and Controversies
– When is a Person Dead?
• active euthanasia
– a situation in which someone takes action to bring
about another person’s death, with the intention of
ending that person's suffering
» slippery slope – the argument that a given action
will start a chain of events that will culminate in an
undesirable outcome
• physician-assisted suicide
– a form of active euthanasia in which a doctor provides
the means for someone to end his or her own life
14
Dying and Acceptance
– The Netherlands
– Oregon
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Dying and Acceptance
• Advance Directives
– living will
• a document that indicates what medical
intervention an individual wants if he or
she becomes incapable of expressing
those wishes
– health care proxy
• a person chosen by another person to
make medical decisions if the second
person becomes unable to do so
16
Bereavement
• Normal Grief
– Grief and Mourning
• bereavement
– the sense of loss following a death
• grief
– an individual's emotional response to the death of
another
• mourning
– the ceremonies and behavior that a religion or culture
prescribes for bereaved people
17
Bereavement
– Seeking Blame and Meaning
• a common impulse after death is for the
survivor to asses blame
• the normal grief reaction is intense and
irrational at first but gradually eases
• time, social support, and traditions help
18
Bereavement
– Complicated Grief
• absent grief
– a situation in which overly private people cut
themselves off from the community and customs of
expected grief—can lead to social isolation
• disenfranchised grief
– a situation in which certain people, although they are
bereaved, are not allowed to mourn publicly
• incomplete grief
– a situation in which circumstances, such as a police
investigation or an autopsy, interfere with the process
of grieving
19
Diversity of Reactions
• bereaved people depend on the customs and
attitudes of their culture to guide them though
their irrational thoughts and personal grief
20