Perceptions of Death in Society Essay Sample
Death is an experience that will inevitably touch the lives of everyone. We speak of it in hushed tones or do not speak of it at all. It is not until death enters our lives shattering that which we know, that we realize we can no longer escape it. The death of a loved one is a profound experience and creating meaning for death in the context of life is a critical task of human development. Kastenbaum (2000) eloquently states that we cannot come to an understanding of life without coming to some understanding of death. The experience of loss can be confusing and painful at any point in a person’s life, yet, to suffer this loss during adolescence brings with it a unique and complex set of issues. In her essay On Death and Dying, Kubler-Ross observed that, “…Death has always been distasteful to man and will probably always be.” She thus concluded that “Death in itself is associated with a bad act, a frightening happening, something that in itself calls for retribution and punishment” (Kubler-Ross, 1969, p. 2).
Factors Influencing Death Response
Servaty-Seib, Peterson and Spang (2003) highlight that every individual’s unique response to a bereavement experience is affected not only by the individual’s personality, but also by the individualized relationship with the deceased. They asserts that various factors such as age, religious belief, coping abilities and support systems affect the intensity and length of grief responses, while Noppe and Noppe (1996) highlighted the salience of experiential factors on death suggesting that previous experiences with death influences adolescents’ ability to conceptualize death.
In addition to the aforementioned variables complicating grief, life stressors have also been found to influence the grief process. For an adolescent, these outside stressors may include issues such as moving, attending a new school, having academic difficulties or relationship problems, or maintaining part-time employment. The death of a parent marks the beginning of a series of recurring changes throughout the lives of the surviving family. It has been found that changes ushered by parental death include changes in family structure, financial status, and the emotional well-being of the primary caretaker (Clark et al., 1994).
For example, if the parent who died was the primary breadwinner for the family, or if the family relied on two incomes to make ends meet, the financial pressures on the family may constitute formidable stress. Because of the financial impact of a parental death, families may also be required to move into smaller homes, to change neighborhoods, or move to different regions of the country. In these situations, there is rarely an opportunity to plan the timing of the move around consideration for the bereaved children and adolescent’s educational and social situation. In this respect, they are likely to have to adjust to a new home, new school, new social structure and the loss of many important roles and relationships while redefining themselves in the wake of loss (Clark et al., 1994).
Although there is a growing body of literature concerning adolescents’ understanding of death, there is a lack of consensus on gender differences in death responses (Stillion, 1995). Worden, Davies and McCown (1999) argue that parental death has greater impact on boys than girls in that they tend to show more social withdrawal. However, Tamm and Granquist (1995) reported that female adolescents show more emotional reactions than male adolescents in such situations. Meishot and Leitner (1993) found that adolescent girls who had lost their parent tended to identify more strongly with their deceased parent than boys and manifested stronger reactions of grief. Furthermore, they found that female adolescents tended to grieve more intensely and for a longer period than did sons who experienced the same loss. These researchers suggest that unresolved grief may be more common for female adolescents.
When examining gender differences in death concepts and grief responses, it is important to consider the role that socialization and development plays. In contemporary western society, males have typically been socialized to be more independent, assertive, dominant, and competitive than females, while females have been socialized to be passive, loving, sensitive, and supportive in social relationships (Stillion, 1995). Boys are taught to deny anxiety and control emotional expression, while girls are expected to express more anxiety under pressure and warmth and nurturance in personal relationships (Stillion, 1995). Such differential socialization in expressiveness may permit females to admit and discuss fears, and be comforted more easily than their male counterparts. Noppe and Noppe (1996) suggest that it is during adolescence that responses to death diverge by gender and that the differences that exist between male and female responses are linked to identity development.
Kubler-Ross also believed a direct correlation exists between advancements in science and medicine and our increased fear and denial of the reality of death. This fear, she contended, is triggered in large measure by the lonely, mechanical, dehumanizing, and, indeed, gruesome manner in which death often occurs today (Kubler-Ross, 1969). Following some two hundred interviews, Dr. Kubler-Ross and her students were able to broadly define the attitudes of patients facing death. She concluded that patients passed through five definable stages in their final passage to death: denial and isolation, anger, bargaining, depression, and acceptance (Kubler-Ross, 1969).
Denial, the first stage, is most often expressed by the dying patient as, “This can’t be happening to me” or “There must be some mistake”-indicating a temporary inability to believe the truth or the diagnosis at hand. Kubler-Ross maintained that denial functions as a buffer, allowing the patient time to absorb shocking news and to consider exactly what to do next (Kubler-Ross, 1969). Denial can be equally difficult for the patient’s family. If the patient is in a state of denial, difficult conversations are not being held; the patient is not only practicing self-protection but is also buffering surrounding family and friends.
The second stage of the dying process defined by Kubler-Ross is anger, which develops when the patient can no longer maintain the denial of terminal illness. The patient may express anger with statements such as, “Why didn’t this happen to a bad person?” in subtle contrast to the denial statement, “This cannot be happening to me” (Kubler-Ross, 1969). This stage is often extremely difficult for the patient’s family, care givers, and significant others. The patient may frequently direct anger at those parties because the illness causing the anger is not a physical presence which can be yelled at, struck, or confronted personally. The patient experiencing anger may prove extremely difficult company, being demanding and unappreciative of others’ efforts to provide comfort. Kubler-Ross suggested that this behavior may be an attempt by the patient to say, “I am alive-don’t forget that! You can hear my voice; I am not dead yet” (Kubler-Ross, 1969).
Bargaining is the third stage in the process of dying. Kubler-Ross compared a patient’s bargaining behavior to that of a child (Kubler-Ross, 1969). When a child is not permitted to attend a party, the youngster will often bargain with his or her parents. The child who needs to be coerced into doing homework will enthusiastically volunteer to complete the entire assignment if he or she is allowed to go to the party. Similarly, the terminal patient who has reached the bargaining stage often bargains secretly with God. Many offer to lead good or holy lives if God will only make them better. Some patients bargain on behalf of others-asking, for example, that God let them live to parent their children.
Kubler-Ross theorized that bargaining is an attempt to postpone. She cited an example of a patient nearing death who simply wanted to attend her son’s upcoming wedding. The health care staff worked diligently to stabilize her and control her pain enough to attend the event. When Dr. Kubler-Ross visited the patient in the hospital upon her return from the wedding, the woman’s first comment was to remind Dr. Kubler-Ross that she had another son (Kubler-Ross, 1969).
When the bargaining “deadline” the patient has set expires without improvement or hope of cure, the patient naturally progresses to the next stage, depression. According to Kubler-Ross, depression is a period of great loss experienced as the illness and accompanying technology progresses (Kubler-Ross, 1969). For instance, a man with malignant prostate cancer is rendered impotent following surgery. As if it were not enough that he accept his impending death, he is also confronted with the realization he is unable to perform sexually. In addition, he may not be able to work and provide for his family, further contributing to a depressive state.
Kubler-Ross recognized two types of depression: reactive depression, which occurs first and in direct reaction to the illness and preparatory depression, which occurs later and is part of the process of actually preparing for death (Kubler-Ross, 1969). Reassurance is the best response for reactive depression. A family member can reassure a patient that he or she still has a role in the family, is still loved, or is still attractive.
Dealing with preparatory depression, precipitated by grief, is more difficult. It entails doing what the patient wants-whether limiting visitation, sitting quietly, or reading prayers. Family members who have not progressed with the patient through the stages of death and dying often find it difficult to support the patient through preparatory depression. Patients and families who are out of step in their acceptance of the dying process are prone to experiencing difficulties which may prevent them from reaching the fifth stage of the process, acceptance.
Acceptance is the final stage of dying, in which the patient who has had both the time and support to work through earlier stages will feel neither depressed nor angry about his or her fate. According to Kubler-Ross,
He or she will have been able to express his or her previous feelings, his or her envy for the living and the healthy, his or her anger at those who do not have to face their end so soon. He or she will have mourned the impending loss of so many meaningful people and places and will contemplate his or her coming end with a certain degree of quiet expectation. (Kubler-Ross, 1969, p. 99)
Although acceptance is far from a “happy” stage because it is the final preparation for death, most persons are relieved that their suffering is nearing an end. Kubler-Ross’ initial work, although completed more than two decades ago, has remained a valuable resource for dying patients, their families, and those who attend them. In her work, On Life After Death (1991), Kubler-Ross she discussed her belief that death does not exist but is “simply a transition to a different form of life”. She compared death to the metamorphosis from larva to butterfly and to graduation from the “school” of life. Although there were spiritualistic overtones to Kubler-Ross’ writings on the subject of life after clinical death, the author advanced the concept of an “ethereal body,” in which we carry on after the physical body ceases to function.
Death and Adjustment in Contemporary Society
According to Therese Rando, author of Grief, Dying, and Death (1984), the United States is an example of a death-denying culture. There is a widespread refusal to confront death. There are fewer rituals for recognizing it; rituals are replaced by mechanisms for coping with it. The attitude is that death is antithetical to living, and that it is not a natural part of human existence. Rando describes two kinds of losses we experience daily, normative and formative. Some examples of a normative loss include a first child leaving for college, a couple becoming parents, moving from one home to another, relocating out of state, ending a job, being fired from a job, and the end of adolescence. Formative losses, on the other hand, are literal and untimely deaths. How we deal with normative losses has a significant impact on how we deal with formative losses.
Death threatens us with the negation of ourselves. We are a future-oriented society. To have no future arouses anxiety. Events associated with death, such as separation, loss, sleep, illness, loss of control, or saying goodbye, can bring out this feeling. The bereaved person must contend with several major situational factors for which adequate compensating customs have not yet evolved. Contemporary society lacks available resources for embracing grief and unhelpful, and maintains unhealthy attitudes about death and bereavement. These factors limit one’s support system, limit one’s experience and knowledge of death, and encourage the denial of death (Kubler-Ross, 1991).
In earlier times people were much less mobile; consequently their family and social support systems were wider and closer. Death occurred most often at home within the family context so that one experienced it at a young age in ordinary surroundings. There was no possibility of denial. Today all services surrounding death are done by people on hire, from transporting the body to the mortuary to care of the body, memorial services for the family, digging the grave, transporting the body to the cemetery (if the body was not cremated—also a service hired), to putting the coffin in the ground (Rando, 1984).
In America, most attention is placed on kin-based relationships and roles. Grief may be disenfranchised in those situations in which the relationship between the bereaved and the deceased is not based on recognizable kin ties. Here the closeness of other non-kin relationships may simply not be understood or appreciated. The role of lovers, friends, neighbors, foster parents, colleagues, in-laws, stepparents and stepchildren, caregivers, counselors, co-workers, and roommates (such as in nursing homes) may be long lasting and intensely interactive. Even when these relationships are recognized, mourners may not have full opportunity publicly to grieve. At most, they might be expected to support and assist family members (Rando, 1984).
Then there are relationships that may not be publicly recognized or socially sanctioned, such as extramarital affairs, cohabitation, and homosexual relationships, which have tenuous public acceptance and limited legal standing, and which face negative sanction within the larger community. With the absence of the extended family comes increased vulnerability to devastation and loss of support following the death of a loved one. There is no opportunity to see aged relatives die and to experience death as a natural part of the life cycle (Rando, 1984).
Individuals are increasingly removed from nature and from witnessing of the life/death cycle. They have less of a sense of community with others and have fewer common rituals to express feelings and guide behavior. Religion used to minimize the impact of physical death by focusing on the hereafter, endowing death with a special meaning and purpose, and providing for a future and immortality. With the decline in organized religion, there has been a marked loss of these coping mechanisms (Rando, 1984).
Advances in medical technology give humanity more of a sense of control. There is less need for systems of thought that make death meaningful, such as philosophy or religion. Technology has promised immortality through cryonics; however, it also has created tortuous bioethical quandaries (e.g., the definition of death, euthanasia). As life can be lengthened, deaths occur less frequently, and terminal illnesses become chronic. Fewer people are dying of cancer, and more are living with cancer. All of these advances in technology have compromised our ability to understand death as a natural part of human life.
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