Death and Dying

Sociological Perspectives

Gerry R. Cox, Neil Thompson

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000175332
• Edition: 1
• Topic: Psicología
• Subtopic: Salud mental en psicología

Death and Dying is an important core text for students and professionals interested in developing a holistic understanding of death and dying.

Chapters are replete with case studies, activities, key point boxes, and other features that enable readers to develop a sociologically informed understanding of the broad range of complex issues that underpin death and dying. Written by two established and highly respected experts in the field, it offers a thoroughgoing account of a wide range of social aspects of death and dying, filling gaps left by the traditionally narrow focus of the existing literature. By drawing the suggested sociological perspectives and highlighting the role of social policy, the authors put forward a fresh perspective of the field of thanatology.

This book is a major contribution in progressing knowledge and understanding of dying and death for students and professionals in counseling, health and human services.

1
Sociological Understandings of Death and Dying

Introduction

This opening chapter explores some key issues in relation to death education and related matters. It helps us understand how various thinkers have made a contribution to the gradual development of an approach to death and dying informed by sociology and the broader perspective it brings to the subject matter. It sets the scene for the chapters that follow.

In order to establish the important role of sociology in developing an adequate understanding of death and dying, we highlight a number of important issues. First, we explore the social nature of death and dying before moving on to consider how suicide, generally regarded as a very private, individualistic matter, is actually a profoundly social (and thus sociological) phenomenon.

We then examine the important topic of gender differences in grieving and the social processes involved. This leads us into a discussion of social support where we emphasize the important role it plays in responding to the challenges of death and dying.

The Social Nature of Death and Dying

One of the topics sociologists study is the social behavior of groups and networks of people. However, sociology is also concerned with individual experience. This is because it too has a social dimension. The concept of “social” means that there is more than one person involved but, significantly, even individuals who are alone also typically behave in response to the expectations of others; the social dimension is “internalized” – it becomes part of our lives. While dying is perhaps one of the most personal things that an individual will do, it is also decidedly a social act. It is not just a biological act or a personal event; it is a social phenomenon that affects the people who are a part of our social network. Similarly, whether we die alone or in the presence of others, our death is not just an individual act – others are deeply affected by it. This extends beyond the immediate family to include parts of the local community, the workplace and sometimes beyond. For example, the grief relating to the death of a well-loved teacher could extend to generations of former students.

Dying and death set off social ripples that can be far reaching in their impact, and each time this happens there will be a set of social norms or expectations around how we should react. Going against those social expectations can bring significant sanctions – for example, someone who does not show a suitable level of respect can face being ostracized for doing so.

SPIDER: Social expectations become internalized and, as such, are a strong influence on thoughts, feelings and actions. Going against such expectations can come at a significant price.

Sociologists are concerned with, among other things, the social norms, values, and attitudes that guide us, and the people around us, on a day-to-day basis. Situations that involve facing death are no exception, and nor are those that survivors would be expected to follow after a death occurs.

Key Point

Where do social norms come from? What role do they play in our society? Who benefits from them? How do they relate to power in society? These questions (and others) illustrate why sociology is concerned with social norms. They are just as relevant to death and dying as they are to any other aspect of human experience.

The Social Nature of Dying

Death and dying are social in a number of ways. Consider the following:

• Who dies – Of course, we all die eventually, but when we look at death sociologically, we can recognize that death rates are not evenly spread across the population. For example, there are widely different death rates across workplace settings. A soldier on active duty clearly faces a much higher death risk than an office worker.
• When we die – Life expectancy differs significantly across class groups. People living in poverty are likely to die far sooner than people who live lives of relative affluence (Toch-Marquarát et al., 2014).
• How we die – Some causes of death are more common in certain groups than in others. One obvious example would once again be that members of the armed forces are more likely to die than various other occupational groups.
• How death is defined – There continue to be debates as to when death is said to have occurred. Consider, for example, the ethical debates about whether and when a life support machine should be switched off.
• How death is understood – The way death is portrayed has changed significantly over the years. For example, the popularity of video games where players “die” time and again, see a screen saying “Game over” and then begin again with a new life a moment later. More broadly than this, the way death is presented in the media is also a strong influence on how death is understood (for example, which deaths are portrayed as important and which are marginalized, which deaths are seen as tragedies, and which as deserved or justified).
• How we respond to death – Grief reactions, as we shall see, are strongly influenced by social expectations about what is perceived as “healthy” grieving, as opposed to “abnormal” or “pathological” grief. What is considered an “appropriate” way of grieving differs from culture to culture, and has changed over time within cultures.

Another important sociological dimension of death and dying is the significance of symbols. Symbols are very powerful conveyers of meaning; they will often vary from culture to culture and social setting to social setting. Their role in shaping social interactions, processes, institutions, discourses, and so on should not be underestimated. For example, consider how logos and other branding symbols for major commercial entities can lead to significant sales, how a police badge can convey authority, and how a red light can bring traffic to a halt.

As we shall see in later discussions, meaning is a key element of understanding death and dying, and symbols are often core elements of meaning making. They represent something that a group or organization has given meaning to. There are many death-related symbols. For example, when President John F. Kennedy died, his body was displayed in the Capitol rotunda with many symbols around it. It was in a casket; there were kneelers for praying; candles; a crucifix; military honor guards; pictures; and a flag. While most of the symbols were from the Catholic traditions of Kennedy’s faith, the flag and military guards, the rotunda itself, and the pictures were part of the traditions used with dead presidents. Similarly, for most people flowers are a symbol of caring and concern. These are mutually shared and understood symbols.

Practice Focus 1.1

Tina was a nurse in a large hospital. For the past three years she had worked on a surgical ward, but she had recently moved to the palliative care ward. She was used to the very occasional death of a patient where the surgery was not successful. In her new environment what struck her was the way her colleagues had developed ways of coping with frequent encounters with death. She realized that the use of certain rituals served to make coping with the pressures much easier. She became aware that symbolism was an important part of this. In particular, she felt that the lighting of a candle in the reception area was a very effective way of acknowledging that a patient had passed away.

From a sociological perspective, the symbolic gestures that are taken for the deceased involve Mead’s (2007) concept of “generalized other,” a symbolic representation of the entire community or wider society (see Chapter 2 in this volume). The survivor imagines the response of others before they pick out the casket, write the obituary, choose the funeral home, pick the clergy person, and opt for cremation or burial, and whether to use a church or not. While no interaction with others may have taken place, the survivor is likely to think of the reactions of others to their choices before making those choices. Thus, our attitudes are ultimately social attitudes.

Symbols and the rituals that of which they often form a part will often be restricted by aspects of the social context. For example, for people associated with traditional, ritualistic religions, the choices are few. The Roman Catholic, Lutheran, Episcopalian, Amish, Navajo or Dine, or Hopi may have very limited choices while many Protestant groups, homeless people, prisoners, people who are not members of faith communities, and those living in nursing homes may face real limitations in decision making around the positive use of symbolism.

Key Point

Social structures are based on “social divisions,” including cultural, ethnic and/or linguistic groups. These social divisions play a key role in shaping the structure of society and thereby create differences in terms of power, access to resources, life chances, status, and so on. Society is not a level playing field.

There can be no doubt, then, that death and dying are very much part of the subject matter that sociology should pay attention to and that anyone seeking to develop a fuller understanding of death and dying needs to incorporate a sociological perspective.

Suicide as a Social Phenomenon

Emile Durkheim is perhaps the leading writer on suicide in sociology. His classic book, Suicide, is a standard in the field (Durkheim, 1951). He defined suicide as any act on the part of the individual which they know will bring about their death. He divided suicide into four different types:

• Egoistic – This refers to suicides that occur because the person concerned feels disconnected from society, with few social links (what we shall refer to in Chapter 2 as “social capital”). They do not feel integrated within their society, with little or nothing by way of a sense of belonging.
• Altruistic – This is where suicide is seen as some form of noble act – for example, a suicide bomber or a sacrificial victim within a cult.
• Anomic – Anomie, or “normlessness,” is an important concept that we will revisit in the next chapter. According to Durkheim, people facing periods of major instability and insecurity are more likely to take their own life.
• Fatalistic – This refers to circumstances where a person is so restricted (for example, by an oppressive regime) that they feel they have no sense of identity or any scope for meaningful action beyond the narrow parameters of their situation.

Of course, the key point here is not that there are different types of suicide, but, rather, that all four types are sociological, in the sense that they are rooted in social factors. While suicide clearly has a psychological dimension and much will depend on issues unique to the individual concerned, we should not neglect the additional significance of the wider social context in which the individual factors operate.

Suicide and homicide represent the premature loss of another person. Our dreams and hopes for them are gone. As a form of violent death, suicide is extremely difficult for survivors, especially as the grief involved is generally not socially sanctioned or supported and will often be stigmatized (see the discussion of “disenfranchised grief” in Chapter 2).

Voice of Experience 1.1

Grief is a difficult burden to bear in any circumstances, but what I have found is that grieving over someone who has taken their own life is particularly challenging. I think it’s to do with the stigma that still hangs around suicide. You’d think that, as a society, we would have a more enlightened approach by now, but that’s not the way it is. So often it makes grievers feel ashamed when there is absolutely nothing to be ashamed about.

Beth, a social worker in a hospice

There is a wide variety of reasons given for why people may take their own life, ranging from failing an examination to the loss of love. The fact that such disappointments are common does not deter those contemplating suicide. From a sociological perspective, these many reasons generally have a strong social component. Failure in a relationship with another person is a very common reason for suicide, and one way to get revenge against those who have caused us harm, whether real or imagined, is to cause them guilt by our manner of death.

Extreme social isolation or loneliness can also be a primary cause. If we feel that our situation is intolerable, suicide may come to be seen as a solution. It is important to understand that what is intolerable to one person may not be to another – there is no set standard at which the point of intolerability can be said to have been reached. The fact that there are social aspects of suicide should not mislead us into thinking that the circumstances are the same for everyone. A sociological understanding is needed as a complement to psychological insights, not as an alternative to them.

SPIDER: Difficulties in maintaining positive, meaningful and affirming social relations can have a devastating effect on a person’s well-being, physical and mental health, and social functioning, and can, at times, lead to suicide.

Gender Differences in Grieving

A common assumption is that there is one correct or “healthy” way to grieve, and that this applies to all people across all cultures and social groups or categories. In reali...