Encyclopedia of Death and Dying

Glennys Howarth, Oliver Leaman, Glennys Howarth, Oliver Leaman

• Publisher: Routledge
• Year: 2003
• Print ISBN:
  9780415188258
• eBook ISBN:
  9781136913785
• Topic: Social Sciences
• Subtopic: Religion
• Index: Social Sciences

In recent years there has been a massive upsurge in academic, professional and lay interest in mortality. This is reflected in academic and professional literature, in the popular media and in the proliferation of professional roles and training courses associated with aspects of death and dying.
Until now the majority of reference material on death and dying has been designed for particular disciplinary audiences and has addressed only specific academic or professional concerns. There has been an urgent need for an authoritative but accessible reference work reflecting the multidisciplinary nature of the field. This Encyclopedia answers that need.
The Encyclopedia of Death and Dying consolidates and contextualizes the disparate research that has been carried out to date. The phenomena of death and dying and its related concepts are explored and explained in depth, from the approaches of varied disciplines and related professions in the arts, social sciences, humanities, medicine and the sciences.
In addition to scholars and students in the field-from anthropologists and sociologists to art and social historians - the Encyclopedia will be of interest to other professionals and practitioners whose work brings them into contact with dying, dead and bereaved people. It will be welcomed as the definitive death and dying reference source, and an essential tool for teaching, research and independent study.

A

abortion

Abortion refers to the induced or spontaneous expulsion of a foetus from the uterus before it is able to sustain life outside of the womb. Although this definition includes miscarriage, the following discussion will focus on induced abortion.

Abortion was historically sanctioned and carried out in the societies of ancient Greece and Rome. Under Christianity, however, it was condemned and in Europe during the nineteenth century there were severe penalties for its use. During the twentieth century, abortion legislation was liberalized, with many countries in Northern Europe, North America, the Soviet Union and Japan allowing abortion under particular conditions. It is estimated that 1.6 million abortions are carried out each year in the United States; in England and Wales, the figure is around 170,000. In some societies, for example in the Catholic countries of Europe, abortion continues to be outlawed. Nevertheless, it is practised in some places as a method of dealing with unwanted pregnancies. In the Philippines, for example, potions to induce menses are sold by traditional healers at stalls outside the main cathedral in Manila. In many former Eastern bloc countries, where contraception was largely unavailable, abortion was a common and culturally accepted form of birth control. In China abortion was still used in this way in the late twentieth century.

The controversial debate to do with the ethics of induced abortion hinges on the philosophical question of when life begins. Opponents of abortion usually argue that the foetus cannot be distinguished from a newborn infant. ‘Right to Life’ organizations, whose membership is predominantly of a fundamentalist Christian or Catholic persuasion, believe that life begins at the moment of conception and that abortion is, therefore, a form of killing. Indeed, it may be argued that with continual advances in medical science that enable a premature baby to survive it is ethically impossible to identify a point at which life is not viable. Those who support abortion tend to focus on the rights of women to retain control over their bodies and reproductive capacities. They argue that the alternative to legalized abortion would be a return to the illegal ‘backstreet’ practices that have cost the lives of so many women.

The question of whether abortion should be legal is fiercely contested and has led to the development of extremely active and sometimes violent pro-and anti-abortion campaigns. The politics of abortion are sometimes likened to the case for or against euthanasia. This, however, is rather misleading as the principles are quite different. Discussions of the morality of abortion deal with the difference between life and non-life; in euthanasia the fact of life is incontrovertible, it is the nature of the ending of that life that is in question.

In countries where induced abortion is legal it is usually performed for the following four reasons. First, abortion may be carried out to preserve the life or the physical or mental health of the mother. Second, the foetus may be aborted if conception was the result of incest or rape. Third, it may be undertaken if the foetus has a serious deformity or is found to have a genetic abnormality. Finally, abortion may be allowed on social or economic grounds that could have an impact on the future of the child, for example if the mother is very young or poor.

Legal abortion is normally carried out during the first trimester of pregnancy that is, in the first twelve weeks. This is thought to be the safest period for the mother and involves the most straightforward operation, usually achieved via endometrial aspiration, suction or curettage. After this period the procedure will be more complicated and may put the mother’s life at risk. If the foetus has died in the womb, for example, it may have to be expelled by inducing labour.

Whatever the reason for abortion, the woman may experience grief. In some women the grief reaction may be minimal or non-existent; for others, the experience may be severe. The grief reaction may occur almost immediately or not for many weeks, months or even years. The decision to abort a foetus is rarely taken lightly and the woman may experience guilt after it has been carried out. This will inevitably affect the nature and ‘resolution’ of grief. The woman’s circumstances prior to abortion may change and she may later regret or rue the decision. The social stigma that is associated with abortion in such countries as the United Kingdom and the United States will also impact on the experience of grief. In communities that may be unsympathetic to the complex reasons surrounding abortion, grief may be deemed to be fundamentally at odds with the choice of abortion. In such cases, the woman’s experience of grief may be disenfranchised (see disenfranchised grief).

In Japan, where abortion was legalized in the 1950s, DeSpelder and Strickland (1996) note the ritual practice of mizuko worship. Mizuko are miniature stone statues that represent children who were conceived but not born. The statues, which cost several hundred dollars each, are deemed to be the repository of the soul and are placed in such temples as the Shiun Jizo Temple, north of Tokyo. In the Hase Temple, a statue of the ‘Goddess of Mercy’, also responsible for safe birth, looks after the 50,000 or so mizuko in her care.

Figure 1 Potions to ‘bring on the menses’. Traditional healer’s market stall outside a Catholic catherdral, Manila, the Philippines.

Source: © Glennys Howarth

See also: stillbirth

References

DeSpelder, L.A. and Strickland, A.L. (1996) The Last Dance: Encountering Death and Dying, 4th edn, California: Mayfield.

Further reading

Doka, K.J. (ed.) (1989) Disfranchised Grief Recognizing Hidden Sorrow, Lexington, Mass: Lexington Books.

Glover, J. (1977) Causing Death and Saving Lives, Harmondsworth: Penguin.

Peppers, L.G. (1987–88) ‘Grief and elective abortion: breaking the emotional bond?’, Omega: Journal of Death and Dying 18: 1–12.

Petchesky, R.P. (1990) Abortion and Woman’s Choice: The State, Sexuality and Reproduction Freedom, Boston: Northeastern University Press.

GLENNYS HOWARTH

absurdity

Existentialists often put forward the idea that our lives are absurd since those lives operate within the certainty that they will at some stage be cut short by death. If we regard our predicament accurately we shall have to acknowledge the pointlessness of hope and the inevitable overwhelming of our lives by nothingness. The question which obviously arises is whether one should commit suicide, given the meaninglessness of life. We look to the world for evidence of meaning, but it is silent, to use the language of Albert Camus. (Camus is not straightforwardly an existentialist, but on this issue he represents clearly what is an important theme in this rather diverse ‘school’ of thought.) The problem with suicide is that it involves the negation of freedom, an attempt to escape from the tragic dilemma in which we find ourselves, and the rejection of the possibility of seeking to assert our dignity in the face of death. We need to establish values in a world which does not itself possess those values. Suicide accepts the absurd as final and universal, and we do not have to limit our futures just because of the omnipresence of death. In experiencing the absurd we can experience at the same time our uniqueness, dignity and freedom.

It is often argued that if God does not exist, if there is no immortality, then life is absurd. This is brought out nicely by Camus (1955) who contrasts how we like to see the world – as orderly, moral and rational – with the reality of a cold, uncaring and unresponsive world. Nagel (1971) emphasizes this point when he observes that we put a lot of care and effort into our projects, only to discover that the outcome may well be disappointing, and in the long term there is no outcome for us at all, since we all die eventually. This kind of realization frequently creates a situation in which suicide is a tempting option, but many philosophers would criticize this belief for not taking seriously enough the need to establish for ourselves a defiant attitude to the absurdity of our situation. That is, the fact that our projects eventually end in nothingness does not in itself demand that we cease to pursue those projects, for there is something exciting in setting out to act within a context in which one knows that the ultimate end of the action is transitory. For many existentialists this is what acknowledging absurdity is all about: appreciating the futility of action and yet, at the same time, acting as though it is just as absurd to continue to act in such a situation as it would be to cease to act, and in the case of suicide to cease to act at all.

See also: existentialism; heaven; Heidegger, Martin; hell; Islam; purgatory; resurrection; Sartre, Jean-Paul

References

Camus, A. (1955) The Myth of Sisyphus, trans. J. O’Brien, New York: Knopf.

Nagel, T. (1971) ‘The absurd’ Journal of Philosophy, 68, 20: 716–27.

OLIVER LEAMAN

acceptance

In death studies, acceptance is the fifth element in the stage theory of dying. Elisabeth Kübler-Ross argued that dying persons could come to accept their imminent death. She described acceptance as going beyond anger and depression, as a stage almost void of feelings, and in many ways the polar opposite to denial. In fact, like denial, acceptance has many variations, ranging from resignation and giving in, to compliance agreement, approval, and even welcoming. Some writers have also proposed that acceptance is the desired outcome for grief work and mourning, but this is not a universally accepted belief.

CHARLES A. CORR

accidents

The Azande people of Africa have no accidents. This not only suggests that everything is seen to be determined in Azande society, but that a line of responsibility can always be traced between a misfortune and human intention. In Western culture, of course, accidents are common. In the United Kingdom, for example, ‘accident’ is the most frequently cited cause of death for young men and women between the age of 15 and 24 years, and for children after the age of 1.

In the context of death, the term ‘accidental’ truly refers to a mode of death rather than the cause of death (the causes are the physical injuries that are concomitant with the accident). In that respect, it is a term which parallels those of homicide and suicide. Unlike these terms, however, an accidental death implies that there was an absence of human intention in bringing about the death. An accidental death, therefore, has to be attributed to an unusual concatenation of events, a system failure of some kind, or to sheer bad luck. The attribution of misfortune to such impersonal factors and forces, however, is always in tension with a desire to allocate responsibility for accidents to some human agent or other. And the manner in which such an allocation occurs provides important insights into the ways in which members of a given culture view the social and natural worlds. It was a point recognized during the 1920s by the sociologist Fauconnet, who argued that the subject of the sentence, ‘X is responsible’, varied markedly between traditional and modern societies. In the contemporary world, there appears to be an ever-greater tendency to identify the ‘X’ with a legally culpable person or organization. Subsequently, references to ‘acts of God’ or ‘Providence’ have come to be regarded as highly unsatisfactory (and uncommon) components of accident accounts.

Accident is also a term that is closely allied with ‘risk’. Once again, however, in the late modern world risk is no longer seen as a capricious creature, but as something that can be rationally accounted for – mainly in terms of the mathematics of probability. Young men can be said to be at a higher risk of accidental death than other groups in the population. Yet, unlike the members of traditional societies, we believe that such risk can be both calculated precisely and reduced by human intervention – for example, by the control of traffic speed or alcohol consumption. The concept of accidental death, therefore, sits uncomfortably with other features of modern Western culture and tends thereby to serve mainly as a default category for those occasions when alternative explanations have been considered and rejected.

See also: coroner; mortality rates; murder; sudden death

Further reading

Green, J. (1997) Risk and Misfortune: The Social Construction of Accidents, London: UCL Press.

Prior, L. (1995) ‘Chance and modernity: accidents as a public health problem’, in R. Bunton, S. Nettleton and R. Burrows (eds) Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk, 133–44, London: Routledge.

World Health Organization (1996) World Health Statistics Annual 1995, Geneva: World Health Organization.

LINDSAY PRIOR

Acquired Immune Deficiency Syndrome

Since the onset of the HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) epidemic at the end of the 1970s more than 47 million people worldwide have been infected by HIV, and millions more have been affected by the impact it has had on their families, friends, neighbours and communities. HIV/AIDS is the work’s fourth leading cause of mortality and is its most deadly infectious disease. It has achieved this position quickly: indeed, ‘the recognition of a disease and its emergence as a leading cause of death within the same decade is without precedent’ (Centre for Disease Control and Prevention 1999: 142). Further, its impact is expected to increase. In 1998 there were 2.2 million deaths, in 1999 that figure reached 2.8 million. Estimates of cumulative deaths up to the end of 1999 are 18.8 million (of whom 15 million have been in Africa). Worldwide, the epidemic has been responsible for creating 13.2 million orphans. Every day 15,000 people become HIV positive. Over 95 per cent of all cases and deaths occur in the developing world, and these are mostly to be found among young adults and, increasingly, in women (UNAIDS 2000).

As a disease predominantly of the young, AIDS has a disproportionate effect on the social fabric and economic well-being of society. It disturbs a modern sense of death being associated with old age (see age and ageing) and it gives a lie to the social construct of the triumph of medicine at the end of the twentieth century. It is one more disease that has been used throughout history to distort fear into prejudice.

The emergence of HIV/AIDS

In the United States in June 1981, the Center for Disease Control and Prevention’s Morbidity an...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• Editorial team
• List of contributors
• Introduction
• Acknowledgements
• List of entries
• Entries A–Z
• Bibliography
• Name index
• Subject index