Thursday, February 18, 2010

"Dying a Prolonged Death"

Below is my first main paper for my Sociology of Birth and Death class.
"Medicalize" (and all forms of it) IS a word, Word! And Firefox!

Next post will be my first main paper for my Psychology of Personality class.
About Freudian thought and psychoanalytic theory in regards to Pink Floyd's The Wall.

I'm really not a fan of Freud. He kind of makes me uncomfortable. Haha.

___________________________________Dying a Prolonged Death
___________________________________Reflection Paper #1

___________________________________Carina Botterbusch
___________________________________Sociology 317
___________________________________Dr. Hayes
___________________________________February 13, 2010

_____There are many different ways to deal with death, such as focusing on funeral rites and customs, striving for symbolic immortality, or ignoring the reality of death. The modern American view of death is particularly interesting because, due to medical technology, death has now become medicalized. Modern medical technology is able to send cancer into remission, ease pain to a degree, and prolong life for a time. However, these advances are not without consequence. I believe that such technology is not having a positive impact on the American view of death. Modern medical technology tries to prevent death, but all it can do is simply postpone it for a short time. Modern medicine may be able to prolong life, but at the same time, it is also prolonging illness, as well as the process of dying. Although acceptance is necessary for an emotionally healthy death, the medicalization and sterilization of death is ultimately a form of denial, which makes us even more afraid to die.
_____In order for an individual to be at ease with his own death, one must accept the inevitability of it. Likewise, in order for an individual’s family, friends, and community to be at ease with the individual’s death, they must also do the same. Avery D. Weisman (1993) explains that acceptance is one of four crucial characteristics that must be present in order for a death to be “befitting and appropriate” (p. 14). The importance of the acceptance of death is also highlighted by Bronislaw Malinowski (2005), who studied how numerous cultures accept death and maintain group solidarity by immersing themselves in funeral rites and customs. This demonstrated acceptance of death serves to unite those that are still alive and assure the survival of their cultural traditions (p. 21). Through these two articles, it is clear to see that denial does not make death easier and that acceptance is a much healthier approach to death. However, the modern medical technology of America has medicalized death which has ultimately sterilized death and surrounded it with an attitude of denial, rather than acceptance.
_____Modern society now has the medical technology to focus on preventing death, which is discussed by Margaret Lock (2005), who says that technology should exist for the good of people (p. 92). Although modern medical technology appears to be a good thing and is thought by most people to be such, in regards to the medicalization of death, I believe the medically-centered American philosophy is doing more harm than good. Focusing on the prevention of death is essentially a kind of denial, but instead we are made even more aware of the inevitability of death. As we try to control death, we are constantly reminded that we cannot. Philippe Aries (2005) discusses the current view of death, which he believes is “the invisible death,” where death is medicalized, which leads to feelings of shame, rather than fear (p. 46). While there is probably some shame of death from feeling hidden by the hospital walls, the hospital curtains, the funeral home, and the coffin lid; the fear of death remains in the invisible death. In order to hide something, one must be aware of it and, in order to keep it hidden, one must constantly remember to do so. The medicalization of death has not made it invisible; rather, its threat is ever present in our minds.
_____Part of the medical system is sterilization, with white walls, white beds, white sheets, and white uniforms. This world of white of the hospital is where most deaths occur and, because of the sterile and unfeeling environment of the hospital, death is likewise sterilized and removed from emotion. This removal from emotion is described by Geoffrey Gorer (1965) as “the pornography of death” (p. 18). Because of this sterilization due to the medicalization of death, grief and mourning are removed from death and replaced by uncertainty and fear because of how hidden and sterile death has become. Death is hidden and we no longer know what to expect.
_____The medicalized view of death and the sterilized hospital environments in which death occurs ultimately create denial in regards to the reality and inevitability of death. This fact is illustrated by how people in death-related professions refused to describe a personification of death for Robert Kastenbaum’s (1992) article (p. 12). Although the article does not discuss this occurrence in-depth, this refusal to personify death is probably because hospital workers, funeral directors, emergency responders, and other people in death-related careers must place themselves in a state of denial so that their emotional health is not severely impacted by being constantly surrounded by death. Death is everywhere in hospitals and the employees are surrounded by it every day. Likewise, so are the patients who are receiving life-prolonging treatments and this means that they are also likely to develop this same sense of denial.
_____Ernest Becker (2005) explains that the fear of death tends to be repressed because people simply do not want to think about it: “He knows that he will die some day, but he does not really care…The affect of fear is repressed” (p. 26). However, this repression of fear is not completely healthy for a person’s emotional state because repression is very similar to denial. In order to repress a feeling, one must first be aware of it and, in order to keep it repressed, one must constantly remember to do so. The effects of repression and denial are actually the reverse of what is expected. Furthermore, although people try to avoid thinking about death until they absolutely must, in a hospital setting, patients are constantly reminded of death and any efforts to repress or deny fear are pointless.
_____Robert Jay Lifton and Eric Olson (2005) discuss how people dissuade the fear of death by trying to attain some kind of symbolic immortality, whether biological, creative, theological, natural, or experiential (pp. 34-36). The medicalization of death tries to achieve a different kind of immortality through ignoring death by trying to prevent it and prolong life in every way possible. Lock (2005) also mentions the idea of immortality in her article and explains that immortality is not simply attained, it is instead the “defiance and denial of death” (p. 94). The modern medical system of America wants to believe that it can achieve immortality, but every attempt simply serves as a reminder that immortality cannot be achieved. Instead of achieving a sense of immortality and defying and denying death, the medicalization of death is constant proof that we can neither defy nor deny death, which makes death even more of an intimidating threat of which we are afraid.
_____The constant attempt to achieve an attitude of denial through the medicalization of death can be contrasted to the death rituals and customs of cultures without such an intricate and overarching system of modern medical technology. One example of this is the Vaqueiros, discussed in Maria Catedra’s (2005) article. The Vaqueiros consider there to be three types of death: the Good Death, the Bad Death, and the Tragic Death, which are characterized by a peaceful sleep, prolonged illness and suffering, and a sudden accident, respectively (p. 77). The Vaqueiros dread a long period of pain and suffering so much that they would prefer to die a tragic death (p. 79). Furthermore, when there is no hope of recovery from sickness and suffering is too great to wait for death to come, the Vaqueiros view suicide as an acceptable and logical solution (p. 84). In considering cultures like that of the Vaqueiros, it would be interesting to know what they think of how American medicalized culture views death. The Vaqueiros are very open about talking about death, but the American medical system does not allow for an open discussion.
_____The American medical system hides sickness and death behind the hospital walls, which keep us from knowing exactly what to expect. Many people believe they know what to expect, only to realize they do not when they enter the hospital environment. Two examples of this happening have occurred within my family. The first is one of my grandmothers, who died before I was born. She went into the hospital for abdominal pain and was diagnosed with cancer. This was in the 1970’s, so cancer treatments such as chemotherapy were relatively new and untested. She began receiving chemotherapy treatments, which reduced her strength to the point where she spent her days lying on the couch. Her treatments continued for two years, until she and her husband began to realize that the doctors did not know exactly what they were doing and that they were essentially treating her as their guinea pig. She and her husband realized that the seemingly infallible and trustworthy doctors were not as infallible as they liked to appear. Another example is my other grandmother, who had been a nurse all of her life and placed a great deal of trust in the American medical system. A few years ago, she was diagnosed with skin cancer and sincerely believed that she could go to the hospital, have a minor operation, and be cured immediately. However, the medical system was again shown as faulty. She went to the hospital expecting to be fine the next day, but she never left. Instead, she remained in the hospital and steadily declined until she died. American society places a great deal of trust in its medical system, which has created a kind of secrecy about what death entails, therefore increasing fear of death, rather than reducing it.
_____Modern medical technology may have the ability to send cancer into remission, ease pain to a degree, or even prolong life for a time, but these advances are certainly not without consequences. By prolonging life, sickness and pain, as well as the dying process are also prolonged. In addition, the medicalization of death that set out to deny death by controlling it has instead made us more afraid. This medicalization is a form of denial, it is false hope, but it does not work. Death cannot be stopped by medicine. The medical system tries to prevent, postpone, or even stop death and we feel like we should be more in control. However, we simply end up reminding ourselves that we are not in control and it is this constant realization of the inevitability of death that makes us most afraid.

Aries, Philippe. (2005). The hour of our death. In Antonius C. G. M. Robben (Ed.), Death,
_____mourning, and burial (pp. 40-48). Wiley-Blackwell.
Becker, Ernest. (2005). The terror of death. In Antonius C. G. M. Robben (Ed.), Death,
_____mourning, and burial (pp. 23-31). Wiley-Blackwell.
Catedra, Maria. (2005). Kinds of death and the house. In Antonius C. G. M. Robben (Ed.),
_____Death, mourning, and burial (pp. 77-89). Wiley-Blackwell.
Gorer, Geoffrey. (1965). The pornography of death. Death, grief, and mourning (pp. 18-22).
_____Harold Ober Associates Incorporated.
Kastenbaum, Robert. (1992). The personification of death. The psychology of death (pp. 9-13).
_____New York: Spring Publishing Company.
Lifton, Robert Jay & Olson, Eric. (2005). Symbolic immortality. In Antonius C. G. M. Robben
_____(Ed.), Death, mourning, and burial (pp. 32-39). Wiley-Blackwell.
Lock, Margaret. (2005). Displacing suffering: The reconstruction of death in North America and
_____Japan. In Antonius C. G. M. Robben (Ed.), Death, mourning, and burial (pp. 91-107).
Malinowski, Bronislaw. (2005). Magic, science and religion. In Antonius C. G. M. Robben
_____(Ed.), Death, mourning, and burial (pp. 19-22). Wiley-Blackwell.
Weisman, Avery D. (1993). A befitting and appropriate death. The vulnerable self (pp. 14-17).
_____Plenum Publishing Corporation.

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