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🎭 Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society Historical Concerns for the Dead Concerns for the dead predate written history Evidence...

🎭 Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society Historical Concerns for the Dead Concerns for the dead predate written history Evidence Cave excavated at Northern Spain record the earliest human funerary behaviour in Europe from 1 million years ago Human remains recovered in Europe dated about 40,000 to 10,000 years ago are recognised as intentional burials, accompanied by manufactured objects, personal effects and other grave goods Key idea - Our Interpretations and perspectives on death are affected by the way we live (culture, experience - social + cultural constructs) 1. Ethnocentrism - making judgements about others based on ones own cultural assumptions and biases 2. Structural view of society - enduring and patterned aspects which provide context and background against which people live out their daily lives 3. Symbolic interactionism - idea that people are actively responsive to and creators of social structures and processes in their lives Evolving Death Image and Perspectives Image of death has changed over time and has come to represent each era’s prevailing concept of health Shaped by Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 1  Political economy Institutional structures Social Actors Enduring Myths 6 Progressive Stages of Changing Death Attitudes in the Western World 1. Dance of the Dead Before 15th Century Death was deemed as a divine act of god Natural part of life, source of renewal, highly religious act People have no control over mortality death is dependent on faith Dawning of Protestant Reformation movement Separation between church and state —> emergence of religious liberty and freedom Death became autonomous Everyone dies 2. Dance of Death : 16-17th Century Death transformed into an independent figure Force of nature calling on every human being New fear of being “in the grip of death” Death was seen as the great equalizer Fall of the Church, Black death and the great plaque Death was the ultimate end Superstitious practices for ensuring a good, easy and speedy death became more prominent and common Ars Moriendi - The Art of Dying became popular Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 2  3. Bourgeois Death: 17-18th Century Time of Industrial Revolution Employment and wealth resulted in unprecedented social segregation Marked the emergence of middle class families Rise of the medical market without institutional justice Death became an untimely event - often happens earlier than it should Wealthy could buy health and keep death away Poor were left to die Good health of children became a responsibility borne by parents Old age became a privilege defined through class and economic power 4. Clinical Death: 18-19th Century Time of union formation and the emergence of the concept of basic rights Death is an outcome of a specific disease certified by the doctor First Civil Code: Enacted in 1803 that required a medical officer to be present to verify Medicine was still underdeveloped death therefore, misdiagnosis of death before this, death did occurred often not certification Assumed a new elite status for clinicians Emergence of death denying culture The ability of doctors to certify death and control Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 3  disease gave rise to the myth of control over death Supremacy over health thrust people into powerful middle class 5. Health As Commodity (useful/valuable): 20th Century Enactment of the Universal Declaration of Human Right (1948) Good health + good death through institutionalised medical care had become a service that society owed to all its members New form of mortality endorsed new forms of social control State now Individuals’ responsibility for upholding responsible for their own well-being diminished proper deaths of all People don’t even do basic things like men and women covering nose when coughing or Deaths without sneezing because doctor’s are seen as appropriate life savers medical treatment was liable to legal inquiries E.g. Medical Malpractice/neglect like denying an elderly Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 4  medical treatment 6. Death in Intensive Care: Mid 20th Century Human lifespan stretched by ~ 36.7 years People protected against death by modern medicine Patients no longer set scene of their own deaths Death became mechanical Process of death has become depersonalised, routine, or handled in an impersonal, procedural manner Death seen as a failure for both doctors and nurses Preoccupation with curation and saving lives Professionals fear death more than those who are sick and dying withdrew from bedsides of dying patients because they do not have the capacity to cope with the emotions and psycho-spiritual processes of death The Rise of Social Death With the professionalisation of the rituals of death and dying, individuals can be socially dead before being biologically dead Individuals not accepted as fully human by society because of deteriorating health Life dissolves in the plain fixtures of hospitals and institutions Dying becomes just procedural People who are dying progressively lose their individual identity, social networks and personhood Individuals who are dying withdraw themselves from society due to fear and stigma The dying experience an increasing sense of isolation and loneliness Death Attitudes in the Asian Chinese Context Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 5  Death in Confucius Heritage Culture (CHC) Interpretation and pronunciation of deaths vary among people of different social status Psychology of Death in CHC: Death-Avoiding yet Death- Worshipping Complex Death is commonly perceived as the opposition to life, failure, bad luck therefore met with avoidance and resistance YET, death is treated with great formalities where elaborate rituals serve to safeguard traditional moral values, family hierarchy and social status 2007-2014 Hong Kong Death Attitude Survey What were the death attitudes among different age cohorts in Hong Kong (HK)? Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 6  Results Fear of Death Elders less fearful of death than adults Fear of death across adults and elders decreased after “Empowerment Network for Adjustment to Bereavement and Loss in End-of-Life” (ENABLE) program implemented in HK Death Avoidance Adults more death avoidant than elders Death avoidance decreased after ENABLE program implemented in HK Did Death Taboos across time (2007-2014) in HK change after Project ENABLE General Trends Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 7  Decrease in most taboos except “Talking about death brings bad luck” Did Death Preparation across time (2007-2014) in HK change after Project ENABLE General Trends Increase in death preparation behaviours Drop in purchase of burial plots/columbarium drop is likely to be due to price increase in plots and columbarium space 2013 Singapore Death Attitude Survey (N = 1,006) How comfortable are people talking about matters related to death and dying Discussing death and dying in Singapore Findings Only 1/2 of Singaporeans talk about death/dying Chinese individuals least likely to talk about dying Those above 60 even less likely to talk about death and dying Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 8  What are the triggers for discussions about death? When faced with a life threatening illness or if someone passes away Are people in Singapore comfortable talking about death? Not really Only 36% said they were comfortable talking about own death no. drops to 20% when talking to someone who is terminally ill Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 9  Why are people in Singapore uncomfortable talking about death? 45% do not know how to broach the topic 34% said it’s just not something that their family would talk about Taoism and Death - Death avoiding + death- worshipping Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 10  Buddhism and Death - Causal and cyclic view of death + death worshipping Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 11  Confucianism and Death - Death avoiding yet death worshipping Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 12  Filial Piety - A highly asian concept Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 13  Study conducted on filial piety and caregiving Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 14 Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 15 Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 16  Filial Piety is changing What are the clinical implications for evolving attitudes on Death? Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 17  What are the policy implications for evolving attitudes on Death? Lecture 3 - Evolving Attitudes on Death and Mortality in Contemporary Society 18