THANAT1025 C7 Culture and Thanatology PDF

THANAT1025 Lecture 7 October 28, 2024 Culture and Thanatology Importance of Cultural Awareness in Death and Dying - While death is universal, it gets mediated by culture, cultural interpretations and...

THANAT1025 Lecture 7 October 28, 2024 Culture and Thanatology Importance of Cultural Awareness in Death and Dying - While death is universal, it gets mediated by culture, cultural interpretations and expressions of death vary widely - Cultural competence — Being aware of and responsive to cultural differences in ways that are sensitive, caring and supportive - Cultural humility — A newer term highlighting our awareness that we can never really be fully competent in a culture in which we don't primary identify There is a continuum or process in the ongoing development of cultural competence....starting with cultural sensitivity, moving to an increasing cultural awareness, progressing with the acquiring of cultural knowledge and cultural skills that ultimately leads to a level of cultural competence, which in itself is an ever evolving process. The current thinking about cultural competence is that while the term implies that we can become “competent” in understanding cultures that differ from our own, we understand that it is never possible to fully understand a culture in which you aren’t primarily identified. We often use the term “cultural humility” to reflect the stance of wanting to learn from others, be aware and sensitive to issues and concerns that others experience, and never assume we “know it all.” Culture - A culture is composed of ideas by which people live. We naturally tend to believe that everyone shares the basic ideas and values that we do. However, that is not the case. An understanding of cultural differences is important for two fundamental values: - Cultural traditions and values act as filters in which individuals understand the world, and through which they hear what is being said to them. - Decisions are made not simply on the basis of immediate data given to us, but on how that data interfaces with our more fundamental values. - Effectively communicating with someone requires knowledge and respect of the person in their physical, social, educational and spiritual levels of being - that is, his or her individuality. While the experiences and expression of grief and the needs that emerge may vary widely from individual to individual, they are subject to many variables, including experiences, cultural expectations, personal beliefs, and relationships.  - Our personal identity comes from our sense of personal uniqueness, our tense of solidarity with the group ideals, our sense of continuity from the past, into the present, and thus into the future, and from the culture in which we were raised and/or the culture that we have adopted - A culture is a cumulative expression of a group of persons attempts, through the rationality available to them, to pursue their interests with one another, and with the material environment. It represents the patter of values passed from generation to generation, the way of life of the group: material objects, knowledge, customs, beliefs, art, laws, moral ideas, and ideas of success. Denial or ignorance of cultural differences does not foster positive interactions. There are real differences in people, their backgrounds, and cultures. Each group is physically and culturally different from other groups. Racial, religious, and other cultural questions and concern should be addressed immediately and with sensitivity Defining Features of Culture Culture is: Dynamic - Created through interactions with the world Shared - Individuals agree eon the way they name and understand reality Symbolic - Often identified through symbols such as language, dress, music, and behaviours Learned - Passed on through generations, changing in response to experiences and environment Integrated - Span all aspects of an individuals' life. Cultural Assumptions A cultural assumption is when an individual assumes that a person has a particular value and attitudes based on their cultural background. Examples can be based on gender, age, lifestyle, family, ethnicity. The most common cultural assumption is: Everyone who looks and sounds the same are the same Cultural Diversity and Death Systems Death Systems differ because of: Life Expectancy Exposure to Death How we understand the physical universe Our idea of what it means to be a person Aspects of Death That Most Commonly Demonstrate Cultural Variations - Degree of death anxiety (fear of death of self and/or others) - Concerns about dependency and care with relatives - Fear of unrelieved pain in the dying process - Religiosity and influence of religious/spiritual beliefs, an afterlife - How grief is understood and expressed - Funeral and burial bites Pittu Laungani (2015), a British psychologist, explored how death systems vary in different societies. He started that ideas regarding how cultures view death and grief can be understood in these broad ideas. Such ideas can be conceived on a continuum of: - individualism vs.communalism - cognitivism vs. emotionalism - free will vs. determinism - materialism vs. spiritualism  Individualism vs. Communalism Cultures that highly value individualism will tend to focus on individual achievement, independence and personal growth Cultures that value communalism will tend to focus on the context of the family or the greater community, with any personal gain or growth seen as a benefit to these groups and a reflection upon these groups more than upon the individual person. Cognitivism vs. Emotionalism Cultures that highly value cognitivism will support the pursuit of scientific endeavours, the explanation of the physical universe from tangible, rational theories, and scientific proof and reason will be highly valued and rewarded. Cultures that value passion, emphasize personal beliefs and intuitive reasoning occupy the emotionalism end of this continuum.  Free will vs. Determinism Cultures that favour an individual’s independent thinking and choice, with an emphasis on personal responsibility for actions and beliefs, tend to encourage the concept of free will. Another aspect of freewill is the sense that you can control outcomes by your own actions. Cultures that embrace a deterministic viewpoint tend to identify patterns such as fate, karma, and external forces outside the individuals control that predetermine how events will unfold. Materialism vs. Spiritualism Cultures that focus on materialism emphasize the role of personal power through consumerism, owning goods, and acquisition of wealth. Cultures that focus on spiritualism tend to emphasize the acquisition of personal beliefs and attitudes that are intangible, and usually de-emphasize the role of material gain in favour of spiritual understanding, greater depth of awareness, and the meaning of human existence  Canadian Death System Secularization and bureaucratization influence how people view and handle death, often distancing the individual from the natural process of dying Overarching "death-denying" culture, where euphemisms (e.g., “passed away”) soften the reality of death, reflecting a reluctance to face mortality directly Canada has a multicultural context, where practitioners encounter diverse end-of-life beliefs and practices, making cultural sensitivity crucial Canadian Fascination with Death Duality of Fear and Fascination: Canada, like many Western societies, experiences a paradoxical relationship with death—characterized by both fear and fascination. While Canadians may avoid direct confrontation with mortality, there is a cultural intrigue around death seen in literature, folklore, and tourism​. Examples in Popular Culture: Canadian literature and folklore are rich with death themes. For instance, dark tourism, such as visits to battlefields or haunted sites, reflects a fascination with mortality from a safe distance, allowing Canadians to engage with death without directly confronting it​. Use of Humour: Humour is also used as a way to manage anxiety about death, with colloquial expressions and euphemisms (“kicked the bucket,” “pushing up daisies”) softening the reality of death and making it more palatable​.  Cultural Perspectives on Death and Dying Impact of Cultural beliefs on Attitudes Toward Death Cultural beliefs shape death anxiety and readiness for death. Death-Denying Societies (e.g., North America and Western Europe): Avoidance of Death: In Western societies, there is often a reluctance to discuss or confront death openly. This is evident in the use of euphemisms ("passed away," "gone to a better place") instead of direct terms like "died." This avoidance reflects a cultural anxiety about mortality and discomfort with the idea of impermanence​. Language of Resistance: Death is often framed as an enemy to be fought, especially in the context of illness (e.g., “battling cancer”). This language suggests a combative stance toward death, reinforcing a societal view that death should be resisted rather than accepted​. Impact on Funeral Practices: Funerals in death-denying cultures may focus on celebration of life rather than acknowledging loss, with less emphasis on mourning. Funeral homes and services also often sanitize and manage the presentation of death to make it appear less threatening​. Death-Affirming Societies (e.g., Eastern Cultures, Indigenous Traditions): Acceptance of Death as a Natural Process: In many Eastern cultures (e.g., Buddhism, Hinduism) and Indigenous societies, death is seen as a natural transition rather than a final end. This acceptance fosters a more open relationship with death, where it is acknowledged and even integrated into daily life and spiritual practices​. Symbolism of Cyclical Life: Cultures with death-affirming attitudes often view death as part of a larger cycle. For instance, in Hinduism, death is not the end but a step in the cycle of reincarnation, which can reduce anxiety around death by framing it as a continuation rather than a cessation​. Impact on Funeral and Mourning Practices: Rituals in death-affirming societies tend to be elaborate and involve symbolic acts that emphasize the peaceful transition of the soul. Practices such as ancestor veneration and rituals for guiding the deceased's spirit are common, reflecting a communal and spiritual approach to death​.  Terror Management Theory (TMT) Developed by Social Psychologists: Terror Management Theory was introduced by psychologists Sheldon Solomon, Jeff Greenberg, and Tom Pyszczynski in the 1980s as a framework to understand how humans cope with the existential anxiety that arises from the awareness of mortality​. We have the capacity to think about the future, the awareness and eventuality of death can be a direct conflict without survival instinct Core Premise: Humans, unlike other animals, have an advanced cognitive capacity that allows them to be self-aware and anticipate their future, including the inevitability of death. This awareness creates a conflict between the survival instinct and the knowledge of eventual death, leading to what is called "mortality salience"—a heightened awareness of one's vulnerability and impermanence​. Role of Cultural Worldviews in Reducing Anxiety TMT posits that awareness of mortality can provoke deep-seated anxiety, motivating individuals to adopt behaviours and beliefs that provide existential security. According to TMT, people adopt cultural worldviews—belief systems that provide order, meaning, and a sense of permanence—to buffer against the anxiety that comes from knowing they will die. These worldviews give individuals a sense of purpose and belonging, which helps to reduce existential fears. - Religious Beliefs: Beliefs in an afterlife, such as heaven or reincarnation, help alleviate death anxiety by providing comfort and a sense of continuity beyond death. In Canada, Indigenous communities may find solace in the belief that ancestors continue to interact with and protect the living​. Legacy and Achievement: Cultural narratives around leaving a legacy, achieving greatness, or contributing to one’s community allow individuals to feel that they will "live on" symbolically through their actions and contributions. National Identity and Ideals: Identifying with one’s country or group helps individuals feel part of something enduring, larger than themselves, which can create a sense of symbolic immortality.  Examples of Death Anxiety Manifestation Avoidance Behaviours: Individuals may avoid attending funerals or discussions about death due to discomfort or fear, a behaviour common in death-denying cultures like Canada and the U.S.​ Risk-Taking as a Response: In some cases, death anxiety can lead to behaviours that confront mortality, such as engaging in extreme sports or high-risk activities. These acts can reflect a subconscious desire to overcome fear of death by facing it directly. Mortality Salience and its Physiological Effects Impact of Mortality Salience: Studies have shown that when people are reminded of their mortality—through things like news of disasters, personal health scares, or encounters with death—they experience increased mortality salience, which can influence attitudes and behaviours: - Increased In-Group Favouritism: Mortality reminders tend to make people more defensive of their cultural values and identities. For instance, individuals may express stronger support for national or religious identities when reminded of death. - Greater Adherence to Social Norms: To gain reassurance and acceptance, people often conform more strictly to cultural norms and moral values when facing mortality salience. This can include intensified patriotism, religious devotion, or alignment with traditional beliefs​. - Resistance to Out-Groups: In response to mortality salience, people may also show increased hostility toward those who hold different worldviews, as divergent beliefs can threaten the stability and validity of their own beliefs. This reaction is known as "worldview defence" and is seen in behaviours like ethnocentrism and prejudice against out-groups. Examples of TMT in Cultural and Social Contexts Religious Martyrdom and Afterlife Beliefs: In some cultures, individuals are willing to sacrifice their lives for a cause, motivated by beliefs that grant them symbolic or literal immortality (e.g., martyrdom in religious contexts). This can be seen in groups who believe that their sacrifice ensures a place in the afterlife, alleviating the fear of nonexistence​. Patriotism and National Loyalty: During wars or national crises, people often exhibit strong loyalty to their country and may even risk their lives to protect it. TMT explains this as a response to mortality salience, where loyalty to one’s nation offers a sense of belonging to an enduring entity and thus a form of symbolic immortality. Legacy-Building Behaviours: Many people seek to "leave a mark" on the world through achievements, philanthropy, or family. For instance, prominent figures might focus on creating an enduring legacy through buildings, charities, or contributions to society. This pursuit of legacy can be a way to manage death anxiety by extending one's influence beyond death. Application of TMT in Thanatology and End-of-Life Care Enhancing Cultural Sensitivity: Understanding that cultural worldviews and beliefs help manage death anxiety can guide practitioners in respecting diverse death and mourning practices. For instance, acknowledging the importance of afterlife beliefs or legacy-building in a patient's life can provide emotional comfort and reduce end-of-life fears. Guiding Conversations around Mortality: TMT emphasizes the importance of sensitive communication about death. Practitioners can support patients by validating their worldviews and creating space for meaningful discussions about legacy, spiritual beliefs, and life achievements, thus addressing their mortality concerns constructively​. Expressions of Grief and Mourning Distinguishing Grief from Mourning Grief: The internal, personal experience of loss, encompassing emotions like sadness, anger, guilt, and relief. It is a private and often unstructured reaction that can vary widely even within the same cultural group​ Mourning: Outward, culturally shaped expressions of grief that follow specific customs, rituals, and expectations. Mourning practices offer structure, community support, and help in acknowledging the reality of loss Canadian Mourning Practices Euphemisms and Softened Language: In Canada, phrases like "celebration of life" and "passed away" are commonly used to describe death. This reflects a broader societal discomfort with openly addressing death and a tendency to soften its harshness​. Private and Reserved Mourning Style: Traditional Canadian practices often emphasize private mourning or small family gatherings. Formal mourning periods are less commonly observed, reflecting an individualized approach to grief​. Influence of Secularization: The decline in formal religious mourning rituals in Canada has led to more secular approaches, such as memorial services rather than religious funerals. There’s often an emphasis on remembering the deceased through personal reflections rather than structured rites​. Examples of cultural Mourning Practices African Mourning Traditions African mourning traditions encourage vocal expressions of grief, including crying, singing, and even wailing, as a way to release sorrow. This openness contrasts with more restrained mourning styles in Western cultures and allows for cathartic release of emotions. Indigenous Rituals in Canada Indigenous communities may observe longer mourning periods and use ceremonial objects, smudging, or storytelling to honour the deceased. The communal nature of these practices emphasizes family and cultural continuity. Jewish Tradition (Shiva) This seven-day mourning period involves close family and community, where visitors support the bereaved in the home. This contrasts with Canada’s more privatized mourning practices, where public expressions of grief are less common. Worden’s Four Tasks of Mourning A model that helps individuals understand and navigate the grieving process. It emphasizes the active role of grievers in adapting to loss through four distinct tasks. - Accept the reality of the loss: requires confronting emotions and acknowledging that the person, relationship, or situation is gone and won't return. - e.g., viewing the body or attending a funeral - Process the pain of grief: requires working through painful emotions rather than avoiding them. Individuals may experience a range of emotions such as sadness, anger, guilt, and even relief. e.g., emotional expression (e.g., crying, wailing), while others may encourage stoicism or restrained grief Adjust to an environment without the deceased: may require learning new skills, redefining roles, or adjusting to an identity that no longer includes the presence of the lost individual. - e.g., African families taking on new roles or Chinese families maintaining shrines for the deceased Finding an enduring connection while moving on: maintaining a healthy connection with the deceased or the past, while also embracing the present and future. This connection is often symbolic, allowing the person to live their life meaningfully. - e.g., honour deceased loved ones through symbols, shrines, or naming new children after the deceased Indigenous Death Practices in Canada Respecting Traditions in End-of-Life Care Indigenous Views on Death as Part of Life: Many Indigenous cultures in Canada view death as a natural continuation of life, where the deceased join the spirit world and continue to play an active role in the lives of the living. This belief impacts how Indigenous families approach death and dying, often focusing on community support and connection with the ancestors​. Common Rituals: Indigenous death practices may include smudging ceremonies, drumming, and prayers, with specific practices varying by community. These rituals aim to help the spirit transition and to bring peace and healing to the family.​ Challenges in Healthcare Settings Restrictions on Family and Ceremonial Objects: Hospital policies may limit the number of visitors or restrict the use of certain ceremonial items (e.g., burning sage for smudging), which can conflict with Indigenous practices that require a strong family presence and the use of cultural symbols​. Need for Culturally Competent Care: Indigenous families may feel disconnected or unsupported in healthcare settings that lack cultural sensitivity. For instance, some healthcare providers may not fully understand the significance of Indigenous rituals and their role in end-of-life care​.  Possible Solutions for Practitioners Flexible Policies: Hospitals and palliative care facilities can adopt policies that respect cultural needs, such as allowing extended family visitation and the use of ceremonial items, as long as safety guidelines are met. Cultural Liaison Roles: Employing Indigenous cultural liaisons or collaborating with local Indigenous leaders to provide culturally sensitive support and guidance to families and staff in end-of-life settings​. Education and Training: Encourage healthcare staff to undergo cultural competency training, focusing on understanding Indigenous perspectives on death and mourning, as well as recognizing the diversity within Indigenous cultures. Guidelines for Practitioners in Multicultural Canada Listening as Learning - Active Listening: Encourage practitioners to view families as the “teachers” about their own cultural values and practices. Strategies for Cultural Sensitivity - Ask Open-Ended Questions: Use questions to better understand family beliefs without imposing assumptions. - Respect Non-Western Practices: Emphasize that families should feel safe in expressing their customs, which may include practices unfamiliar to mainstream Canadian healthcare​.