Edited by
Dennis R Cooley & Lloyd Steffen
Re-Imaging Death and Dying
Probing the Boundaries
Series Editors
Dr Robert Fisher
Dr Nancy Billias
Advisory Board
Dr Alejandro Cervantes-Carson
Dr Peter Mario Kreuter
Professor Margaret Chatterjee
Martin McGoldrick
Dr Wayne Cristaudo
Revd Stephen Morris
Mira Crouch
Professor John Parry
Dr Phil Fitzsimmons
Paul Reynolds
Professor Asa Kasher
Professor Peter Twohig
Owen Kelly
Professor S Ram Vemuri
Revd Dr Kenneth Wilson, O.B.E
A Probing the Boundaries research and publications project.
http://www.inter-disciplinary.net/probing-the-boundaries/
The Making Sense Of: Hub
‘MSO: Dying and Death’
Re-Imaging Death and Dying
Edited by
Dennis R Cooley and Llyod Steffen
Inter-Disciplinary Press
Oxford, United Kingdom
© Inter-Disciplinary Press 2009
http://www.inter-disciplinary.net/publishing/id-press/
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ISBN: 978-1-904710-82-0
First published in the United Kingdom in eBook format in 2009. First
Edition.
Table of Contents
Introduction
Dennis R. Cooley and Lloyd Steffen
PART I
ix
Philosophical Re-Imaging
Pragmatic Immortality and the Insignificance
of My Own Death
Peter Caws
3
Concepts of Value, Attitudes toward Death
Stephen E. Rosenbaum
15
There Is Good Hope That Death Is a Blessing
J. F. Humphrey
25
Dignity of the Dead?
Julia Apollonia Glahn
33
The Haunt/ Demons and The Complex
of Noon
Tolulope Onabolu
The Concept of Death in Children’s
And Juvenile Literature - Reading and
Interpreting Death in The Book Thief
by Markus Zusak
Maria Kissova
The Confrontation with Death from Rilke
to Heidegger
Jacob N. Graham
Burial Law as View-Point towards Death
Wim Cappers
To Death - To Life: Grounding Sigurd
Lewerentz and Erik Gunnar Asplund’s
Tallum Cemetery
Courtney D. Coyne-Jensen
43
57
69
77
85
Heroic Death and Selective Memory: The
U.S.’s WWII Memorial & The U.S.S.R.’s
Monument to The Heroic Defenders
of Leningrad
Susan M. Behuniak
Rethinking and Recognizing Genocide: The
British and the Case of the Great Irish
Potato Famine
Neysa King
Death in Self-harmers’ Eyes
Namino Kunitoh
PART II
113
123
Communication Re-Imaging
Analysis of Terminally Ill Patients’ Weblogs
Using the Linguistic Inquiry and Word
Count (LIWC) Program
Nothando Ngwenya, Stella Mills, and
Paul Kingston
135
Archiving Grief: (Re-) Writing Histories in
the Aftermath of Loss
Nate Hinerman
151
Communicating with the Dead through the
Newspaper: A Quantitative and Qualitative
Analysis
Patricia L. Bromley and Mitte J.A. Nimocks
Agencies of the Afterlife: Weblogs
and Television Shows on Death
in the Netherlands
Marga Altena
PART III
99
163
173
Ethical Re-Imaging
Physician-Assisted Suicide
and the Supreme Court: A Decade
in the Life of a Constitutional Issue
That’s “Not Dead Yet”
Arthur G. Svenson and Susan M. Behuniak
183
The Ethics of Patient Non-Treatment
Lloyd Steffen
201
What's Wrong with the Brain Death Debate?
Joseph Wang
215
Death & Justice: An Ethical Response
to Massacre
Vanessa Fredericks
227
Kantian Obligatory Suicide: Further
Developments
Dennis R. Cooley
PART IV
237
Experiencing Re-Imaging
“I’d Rather Be Home All My Life”:
Older People and Place Care at the End
of Life
Eileen Sutton and Joanna Coast
Waiting for Death: An Exploration of
Suicide and Old Age in Ireland
Christine De Largy
To Worship God or Celebrate a Life:
Conflicting Scottish Perspectives on
Funerals?
Glenys Caswell
Quasi-Widowhood: Crossing Boundaries
of Marriage, Divorce, and Death
Jacque Lynn Foltyn
The Survivor’s Guilt: The Case of Cancer
Shulamith Kreitler, Frida Barak, and
Nava Siegelman-Danieli
Bereaved Employees, Professional Activity
and Pain of Loss
Marc-Antoine Berthod
249
261
277
285
297
307
Introduction
Re-Imaging Death and Dying
Dennis R. Cooley and Lloyd Steffen
Apprehension – some might call it an outright fear - surrounds the
efforts to investigate, analyse, or discuss the inescapably profound
experiences of dying and death. Most people have encountered death and its
consequences in their own lives in some way; many have suffered from a
loved one’s dying process. The experiences associated with dying, especially
in regards to a loved one, are not abstract but emotionally involving and very
personal, and discussion can be provocative and emotionally arousing. It is
even possible that conversations that open on the topics of dying or death
may include participants who are themselves dying or undergoing a grief or
mourning experience that makes them much more sensitive to the subject
than would otherwise would be the case. So the topic is itself an emotionally
sensitive one, and sensitive people do not want to cause hurt or offend. The
result is that there are so many difficult and complex emotions involved in
death and dying issues that, at times, it is hard to focus clearly on the
cognitive aspects.1
The prospect of hurt feelings does not, however, provide adequate
grounds to avoid controversial issues. The central flaw with the sensitivity
argument – which makes morality depend upon the emotional reactions of
one or more people – is that merely feeling a certain way does not entail that
one should feel that way. At one time, interracial relationships caused
extreme reactions from racists, but obviously, what the racists felt indicated
nothing about such relationships but a great deal about their own moral
failings as people. The same conclusion might apply when emotions are
involved in death and dying discussions.
On the other hand, feelings and emotional reactions should not be
ignored or discarded. Emotion is a fundamental component in ethics for
without it, morality and ethics would be empty terms. Recall Hume’s
argument that without emotions, especially sympathy or what we call
empathy, it would be impossible to select between the pricking of one’s
thumb and the destruction of the world. Should we be so devoid of emotion,
so indifferent as not to care more about the destruction of the world than the
pricking of one’s thumb, we would be like Buridan’s ass starving to death
between two equidistant bales of hay. Hence, in order to be applicable to the
real world, emotions and feelings have a role to play in ethics, but what that
role is to be must itself be subject to critical scrutiny.
The 6th Global Conference: Making Sense of Dying and Death held
in Salzburg, Austria in October and November, 2008 is a component of the
Inter-Disciplinary.Net’s Probing the Boundaries project. The project’s
x
Introduction
______________________________________________________________
purpose is “to create working ‘encounter’ groups between people of differing
perspectives, disciplines, professions, vocations and contexts.” The interdisciplinary and multi-disciplinary aim of the conference, and hence, of this
book and its articles, is the building of an enduring, useful marketplace of
ideas much along the lines John Stuart Mill advocated. Mill argued that if too
few people control information processes or if access to data is too restricted,
then the beliefs people have and the solutions they create to solve problems
are likely to be more myopic than if an unrestricted marketplace of ideas
existed.2 A lack of diversity gives some individuals excessive power over
those lacking the ability to be fully invested in the market, and although the
former might be well intentioned, the beliefs they have and solutions they
pursue could themselves be distortions that fail to reflect reality.
On the other hand, inclusiveness and diversity, by definition,
beneficially increase the supplies of information, relevant insights,
experience, and other essential components of good decision-making to a far
greater number of affected people. Through the wide variety of views being
presented in the market, individuals are able to use their critical reasoning
skills to find what is correct in each position, and then to build toward a true
belief that will guide their decisions. Generating more options, for example,
increases the likelihood that a superior alternative can be chosen, or at least a
solution that each concerned party can accept. If dying and death
“information” is in a market open to all, then each stakeholder will have the
opportunity to share in the work of clarifying the issues involved in dying and
death moral problems. Each person can lay claim to helping fashion
necessary compromises because each person is contributing to the solution.
The conference’s approach to moral issues promotes the freedom of
thought in a way in which Mill would have approved. For Mill, people must
not only have the total freedom to form true opinions, but they also need
liberty to act upon those beliefs. Liberty does not extend to unjustified harm
to others, but if liberty is curtailed too much, the results are dire. People who
do not think and act for themselves are merely “automatons in human form,”
whose minds are “bowed to the yoke.”3 Eventually, “their human capacities
are withered and starved”, so much so that they become mere husks of human
beings.4 Thus, in order to reach their full potential, individuals must have
intellectual vigour and manifold diversity, which come from freedom and the
variety of situation’s union. In other words, people need originality that is
agreeable to each individual and all of society.5 Moral agents, in order to
realize their intellectual potential as human persons, must be given free reign
to think and discuss opinions as they choose, make informed decisions, and
then act upon them. The alternative is far too costly for it takes from
individuals what, in part, makes them persons with intrinsic worth.6
The inter-disciplinary and multi-disciplinary nature of the
conference itself and this e-book collection of conference papers add in a
Dennis R. Cooley and Lloyd Steffen
xi
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significant way to Mill’s marketplace of ideas. Often, professionals with
good intentions believe that their field can find the answer for many, if not
all, questions. However, this overly narrow approach often leads to solutions
that do not address real world situations, but rather merely give additional
support to the wrongheaded view that many professionals are ivory-tower
thinkers who have little to nothing to say about how they should live their
lives or think about the important issues confronting them.
This volume’s diversity of offerings counteracts that unfortunate
view by showing how each discipline captures part of the overall truth, which
must then be synthesized into a whole. What is most interesting is how this
weaving together of ideas is achieved in this anthology. The articles located
within challenge the perceived status quo; use familiar ideas in new, useful
ways, or work to add other innovative knowledge to our databases. However,
it should not be thought that any one of the papers does just one thing. Rather
although each might primarily operate in one of the three aforementioned
ways, it also has elements of the remaining two. This fact could very well be
one of the reasons that every paper contributes significantly to its disciplinary
field as well as others.
Perhaps more importantly, the combination of papers provides
greater insight into the subjects of death and dying – hence the eBook’s title
and theme of re-imaging. Not only do some of the works support
components in other authors’ papers, but the former augment them with new
ideas, information, or arguments. That is not to say that all the works are in
agreement or that the claims and positions are consistent with each other. Far
from it. And that is not to say that the mere fact there is disagreement entails
that there is anything defective in any one of them. Again, far from it.
Through clashing opinions, we are able to come closer to what is real and
true in three different ways.
First, if we are right in what we say, our arguments and thoughts can
benefit from the challenge of intellectual exchange. We know better what
works and what does not work in our intellectual encounters, as well as
coming to know in more detail why we are correct in our beliefs. In addition,
a benefit in common to all three ways, we hone our critical reasoning
processes to create more useful mental tools.
Second, if we are wrong, then obviously we will be in much better
intellectual shape to discover the truth for ourselves. One joy of entertaining
clashing opinions is that by doing so we overcome our natural reluctance to
give up a cherished position that we have come to through careful, but
somehow incomplete, reasoning. We know that often we do not want to
admit either to others or ourselves that we are wrong; hence, it is sometimes
necessary to challenge ideas in a more aggressive way to force a needed
reconsideration.
xii
Introduction
______________________________________________________________
Finally, we know that in the vast majority of cases, people find part
of the truth, but not the entire whole of it. Our hope is that this collection of
essays will contribute to the process of reflection and critical discernment that
will uncover and discover yet more truth, so that readers can improve their
belief sets and decision-making processes.
What follows is a short introduction and overview of the papers
included in this volume. One of the great benefits of the conference and
eBook is the vast differences in subject matter addressed. This diversity also
makes it difficult to segregate cleanly the material into distinct groups. As a
result, we have created four useful, general categories. The volume is divided
into re-imaging the philosophical, communication, ethical, and experiential
aspects of dying and death.
1.
Philosophical Re-Imagings
Each society and culture has conventions and mores about death and
dying, which it believes to capture the full truth of reality. Often, when these
fundamental components of the society or culture are challenged, the
response is neither thoughtful nor measured by the components’ dogmatic
adherents. However, even in the face of resistance from the public and
academic communities, it is a duty of those working on dying and death
issues to examine the concepts and arguments being used in the various
conversations to evaluate their perspicacity, accuracy, and soundness. After
all, to be human we must strive to find out how the world really is rather than
merely accepting how we individually would like it to be or what the vox
populi claims it is. The contributing authors from the conference make use of
a variety of ways to re-image the philosophical groundwork of the field.
Included among these is re-defining terms by either narrowing or expanding
the meaning of the concept, throwing out the old definition and replacing it
with a better working model, or demonstrating the need for, and value of, a
new term or argument in the debate.
Peter Caws starts off this section by arguing that a person can have
pragmatic immortality in his or her life by realizing that death itself cannot
harm the person, since nothing remains to be injured. In addition, people can
be liberated to live their lives more fully and enjoyably if they realize that a
quick and painless death need not be feared by them. Stephen Rosenbaum
challenges the still relatively common belief in philosophical circles that
Aristotle’s view of death as a great harm to those who die and Epicurus’
position that death means nothing to us since there is nothing left of us to be
harmed are incompatible positions. To show consistency, Rosenbaum points
out an equivocation often made on the word “value.” According to him,
Aristotle uses the concept of abstract value in his work, which does not have
effects on individuals, while Epicurus’ position incorporates the concept of
concrete harm, which does have effects on individuals. J. F. Humphrey
Dennis R. Cooley and Lloyd Steffen
xiii
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considers three views of death found in Plato’s Apology: death is a long
dreamless sleep, death is a journey to another place, and death is a way to
become immortal. Humphrey presents an argument that Socrates’ adoption
of the latter position leads to an interesting result. If the position is accurate,
then Socrates’ death immortalized the practice of Socratic philosophy, as well
as himself. Julia Apollonia Glahn questions the western belief that cadavers
have no dignity because they do not exist as human beings. After
demonstrating with examples of cadavers used in car crash tests that people
are uncomfortable with treating cadavers as mere objects, Glahn states that
by redefining dignity as a social and interactional concept, it becomes
apparent that dead bodies still have dignity, and thus, should be treated
accordingly.
Tolulope Onabolu maintains that “nonsensical” definitions of dying
and death are not only possible; they are extremely valuable in the discussion
of these issues. Using a Deleuzian thesis of becomings, Onabolu argues that
death is a transformation into “something else,” which should be embraced
by us. Maria Kissova employs a book by Markus Zusak, The Book Thief, to
find a new way of understanding death and its interconnectivity to Art,
Literature, and human psychology. Kissova weaves a narrative explaining
why Death can be both frightening and fascinating to us, as well as being a
constant companion guiding our lives. Jacob Graham combines philosophy
and literature in his paper on Martin Heidegger and Ranier Maria Rilke.
Concentrating on Rilke’s literary work, letters, and correspondence, Graham
argues, “In our very affirmation of being, we solemnly, quietly, and perhaps
even unwittingly affirm death.” Death, hence, is nothing to be feared, but
something that is part of our true being, or as Rilke calls it, our friend.
Wim Cappers’ research focuses on Dutch burial law and its
influence on the taboo towards death. Cappers shows that burial law
medicalised death’s definition based on the medical facts that dead bodies
pose hygiene problems and that medicine could not clearly demarcate
between life and death. The result was a significant shift in mores and social
beliefs about death and death related processes. Courtney D. Coyne-Jensen
examines Tallum Cemetery to see if its design provides a better linkage
between the living and the dead than is used in standard practice. She argues
that a Heideggerian notion of ground is key to understanding not only the
cemetery but many of the death concepts associated with such places. Susan
M. Behuniak’s work on heroic death, selective memory, memorials and
monuments takes the stand that the USSR’s Monument to the Heroic
Defenders of Leningrad and the US’s World War II Memorial serve to
commemorate the sacrifice made by those involved in the conflicts, but also
act as political statements that heroic deaths for patriotic causes are worth the
price paid. Memorials and monuments, hence, can shape collective memory
xiv
Introduction
______________________________________________________________
in such a way that terms in the public mind can be redefined and ideas
implanted to suit those in power.
Contradicting standard conceptions, Nyesa King contends that the
concept of genocide as currently used by most is lacking significant elements,
which can be discovered in a careful study of the Great Irish Potato Famine.
King maintains that genocides are unfolding processes rather than the
standard contained systematic events definition. If correct, King’s re-imaged
concept would expand genocide’s definition to include many additional
events, which in turn, would cause a re-thinking of what those episodes
actually mean and entail.
Finally, Namino Kunitoh discusses her pilot study on self-harmers’
beliefs about suicide and self-harm, such as cutting oneself. She finds that
self-harmers’ actions are generally intended to solve problems in their lives
rather than end their existence. As a result, treatment of such individuals
would require a different framework from that used in helping suicidal
people.
2.
Communications Re-Imaging
Dying is an experience in life, and difficult and profound as that
experience is, it nonetheless presents opportunities for continued human
contact, reflection, and interpersonal exchange. People who confront death
and dying communicate with other people about this fact of life - death - that
is at once a certainty as well as an unknown, an inescapable reality yet a
contentious mystery. In their communications about their fears and anxieties,
their hopes, and their concerns for loved ones, those who are dying or who
have experienced the loss of loved ones reach for the mechanisms of
communication available to them, and thus do they speak, write, go on-line,
devise and visit the internet and blogs, and even share their personal feelings
of grief and suffering in ways that seek to draw in anonymous individuals
through mass media communications. Certain papers delivered in Salzburg
reflect the effort some authors have made to investigate how living and dying
people come to express themselves about their experiences and feelings
related to dying and death through modes of communication as basic as
speech or as up-to-date as internet access.
Nothando Ngwenya, Stella Mills, and Paul Kingston have
investigated the way some hospice-bound individuals dying of terminal
illness and acutely aware of their situation have resorted to using weblogs.
Weblogs provide a form of therapeutic writing to journal and, as the authors
say, “help interpret death.” The authors contend that the weblog provides an
opportunity to address the physical and spiritual needs of dying patients
through therapeutic writing, and they share the results of having subjected the
writings to a word counting program that then can be used to analyse and
more deeply understand the cognitive, emotional and structural components
Dennis R. Cooley and Lloyd Steffen
xv
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of these terminal communications. Nate Hinnerman, a religion professor who
sometimes teaches nurses in training, shares his experience of having
students write their personal reactions to loss, which are then compiled into
“grief archives.” Hinnerman focuses on his students’ reactions and feelings of
loss in the wake of the September 11, 2001 attacks, the grief archive
providing a way to scale down a bewildering national tragedy to personally
felt loss. The death or grief archives he has complied give evidence that
sharing stories of loss not only can bring people together but can allow as
well for the continuation of relational connectedness with those who are
mourned.
Patricia Bromley and Mitte Nimocks explore the phenomenon of “In
Memoriam” advertisements in newspapers, many seemingly directed toward
the dead themselves. The advertisements direct a statement of feeling to a
public who know neither the writer of the advertisement or the deceased who
is its subject. Their quantitative analysis reveals that such a mode of
communication commemorates the dead, but more importantly expresses the
desire of the still grieving for richer and more extensive community. Finally,
Marga Altena discusses the role weblogs and television programs dealing
with death are providing people in the Netherlands with a new way to deal
with death, mourning and memorialising. With special attention given to the
Dutch television series, Over My Dead Body, Altena argues that modern
media allow unexpected opportunities for people to express themselves
emotionally and spiritually in relation to dying and death.
3.
Ethical Re-Imagings
Dying is a natural process, but not simply so. Human action and all
that human action entails – motives, intentions, aims, purposes, emotions,
values, evaluations, judgments, care-giving, virtues, and many other matters
– infiltrate the dying process and render it a fit subject for ethical
interpretation. Technology is a major factor in this ethical infiltration, since
technology has extended life beyond the point where nature, left to its own
devices, would end it, and all kinds of questions – ethical questions – arise
concerning the good, fitting and right thing to do in particular situations or in
relation to certain kinds of care-giving practices or medical procedures. What
is a good death, ethically speaking? The papers that were contributed to
ethics discussions at the Salzburg conference addressed many of these
broader issues by focusing on particular aspects of the ethics of dying
question, and the authors have explored some difficult issues as they have reimaged ethics in relation to dying and death.
Arthur G. Svenson and Susan M. Behuniak explore the ethical issue
of physician-assisted suicide as it has presented itself as a legal and
constitutional issue in the United States. The authors consider various
landmark decisions relevant to court determinations about the permissibility
xvi
Introduction
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of physician assistance in dying, concluding that conflicts between federal
and state laws over physician assisted suicide parallel similar conflicts over
legislation by states authorizing medical uses of marijuana. They argue that
congressional power could rule the day and overcome legal efforts to prevent
physicians from prescribing the particular drugs individuals would use in an
instance of physician assisted suicide. Lloyd Steffen investigates the ethics of
not treating severely handicapped newborns. Despite the widespread moral
agreement that ordinarily newborns facing medical issues should be treated,
Steffen points to some particularly catastrophic disorders that present
compelling evidence for non-treatment, and he re-images the ethical
approach to this issue by using the structure of “just war” thinking to make
his case, that is, laying out conditions that would have to be met to overrule
the basic moral agreement that ordinarily handicapped newborns should be
treated.
Joseph Wang undertakes an inquiry into the ethical meaning of brain
death. He argues that physicians approach the questions in ways philosophers
do not, and that a way beyond some of the disputes over whole brain death
versus the death of a whole person can be gained by shifting the focus from
ontological questions to the issue of organ transplantation, for which a
practical ethic is required to guide the process of preparing for a removal of
organs. Wang calls for a new ethic of organ transplantation to supplant the
sometimes irresolvable conflicts between physicians and philosophers over
how to define and interpret the meaning of death. Vanessa Fredericks applies
Derrida’s “politics of mourning” idea to the Katyn massacre in Poland during
the Second World War. Concerned about the ethical silence concerning
Russian involvement in the massacre of up to 22,000 Polish prisoners of war
by the Red Army, and then the subsequent failure to admit involvement,
Fredericks finds in Derrida’s idea of a mourning, which is constructed as an
ethically responsible “future-oriented memory,” a way of constructing ethical
response to this particular act of genocide. And Dennis R. Cooley considers
the question of a good death by asking how the looming and imminent
prospect of dementia and loss of agency could – and should - affect the
decision of Alzheimer patients to end their own lives. His controversial
argument, based on a modified interpretation of Kant, is that the “soon to be
demented” have a duty, while not yet demented, to end their lives before they
lose their moral agency. Suicide in such a circumstance could be seen as a
loving and caring act, Cooley argues, with the obligation to suicide yielding
benefits to the patient, loved ones and society in general.
4.
Experiencing Re-Imaging
The experience of dying is not the end of death-related experiences.
Death comes with an aftermath for the living - the grief, the mourning, and
all kinds of other possible reactions, including guilt and even possible relief
Dennis R. Cooley and Lloyd Steffen
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that a difficult dying is over. The papers in this section focus on how people
deal with the end of life experience and how those who experience the loss of
loved ones confront and deal with the pain of bereavement. The essays here
re-image the reality of the dying experience itself, as roles like caretaking
present a trajectory of emotional reactions subject to change, and as people in
the aftermath of a death find themselves adopting new identities as survivor,
or widow, or even colleague of the bereaved.
Eileen Sutton and Joanna Coast investigate the “National End of
Life Care Strategy” devised in the United Kingdom and published in 2008.
Given that a mismatch has been occurring between the fact that most people
die in hospitals while the dying themselves self-profess a desire to die at
home, the researchers consider problems with hospital and nursing care and
reflect on the way state policies affect the quality of dying. At issue in their
article is the need to allow more people to exercise choice and thus maintain
personal dignity when they are dying. Christine De Largy examines the
phenomenon of older adult suicide in Ireland, concerning herself with the
complex motives that lead some older adults to suicide. Research indicates an
increase of older adult suicide in Ireland by 30% from 2000-2005, and this
leads the author to reflect on the kinds of preventive strategies that might be
called for as government and social programs coordinate to address a
significant problem that is often overlooked due to the heavy focus given to
suicide among the young.
Glenys Caswell, a doctoral student in sociology at the University of
Aberdeen, shares the results of research she has been doing in Scotland on
funerals in the context of the increasingly secular, non-religious orientation of
survivors and mourners. Her inquiry is directed at how Scottish clergy and
mourners alike are devising new ways of responding to spiritual need even
amid secular and humanistic orientations. Caswell explores the new
movement toward religious and secular coexistence as clergy try to maintain
balance between their own beliefs and integrity while still attending to the
needs of secularly oriented people who present themselves as wanting to
celebrate the life of the deceased life yet who are also spiritually grieving
loss. Jacque Lynn Foltyn draws on her experience as a divorced woman who
was primary caretaker for her dying ex-husband, Matt, who, divorced a
second time and now single, still considered her his primary relationship.
Foltyn, a death researcher, shares how this experience jarred her from her
previously abstract encounter with dying and death and led her to a
transformative reconciliation, grief, and healing, stating, “we honoured a
bond that would not be broken, no matter what social mores dictate.”
Shulamith Kreitler, Frida Barak, and Nava Siegelman-Danieli
conducted research into the topic of survivor’s guilt. Using as their research
population 195 caretakers of cancer patients, they discovered that survivor’s
guilt among caretakers is not so much related to depression and pathology as
xviii
Introduction
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it is to remorse. Guilt is aroused by the intensity of the personal relation to
the patient. The authors conclude that such guilt is an affective response that
corresponds positively to pro-social behaviours, such as increased
volunteerism and other positive forms of social bonding. And Marc-Antoine
Berthod undertakes an anthropological inquiry into the phenomenon of the
bereaved employee. Berthold found evidence that co-workers and superiors
in the work hierarchy go out of their way to be flexible with an employee and
colleague who has experienced loss, adjusting schedules yet trying to keep
the rules governing bereavement still in place. Bereaved people experience
the pain of loss even while they are also working people with colleagues and
bosses and policies governing what to do in the event of death, and Berthold
reminds his readers that this topic – bereavement in the workplace – is an
understudied topic that is here reimaged to expand the boundaries of the way
the bereavement experience affects all of life.
Notes
1
This does not entail that we think pure reason is the only or best method to
use in analyzing this subject area. Emotions have a vital role to play, but they
should not be allowed to overplay it.
2
J Mill, On Liberty, in Utilitarianism, On Liberty, and Consideration on
Representative Government, H B Acton (ed), J.M. Dent & Sons Ltd, London,
GB, 1988, chapter 2.
3
ibid., pp. 127 and 129.
4
ibid, p. 129.
5
ibid, pp. 101 and 132.
6
Mill, however, does not promulgate a system of absolute freedom to do as
one pleases whenever the desire strikes one to do so. Freedom in action,
though not in opinion, may be limited if the agent makes “himself a nuisance
to other people”. ibid., p. 124. Nevertheless, if the action does not entail
harm to anyone other than the actor, and perhaps a more minor injury to
others than that would have been suffered by the loss of autonomy to the
agent, then it is permissible to do it.
Bibliography
Mill, J., On Liberty, in Utilitarianism, On Liberty, and Consideration on
Representative Government, H. B. Acton (ed), J.M. Dent & Sons Ltd,
London, GB, 1988, pp. 69-187
PART I
Philosophical Re-Imaging
Pragmatic Immortality and the Insignificance
Of My Own Death
Peter Caws
Abstract
The human being who lives and dies, seen not as a biological entity but as a
centre of experience and feeling, is a transcendental subject in the Husserlian
sense, essentially temporal in its structure (though essentially timeless in its
situation), essentially situated over against a world. “Transcendental” means
that the subject is not an object in its own world but is presupposed by the
experienced unity of that world. The transcendental subject in time
remembers past states and anticipates future ones, but can know neither its
beginning nor its end. It can accept the prediction that its embodiment will
cease, but this is to cast itself in the role of another, as seen from outside. It
cannot anticipate its own cessation from within - at every moment into which
it can imaginatively enter there will always be another moment to come. This
situation satisfies the Aristotelian definition of infinity: a quantity is infinite
if, however much has been taken, there is always more.1 Infinity of lived
subjectivity is equivalent to immortality. Put aphoristically and
paradoxically, “until the moment of death, everyone is immortal.” In less
abstract terms this attitude opens up the possibility of living an effective or
pragmatic immortality, not being touched by death at all, suspending all
attention to it, like a permanent phenomenological bracketing. Even if we
accept and anticipate death it still matters less than most people think and
fear. My own sudden and painless death cannot possibly matter to me, and
even pain can be borne. It can of course matter to those who love or depend
on me, but this point, while crucial in other contexts, falls outside the scope
of the present paper.
Key Words: Death, subjectivity, transcendental, infinity, immortality,
bracketing, Epicureanism, lifeworld
*****
Diogenes of Oenoanda (2nd century CE) left a legacy to his fellow
townspeople in the form of excerpts from the doctrines of Epicurus, carved
into a wall in a public place. Four of the principal maxims were:
God is not feared
Death is not felt
Good is easily grasped
Evil is easily overcome.2
4
Pragmatic Immortality and the Insignificance of My Own Death
______________________________________________________________
Subscription to these claims would clearly go some way to
producing the ataraxia, or untroubled state, that the Epicureans valued. It is a
state that is still desirable today. For the purposes of this communication I
concentrate on the first two, since they are connected in the popular mind:
death is feared, because God’s judgment is feared, but also because death is
associated with pain.
I remember being struck in a book I read as an adolescent, a great
Antarctic adventure story by Apsley Cherry-Garrard called The Worst
Journey in the World, with a passing remark as he is recounting one of the
nearly fatal episodes of the journey: “men do not fear death, they fear the
pain of dying.”3 This seemed to me, when I thought about it, to be obviously
true, perhaps especially because I had been taught to fear both death and God
and had come to regard both threats with a kind of native scepticism. When,
later on, I discovered Diogenes (in Gilbert Murray’s elegant little book on
Greek religion), I recognized him at once as an ally. If death is not felt, and
God not feared, I am free to direct my life to higher objectives than craven
avoidance or propitiation.
My own death, I concluded, could not really matter much to me. If it
were sudden, quick, unexpected, and painless, it would not matter at all. That
is what I mean by “insignificance” in my title. My death could matter to
others, and the anticipation of it could matter, temporarily, to me. But my
subsequent thinking about death has led me to even more radical conclusions.
I sometimes amuse and sometimes perplex my students by telling them, quite
matter-of-factly, that I’m not going to die. Dying, I say, is just not the sort of
thing I do - it would be quite out of character, and I have no intention of
starting now. I can’t envisage making a true assertion using the first person
active singular of that particular verb.
Does that mean I think I’m going to live forever? Well in a sense
yes (making sense of this sense is partly what this paper is about), but in
another of course not. I’m not denying that some years from now (their
number depending on luck, prudence, and the state of the art of medicine)
this body will be absent in its present form from the earthly scene. It will be
present as distributed in other forms, but they won’t be me. The question is
whether between now and then something called “my dying” will take place.
Nothing can be “mine” except in relation to me, so that even my eventual
absence can be properly spoken of only from the point of view of my present
presence - in the event it won’t be my absence. Similarly for my dying - if I
decline to do it, will it have taken place?
Eventually, someone might insist, I will certainly be dead. But
there’s that troubling first person: I will be - but if the time ever comes, I
won’t be, anything or anywhere. It is possible to envisage someone else’s use
of the first person active singular of the verb “to die,” but even then only by
literary device. Two classic cases come to mind, out of many, no doubt; one
Peter Caws
5
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is of playing dead, one of being dead. In Shakespeare’s A Midsummer
Night’s Dream Bottom the weaver, as Pyramus, shattered by the death of
Thisbe, decides to join her:
Thus die I, thus, thus, thus.
Now am I dead...4
There are many comic examples of this sort, in some of which the
dead actor gets up to reassure the audience that it is, after all, only a play. The
second case is early science fiction, in Edgar Allen Poe’s “The Facts in the
Case of M. Valdemar.” The narrator wishes to try mesmerism (i.e.
hypnotism) in articulo mortis, and succeeds in this with his friend M.
Valdemar, who is on the point of death. On being asked at intervals whether
he is asleep (hypnotic subjects can apparently understand and respond to such
questions) M. Valdemar gives a succession of answers that Poe builds to a
point of horror:
“Yes; --asleep now. Do not wake me! - Let me die so!”
“No pain - I am dying!”
“Yes; still asleep - dying,”
and finally, in a hollow voice that “seemed to reach our ears ... from
a vast distance, or from some deep cavern within the earth,”
“Yes;--no;--I have been sleeping--and now--now--I am
dead.” 5
The whole apparatus of the story has been devoted to rendering this
last remark plausible, and Poe can stand in here for generations of writers
who have explored similar themes, the most notable among them perhaps
Bram Stoker and his imitators with their tales of the Undead.
All this is fiction. Such imaginations apart, there seems to be a
problem about being dead, as seen from the point of view of the speaking
subject. Hoping for life on the other side of death doesn’t really change
things, because that will after all be life, not death. Plato encourages us to
practice death metaphorically - as the separation of the soul from the body but this is not real death, not death as the end of existence. Socrates confronts
his own bodily death quite cheerfully, and seeks to reassure his disciples: “I
can’t persuade Crito that I am this Socrates here who is talking to you and
marshalling all the arguments. He thinks that I am the one who he will see
presently lying dead...”6
6
Pragmatic Immortality and the Insignificance of My Own Death
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Socrates is not quite sure whether, after his bodily death, he will be
nowhere or elsewhere; at his trial he explains that one of two things must be
the case - an endless sleep without dreams, or a journey to another place,
where he will meet the good judges. Going to sleep is clearly not really dying
- even the resurrection miracles in the Gospels involve sleep, on the part of
Lazarus and the daughter of Jairus, rather than real death. Still this option is
suggestive: according to Socrates, time in dreamless sleep will be like a
single night, and if one went to bed the night before exactly as on all the
other nights, in the assured expectation of waking up the next morning, how
could one distinguish between the last day and all the others? One might have
lived as fully on that day as on any day, physical weakness apart perhaps.
The sleep analogy can be reinforced by a technological one, that of
the turning off (or putting into “sleep mode”) of a computer. I may turn a
computer off and never turn it on again; sometimes I can’t turn it on again, in
which case I may say of it that it died. But from the computer’s point of
view, if I am allowed a bit of anthropomorphism (something I’ve explored
elsewhere7), is there an obvious difference between the two cases? Life, we
might say, is animation and metabolism, death the suspension of these things
- if it really is death, their definitive and not merely temporary suspension.
The program is no longer running, and can’t be re-started. What happened to
it? Children sometimes ask: what happens to the light, when it goes out? We
have to explain that that is not a well-formed question: there is no longer a
light for anything to happen to. To revert to Aristotelian infinity, one doesn’t
just keep taking away and seeing what’s left, the whole thing is gone, at one
swoop - and we with it, so that we can’t know it didn’t go on forever.
Taking a journey is not dying either, even less so. If “death” were
really, convincingly, understood as a change rather than as an ending, if it
marked a stage in a history of which only a part (perhaps a minor or
preliminary part) was called “life,” or if there were two or more successive
lives separated by one or more deaths, the first death would lose, for most
people, most of its seriousness. There would remain of course the fear of the
unknown, the sadness of friends or lovers bereaved, the terror (for imprudent
believers) of eventual judgment - but there might also remain a hope of being
agreeably surprised, of being reunited, of being pardoned. Clinging to such a
hope might be one way of refusing death, or of accepting it under a more
comforting description: transition, metamorphosis, temporary state.
Another way of refusing death is to refuse to think about it: this was
Spinoza’s strategy in the Ethics. “The free man thinks of nothing less than of
death, and his wisdom is a meditation, not upon death, but upon life.”8 This
can be construed in two ways, one obvious, and the other less so. (a) We can
take it to mean that the free man is the courageous man, who, knowing that
death is certain, refuses to be preoccupied with it, having liberated himself
from mundane cares. This refusal implies a prior acceptance, and rests on
Peter Caws
7
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self-mastery, the conquest of fearful and obsessive thoughts. But it does not
go deep enough for my purpose here. The second construction is much
stronger: (b) The free man is liberated from death itself - it will not touch
him, so he need not think of it at all.
For Spinoza this sense is possible, but in a purely cerebral fashion.
Living sub specie aeternitatis, under the aspect of eternity - living, that is,
under the dictates of reason, which operates in the same way whether its
objects are past, present, or future - frees the subject from time, but it takes
devotion, the cultivation of the intellectual love of God, through which the
philosopher can participate in God’s timelessness, in Being outside of Time.
It has also, however, been given a much more down to earth doctrinal form,
in the story of the conquest of death by the Atonement: “O death, where is
thy sting? O grave, where is thy victory?”9 This constitutes a refusal not so
much of death itself as of its power. Instead of being difficult to attain, this
state is preached as simply accessible to anyone: all can face death and the
idea of death in tranquil confidence. That is what has happened, in effect,
throughout the centuries of Christian faith. It is one of those cases, like
conversion or sin, in which a mystery of belief is doubled by a perfectly
secular philosophical understanding - and vice versa.
Other philosophers have made other attempts to tame death, in some
cases by embracing it - I think of Heidegger’s “Being-towards-death,” which
he takes to be constitutive of the existential condition. Heidegger’s problem
is that he wants to characterize Dasein as a whole, which it cannot be until it
is finished. But the defining character of Dasein is care, which is always
ahead-of-itself, so how is he to understand the moment of completion, i.e.
death? Up to that point Dasein has a constitutive “not-yet,” because there is
always something outstanding - hence Being-towards-death. But if it ever got
there it would become a thing, present-at-hand, and that is not admissible. So
there has to be something called “demise” which is not death, and death has
to be “impending” rather than something that ever actually happens:
...[J]ust as Dasein is already its ‘not-yet,’ and is its ‘not-yet’
constantly as long as it is, it is already its end too...Death is
a way to be, which Dasein takes over as soon as it is.10
This seems to me a quite unnecessary encumbrance for the
existential subject, a response to a problem that need not even arise if we are
content with a less portentous conception of our own existence.
The everyday attitude of most people is to accept death as a fact of
life, to think about it just enough - by making a will, or buying life insurance
- but not to talk about it too much. Like taxes, it is taken to be inevitable. The
evidence that I am going to die is provided for me by the deaths of other
8
Pragmatic Immortality and the Insignificance of My Own Death
______________________________________________________________
people - it seems to be forced on me, even if I rarely or never see actual
corpses. There are pictures in the newspapers, there are obituaries and printed
cards, and hospitals, and funerals, and cemeteries, and monuments, not to
speak of more immediate cases when I myself am mourning someone whom
I loved and who will never return. But all these are the deaths of others. Am I
entitled to draw any conclusion from them about my own case? Their deaths
I can experience, given the right circumstances - but mine?
Wittgenstein says bluntly that “death is not an event in life.”11 The
deaths of others count as events in my life - they have their before and after,
they have their place alongside other events, other events succeed them. But
the sense that we give to the term “event” involves a certain unity and
totality, it implies a closure, whereas my death, even if it comes to me out of
some other place (which is the root sense of “event”), cannot be packaged or
confined like this. It lacks a conclusion. In the limit I can imagine something
that could be called the beginning of my death, but after that point everything
becomes indefinite. “In the limit” - limits can be approached asymptotically,
and do not necessarily coincide with boundaries. What if life were like that,
ending with a Zeno paradox?
Clearly the death I am talking about here is not my physical death as
seen from the point of view of other people, for whom it can begin and end
like any other event. For them I am one among others. It is myself for myself
that is in question. Where will I be when they dispose of my body? How will
I have arrived there? Death is not a state that I can realize, voluntarily or
involuntarily. What about suicide? someone may ask. One might suppose
that one could always kill oneself, se donner la mort, as the French have it,
“give oneself death.” But the problem with suicide is not that those who kill
themselves have given themselves death - on the contrary this death, which
they thought was theirs, has been given to us, who are left with its
consequences. To give ourselves death is less easy than we thought (though
there is an interesting inversion of this case - by not committing suicide we
can give ourselves life, and this can be a powerful psychological strategy).
Jacques Derrida gives a different sense to the idea of my giving
myself death - I must, he says, take my death upon myself as a condition of
being a self at all:
The sameness of oneself, what remains irreplaceable in
dying, doesn’t become what it is - in the sense of a same
that relates to self in the oneself - before encountering what
relates it to its mortality understood as irreplaceability.12
No one can die in my place, and making myself the gift of that realization is
the only way in which I can achieve autonomy and responsibility, or put
myself in the position of giving anything (including my own death, in heroic
Peter Caws
9
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sacrifice) to anyone else. There is an obvious echo of Heidegger here. But no
one can have lunch in my place either, not my lunch, and it seems
extravagant to insist that I give myself my death as a passport to my life as an
individual. That is a gift I can safely refuse without compromising in any
way my capacity for giving, or even for self-sacrifice. If I were to “go to my
death” for the sake of another or others it would make no difference to the
thesis of pragmatic immortality.
The situation in which I find myself in relation to my own death is
reproduced in relation to my own birth. I can observe the birth of others as a
daily fact, I can be present at it, it can be - if for example the birth is that of
one of my own children - a central fact of my life. But I cannot know my
own birth except as a story told me after the fact, and long after. There is of
course a significant difference between the cases, in that nobody can tell me
the story of my own death. But my birth cannot be an event in my life as
lived by me any more than my own death can.
Everything happens as if I myself, in contrast to anything else in the
world, were a being without beginning and without end. Events happen
around me; time passes, but this passage belongs to it, not to me - I remain
immobile at the centre of my world. A megalomaniacal position, you may
say. And yet a comparable position, bearing on my spatial position at a
cosmic level, follows necessarily from the theory of relativity, and can be
applied (as I have shown elsewhere13) locally as well. Why not apply the
same principle to my temporal situation?
To maintain that it is other things that move around my immobility,
that just now Salzburg and Austria itself took the trouble to come towards me
so as to make possible my presence here, obviously involves an element of
fantasy. And yet, from my original point of view on the world, that is what I
was bound to think - I had to learn that it was I who moved against a fixed
background of space and time, I had to construct (or have constructed for
me) the system of coordinates of a world that existed before I was born, that
would continue to exist after my death, and that existed elsewhere, out of the
reach of my perception. This whole external world, this universe, is in a way
only a part of my own personal world, at the centre of which I remain in my
here and my now.
It was Husserl who best understood the relation between the subject
and its world, reversing the familiar order of container and contained so that
the world was carried in the ego rather than the ego in the world. Every
subject lives his or her own world, a world-of-living or Lebenswelt, a
“lifeworld” (the expression “lived world” that is sometimes used misses the
active sense).14 “Living” could thus be understood as “having a lifeworld.”
The contrast between life and death is intelligible only from within the
lifeworld, whose unity and coherence are presupposed by every human
10
Pragmatic Immortality and the Insignificance of My Own Death
______________________________________________________________
activity, including philosophy. It is the life of this world whose ending cannot
be incorporated into itself, which renders it effectively boundless.
This boundless character of the lifeworld is also stressed by
Wittgenstein, though he does not use that term. Having remarked that death
is not an event in life he continues:
If we take eternity to mean not infinite temporal duration
but timelessness, then eternal life belongs to those who live
in the present. Our life has no end in just the way in which
our visual field has no limit.15
The analogy is not exact - our visual field is normally limited on all sides by
the materiality of seen objects. At the same time we can always push back the
limits, for example by using a microscope, or by walking around objects in
search of new perspectives. The visual field (and here I think of Plotinus) can
be identified with the field of Being itself - if this has limits they can only be
at the threshold of Nothingness, and these are limits that as we have already
seen can only be approached asymptotically, and thus never reached.
According to this view, even if we think of a death long prepared, at
the end of a slow illness or in extreme old age, it will always be too soon to
accept it as definitive. How can I know, given the total absence of relevant
experience, that some purely internal detour is excluded a priori? I think we
should maintain until the very last moment the attitude of the old codger in
Vermont, who, when a visitor to the village asked him condescendingly: “So,
my good man, you’ve lived here all your life?” replied “Not yet I ain’t!”
This “not yet” expresses the central idea of this text. My
Vermonter’s “not yet” is not, like Heidegger’s, “towards-death,” it is serenely
indifferent to death - he is evidently, like me, of Spinoza’s mind. Situated as I
am at the immobile centre of my lifeworld (immobile because it is the point
of reference for all motion), able always to take refuge in the fortress of the
transcendental ego, whatever may happen to the “naively interested ego” (as
Husserl describes it16), I remain exactly what I was at the dawn of my
consciousness, and will I am convinced to continue to be that for ever. For if
this being that I am one day ceases to be, it certainly won’t be I who know it.
I am not in a position to know what I shall know, and moreover no one is or
could be in a position to know that. Which is to say that in spite of the “neardeath experiences” reported by Elizabeth Kübler-Ross,17 in spite of the long
history of speculation and of doctrine on the topic, we are still in complete
ignorance of what our own death will be like. It is, to repeat, the one thing
about which it is in principle impossible for us to have any empirical
knowledge. That being the case, I have no reason whatever to draw any
conclusions about my own mortality. And in this light there is no reason
either not to attribute to myself and to everyone else the pragmatic
Peter Caws
11
___________________________________________________
immortality of my title. In the absence of all definite knowledge on what the
moment of death may be, nothing prevents us from living, to adapt Spinoza’s
formula about eternity, “under the aspect of immortality.”
Notes
1
Aristotle, Physics, 207a8, in The Complete Works of Aristotle, Bollingen
Series LXXI:2, J Barnes (ed), Princeton University Press, Princeton, 1984.
2
Cited in G Murray, Five Stages of Greek Religion, Watts, London, 1935, p.
170.
3
A Cherry-Garrard, The Worst Journey in the World: A Tale of Loss and
Courage in Antarctica, The Narrative Press, Santa Barbara, California, 2001,
p. 337.
4
W Shakespeare, A Midsummer Night’s Dream, act V, scene I, lines 295-6.
5
E A Poe, ‘The Facts in the Case of M. Valdemar’. in Poetry and Tales, The
Library of America, New York, 1984, pp. 840-1.
6
Plato, Republic, 115c7-10, in The Collected Dialogues of Plato including
the Letters, eds. E Hamilton and H Cairns, Bollingen Series LXXI, Princeton
University Press, Princeton, 1961.
7
P Caws, ‘Subjectivity in the Machine’. in Yorick’s World: Science and the
Knowing Subject, University of California Press, Berkeley and Los Angeles,
1993.
8
B Spinoza, Ethics, J Gutmann (ed), Hafner, New York, 1949, part IV,
proposition LXVII.
9
I Corinthians 15:55.
10
M Heidegger, Being and Time, J Macquarrie and E S Robinson (trans),
SCM Press, London, 1962, Division Two, I, p. 46.
11
L Wittgenstein, Tractatus Logico-Philosophicus (6.4311), C K Ogden
(trans), Routledge and Kegan Paul, London, 1922, p. 185.
12
J Derrida, The Gift of Death [second edition] and Literature in Secret, D
Wills (trans), University of Chicago Press, Chicago, 2008, p. 46.
13
P Caws, ‘On Being in the Same Place at the Same Time,’ in Yorick’s
World.
14
E Husserl, Cartesian Meditations: An Introduction to Phenomenology, D
Cairns (trans), Martinus Nijhoff, The Hague, 1960, pp. 24-6.
15
L Wittgenstein, loc. cit.
16
E Husserl, op. cit., p. 35.
17
See e.g. E Kübler-Ross, On Life after Death, Celestial Arts, Berkeley,
2008.
12
Pragmatic Immortality and the Insignificance of My Own Death
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Bibliography
Aristotle, The Complete Works of Aristotle. J Barnes (ed), Bollingen Series
LXXI:2. Princeton University Press, Princeton, 1984.
Caws, P., Yorick’s World: Science and the Knowing Subject. University of
California Press, Berkeley and Los Angeles, 1993.
Cherry-Garrard, A., The Worst Journey in the World: A Tale of Loss and
Courage in Antarctica [Constable, London, 1922]. The Narrative Press,
Santa Barbara, California, 2001.
Derrida, J., The Gift of Death, 2nd edn, and Literature in Secret. D Wills
(trans), University of Chicago Press, Chicago, 2008.
Heidegger, M., Being and Time, J Macquarrie and E S Robinson (trans),
SCM Press, London, 1962.
Husserl, E. Cartesian Meditations: An Introduction to Phenomenology. D
Cairns(trans), Martinus Nijhoff, The Hague, 1960.
Kübler-Ross, E., On Life after Death. Celestial Arts, Berkeley, 2008.
Murray, G., Five Stages of Greek Religion, Watts, London, 1935.
Plato, The Collected Dialogues of Plato including the Letters. E Hamilton
and H Cairns (eds), Bollingen Series LXXI, Princeton University Press,
Princeton, 1961.
Poe, E A., ‘The Facts in the Case of M. Valdemar’, in Poetry and Tales. The
Library of America, New York, 1984.
Shakespeare, W., A Midsummer Night’s Dream, in The Riverside
Shakespeare. G B Evans (ed), Houghton Mifflin, Boston, 1997.
Spinoza, B., Ethics. J Gutmann (ed), Hafner, New York, 1949.
Wittgenstein, L., Tractatus Logico-Philosophicus (6.4311). C K Ogden
(trans), Routledge and Kegan Paul, London, 1922.
Peter Caws
13
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Peter Caws is University Professor of Philosophy and Professor of Human
Sciences at the George Washington University. His eight books and more
than 150 articles include work on the philosophy of the natural sciences, on
ethics and continental philosophy (Sartre, and the structuralists), and more
recently on psychoanalysis and the human sciences.
Concepts of Value: Attitudes toward Death
Stephen E. Rosenbaum
Abstract
Philosophers have for 40 years actively discussed ancient Aristotelian and
Epicurean differences regarding the value of death for individuals who
die. Aristotle thought that death was a terrible thing, whereas Epicurus
believed that it “is nothing to us,” not bad for people who die. The discussion
has proceeded along many fronts, basically considering whether the
Epicurean view can accommodate common “intuitions” about death
valuation, such as the ideas that killing is generally wrong, that death’s not
being bad is inconsistent with important “life-death comparisons,” and that it
is widely incompatible with many value judgments people make about death.
Clarification of the different views shows how they are each plausible and
defensible. However, contrary to still relatively common opinion, I argued in
a 2000 article that the Aristotelian and Epicurean views over which
philosophers have long argued are strictly compatible. Although they appear
contradictory, they are not, because they employ two quite different concepts
of value, and are thereby consistent. One notion of value at issue is
“concrete,” necessarily involving effects on individuals. The other notion is
“abstract,” involving facts about people, which do not entail effects on them,
but might nevertheless be good or bad for them. This paper will clarify
further the distinction between the two relevant “modes of valuation,” and
suggest how it applies to such issues as the fear of death; the death penalty;
the rationality of suicide; and life-death comparative judgments, like the
belief that life is sometimes better (or worse) than death. The purpose is to
suggest that in light of different human concerns and attitudes, one concept of
value may be appropriate and useful in issue contexts in which the other may
not be appropriate and useful. A further result is a demonstration of how to
explore more comprehensively various issues about death.
Key Words: Aristotle, Epicurus, value concepts.
*****
1.
Introduction
One of the issues, which have occupied philosophical thinkers over
the past 35 years, is the question of the value of death for those who die.
They have discussed whether death is or can be good or bad for those who
die, and have recurred to Aristotle and Epicurus, who apparently disagreed
about the matter. Aristotle declared that “death is the most terrible of all
things” while Epicurus, argued, “Death is nothing to us.” Most thinkers have
16
Concepts of Value, Attitudes Toward Death
______________________________________________________________
followed Aristotle’s thinking about this, but a few have endorsed Epicurus’
thinking on the matter. While I do not have time now to recount all the
aspects of Epicurus’s or Aristotle’s views, or the outlines of the philosophical
dialogue about this over the past 35 years, I do want sketch Epicurus’s
argument, and to share reflections about how different concepts of value
affect the dialogue and how they operate generally in our thinking about
death. These notions of value can shape our attitudes toward many aspects of
death.
However persuasive Epicurus’s thinking about death is and however
well it can be defended, it has encountered considerable resistance, mostly on
the ground that it is starkly incompatible with many of our most common
judgments and attitudes toward death. For this reason, many have rejected it.
There are serious methodological issues involved in the issue and the
dialogue, but I do not have time now to review these.
Epicurus based his thinking on the idea that something could not be
(good or) bad for someone unless it could affect the person in a way of which
the person might be able to be conscious. Being, like Democritus, a
physicalist, he thought that death, by which he understood being dead (as
distinct from the process of dying or the moment of death), was the end of
consciousness, the end of a person’s conscious existence. Since he thought
that the dead could have no experiences, he concluded that death couldn’t be
bad for them. It cannot affect the dead.1
The idea that death is not and cannot be bad (or, for the same
reasons, good) for those who die seems to result in several untoward
consequences, which would apparently require a significant revision in many
of the things we think about death. It seems to imply, for example that death
itself cannot be a penalty. However much capital punishment might satisfy
feelings of vengeance, it cannot literally be a penalty or punishment, since it
cannot be bad for the one killed. Since it cannot be experienced, it cannot be
a punishment as incarceration or fines. Epicurus’s view also calls into
question the ground on which killing could generally be wrong (since many
think that the wrongness of killing is rooted in the badness of death for those
who die.) It also would seem to question many comparative judgments we
make about death.2 We think, for example, that suicide might be
unreasonable, because it might be better for someone to continue living than
to be dead. We also sometimes suspect that death might be better for some
people than continued life, in cases in which continued life would generate
great physical and/or psychological misery.
Although one could discuss many of the conundrums clustered
around the Epicurean view, I shall focus on life/death comparisons, and then
make a few general remarks about other issues at the end. I am going to urge
that comparative judgments we make about life and death are compatible
Stephen E. Rosenbaum
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with the Epicurean idea that one’s death cannot be bad for one and that they
thus constitute no adequate ground to question Epicurus’s idea.
Operating implicitly and mostly unnoticed in ideas we have and
express about death are two concepts of value, and in light of these different
and logically compatible concepts, one can argue not only that Aristotle’s and
Epicurus’s views are consistent, but also that many ideas we have about
death which may seem initially opposed to the Epicurean view are really
consistent with it.3 Additionally, these concepts should perhaps engender
possible revisions in various of our views about death. I want first to
explicate these different ideas of value.
One concept of value is concrete, and the other is abstract.
Epicurus’s concrete notion of value is that nothing can have any value for
someone; nothing can be good or bad for someone, unless it can affect him or
her in some way. This is a concrete concept of bad (or value) requiring for its
applicability some concrete effect on someone, say a pain, or something else
which is capable of being experienced. The other concept of value is abstract
in that it attributes value to propositions about people, which might not entail
concrete effects on them, but would be true of them at any time, before and
after they live. In fact, some propositions about people, which are supposed
to have value for people, are according to this view not associated with any
concrete effects on them. There are possibly numerous facts in some sense
about us, which are not connected to effects on us. One might think of such
facts as being remarked about in passing by two strangers, where whatever
they say, however positive or negative, never affects one. There are similarly
facts about one concerning events which happen after one dies, which can
have no effect on one. If after one’s death lies by maleficent enemies destroy
one’s reputation, this can have no effect on one, but is nevertheless a fact
about one. If, after one’s death, one’s descendents, about whose future
welfare one cared deeply, are destroyed horribly, this is a fact about one,
about one’s life narrative, but cannot affect one literally. Yet, we tend to have
some sort of feeling about such cases, especially if we project ourselves into
such circumstances. How would we feel if that happened to us? Such ideas
about abstract valuation have been used to support the idea of posthumous
harm for individuals who are dead (and there is a considerable literature on
this).
We may believe that the betrayal of someone, after he or she dies,
by his best friend is unfortunate and “too bad for the person betrayed.” We
may continue to think this even in the face of realizing that although the
person was betrayed by the friend, it did not affect the person in any way,
assuming with Epicurus that in some important sense he or she ceased to be
at death. It may have had no negative effects on the person, and have not
affected the quality of life. If we think this way, we may implicitly be
using/accepting an abstract notion of valuation, according to which
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propositions may have value for someone, even if they do not entail effects
on the person. Those who, like Epicurus, endorse a concrete notion of value
could accept and countenance the narrative elements about a person’s life,
but deny that those narrative elements which do not have any effects on the
person who lived and existed have any value for the person, at least from the
point of view of concrete valuation. They might think that to the extent that a
person’s narrative is not identical with the person and effects on the person,
the narrative can have no value, except perhaps in some artificial sense,
which might depend on culturally specific and possibly relative ways of
valuing.
Events, which affect people and cause effects on people, can have
concrete value for them. These events, like all events within a person’s life,
can be expressed in statements about the person, and can be part of his or her
life narratives. All events, which affect people, are parts of the complete
narrative about his or her life, but not all propositions included in the
complete narrative of people’s lives, entail effects on them.
Think of abstract valuation in relation to propositions about people
and/or people’s lives. Human lives are described by, and conceived in terms
of, stories, narratives, which may be thought of as conjunctions of
propositions. Some of the propositions in a person’s narrative may be value
neutral, in the sense that they are neither good nor bad. The proposition that
a person woke up on January 20 at 8:31 am, could well be neither good nor
bad “for the person of whom it is true,” given that it is not logically related to
non value neutral propositions (ones that are good or bad for the person) and
does not entail that a person either is in or is caused to be in states or
conditions which are good or bad for the person. Many of the statements in a
person’s narrative will, however, not be value neutral, but will rather be, or
may occasionally be described as being, good or bad for the person.
2.
Life/Death Comparisons
Let me turn to life/death comparisons. Among the things we
sometimes think about people’s lives involve comparisons between death and
life. We sometimes judge for example that someone’s suicide is irrational
partly on the ground that it would have been better for him or her to have
continued living. In other words, death was worse for him or her than
continuing to live would have been. We also sometimes think that death is
better for certain people than continuing to live, say because continuing to
live would be very physically and psychologically painful. Whether we are
right about these judgments in whatever cases in which we make them is less
my concern now than the logical and conceptual basis for thinking or saying
such things. These judgments, which can be proper, would seem to
undermine the Epicurean idea that death (being dead) can have no value for
people and can be neither good nor bad for them. Such judgments implicitly
Stephen E. Rosenbaum
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assign a comparative value to death for some people, and thus imply that
death can have some value for people, can be at least relatively (or
comparatively) good or bad.
You see here the shadow of a kind of paradox: Either we give up the
logically strong Epicurean view, or we give up the conceptual basis for
comparing life and death in the way suggested. Most have just rejected the
Epicurean view and have insisted that contrary to Epicurus and in accord
with Aristotle, death is bad for those who die, or it can be.
We can account for the basis of our concept of comparative
evaluation of the kind illustrated by using the idea of abstract valuation.
Accordingly, we can think of life/death comparisons we might feel inclined
to make as being about comparisons between the actual narrative of a
person’s life and possible different, alternative narratives, which might
depend upon the fact about when the person dies in relation to various
narrative elements in a person’s life. For example, when we think that it
would be better for a person to continue living than to die, we would judge
this on the basis of believing that the narrative in which the person lives for
20 more years rather than dying in the next three months is a better narrative.
When we think, in other cases, that it was better for a person to die yesterday
than to continue living for another six weeks, we are judging that the person’s
life story was better than it would have been if he had continued living. I
think that the grounds on which we make such judgments are complex and
depend on various values we have about human lives and the structure of
those lives. Those values and the ideas with which they are associated are
important, and would be interesting to explore, but I want to focus on the idea
that when we make such comparative judgments, we are using the idea of
abstract valuation, according to which propositions about a person can have
value for the person, whether or not they are associated with any effects on
the person. When we think that it would be better for a person to die than to
continue living, our thought does not imply either that the condition of being
dead would have positive value for the person or that anything occurring
while the person is dead would have such value. We are just attributing value
to a fact about a person’s life, to a statement about a person’s history.
If we can account for comparative judgments about people’s deaths
using the notion of abstract valuation and thus think that the fact that a person
died when he or she did can be good or bad for the person, then the
propositions which have value in relation to statements about the person’s
life narrative need not entail that any condition of the person is actually good
or bad for the person. Therefore, comparative judgments are not incompatible
with the Epicurean idea that death is not bad for those who die, and constitute
no ground on which to reject or question the Epicurean idea.
The main argument against the Epicurean idea, the “deprivation
argument” is supported by many who endorse Aristotle and reject the idea
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that “death is nothing to us.” They argue that death can be bad for those who
die because of that of which it deprives them, namely continued life, and the
possibility of completing projects and plans they have. Most human lives
have a kind of structure, they argue, which requires time for completion,
roughly an average human life span. Without seeing clearly how long they
will live, most people nevertheless make plans to accomplish certain goals, to
raise their children and enjoy their grandchildren. When an unexpectedly
early death interrupts those plans and makes them impossible to complete, it
will be bad for the person who dies, according to those who endorse the
deprivation argument.
This deprivation argument, sympathetic to Aristotle, depends on the
idea of abstract valuation. Those who advocate this idea4 are implicitly using
the idea of abstract valuation. They would not declare, contrary to Epicurus,
that the condition of being dead is or could be bad for people, but they
nevertheless think that death could be bad for people. They can believe this
only if they employ a sense of value, which gives value to propositions about
people’s lives, which may not entail that they suffer negative effects in their
lives or deaths. They are thinking about, say, the proposition that the person
died at a time before he or she could finish projects or complete the plan for
his or her life. This is not inconsistent with the Epicurean view that being
dead is not bad for those who die. Therefore the “deprivation argument” does
not negate the idea that death is not bad for us.
There are many judgments we make about individual deaths, which
fit into the framework of abstract valuation, and are not inconsistent with the
Epicurean view. One might in light of my discussion wonder whether the
Epicurean view is perhaps mildly interesting, but may not be able to find any
interesting traction in many of our concerns about death and how we think
about death in human life. After all, if it is consistent with judgments people
feel it important to make about death, why does it merit any attention. How
could it be useful? I can only sketch an answer to this question, by raising
other considerations related to other ideas about death.
First, one of the points of Epicurus’s efforts was to undermine the
fear of death, as is clear both from what he says and how Lucretius developed
his ideas. How relevant to the fear of death is the idea of concrete value is
certainly central here. The idea of the fear of death is not very definite, but if
it is fear of the condition of being dead or fear of what will happen to one
after death, rather than the fear of, say, dying too early and then there being
undesirable aspects of one’s life narrative, then the Epicurean idea, with its
notion of concrete value would be relevant. If, as Epicurus thought, there is
nothing bad, which can happen to one in death, then it might be groundless to
fear death (being dead).5 I do not have time to discuss the fear of death, but I
would urge further reflection on this, and the relevance of Epicurean ideas.
Stephen E. Rosenbaum
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The Epicurean view also raises questions about the death penalty, as
it did for Julie Caesar when he considered punishments for the Cataline
conspirators. If death, being dead, cannot be bad for people, how can it then
be any sort of punishment, since it would be unlike incarceration and fines,
which affect people badly and are thereby said to be bad for people?6 Unless
punishments are not literally bad things (concretely bad things) done to
people in relation to what they are said to deserve, but are rather something
else such as state-sponsored indirect substitutes for direct revenge, or perhaps
something else, then it is difficult to see how the death penalty could be much
of a punishment.7 If one assumes that punishments necessarily have concrete
(negative) value for those punished, then it seems that the Epicurean idea
does imply that death cannot be much of a penalty for anyone, certainly not
significantly more of a penalty than, say, incarceration.
Finally, I should mention the general idea of the wrongness of
killing in societies across the globe. Killing is commonly regarded as morally
wrong in all human societies, with possibly appropriate exceptions, such as
killing in self-defence. Where does this moral prohibition come from? That
is, what is its logical source? Many have suggested to me that this thought
about the morality of killing is reason enough to reject the Epicurean view of
the value of death, because it seems conceptually inconsistent with the very
widely shared view that killing is morally wrong. Obviously a full discussion
of this issue is not possible now, but I want to share a few thoughts. The
objection made here depends on the idea that only if death is bad for those
who die can killing be morally wrong. Some theories of morality may take
this view, such as possibly a utilitarian ideal. However, such theories are not
the only possible accounts of morality and its precepts. Some think that
morality is a social phenomenon, and arises as implicit and explicit
understandings of what behaviour is proper and what improper. Epicurus was
this sort of moral thinker, and like Democritus before him (and Hobbes after),
thought that morality was the result of a compact or contract (syntheke).8
Accordingly he believed that society somehow adopted the prohibition
against killing as one its most serious principles for conserving social order
and the basis for personal happiness. A contractarian view of morality is
entirely compatible with the Epicurean idea that death is not bad for people.
Whether such a view of morality can accommodate the various proper
desiderata of moral theory is a large question, certainly beyond the scope of
what we can address here. However, it is worth considering and suggests
another possible implication of the Epicurean view and its companion notion
of concrete value.
3.
Conclusion
I hope my sketchy arguments have not been too opaque, but I
wanted to share with you some ideas about value in the context of thinking
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about death, and express a few ideas in order to provoke further thinking.
There are two notions of value underlying what we think about say about
death and numerous issues surrounding death, and it is important to consider
their implications and their significance in various contexts.
Notes
1
S E Rosenbaum, ‘How To Be Dead and not Care: A Defence of Epicurus’,
American Philosophical Quarterly, vol. 23 (1986), p. 217-225.
2
J McMahan pursues this issue in ‘Death and the Value of Life’, in The
Metaphysics of Death, J M Fischer (ed), Stanford, Stanford University Press,
1993, p. 231-266.
3
S E Rosenbaum, ‘Appraising Death in Human Life: Two Modes of
Valuation,’ in Midwest Studies in Philosophy, P A French and H K Wettstein
(eds), Oxford, Blackwell Publishers, 2000, p. 151-171.
4
For just a couple of examples, Thomas Nagel, ‘Death,’ in The Metaphysics
of Death, J M Fischer (ed), Stanford, Stanford University Press, 1993, p. 5969. Among many others, Martha Nussbaum and Gisela Striker also take this
view in various places..
5
Diogenes Laertius, Lives of Eminent Philosophers, Epicurus’s ‘Letter to
Menoiceus’, R D Hicks (trans), London, W. Heinemann, 1925, Book X, 125.
6
S E Rosenbaum, ‘Death as a Punishment: A Consequence of Epicurean
Thanatology’, in Epicurus: His Continuing Influence and Contemporary
Relevance’, Gordon and Suits (eds), Rochester: Rochester Institute of
Technology Cary Graphic Arts Press, 2003, 195-206.
7
This is obviously more of a concern for the North American conversation
about the death penalty than for other conversations.
8
Diogenes Laertius, op cit., Book X, 139-154, especially Kuriai Doxai #3138.
Bibliography
Nussbaum, M., The Fragility of Goodness. Cambridge, Cambridge
University Press, 1986.
_____., ‘Therapeutic Arguments: Epicurus and Aristotle,’ in The Norms of
Nature, M. Schofield and G. Striker (eds), Cambridge, Cambridge University
Press, 1986.
Rosenbaum, S., ‘How to be Dead and not Care: A Defense of Epicurus’.
American Philosophical Quarterly, vol. 23 (1986), 217-225.
Stephen E. Rosenbaum
23
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_____., ‘Appraising Death in Human Life: Two Modes of Valuation,’ in
Midwest Studies in Philosophy, P A French and H K Wettstein (eds), Oxford,
Blackwell Publishers, 2000, 151-171.
_____., ‘Death as a Punishment: a Consequence of Epicurean Thanatology,’
in Epicurus: His Continuing Influence and Contemporary Relevance, D. R.
Gordon and D. B. Suits (eds), Rochester: Rochester Institute of Technology
Cary Graphic Arts Press, 2003, 195-206.
Silverstein, H., ‘The Evil of Death.’ The Journal of Philosophy 77, 1980,
401-424.
Striker, G., ‘Commentary on Mitsis.’ Proceedings of the Boston Area
Colloquium in Ancient Philosophy, vol. 4, J. J. Cleary (ed), Lanham, 1988,
315-320.
Stephen E. Rosenbaum is Professor of Philosophy at University of Nevada,
Las Vegas USA
There Is Good Hope That Death Is a Blessing
J. F. Humphrey
Abstract
In Plato’s Apology (29a-b), Socrates agues that he does not fear death;
indeed, to fear death is a sign of ignorance. It is to claim to know what one in
fact does not know (Ap. 29 a-b). Perhaps, Socrates suggests, death is not a
great evil after all, but “the greatest of all goods.” At the end of the dialogue,
after the judges have voted on the final verdict and Socrates has received the
death penalty, the philosopher considers two common views of death: that
death is a long dreamless sleep and that death is a journey to another place Hades. According to Socrates, either of these views of death would be
acceptable to him; the one, because he would receive a wonderful rest with
no dreams to disturb him; the other, because he would be able to talk
philosophy with those who had gone before with impunity. In this paper, I
will examine Socrates’ view of death, and I will argue that, according to
Socrates, there could be a third perspective on death that will not only make
him truly immortal in a certain way, but will also immortalize the practice of
Socratic philosophy. Hence, Socrates embraces his sentence because dying at
the right time and dying in the right way provides him the possibility of a
good death.
Key Words: Plato’s Apology, Socrates, ‘good death,’ immortality.
*****
1.
Socrates’ Defence
In Plato’s Apology of Socrates, Socrates is at the Stoa of the King,
the court that tried cases involving offences against the citizens and the city.1
He has been accused of doing “injustice by corrupting the young, and by not
believing in the gods in whom the city believes, but in other diamonia that
are novel” (Ap. 24b). In the course of his apologia, Socrates defends himself,
first against his first accusers - those who are not presently accusing him, but
who, by slandering him in the city, created the conditions whereby he has
now been called to the court to answer an indictment, and then against his
second accusers - those who are actually accusing him and bringing him to
court because they believed the slanders of the earlier accusers. Although
they are not actually accusing him in the court, because their accusations may
have influenced those on the jury, Socrates defends himself against the many
unknown first accusers by arguing that he is not the kind of man that
Aristophanes makes him out to be in the Clouds because he does not walk on
air or have magical knowledge. Then, he argues that he is not a Sophist; he
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does not teach because he does not teach for money. Finally, he contends that
he does not corrupt the youth because he does not teach them; they simply
follow him around the city and enjoy listening to him question himself and
others. When they try to imitate Socrates with their parents and family
members, the family members do not blame the youth, they blame Socrates.
He defends himself against the second set of accusers, Meletus,
Anytus, and Lycon, by interrogating the young Meletus. Against the second
set of accusers, Socrates argues that it would be absurd to think that he is the
only one who corrupts the young and that it is far more likely that it is the
many, the citizens of the city, who corrupt the youth. Next, he claims that if
he corrupts the youth, he must have done it unknowingly and that he should
not be brought to court for committing a crime but should be educated about
his mistakes. Finally, he argues that Meletus contradicts himself by accusing
him of atheism; since he believes in the offspring of the gods, he must
believe in the gods themselves.
In the detour found in the arguments against the first accusers,
Socrates claims that Apollo, the god that governs the Oracle at Delphi, told
his now deceased friend Chaerephon “no one was wiser than Socrates”
because the god,
made use of my (Socrates’) name in order to make me a
pattern (paradeigma), as if he would say, ‘That one of you,
O human beings, is wisest, who like Socrates, has become
cognizant that in truth he is worth nothing with respect to
wisdom’ (Ap. 23a-b).
Socrates, then, is wise because he recognizes his own ignorance and
we should pattern ourselves on him and recognize our own ignorance.
Furthermore, in concluding his defence speech, Socrates argues that he has
been directed by the god to investigate others and that if he discovers that his
interlocutors are unable to give an adequate account of themselves, he
(Socrates) must obey the god and point out his their ignorance. “I have been
ordered to practice this by the god, as I affirm, from divinations, and from
dreams, and in every way that any divine allotment ever ordered a human
being to practice anything at all” (Ap. 33c).
To support this claim, Socrates asserts that it would be ignoble, “to
suppose that a man who is of even a little benefit should take into account the
danger of living or dying, but not rather consider this alone whenever he acts:
whether his actions are just or unjust, and the deeds of a good man or a bad”
(Ap. 28b). Although he does not refer to Achilles by name, according to
Socrates, the son of Thetis had been warned by his mother that if he avenged
J. F. Humphrey
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the murder of his friend, Patroklus, by killing Hektor, he would die shortly
thereafter; Achilles, however, chose to avenge his friend’s death and die
without giving a thought for death and danger. “So I would have done terrible
deeds,” Socrates tells the jury,
if, when the rulers whom you elected to rule me stationed
me in Potidaea and Amphilpolis, and at Delium, I stayed
then where they stationed me and ran the risk of dying like
anyone else, but when the god stationed me, as I supposed
and assumed, ordering me to live philosophising and
examining myself and others, I had then left my station
because I feared death or any other matter whatever (Ap.
28d-e).
Just as Achilles did his duty in avenging Patroklus’ death, so too, Socrates
did his duty by obeying his generals in war and hence he must also do his
duty by obeying the god who, he claims, has ordered him to practice
philosophy by examining himself and others. Had he failed to do his duty,
had he committed such terrible deeds against the city and the god, it would
indeed be just for him to be brought into court and punished.
Terrible that would be, and truly then someone might justly
bring me into a law court, saying that I do not believe that
there are gods since I would be disobeying the divination,
and fearing death, and supposing that I am wise when I am
not. For to fear death, men, is in fact nothing other than to
seem to be wise, but not to be so. For it is to seem to know
what one does not know: no one knows whether death does
not even happen to be the greatest of all goods for the
human being; but people fear it as though they knew well
that it is the greatest of evils. And how is that not that
reproachable ignorance of supposing that one knows what
one does not know? But I…am perhaps distinguished from
the many human beings also here in this and if I were to say
that I am wiser than anyone in anything, it would be in this:
that since I do not know sufficiently about the things in
Hades, so also I suppose that I do not know (Ap. 29a; italics
added).
One might object that Socrates misses the point here. Certainly,
Crito and the many understand death to be the greatest evil (Cr. 44c-e). Are
the many wrong to fear death? Perhaps the fear of death is associated with the
fear of the painful ways in which people die. Another possible reason that
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people seem to fear death is not because we know it to be an evil, but because
we do not know what the experience of dying will bring; the fear of death is
the fear of the unknown. Still, according to Socrates, since no one has ever
returned to report his or her experience, we cannot actually know what death
is and since we do not know what death is, we should not judge it to be an
evil. For the same reason, however, despite what Socrates says, it would also
follow that one ought not to assume that death is good. Socrates, however,
raises the possibility that death may be “the greatest of all goods” for
humans.
After Socrates makes his speech defending himself from the charges
brought against him by Meletus, Anytus, and Lycon, the jury finds Socrates
guilty by a narrow margin. Meletus proposes the death penalty and Socrates
offers his counterproposal. After considering Meletus’ proposal and Socrates’
counterproposal, the jury votes to condemn Socrates to death. Before he is
taken away to await his execution, however, Socrates has the opportunity to
make a few remarks to the jury. He begins by addressing himself to those
who voted to condemn him to death. He warns them that given the fact that
he is advanced in age, had they only waited a short time, he would be dead.
Since Socrates wrote nothing, had he died of old age, we might not have
heard of him and his philosophical pursuits; indeed, had he not received the
death penalty all we would probably know of his trial is a brief line in the
history books. We know of this philosopher through the writings of those
who knew him and were impressed by his attempt to appeal to principle to
convince the jury, The fact that he stood before the city and defended himself
and his philosophical life without compromising his principles has made this
philosopher live in the imagination across generations. By killing him, the
city and its citizens make Socrates a martyr for philosophy.
2.
Socrates’ Response to Those Who Voted to Put Him to Death
“Perhaps you suppose,” Socrates claims, “that I have been convicted
because I was at a loss for the sort of speeches that would have persuaded
you, if I had supposed that I should do and say anything at all to escape the
penalty. Far from it.” He continues,
Rather, I have been convicted because I was at a loss, not
however for speeches, but for daring and shamelessness and
willingness to say the sorts of things to you that you would
have been most pleased to hear, me wailing and lamenting,
and doing and saying many other things unworthy of me, as
I affirm - such things as you have been accustomed to hear
from others. But neither did I then suppose that I should do
J. F. Humphrey
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anything unsuitable to a free man because of the danger, nor
do I now regret that I made my defence speech like this: I
much prefer to die having made my defence speech in this
way than to live in that way (Ap. 38d-e).
Socrates was convicted not because he lacked words to defend himself, but
because he refused to beg in the courtroom. Instead, he stood on principle
and he chose to present himself as a free man. In battle, one can easily escape
death with little effort if one is willing to become a slave; all one need do is
to throw down his or her weapons, turn to face the enemy, and plead for
mercy. “And there are other devices to escape death in each of the dangers, if
one dare to do and say anything at all” (Ap. 39a). “But it is much more
difficult, according to Socrates, to escape evil for it ‘runs faster than death’”
(Ap. 39a).
Socrates then delivers his prophecy to those who voted for the death
penalty. He accuses the jurors who voted to put him to death of thinking that
once they have killed him, they will not have to give an account of
themselves; they will be quit of philosophy. However, he warns that his death
will be avenged in the near future by those who follow him and there will be
more of them and they will be “harsher,” “younger,” and “more indignant”
(Ap. 39d). Socrates chides them for thinking that they can escape from giving
an account of themselves by killing people.
For if you suppose that by killing human beings you will
prevent someone from reproaching you for not living
correctly, you do not think nobly. For that kind of release is
not at all possible or noble; rather, the kind that is both
noblest and easiest is not to restrain others, but to equip
oneself to be the best possible (Ap. 39d; emphasis added).
However, if those who voted to put Socrates to death, equip themselves to be
the best possible, they will be examining themselves and others; they will be
practicing philosophy. Ironically, Socrates encourages the jurors who voted to
put him to death to become philosophers.
3.
Socrates’ Response to Those Who Voted to Acquit Him
Next, Socrates addresses himself to those who voted to acquit him,
his true judges. With them, he wants to talk about what has happened to him.
Socrates tells those who voted for acquittal that since there is time, nothing
prevents them from talking philosophy until he is taken away to the place
where he will die. Socrates explains, “something wondrous has happened” in
the court (Ap. 40a). Formerly, his divine sign had warned him when he was
about to do “something incorrectly” - “even in quite small matters” - and had
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There Is Good Hope That Death Is a Blessing
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never told him what to do (Ap. 40a). Anyone who observed what had
happened to him, however, would believe that he had suffered “extreme
evils” (Ap. 40b). However, Socrates explains that his divine sign had not
opposed him when he left his house in the morning, when he came to the
court, nor at anytime during his defence speech. The reason for this, Socrates
concludes, is that:
probably what has occurred to me has turned out to be a
good and there is no way that those of us take it correctly
who suppose that being dead is bad. In my view a great
proof has happened. For there is no way that the
accustomed sign would not have opposed me unless I were
about to do something good (Ap. 40b-c).
Then, Socrates asks the jurors who voted for his acquittal to
consider “how great a hope there is that it (death) is a good” (Ap. 40c). But to
say that there is hope that death is a good is not to say that death is a good;
hoping for something is not the same as saying that something is the case. On
the other hand, if one believes that death is a blessing, one might be released
from the fear of death and be free to do wondrous things in this life. Even
though Socrates does not know what death is and whether it is good or evil,
he considers two common views of death, namely, that death is “either like
being nothing and the dead person has no perception of anything, or else, in
accordance with the things that are said, it happens to be a sort of change and
migration of the soul from the place here to another place” (Ap. 40c). If death
is the former, i.e., if the dead have no perception of anything, it is like a
dreamless sleep and this would certainly, be a wondrous gain” (Ap. 40d). If
one compares the one night during which, because of exhaustion, one slept so
soundly that one did not dream with those other nights during which one
dreamed, one would conclude that the one night without dreams would be
better and more pleasant than all the other nights and days. If death is like
that one night of dreamless sleep, Socrates argues, then it would indeed be a
gain. But what allows us to have dreamless sleep if it is not the ability to be
free of worry and care? Hence, only those who are able to live a virtuous life
will achieve dreamless sleep.
However, if death should turn out to be like a journey to another
place and everything that one hears about death should turn out to be true,
Socrates claims, then there would be no greater good for us. When one is
released from the judgments against him or her in this life, one would arrive
in Hades to face true judges, those “who turned out to be just in their own
lives” (Ap. 41a). Socrates admits that he would be willing to die many times
J. F. Humphrey
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to spend his time “examining and searching out among those there,” as he has
done in the city of Athens, “who among them is wise, and who supposes he
is, but is not” (Ap. 41b). Unlike the Athenians, the residents of Hades will not
put Socrates to death; they “are happier than those here not only in other
things but also in that they are immortal henceforth for the rest of time, at
least if the things that are said are in fact true” (Ap. 41c).
Socrates concludes his conversation with those who voted for his
acquittal by encouraging them to be hopeful regarding death.
But you too, judges, should be of good hope toward death,
and you should think this one thing to be true: that there is
nothing bad for a good man, whether living or dead, and that
the gods are not without care for his troubles. Nor have my
present troubles arisen of their own accord, but it is clear to
me that it is now better, after all, for me to be dead and to
have been released from troubles. This is also why the sign
did not turn me away anywhere, and I at least am not at all
angry at those who voted to condemn me and at my
accusers. And yet it was not with this thought in mind that
they voted to condemn me and accused me: rather, they
supposed they would harm me. For this they are worth of
blame (Ap. 41c-e).
Finally, Socrates asks that when his sons grow to be adults that the
citizens punish them just as he had pained them.
This much, however, I beg of them: when my sons grow up,
punish them, men, and pain them in the very same way I
pained you, if they seem to you to care for money or
anything else before virtue. And if they are reputed to be
something when they are nothing, reproach them just as I
did you: tell them that they do not care for the things they
should, and that they suppose they are something when they
are worth nothing. And if you do these things, we will have
been treated justly by you, both I myself and my sons (Ap.
41e-42a).
But what is Socrates asking of the jurors when he asks them to punish and
pain his sons as he has punished and pained them? In The Apology, he
mentions having three sons (Ap. 34d) and he certainly may be talking about
his three sons here. But it is also possible that he is talking about all the
people in the city for he says that he is a gift given by the god to the city to
make certain that the citizens are attuned to virtue.
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There Is Good Hope That Death Is a Blessing
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That I happen to be someone of this sort, given to the city
by the god, you might apprehend from this: it does not seem
human, on the one hand, that I have been careless of all my
own things and that for so many years now I have endured
that the things of my family be uncared for; and on the other
hand, that I always do your business, going to each of you
privately, as a father or an older brother might do,
persuading you to care for virtue (Ap. 31a-b).
Furthermore, if Socrates comes to the citizens as a father, then the inhabitants
of the city are his children. And if the jurors are to punish and pain his
children as he has pained them, they will be practicing Socratic philosophy
with the people in the city. If they are practicing Socratic philosophy, there is
a third possible way to understand death. Suppose that death does not involve
a journey to another place. Suppose that death is more like a long dreamless
sleep. Still, if those who voted for the death penalty equip themselves to
become the best that they possibly can, they will be practicing philosophy. If
those who voted for his acquittal treat his sons, whether Socrates means his
own biological sons, the entire city, or both, they too will be doing
philosophy. And if the citizens of the city are doing philosophy, not only will
the citizens of the city become better, but the city will also become better.
More importantly, Socrates will have become a martyr for philosophy; he
will have achieved a certain kind of immortality.
Notes
1
Plato, Euthyphro in Plato and Aristophanes, Four Texts on Socrates:
Plato’s Euthyphro, Apology, and Crito and Aristophanes’ Clouds, T G West
and G S West (trans), Ithaca, NY, Cornell University Press, 1986, n. 5, p. 41.
Bibliography
Plato, Euthyphro, in Plato and Aristophanes, Four Texts on Socrates: Plato’s
Euthyphro, Apology, and Crito and Aristophanes’ Clouds, T G West and G S
West (trans), T G West (“Introduction”), Cornell University Press, Ithaca,
NY, 1986.
J. F. Humphrey teaches at the North Carolina Agricultural and Technical
State University, The Department of Liberal Studies and The Division of
University Studies, Greensboro, North Carolina, USA
Dignity of the Dead?
Julia Apollonia Glahn
Abstract
Dealing with death confronts us with a cornucopia of problems. A particular albeit long neglected - difficulty arises concerning the moral status of dead
human bodies. On the one hand, we assume that what constitutes a human
being - in particular human value und dignity - comes to an end with her
death. On the other hand, we have strong intuitions about the duty to handle
dead bodies with respect instead of violating their dignity. For example,
consider the debates on organ transplantation, the plastination of human
corpses for public exhibitions, and the use of human corpses as crash test
dummies. Thus, paradoxically, we seem to simultaneously deny and
recognize the dignity of dead human bodies. However, this tension can be
resolved by way of two argumentative steps. First, it behoves us to reconsider
the status of dead human bodies. Second, we have to clarify our
understanding of human dignity. In my paper, I argue that a human being’s
existence does not end with her death. In fact, dead people are still human
beings. Although we usually do not treat dead humans as if they have dignity,
because they do not fulfil the particular sets of criteria we associate with
dignity, it turns out that dead human beings still have dignity. So, far from
being without dignity, dead humans belong to a group of people who are
extremely vulnerable to dignity violations. Therefore, any concept of dignity
that fails to incorporate these most vulnerable beings is highly deficient and
problematic. Instead of arguing in favour of the traditional criteria of dignity,
I develop a social and interactional concept of dignity. According to this
approach, refusing decent and humane treatment to the dead is what Avishai
Margalit called “human-blindness” and constitutes an instance of a violation
of dignity.
Key Words: Human dignity, human dignity violation, dead, death,
interaction, human-blindness.
*****
Although philosophy has, for a long time, neglected the problem of
the moral status of human corpses, reality frequently teaches us otherwise.
It confronts us with situations, in which we have to decide how to treat dead
human bodies. Many of these situations take place in the private realm.
Others, however, become a matter of special public interest. When journalists
exposed that an Austrian University was using human corpses as crash test
dummies1 to get more realistic testing results, the public was shocked. In
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Dignity of the Dead?
______________________________________________________________
many people’s opinion, such a handling of dead human bodies was
disrespectful and a violation of the people’s human dignity.
The sentiment that a lot of people seem to share is that dead human
bodies are not at the mere disposal of others,2 but, in fact, deserve a particular
treatment that respects their human dignity.
Yet, we share another strong intuition about human dignity as
something that is closely related to certain human characteristics and
capabilities. Prominent candidates for the basis of human dignity are the
human capacity for reason, self-consciousness, morality3 or free will.4 All
these human capacities that are supposed to justify human dignity have one
thing in common though: They all require being alive. Only living people
and, in fact, not all of them, are capable of being self-conscious, reasonable,
free willing or moral agents. Usually, we share the assumption that with a
person’s death, not only her life comes to an end, but accompanied by it, all
her mental and physical capabilities as well. After death, no one is able to be
reasonable, self-conscious, free willing or a moral agent anymore. However,
if everything that constitutes human dignity in human beings is lost with
death, a dead human being cannot hold human dignity.
So, obviously, we are running into a dilemma. On the one hand, we
share the intuition that dead human bodies are not at the mere disposal of
others and deserve a treatment that respects their human dignity. But on the
other hand, we assume human dignity to be linked to certain human
capacities that dead humans are definitely lacking.
One possible answer to this problem is to say that dead human
bodies indeed do not have human dignity, but instead a weaker form of
dignity called residual or contingent dignity, which protects them from the
mere disposal by others and guarantees them some post mortem rights,5 e. g.
to respect a last will or not to do anything to the corpse the person did not
give her agreement to before she died; but this is not the “full” human
dignity.
However, this answer is misleading. The idea of a residual dignity is
not reconcilable with the important aspect that human dignity does not know
any gradation. Moreover, these granted post mortem rights based on a
residual dignity do not satisfy our intuition about the proper handling that
dead human bodies actually deserve. Rules, derived from a residual dignity
seem arbitrary and lack a sound justification. Why, for example are U.S.
citizens allowed to keep the ashes of their loved ones at home, whereas in
Germany ashes have to be buried at the cemetery?
So, as we still hold the two contradicting intuitions, we are still on
the horns of a dilemma. Paradoxically, we seem to simultaneously deny and
recognize the human dignity of dead human bodies. How can this be correct?
Doesn’t one of these assumptions necessarily have to be wrong? Either our
intuitive language of human dignity in connection with the handling of dead
Julia Apollonia Glahn
35
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human bodies is wrong and misleading or the limitation of human dignity to
only living human beings is wrong.
In the following, I would like to suggest a way out of this dilemma. I
claim that we only run into this dilemma, because we stick to a misleading
description of human dignity. Let me show you why our common idea of
human dignity is deceptive and what a better concept of human dignity can
look like.
The fact that most conceptions of human dignity limit the scope of
potential bearers of human dignity merely to living people is due to the ways
they try to justify human dignity in general. These conceptions identify some
human characteristics as crucial for the assigned special status of human
beings. They do so in order to give convincing reasons, why human beings
have dignity and therefore deserve certain rights and treatments. Different
approaches throughout history suggested a big variety of substantially human
qualities. As mentioned above, the human capacity for reason and autonomy,
self-consciousness or free will were and still are common candidates for the
one and essential human quality that justifies the special human status and, in
consequence, human dignity. All these proposals have their shortcomings,
but what they all have in common is that they focus on something
characteristic within the individual human being – i.e. something that
characterizes a human individual as being worth having the highest
normative standard called human dignity. But this focus is off target. The
commonly shared problem of all these concepts is that they always and
necessarily exclude certain groups of people. Relating the attribution of
human dignity to certain cognitive capacities means to ignore all the people
who are temporarily or permanently lacking these capacities.6 A comatose
patient, a severely brain damaged or profoundly mentally disabled person, or
even a healthy unborn or newborn infant is lacking most or all of these
capacities. To account for human dignity by referring to one or a set of these
qualities must fail, because it is requiring too much. It is extremely
misleading to ground the highest normative standard among human beings on
supposed characteristics that a lot of people do not even share. The capacity
for reason, self-consciousness, morality or free will might be typical for
human beings. But the mere identification of a capacity as typical for most
human beings is not a sound and plausible reason to make it crucial and
essential for the constitution of a status that should be granted to every
human being regardless of their natural capabilities.
An alternative concept that avoids this mistake is founded on the
fundamentals of Christian ethics.7 It considers all human beings to be God’s
children. Regardless what qualities they have they are all created in God’s
image and it was God himself who gave them their human dignity.8 Secular
concepts however, which try to rely on this argumentation are confronted
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Dignity of the Dead?
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with the lack of a theological authority like God, as an approach like this can
only be convincing for those who believe in God.
Unlike the religious approach, the preamble to the Charter of the
United Nations9 describes a modern and secular concept, in which the
equality of all human beings is agreed on, regardless of their ethnicity, social
status, nationality or religion. Every one is born free in rights and dignity.
Being human is the only condition one has to fulfil to have human dignity.
This formulation is, above all, understandable as a strong refusal to all antiSemitic, racist and fascist ideologies, but remains problematic nonetheless, as
it does not give a sound justification. Even though the attempt to enunciate
human dignity’s inherent aspects of universality, equality and un-graduality,
is invaluable, it fails to give a convincing justification beyond the divine
authority or certain sets of mental capacities. The underlying concept of all
people being born free and equal in rights and dignity might be a matter of
course to people within the western world. But it could also be understood as
a way of western cultural imperialism. We just do not know whether it is
correct or not. Moreover, merely being a member of a particular biological
species can hardly count for the justification of a moral status.10 The line
between different biological species is drawn arbitrarily and lost to any good
moral argument.
Thus, it turns out that neither of these concepts can help us solve our
problem. If we draw on certain mental capacities to justify human dignity we
are doing so on good grounds, but we are unjustifiably excluding some
groups of living people as well as human corpses. However, if we resort to
the fact of being human as essential for human dignity, we do include all
kinds of living and dead human beings, but we fail to give good reasons for
it. So, we are faced with a Hobson’s choice. Either we accept a way too
narrow concept or one that is lacking a sound justification.
What could be the way out? Although it is unsatisfying, what the
genuinely Christian approach correctly emphasises is the relational moment
of human dignity. According to this concept, human dignity is not only
founded in any individual human being, but it is in fact constituted in her
relation to God. I think this relational element of human dignity is the key to
a satisfying concept of human dignity.
In order to develop a convincing concept of human dignity, we need
to replace the idea of a divine authority with the social interaction among
human beings. It is, in fact, the social interaction all human being always
naturally engage in, that makes human dignity possible.
Every time, two or more people interact with each other, they create
a realm in which dignity arises. As social interaction is something all beings
are bound to, it represents one cornerstone of human togetherness. It is
exactly the fact that and the way that we interact with other people that
constitutes human dignity.
Julia Apollonia Glahn
37
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It was Avishai Margalit who, in his work “A Decent Society,”11
developed this idea of a social concept of human dignity. He proceeds ex
negativo by defining “a violation of human dignity”. Essentially, violations
are acts of humiliation. The strongest way to humiliate a person is to exclude
her from the community of human beings. This exclusion happens, when
people are treated as if they were not human beings. Naturally, all human
beings are capable of recognizing other beings as human. What they
recognize in the other one is themselves. To see people as not being human
requires an active effort: namely ignoring their humanity. Such a perception
of human beings as if they were not human beings must be created actively
and intentionally. So, if we actively try to see other human beings as if they
were not human, if we ignore their humanity, we make ourselves guilty of
what Margalit calls “human-blindness”.12 Acting human-blindly does not
mean one does not recognize the humanity in another person. It rather means
to make an active effort to ignore another person’s humanity intentionally. In
most cases, where people ignore the humanity of others, it requires an
intentional active effort to overlook another one’s humanity, to make oneself
blind to the humanity of the other one. Margalit’s crucial point, hence, is not
that we have to respect and treat people as people, but stronger, that as human
beings we naturally cannot do differently. Seeing people as people that we
ourselves are, is genuinely interpersonal.
This active and intentional exclusion from the human community is
what happens, when we feel uncomfortable with a certain handling of dead
human bodies. The discomfort we feel, if a dead human body is used as a
crash test dummy or is carelessly disposed in a trash can, is due to the fact
that what we see in the corpse is a human being. Therefore, such a handling
of human corpses is ignoring their humanity, it is human-blind. In those
situations with dead human bodies, where we feel the diffuse discomfort that
we try to name by saying: this is violating or disrespecting the dead person’s
dignity, we recognize that someone is recognizing the corpse as human, but is
treating him as if she were not a human being and hence is making himself
guilty of being human-blind. By treating dead human bodies incorrectly,
namely as non-humans, we erroneously and unjustifiably exclude them from
the community of human beings. And being excluded from the community of
human beings is humiliating and therefore violates one’s human dignity.
But in order to be excluded from the community of human beings, it
is necessary to be a member in the first place. Thus, the question comes up
whether dead human bodies are still human beings. From the legal
perspective (at least in Germany), they are entities between a ‘person’ and an
‘object’, which leads to the odd formulation of ‘personal objects’ and even
some philosophers prefer the idea that dead human bodies, although they
have certain rights, actually are objects. 13
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Dignity of the Dead?
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But I think this is wrong. Philosophically, there are reasons to
assume that dead human bodies are still human beings. Although, as stated at
the beginning, a lot that we care about comes to an end, when we die, it is not
true for everything. Instead of limiting the membership in the human
community to the living ones, I want to argue for an overcoming of the
boundary between life and death. This border might be incisive and morally
relevant in several regards, but it is not when it comes to a proper handling of
human bodies. Being alive or dead is not the crucial criterion for the
treatment as relevant as the realm of human dignity is not marked by the
biological dimension between life and death, but rather by the social
dimension between people. So there is no good reason to assume a significant
and morally relevant difference between the claims for respect in interactions
among living people, or between living and dead people. This becomes
obvious, when we look at the proper treatment of comatose or brain dead
patients. In these situations we become aware that the mere fact of being
alive is not as pivotal for the evaluation of a treatment as we might think.
Like with a comatose patient, we might not be able to hurt a dead human
body physically or psychologically, but we can harm him by neglecting the
status that he deserves as a member of the human community, dead or alive.
What is much more important for the question of human dignity in
this case is the existence, the mere being there. Usually, when a person dies,
there is a corpse. This corpse, although subjected to severe physical changes,
namely degeneration and autolysis, is recognizable as human. By this, he
does not only provide the above-mentioned surface of identification, but does
something more. By being there he calls for action. In the presence of a dead
human body we cannot omit acting. No matter what we do, what is crucial is
that we have to do something. We cannot do nothing. The physical presence
of the dead body requires our action. For Margalit, towards human beings we
are always and necessarily acting beings. To respect someone’s human
dignity means to see him as a human being and therefore, treat him as a
human being. Whereas a violation of human dignity means to see someone as
a human being, but ignore his humanity and, in consequence refuse him the
human treatment he actually deserves. By this postulation of human beings as
necessarily acting beings, interaction among humans inevitably has to happen
and therefore, the possibility of the constitution of a realm of human dignity
is given.
Where does this conception lead us to? Does it mean there is no
difference between the interactions among living people or between living
and dead people? As interpersonal interaction is so closely related to the
physical presence of its participants, we have to acknowledge that in cases of
dead human bodies it is definitely limited. As mentioned above, the human
corpse is on the point of physical disintegration, which marks the limits of
Julia Apollonia Glahn
39
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interactions. Many ways of interactions necessarily need to be limited.
Imprisonment, torture or other ways of physical harm are pointless.
However, dead human bodies are still potential victims of human
dignity violations. The fact that dead human bodies are immune to some of
the most common violations of human dignity does not mean that they are
immune to all possible violations. In fact, they belong to a group of people,
like comatose patients, severely brain damaged or mentally disabled persons
or unborn and newborn infants, who are limited in their interpersonal
interaction and thus extremely vulnerable, when it comes to the most
fundamental violation of human dignity: the exclusion from the human
community! Exactly because they cannot defend and protect themselves,
others have to be particularly careful with them.
So, a proper handling of dead human bodies does not mean treating
a dead human body in the same way we would treat a living person. It means
to recognize and treat him as human and thereby respect his human dignity.
By ignoring his humanity, we automatically exclude him from the human
community. And such exclusion would necessarily be intentional and humanblind, as it ignores the potential of identification that dead human bodies have
for living people. By means of their presence, corpses enable people to
recognize themselves in them. The realm, in which human interaction takes
place, creates the basic requirement for the constitution of human dignity.
When this realm that comes to existence naturally and directly between all
human beings who interact with each other is neglected, it is our feeling of
discomfort and the intuition that arises telling us that this is not the way to
treat dead human bodies, because it disrespects their human dignity.
Therefore, we are justified to use human dignity as the valid
criterion for the evaluation of a treatment of dead human bodies. Our
intuition is not doomed to be a naïve illusion, but is shown to be correct, as it
is possible to formulate a concept of human dignity to which it reconciles
itself.
Notes
1
T Hofstätter, ‘Crahstests mit Leichen. Skandal rund um die Crash Test
Dummies’, in Via Medici Online, April 2005, viewed on 25 January 2009,
http://www.thieme.de/viamedici/studienort_graz/aktuelles/crashtest.html.
Veröffentlichungen des Instituts für Deutsches, Europäisches und
Internationales Medizinrecht, Gesundheitsrecht und Bioethik der
Universitäten Heidelberg und Mannheim (eds), Kommerzialisierung des
menschlichen Körpers. Leichen-Schau und Menschenwürde. Von
Körperwelten, Kuriositätenkabinetten und Crash-Test-Dummies, Springer
Verlag, Berlin, 2007.
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Dignity of the Dead?
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2
A Esser, ‘Respekt vor dem toten Körper’. Deutsche Zeitschrift für
Philosophie, 56, 1, 2008, pp. 119-134.
3
I Kant, Groundwork of the Metaphysics of Morals, Wilder Publications,
Radford, 2008.
4
Augustinus, ‘De libero arbitrio – Vom freien Willen’, in Theologische
Frühschriften – Vom freien Willen – Von der wahren Religion, Artemis,
Zürich, 1962.
G Pico della Mirandola, On the Dignity of Man (De hominis dignitate),
Bobbs-Merrill, Indianapolis, 1965.
5
D Sperling, Posthumous Interests. Legal and Ethical Perspectives,
Cambridge University Press, Cambridge, 2008.
6
P Balzer, K P Rippe, and P Schaber, Menschenwürde vs. Würde der
Kreatur. Begriffsbestimmung, Gentechnik, Ethikkommissionen, Alber,
Freiburg, 1999. ‘Symposium on the Identity and Dignity of Man 1969’, in
Ethical Issues in Biology and Medicine, P N Williams (ed), Schenkman Pub.
Co., Cambridge, 1973.
7
R Duffy and A Gambatese (eds), Made in God's Image. The Catholic Vision
of Human Dignity, Paulist Press, New York, 1999.
8
Bible, Genesis, I, 26-27.
9
Charter of the United Nations and Statute of the International Court of
Justice, 1978.
10
P Singer, Practical Ethics, Cambridge University Press, Cambridge, 1993.
11
A Margalit, The Decent Society, Cambridge University Press, Cambridge,
1996.
12
ibid., pp. 96-101.
13
S Schenk, Die Totensorge – Ein Persönlichkeitsrecht. Zivilrechtliche
Untersuchung der Verfügungsbefugnis am menschlichen Körper, Verlag Dr.
Kovač, Hamburg, 2007. M Weck, Vom Mensch zur Sache? Der Schutz des
Lebens an seinen Grenzen, Shaker Verlag, Aachen, 2003.
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Julia Apollonia Glahn
41
______________________________________________________________
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1973.
42
Dignity of the Dead?
______________________________________________________________
Veröffentlichungen des Instituts für Deutsches, Europäisches und
Internationales Medizinrecht, Gesundheitsrecht und Bioethik der
Universitäten Heidelberg und Mannheim (eds), Kommerzialisierung des
menschlichen Körpers. Leichen-Schau und Menschenwürde. Von
Körperwelten, Kuriositätenkabinetten und Crash-Test-Dummies. Springer
Verlag, Berlin, 2007.
Weck, M., Vom Mensch zur Sache? Der Schutz des Lebens an seinen
Grenzen. Shaker Verlag, Aachen, 2003.
Julia Apollonia Glahn is, after graduating in Philosophy in 2008, a research
fellow at the Institute of History, Theory and Ethics of Medicine at the
RWTH Aachen, Germany, where she is mainly working in philosophical
thanatology. Currently her research and writing is devoted to various
problems with death, dying and the dead. Moreover, she is interested in
moral theory, ethics and applied ethics.
The Haunt: Demons and The Complex of Noon
Tolulope Onabolu
Abstract
Above the Gate of Intrepid is painted the inscription… “He
who follows this path alone and without looking behind
him, will be purified by Fire and Air; and if he strives to
conquer the dread of Death he will emerge from the
underworld, and will behold the Light once more, and will
be worthy to be admitted into the company of wise men
and men of valour.”1
This is the moment when the sun, at its zenith divides the
day into equal parts, each governed by the opposing signs
of rise and decline. This, then, is the moment when the
forces of life and light yield to the powers of death and
darkness. In ancient Greece, noon was in fact the hour of
transition marking the boundary between the reign of the
Uranian and of the infernal gods.2
To make a “nonsensical” reading of dying, or of death, is problematic – for a
subject which is taken so seriously - the tone set up in the call for papers
implies such (discussions on euthanasia, abortion, suicide, homicide,
genocide, infanticide, etc.) However, (as part of a creative practice) is not this
“nonsensical” reading precisely what is required for a theme which is caught
up in the form of its description (making sense of) - precisely what is the
sense (or nonsense) of dying and death? Between the sovereignty of
initiation, sacrifice and the rites of passage, and the death of the soul implied
in ennui (specifically psychasthenia and acedia with reference to Caillois3),
this paper will attempt (by expanding on Lequeu’s Gothic House, also known
as The Haunt of Magicians, and Caillois’ “The Noon Complex”4) to make
sense of dying and death. As implied in The Haunt,5 we will argue that the
transformation in dying/death is indeed “an awakening.”6
Key Words: Becoming(s), creative practice, death, desire, initiation,
sympathetic magic, transformation, virtual.
*****
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1.
Preface
In this paper, I attempt a creative approach to death, within a
Deleuzian thesis of becomings.7 Thus, taking cue from Caillois, death
becomes a threshold for virtual becomings: a transformation from a previous
state of being, emerging from a state of boredom, drudgery, or delirium8 and
located within a propositional framework - in this case, a paradoxical, or
affirmed and negated (fictive) architecture.
There are three seemingly unrelated issues in this paper: acedia or
sinful sadness, legendary psychasthenia or the maligned perception of self,
and finally, initiation. What these three have in common is death.
In acedia, there is a protracted death of the soul, born out of
boredom; in legendary psychasthenia, there is a death of self - from a
dissolution of perceived reality (the subject does not distinguish between
itself and its environment); and in initiation, there is a death to a previous
state of being and a subsequent transformation into “something else.” In all
three, “something else,” something phantasmatical happens after death - this
is what I have termed (borrowing from Tolstoy) an awakening. As such, the
awakening is a transformation into something other than one’s previous state
of being or in another sense, a magical becoming.
Further, there are three unrelated authors: Lequeu, Caillois, and
Tolstoy. These authors in various ways support a love of and a desiring into
death; viewing death as a transformative process, which one must necessarily
go through to achieve the transformative becomings argued in this paper. In
Lequeu and Tolstoy, through a materialist mysticism, and in Caillois though
delirium.
We will confront these awakenings and magical becomings through
the transformative texts of these authors.
2.
Introduction
Initiating this magical reading into Dying and Death, I open from
the third part of Memories of a Sorcerer in Deleuze and Guattari’s “1730:
Becoming-intense, Becoming Animal, Becoming Imperceptible…”
A man totters from one door to the next and disappears into
thin air: ‘All I can tell you is that we are fluid, luminous
beings made of fibres.’ All so-called initiatory journeys
include these thresholds and doors where becoming itself
becomes, and where one changes becoming depending on
the ‘hour’ of the world, the circles of hell, or the stages of
a journey that set scales, forms, and cries in variation.
From the howling of animals to the wailing of elements and
particles.9
Tolulope Onabolu
45
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In presenting the three disparate concepts of death previously stated, will
discuss some events between Volumes 1 and 2 of Tolstoy’s War and Peace,
demonic transformations in Caillois, and a site of one such transformation
(The Haunt of Magicians) rendered by the 18th Century Architect, JeanJacques Lequeu.
A nonsensical reading of death is therefore a virtual sense of death,
as opposed to any representation of death itself, which I believe permanently
eludes us, i.e. death knows us, but we cannot know death. Thus in speaking
about demons, we are actually speaking about phantoms of the undead: those
awakened or transformed beings, which elude representation.
Starting with Lequeu, we will explore the Haunt of Magicians, a
formless form, where one goes through an initiatory process by dying
(passing through the realm of the dead), then proceeding to Caillois to
uncover the demonology of the hour of the dead, and the resulting excess
leading to delirium and war, and finally concluding in a treatise on war
(through Tolstoy), itself a confirmation of excess, springing from an entering
or desiring into death.
What is argued in this paper is that the initiatory death in Lequeu is
akin to the death in war, i.e. the initiate must go through The Haunt, to enter
into a becoming, just as the warrior must go to war to enter into a dying (by
entering into war, one is entering into dying). In both cases, the field of battle
(death) is rife with its own excesses and inflections. Therefore death is initself not an instant, but a process leading to other transformations, or
awakenings; or to use a Deleuzian term, Death is the process of
transformation where “becoming” itself becomes. In this, The Haunt of
Magicians becomes The Field of Battle and The Circle of Hell through the
given Hour of The World.
The Haunt enters into a transformation of becoming war and
becoming field of battle.
3.
Lequeu
Jean Jacques Lequeu was an 18th century French architect. In the
foreword to Philippe Duboy’s volume on him10, Middleton draws to our
attention in the opening lines, the impact of a materialist mysticism in art (to
a certain degree, and with reference to Bataille, a sort of artistic eroticism).
Central to Duboy’s representation of Lequeu, is representation itself, and
along with it the history of art, exemplified in the exclamation “a blank
page!” against the outlined statement “Science of natural shading and wash
for finished drawings” - on the first page, under “A Certain Chinese
Encyclopaedia,”11 a statement made by Foucault in The Order of Things, on
the classifications of Borges - itself an analysis of the history of
representation.12
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The Haunt/ Demons and The Complex of Noon
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In the collection of works that constitute the volume by Duboy, we
are presented with a somewhat enigmatic Lequeu - a sort of creative genius;
whereas Lemagny in Visionary Architects has him down as a tormented mind
- “a motionless and disturbing universe.”13 Again we are presented with the
undeniable impact of representation. The words or gaze upon a thing, within
which it is described i.e. its signifier.
In my reading of Lequeu, (taking a cue from Duboy) I attempt a
similar non-representational reading. Hence in The Haunt of Magicians,
which I will discuss below, I make no allusion to any representation of a
building.
A. The Haunt of Magicians14
In The Haunt of Magicians, which is alluded to in both the abstract
and title of this paper, Lemagny presents us with a somewhat sombre
representation of the building. He states: “From one of the grilled openings
comes “moaning and weeping.” We are unmistakably in the age of tales of
terror.”15 By contrast, in Duboy, we are presented with a frivolous/delirious
Lequeu who wishes to impose a Masonic initiation on his public. What is
clear from both Duboy and Lemagny is that The Haunt of Magicians, or the
Gothic House as it is also known, is a temple of initiation, of which Death is
a threshold that must be crossed.
In describing this path of initiation, or confrontation with death by
Lequeu, Lemagny citing Metken states:
All the steps along his road to true knowledge appear again
in Lequeu’s picture, where they are accompanied by
explicit legends. The aspirant’s first trial is ‘Tartarus,’ a
‘fiery furnace’ hung with instruments of hellish torture.
From the centre of this grotto emerges a statue symbolic of
fire. Farther on, ‘the forbidden River Cocytus … [with]
waterfall and pool’ opens up. A statue symbolising water
stands in its midst. Next, in the hollow pedestal of a
colossal statue of wisdom, there is a mesh of wheels, pins,
and pulleys. They command the opening to the sanctuary
itself. Finally, within the sanctuary is the full cup of water
of forgetfulness, ‘Mnemosyne’s potion.’ Here in the ‘place
where true wisdom is learned.’ It is “the sanctuary of the
initiated, the content.” Günter Metken, ‘Jean-Jacques
Lequeu ou L’Architecture Rêvée,’ Gazette des Beaux-Arts
(April, 1965), pp. 223-225.16
Tolulope Onabolu
47
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B. The Haunt/ Demons
We thus have three elemental constituents of the Gothic House:
Tartarus, Cocytus, and Mnemosyne, all of which have Death at their core.
We know from The Theogony of Hesiod that Tartarus, third after Chaos and
Earth, and last before Eros, is both deity and abyss located in Hades (the
mythological abode of the dead); also, that [it] “is the unbounded firstexisting ‘thing’” from which is born Light and Cosmos.17
Again, from Greek Mythology, Cocytus is a river which flows in the
domain of the dead, but represented as a lake (frozen by the flapping wings
of Lucifer) in Dante’s Divine Comedy as the ninth and lowest circle of hell,
and home to traitors (the biblical Cain, Judas Iscariot, etc.).
Finally, Mnemosyne, mother of the nine Muses by Zeus, and
presider over one of the pools in Hades, of which initiates of Orphic poetry
were encouraged to drink so as to enter into forgetfulness.
We can thus conclude that for Lequeu, The Haunt of Magicians was
a place where one descended into the very depths of the underworld (Hades/
Hell), to come out renewed. Hence the inscription on the drawing:
Above the Gate of Intrepid is painted the inscription… ‘He
who follows this path alone and without looking behind
him, will be purified by Fire and Air; and if he strives to
conquer the dread of Death he will emerge from the
underworld, and will behold the Light once more, and will
be worthy to be admitted into the company of wise men
and men of valour.’18
Whether or not it is the protracted form of a Masonic initiation
according to Duboy remains the subject of a different sort of speculation. We
will now proceed to Caillois for the demonology of the hour of death, and the
conditions and excesses of the said hour.
4.
Caillois
In A Caillois Reader, Claudine Fink suggests, in the Introduction to
The Noon Complex, that Caillois might have written the essay as a treatise on
laziness, and of what I might add, boredom. Fink suggests that between Les
Démons de midi (The Demons of Noon), and The Noon Complex, Caillois
addresses one of the questions central to the College of Sociology: of what
has replaced the excess of the archaic festival?19
In Man and the Sacred, Caillois suggests that the period of excess,
which was marked by festival, has come to be replaced by the vacation, that
the escape from the drudgery of organised life which culminated in the
orgiastic festival has been replaced by the ephemeral pleasure of the vacation.
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He asks: “Is not the ephemeral pleasure of vacation one of those false senses
of well-being that mask death throes from the dying?”20
In this we see a suggestion of the relationship between laziness,
drudgery, boredom, and death (in the form of a prohibition, or denial of
orgiastic excess). In fact, Caillois suggests that this state of existence was
reserved exclusively for those under sovereign exception i.e., sacred beings
(the ideal being that they did nothing).
A. “The Noon Complex”
Referencing Virgil’s Georgics, Caillois states that Servius’ assertion
that the demons appeared mostly at noon provided sufficient grounds for his
research into solar mythology.21
In a similar vein, I will present Caillois essay as adequate for a
demonology of noon, or what I have termed (borrowing from his Noon –
Hour of Transition) The Hour of The World.
Caillois’ essay on the “Noon Complex” is fascinating in terms of its
revelation. We have the transitional phase of day into night occurring at
noon, similarly the transformation from the reign of (heaven/ the sky)
Uranus, to the reign of (Hades) the Abyss, and through a form of sympathetic
magic (where the soul is identified with the body’s shadow), the reemergence of the dead (those who cast no shadow). This is a fairly simple
analogy, which when associated with Bataille (Solar Anus),22 becomes fairly
complicated. Thus, we will take it in its simple form, as the hour when the
sun is at its zenith.
At its zenith, the intensity of the directly overhead sun brings with it
certain physiological conditions that were related to these infernal beings
(those who cast no shadow). Caillois states:
The sun’s burning heat is unforgiving at this time of day.
Heat stroke, sunstroke, cerebral fever, and their attendant
mental and physical ailments offered sufficient proof of
demonic activity to persuade people that they existed.23
This strain of thought is followed by a discussion of the decline of
the pre-eminence of noon through Christianity, and the invention of the
chiming clock, but again undermined by the human condition of hopelessness
experienced at noon. Caillois states:
At noon, it would seem like life takes a pause, organic
matter returns to an inorganic state, and everything blazes
pointlessly and without ardour in a futile desire for luxury
and display. Activity of any kind seems to involve
unpleasant and risible agitation. All heartbeats come to a
Tolulope Onabolu
49
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halt. The supreme triumph of all the positive forces
dissolves into renunciation, their surging forth into slumber
and their plenitude into resignation. The will to live
withdraws somewhere unknown, as if absorbed by thirsty
sands. This silent exaltation of every abdication, like a
flood invincibly overwhelming all morality, swiftly drowns
any uncertain inclination or remorse it might find.24
Caillois thus suggests that at this time, and with particularly
association to medieval monks, there is a feeling of boredom, drudgery, and
insuperable laziness – the acedic condition, overwhelmed by carnal desire.
Elsewhere, he suggests that the demon of noon would disguise itself as a nun,
assault the monk during its siesta, and caress it like a prostitute. He states:
The ailing monk comes to feel an overwhelming revulsion
for his life, for his monastery and companions. He is
overcome with insuperable laziness. Daily work
disheartens and repels him; even reading fills him with
disgust. He is weary and yet ravenously hungry, with a
kind of morbid need to sleep as the sixth hour is drawing
near - the fearful hour of noon. At that time, he keeps on
watching the sun, judging that its decline towards the sun is
too slow. […]. Here then is acedia: […]. Acedia is a sense
of apathy towards life, the dull anxiety of a frustrated heart,
and an intellect confused by irrationality. […]. And beneath
it all we find the lure of sexuality: the acedic subject will
like to visit a woman with no one to support her.
Sometimes the sexual obsession is more explicit.25
Caillois concludes his essay by suggesting that if the tendency in
nature is towards a state of delirium, and the irrationality of the monk is
justified as a state of absolute becoming,26 again suggesting that human
excess manifests itself in this state of becoming.
We can conclude that the death being sought in Caillois is one
brought about in the excess of the orgiastic event, (again, with reference to
Bataille) in the ejaculatory eruption of blood, sweat, and semen.27
In Lequeu, we have located the place, and the demonic constitution
of death, and in Caillois, the demonology of the hour of dying. With a certain
empirical twist, we may suggest the event necessary for a transformative
becoming (dying) - War; for as is in orgiastic event, in war we have all the
eruptions of excess (blood, sweat, and semen).
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B. War: Legendary Psychasthenia, Boredom and Delirium
In “Mimicry and Legendary Psychasthenia”, Caillois introduces a
form of dematerialised space, what Lacan terms “dark space,”28 and Deleuze
“black holes.”29 Dark space is any non-geometric definition of space: the
space of music, of groping, of hallucination - a space where one feels oneself
permeable to ones surroundings.
Within a similar framework, The Haunt of Magicians is a dark
space, transformed into a field of battle by the very act of initiatory
transformation that occurs within it. As such, the architecture of Lequeu
becomes the dematerialised/deterritorialised architecture of the battlefield.
Further, the demons of The Gothic House become the asthenic conditions of
the battlefield: boredom, fear, delirium, and the eruption of excess.
We know that the asthenic conditions of Caillois’ insects (which he
termed Legendary Psychasthenia), where the insect became indiscernible to
its kind, was not as a form of protective or defensive camouflage, but an
eruption of excess (as it no longer knows what to do with itself), culminating
in cannibalism (the insects appeared as food to each other).30
5.
War and Peace
In my reference to war, I draw upon Volumes 1 and 2 of Tolstoy’s
War and Peace.
In Tolstoy’s recollection of war, and in some other fictional works
on war, the movie Jarhead and Sebastian Faulks book Birdsong, some of the
most demonic manifestations are boredom and delirium, followed by excess:
torture, looting, the use of women, etc. Tolstoy brings this to bear in many
ways; from the inanity of aristocratic life to actual psychological turmoil in
the field of battle. While it might appear outrageous to engage the acedic or
asthenic condition with warfare, Tolstoy already provides us with the
conditions: boredom, sexual tension and anxiety; from the teenage girls in the
Rostov household to members of the infantry’s preoccupation with climbing
over a convent wall.
…’No, but what I’d like’ he added chewing a little pipe
with his handsome, moist mouth, ‘is to climb in there.’ He
pointed to the convent with its towers, visible on the
hilltop. He smiled, his eyes narrowed and lit up ‘…At least
to put a fright to those little nuns. There are some Italian
ones, young ones they say…’ ‘They must be bored, too’ an
officer, a bolder one said laughing.31
Elsewhere, we experience delirium in Rostov, while he is advancing with his
regiment, he is finding difficulty keeping awake, and begins daydreaming,
again an engagement with dark space - psychasthenia:
Tolulope Onabolu
51
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‘It must be snow - this spot; a spot - une tache,’ thought
Rostov. ‘Tache or no tache….’
‘Natasha, my sister, dark eyes. Na…tashka… (She’ll be so
surprised when I tell her how I saw the sovereign!)
Natasha…take the…tashka…’
A young, childish sleep was irresistibly coming over him.
‘…Yes,yes! Na-tashka…at-tack a… attack who? Hussars.
Whose hussars? The hussar you saw ride down the
boulevard, remember, just across from Guryev house…
Old man Guryev.…’32
Further on, we experience the excesses of war, in the place of the
bodies of the dead and wounded over the battlefield, and a robbery. Denisov
robs the infantry supplies transport, he is court-marshalled, but gets shot and
ends up in hospital. In the hospital, again, more death, decay and disease; the
description of the hospital wards is so invoking, that one almost experiences
the stench and decay of the multitude of human bodies. Even more
remarkable is the doctor’s indifference to death.
In all, war which is also an engagement with death brings with it
transformations of a sort not usually associated with it.
One step beyond that line, reminiscent of the line
separating the living from the dead, and it’s the unknown,
suffering, and death. And what is there? Who is there?
There, beyond this field, and the tree, and the roof lit by the
sun? No one knows, and you would like to know; and
you’re afraid to cross that line, and would like to cross it;
and you know that sooner or later you would have to cross
it and find out what is there on the other side of the line, as
you will inevitably find out what is on the other side of
death.…33
Is this any different from the Masonic initiation of Bezukhov that is
folded into the story, especially in volume 2, where he is encouraged to
embrace death, to love death…? “Whatever happens to you,” he said, “you
must courageously endure everything, if you are firmly resolved to enter into
our brotherhood…”34
Also, in the virtues of which he is supposed to uphold, the love of
death (the seventh virtue) is tantamount to his redemption.
‘Seventh’ said the rhetor, ‘try by frequent thoughts of death
to bring yourself to the point where it no longer seems a
fearsome enemy to you, but a friend…who delivers the
The Haunt/ Demons and The Complex of Noon
52
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soul grown weary in the labours of virtue in this calamitous
life and leads it to the place of recompense and peace.’35
Between books 1 and 2 of War and Peace, a number of deaths are
recorded. Beginning with Count Bezukhov, the uncountable deaths and fields
filled with masses of dead and wounded soldiers during the war with
Napoleon’s army, the blissful and somewhat heroic and puzzling death of
Andrei Bolkonsky, the duel between Bezukhov and Dolokhov over the
latter’s intimacy with Bezukhov’s wife, the death of Andrei’s wife and the
birth of their son at the moment of his return from the dead.
These deaths, or seeming deaths and their associated becomings/
transformations constitute the war machine of Tolstoy.
The transformations in the characters, especially Andrei Bolkonsky,
through his actual engagement and erstwhile purported heroic death in battle,
and Pierre Bezukhov’s transformation through Masonic initiation, also an
engagement with death through a form of sympathetic magic a la Lequeu,
become the dark space or “night of senses” of death in this paper.
The principles of their engagement can be summarised in the three
central principles of Bezukhov’s initiation:
6.
Self-knowledge - for man can only know himself
through comparison
Perfection - for it is achieved through struggle
The main virtue - The Love of Death
Conclusion: Becoming-Myth/ Desiring into Death
At the onset of this paper, we set out to confront the magical
becomings (myths of dying) from a desiring into death. We can conclude as
follows:
We have seen that death is in-itself a transformation into “something
else”, we have seen that whether in war, delirium or initiation, one is entering
into death; as such, death is a sort of “dark space” through which one must
necessarily enter to re-emerge transformed in a demonic becoming.
In speaking about a desiring into death, we have been speaking
about sorcery, or would-be sorcerers: Deleuze, Lequeu, Caillois, and Tolstoy,
and their planes of composition: The Haunt of Magicians, The Circle of Hell,
The Hour of the World, and The Field of Battle. We have argued that each
(plan(e)) becomes the other through constant transformations or demonic
awakenings centred on a desiring into death. And especially, that The Haunt
of Magicians that we started with, in this empirical twist (becoming) enters
into a becoming - Battle Field (the dark space of demons).
Tolulope Onabolu
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Finally, whether in Lequeu, Caillois or Tolstoy, we have been
encouraged to embrace death (in a becoming-sorcerer/ becoming-demon):
through initiation and strife in Lequeu and Tolstoy; and through orgiastic
excess, boredom, and delirium in Caillois.
Notes
1
J-J Lequeu in P Duboy. Lequeu: An Architectural Enigma, Thames and
Hudson, London, 1986, p. 72.
2
R Caillois, ‘The Noon Complex’, in The Edge of Surrealism: A Caillois
Reader, C Frank (ed.), C Frank and C Naish (trans), Duke University Press,
Durham and London, 2003, p. 125.
3
R Caillois. ‘Mimicry and Legendary Psycasthenia’, in The Edge of
Surrealism: A Caillois Reader, C Frank (ed.), op. cit.
4
R Caillois, ‘The Noon Complex’, op cit.
5
The Haunt is a shortened form for Lequeu’s drawing The Haunt of
Magicians also known as The Gothic House that I have adapted for this
essay. http://visualiseur.bnf.fr/ark:/12148/btv1b7703097t
6
See L. Tolstoy, War and Peace, Vintage, 2007.
7
See G Deleuze, Logic of Sense, Continuum, London, 2004; see also, G
Deleuze and C Parnet, Dialogues II, Continuum, London and New York,
2006.
8
See R Caillois ‘Mimicry and Legendary Psycasthenia,’ op cit.
9
G Deleuze and F Guattari, A Thousand Plateaus: Capitalism and
Schizophrenia, Continuum, London, 2004, p. 274.
10
R Middleton, foreword to Lequeu: An Architectural Enigma, op. cit.
11
P Duboy, Lequeu: An Architectural Enigma, op. cit.
12
See M Foucault, The Order of Things: An Archaeology of the Human
Sciences, Routledge, London and New York, 2008, pp. xvi – xxvi.
13
J-C Lemagny, Visionary Architects: Boullée, Ledoux, Lequeu, Hennessy
and Ingalls, California, 2002.
14
See P Duboy, Lequeu, op. cit. ‘Le Repaire des Magiciens’ (‘The Haunt of
Magicians’), p. 75, Illustrations on p.84, p. 215. See also:
http://visualiseur.bnf.fr/ark:/12148/btv1b7703097t
15
J-C Lemagny, op. cit. p. 187.
16
ibid.
17
Hesiod, The Theogony, H G Evelyn-White (trans), http://www.sacredtexts.com/cla/hesiod/theogony.htm. See also, A Pérez Gómez, Built upon
Love: Architectural Longing after Ethics and Aesthetics, MIT Press,
Massachusetts, 2008, pp. 32-33.
18
J-J Lequeu, op. cit.
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19
C Fink, ‘Introduction to The Noon Complex,’ The Edge of Surrealism: A
Caillois Reader, op. cit., pp. 124-125.
20
ibid.
21
R Caillois, ‘The Noon Complex,’ op. cit., p.125.
22
G Battaile, ‘Solar Anus,’ in Visions of Excess: Selected Writings, 19271939, Theory and History of Literature Vol 14, University of Minnesota
Press, Minneapolis, 2006, pp. 5-9.
23
R Caillois, ‘The Noon Complex’, op cit., p.126.
24
ibid., p.127.
25
ibid., p.128.
26
ibid., p.129.
27
See G Bataille, ‘“Story of The Eye” by Lord Auch’, J Neugroschal (trans),
Penguin Classics, England 2001.
28
J Lacan, ‘The Mirror Stage as Formative of the I Function as Revealed in
Psychoanalytic Experience’, in Écrits, B Fink (trans.), W W Norton and
Company, Inc., London and New York, 2006, pp. 75-81, 93-100.
29
See G Deleuze and C Parnet, Dialogues II, op. cit.
30
R Caillois, ‘Mimicry and Legendary Psycasthenia,’ op. cit.
31
L Tolstoy, op. cit. p.138
32
ibid., p. 266.
33
ibid., p. 143.
34
ibid., p. 355.
35
ibid., p. 357.
Bibliography
Bataille, G., ‘Story of The Eye’ by Lord Auch. J. Neugroschal (trans), Penguin
Classics, England 2001.
Bataille, G., Visions of Excess: Selected Writings, 1927-1939, Theory and
History of Literature Vol 14. University of Minnesota Press, Minneapolis,
2006.
Caillois, R., The Edge of Surrealism: A Caillois Reader. C. Frank (ed), C.
Frank and C. Naish (trans), Duke University Press, Durham and London,
2003.
Deleuze, G., Logic of Sense. Continuum, London, 2004.
Deleuze, G. and F. Guattari, A Thousand Plateaus: Capitalism and
Scizophrenia. Continuum. London, 2004.
Tolulope Onabolu
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Deleuze, G. and Parnet, C., Dialogues II. Continuum, London and New York
2006.
Duboy, P., Lequeu: An Architectural Enigma. Thames and Hudson, London,
1986.
Foucault, M., The Order of Things: An Archaeology of the Human Sciences.
Routledge, London and New York, 2008.
Hesiod, The Theogony. H. G. Evelyn-White (trans), viewed Friday 30th
January 2009, http://www.sacred-texts.com/cla/hesiod/theogony.htm.
Lacan, J., Écrits, B Fink (trans.). W. W. Norton and Company, Inc., London
and New York, 2006.
Lemagny, J.-C., Visionary Architects: Boullée, Ledoux, Lequeu. Hennessy
and Ingalls, Berkeley, CA, 2002.
Pérez-Gómez, A., Built upon Love: Architectural Longing after Ethics and
Aesthetics. MIT Press, Cambridge, MA, 2008.
Tolstoy, L., War and Peace, Vintage, New York, 2007.
Tolulope Onabolu is in the final stage of a PhD in Architecture at Edinburgh
College of Art. His research is by creative practice, where explores
“seduction and eroticism” in architecture within a Deleuzian virtuality. In his
approach to Deleuze, he has had recourse to Sovereignty, Eroticism, and
Nonsense.
The Concept of Death in Children’s and Juvenile Literature:
Reading and Interpreting Death in The Book Thief by
Markus Zusak
Maria Kissova
Abstract
The paper deals with the representation of death in children’s and juvenile
fiction written in English. It briefly introduces historical background of death
and dying in literature for children and teenagers and presents trends of
depicting various forms of death in contemporary literature. Here, death
appears in several genres such as domestic fiction, girls’ stories, adventure
stories, war and historic novels, and many others in different forms. The
depiction of death is thus hugely based on specific genre differences and
there are some basic trends and even stereotypes, which the paper also
suggests and presents. The analytical part of the paper is focused on the work
The Book Thief by an award-winning Australian author Markus Zusak
(2005). The paper discusses the concept of death in the story set in Nazi
Germany and depicting the life of a girl Liesel Meminger at the time when
death could have been felt everywhere. The paper tries to deal with three
main issues. The first one is the analysis of death in the novel – its different
forms, thematic concepts and Death being a narrator of the story. The second
one is more interdisciplinary and connects death, literature and art in general
when Death stands in opposition to Literature and Art in the novel. This
contrast is explained in terms of psychology when Artistic expression is
natural to humankind in any condition. The third issue is the reader’s role or
position in interpretation of this appealing and very emotional novel. It also
discusses the terms such as irony, catharsis and reader’s response to the
literary work.
Key Words: Children’s literature, juvenile fiction, taboo topics, death,
literature, art, interpretation, narrator.
*****
1.
Encounters with Death
My great-great-grandmother told me a mysterious and fascinating
story about her encounter with Death. Once - as a little girl - while running
up the hill alone in the autumn afternoon she spotted something she could not
explain. The growing object resembled a white salty pile appearing out of
nowhere. My great-great-grandmother later said that she somehow felt it
must have been Death. She interpreted the pile as a symbol of Death and in
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The Concept of Death in Children’s and Juvenile Literature
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her old age linked the strange event with a folk wisdom connecting the
meeting Death with longevity. While telling her story, my great-greatgrandmother was always very calm with a serene look and as a devout
Christian seemed to have accepted death peacefully when it comes. As if the
encounter from the past had prepared her for the coming end of life.
However, when lying on the deathbed, she strongly required company of her
daughters; afraid and adamant not to be left alone at the moment of death.
Her fear strongly disturbed her previous peace and I have realized then that it
is really difficult not to be afraid of the unknown though one may think to be
prepared to face it. My great-great-grandma passed away two years ago in
sleep, just a few months before her hundredth birthday.
I have decided to put her story into the conference paper for two
reasons. First, for me as a child it was the first encounter with Death in
literature through an oral tale. The story introduced me into its enigmatic
concept and I could see that Death does not have to be depicted just as a
woman with a scythe – a traditional portrayal of Death in Slovak cultural
tradition; but it may be utterly personal and individual notion. A capturing
story blurred the distinction between things known and unknown and shaped
my childhood ideas about Death for future years. Since the topic of my paper
is an interpretation of a literary work - which is a highly subjective act - one
cannot and does not want to escape previous personal experience. Second
reason is that reading The Book Thief I have found parallels with the story of
my great-great-grandma. Death had accompanied my great-greatgrandmother in a very alike way he accompanied the main character Liesel in
The Book Thief. Though Liesel is unaware of his presence as a being, he
followed her all her life taking most of her beloved away but leaving her
alive. My great-great-grandma claimed to have met Death and since then she
believed Death somehow guided her through life with a promise of a long
age. In both stories the presence of Death fascinates and frightens at once. An
interpreter tends to believe them but has some doubts as well. I do not know
whether the story which great-great-grandma told me really happened and I
have realized that it does not matter so much.
2.
Death in Children’s and Juvenile Literature
The representation of death in children’s and juvenile fiction written
in English is analysed in detail in Representation of Childhood Death (2000)
edited by Gillian Avery and Kimberley Reynolds. Studies in the book
provide the historical overview of child death depicted in literature starting
with the oral tradition of folk tales, ballads and song cycles; moving to
Victorian and Edwardian fantasy books for children. I assume that most
important fact is - also stressed by Avery and Reynolds - that death is a
cultural construct and it is apt to change with prevailing belief system.1 How
different nations and cultural groups depict and interpret death depends
Maria Kissova
59
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strongly on their cultural background and tradition. In the 18th century early
literature for children, children’s death is described mainly through parental
grief and there is almost no evidence of child perspective of death and dying.
Literature for children was also much influenced by Puritanism and its stress
on the fear of death. For Victorian literature, probably most well known
depiction of death is in dying Dickensian children evoking social, moral and
often sentimental effect on the reader.
Modern children’s literature stands in contrast with its previous
tradition as the spectrum of literary works for children has widened
enormously and books have started to bring various challenging and also
until recently taboo topics. There is no doubt that the trend which has been
set in recent years is rooted in the loosening boundaries of what is suitable for
children and what is not. The trend is noticeable in various genres of
children’s literature. In domestic fiction, for instance, it is the depiction of
lesbian/ gay parents, violence, and the use of harsh language. There have also
been a number of books published in English, which have some political
matter or some political problem as their major issues (e.g. war or social
conflicts).
The books such as Peter Dickinson’s AK, David Almond’s The FireEaters, Gillian Cross’s The Wolf, Michael Morpurgo’s Private Peaceful and
Pam Munoz Ryan’s Esperanza Rising present sensitive political and social
issues such as terrorism, war, social unrests, discrimination, the problems of
immigration, etc. In the above-mentioned stories death occurs very often. It is
presented as a consequence of some political acts and children prove to be
strong enough to face death in a brave and adult-like way often with no help
from their parents who might have died in a conflict. In girls’ stories often a
beloved person - a girlfriend or a boyfriend - dies and the story describes how
one overcomes the loss of the beloved, which is followed by the return to
everyday (and again happy) teenage life. The depiction of death thus mainly
depends on specific genre differences and its analysis would need a separate
complex paper or study.
3.
The Book Thief – The Story Told by Death
Markus Zusak’s award winning book The Book Thief (2005) may be
included in the works with above-mentioned taboo topics uncovered in
children’s and young adult literature just recently. The story is set in the
2WW Nazi Germany and apart from the war conflict itself and the Munich
air raids, it also depicts cruelties of the Holocaust, ever-present fear, terror
and the dominance of the only one truth prescribed by the Nazi Party.
The book thief is Liesel Meminger, a young girl, brought up by
foster parents of Hans and Rosa Hubermanns in Munich. Liesel loves reading
and in the ruins of the war city she comes across books in different ways and
under different circumstances. Liesel is a character that any reader just must
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love. Her beautiful and rosebud-like innocent friendship with Rudy Steiner,
her taking care of the Jew Max Vanderburg hiding in Hubermanns’ cellar and
Liesel’s all-embracing love for life strongly contrast with the war-destroyed,
cold and devilish Nazi Germany regime. The seriousness of the theme and
the explicit presence of Death raise the question of the suitability of the book
for a child or a young adult reader. Avery and Reynolds explain:
Death today can only be understood as ‘good’ when it
comes painlessly at the end of a long life of achievement all elements which effectively preclude child death. This
situation makes representing child death both peculiarly
powerful and peculiarly problematic in contemporary art
forms.2
The Book Thief is full of “bad deaths” of children and adults alike,
since dying is the consequence of the war conflict. The following analysis
and a feedback I got from my teenage student have provided me with the
clear answer to the challenging question of the book, namely, its suitability
for specific age groups. Apart from that, it is also important to mention that
The Book Thief belongs to so-called “cross-over” literature, which covers
works read by children/young adults as well as by adult readers.
The novel may be interpreted from several aspects, and I have
chosen to deal with its three main issues. The first one is the analysis of
various forms and concepts of death in the novel. It closely discusses death as
a narrator and a character (i.e. Death with a capital letter “D”) present in the
story, but also death as an end of a man’s life (i.e. death and dying as the end
of one’s life). The second issue is more interdisciplinary and connects death,
literature and art in general. The analysis tries to show how artistic expression
is natural to humankind regardless the political or social conditions. The third
issue is the reader’s role in interpretation of this appealing and very
emotional novel. It then discusses the terms such as reader’s response to
literary work and irony.
There are two main concepts of death in the story. First, Death has
the function of an omniscient narrator and a character. Besides that, there are
deaths and dying of particular characters. These two concepts are naturally
connected – since Death takes the dead - but it is important to analyse them
separately because of their significance for the story. Death as a narrator/
character in The Book Thief is a spiritual entity invisible to a man but having
specific physical (a body) and psychical (thoughts, emotions) attributes of a
person. He breaks and detaches himself from the traditional depiction of
Death as could be found in art and mythologies:
Maria Kissova
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I do not carry a sickle or scythe. I only wear a hooded black
robe when it’s cold. And I don’t have those skull-like facial
features you seem to enjoy pinning on me from a distance.
You want to know what I truly look like? I’ll help you out.
Find yourself a mirror while I continue.3
This quotation will prove to be a key to understanding Death in The
Book Thief. The main contrast of the story is between life and death, with
Liesel Meminger representing the power of life and love. To mark the
position of Death as the negative opposing force would be too
oversimplifying because another stereotyped view about death as a close
friend of war is broken by the narrator:
To me, war is like the new boss who expects the
impossible. He stands over your shoulder repeating one
thing, incessantly. ‘Get it done, get it done.’ So you work
harder. You get the job done. The boss, however, does not
thank you. He asks for more.4
Death in the novel declines to be a force to be scared of. He is not
the one who is powerful, taking life when he wishes. He is actually an
employee, like a person complaining about work he hates but as a worker has
to do. We trust this merciful Death who feels pity for the dying. Death is
rather a father-like character sorrowing over the “bad” deaths and unnatural
losses he has to collect:
I shiver when I remember – as I try to de-realise it. I blow
warm air into my hands, to heat them up. But it’s hard to
keep them warm when the souls still shiver. ‘God.’ I
always say that name when I think of it. ‘God.’ Twice, I
speak it. I say His name in a futile attempt to understand.
‘But it’s not your job to understand.’ That’s me who
replies. God never says anything. You think you’re the only
one he never answers? ‘Your job is to…’ and I stop
listening to me, because to put it bluntly, I tire me.5
The author’s strategy makes Death a positive character responsible
only for “good deaths” as a natural part of life and in accordance with
accepted laws of biology and who thus cannot be blamed for the “bad dying”
of violent deaths. Probably the greatest irony and power of the story lies in
the realisation of human culpability for the deaths of millions, an act which
even Death is terrified of and cannot understand. He says: “That’s the sort of
thing I’ll never know, or comprehend – what humans are capable of.”6 The
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The Concept of Death in Children’s and Juvenile Literature
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roles of Death and a man are thus reversed in the story; a man is made
responsible for suffering and has to bear the burden of guilt. It is interesting
that though the story is told by Death, there is nothing said about the afterlife,
God, resurrection or redemption. Omitting God’s voice, heaven and hell has a
specific purpose in the narrative because it stresses the thematic concept of
man’s responsibility for the tragedy.
The frequent depiction and presence of death, dying and close-todeath states evoke the sad and gloomy mood of the story. In extreme life-anddeath situations people react unpredictably and in different ways. It is
influenced by various factors such as their age, emotional stability, health
condition, faith, presence of relatives and other social circumstances. Two
basic and opposing attitudes of the adults in The Book Thief are that of the
acceptance and fighting, most obviously represented by Max Vandenburg
and Frau Holtzapfel. The development of two mentioned characters is quite
ironical. Max Vandenburg, a Jew hiding at the Hubermanns, has a strong will
to live and succeeds in the pretended fight with Hitler and also with Death.
The narrator describes the fight:
It must have been one of the few moments when the girl
was not there with him, for all I saw was a man in bed. I
kneeled. I readied myself to insert my hands through the
blankets. Then there was resurgence – an immense struggle
against my weight. I withdrew, and with so much work
ahead of me, it was nice to be fought off in that dark little
room.7
Before both her sons die, Frau Holtzapfel approves of the current
political situation. She is more than optimistic until the encounter with the
death of her sons makes her realise the opposite. From never-ending
optimism she turns into a live corpse. Once she loses both sons, she declines
to live. She does not want to hide during an air raid and passively waits for
Death. Max is quite the opposite. He hates Hitler and would do anything to
revenge the life tragedy he has to experience. Max remains active though he
is more-or-less awaiting death as well.
The emotional appeal of the story is strengthened through the
depiction of suffering and dying children. There are two main deaths of
children in the story: the death of Rudy followed by the social death of
Liesel. When Liesel loses her family, and above all Rudy, she is socially
dead. There is no one related to her and all links she has with people
disappear. Rudy’s death is described with a strong emotional appeal and love
of Death:
Maria Kissova
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I carried him softly through the broken street, with one
salty eye and a heavy, deathly heart. (…) I saw him hipdeep in some icy water chasing a book, and I saw a boy
lying in bed, imagining how a kiss would taste from his
glorious next-door neighbour. He does something to me,
that boy. Every time. It’s his only detriment. He steps on
my heart. He makes me cry.8
Avery and Reynolds state that
children belong not only to their families, but also represent
the future of society. Times when children and young
people die en masse threaten the fundamental mechanism
by which societies as well as individuals reproduce
themselves.9
The dying of innocent children by an unnatural and violent end of
life is “bad” as such, which is particularly stressed in Death’s dealing with
children, which is different than his dealing with adults: “Five hundred souls.
I carried them in my fingers, like suitcases. Or I’d throw them over my
shoulder. It was only children I carried in my arms”10 or in another place
when he is taking a young boy’s life:
It was exactly when I kneeled down and extracted his soul,
holding it limply in my swollen arms. He warmed up soon
after, but when I picked him originally, the boy’s spirit was
soft and cold, like ice cream.11
Analysing depiction of different attitudes facing death, we come
again to Death as a human-like character. He lets people fight him and some
people are strong enough to succeed in the fight. There is a strong contrast
between Death as a character in The Book Thief, the conventional depiction
of Death, and death as the moment of violent dying traditionally perceived as
unwanted and tragic. The contrast is caused by the war setting when dying
children (with whom Death himself feels pity) stand in opposition to the
cruelty of mankind – adults (blamed for all deaths).
4.
The Power of Texts
Though it is true that “Inter Arma Silent Musae, ”Art is a natural
and fundamental expression of a man in any time. Even in the time of war
there is a need to create, have and interpret Art. Though the works of Art in
The Book Thief are of a questionable artistic value in terms of applying
traditional critical judgement and textual criteria, their perception and
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acceptance is unique for their subjective significance for an individual.
Hans’s accordion, Liesel’s love for books and writing, Max’s desire to give
something precious to thank Liesel so that he makes a picture book for her –
these all support the idea of the strong purpose of Art in times of crisis.
Though in this case we do not deal with artistic criteria, we are on the ground
of the contextual importance of a specific work. The Book Thief presents Art
as a powerful means to escape from harsh and cruel reality; it provides people
with mental strength, unites them, and makes them feel safer as well. Liesel
is eager to read. After she learns that, she would read anything just to satiate
the urge. She needs books because of the social webs, associations and
memories they bring back to her. Literary works she finds are not of much
worth in the terms of aesthetic and artistic value, but their pure existence and
the ways of acquiring make them special.
The first book she steals (though she cannot read at the time) is
actually a morbid manual - The Gravedigger’s Handbook lost by a young
digger at her brother’s grave. She takes the book so that she has something to
remember her late sibling. However, the manual changes its function. It is not
a non-fiction book any more because it has become an intimate work of Art
for Liesel. She learns its content by heart, which suggests an attempt to keep
the memories on her late brother alive. Other books she gets are poor Faust
the Dog and The Lighthouse - for Christmas and later she steals The Shoulder
Shrag from the Nazi fire of entartete Kunst. There are many situations in the
story where literature gives people the strength to survive. When Liesel reads
stories during aid raids in a shelter, everyone feels somehow safer; Liesel’s
patient reading to unconscious Max keeps him alive. Her visits to mayor’s
wife help to better the poor woman’s hopeless life.
Literature and the power of words are stressed in the story; they are
both highly praised but also disapproved since people’s works can also be
poisonous. It is ironical enough when Max’s present – a book written and
drawn by him for Liesel – is written on pages of Hitler’s Mein Kampf in
which words manipulate in order to support the sick idea of one’s ultimate
superiority over others. The power of words is so enormous that even Death
is enchanted by it. The title of The Book Thief is meta-textual. It is also the
title of Liesel’s book that she writes hiding in the cellar and which saves her
life when all her beloved are killed overnight in an air raid while she was
putting her story down. Literature and Art in general link the contrasts and
oppositions between life and death, hope and despair, memory and oblivion,
immortality and temporariness in the book.
“Real” life and fiction have a lot in common and the boundaries
between them are often blurred. Most people read literature for their love of
stories. Through reading, we get to know the characters and they might be
more or less likeable so that we develop a specific relation to them (believing
in their real nature until we close the book) often resulting in identification.
Maria Kissova
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The process of reading may thus strongly resemble life situations and social
contacts in general. It is, of course, clear that the character is not a “real”
person but the power of words and the verisimilitude of the narrative make
him so. There are for sure parallels between social bonds we have in reality
and those in the fiction. What Scarre says about real life situations is then true
also about fiction:
Because we are social animals, we are characteristically
involved in a host of different, criss-crossing and
overlapping relationships with other people, some intimate
and private, others more impersonal and public. When we
die, our death disrupts this extensive set of relationships,
forcing a greater or lesser reconstruction of the social
web.12
When we experience any kind of loss, we feel sad and frustrated. It
is true of material things as well as of nonmaterial property such as
relationships, values or hopes. The Book Thief is a story of permanent loss
which provokes strong emotional reactions in the reader. It is not only
because of the permanent loss and the sad and hopeless atmosphere of the
story. The reader feels powerless and frustrated mainly because specific
traditional conventions of the novel are broken. It is not very often that the
reader learns about the death of the character(s) before it really happens.
Usually, death comes by surprise and its unpredictability emphasizes its
effect. In The Book Thief it is just the opposite. Death as an omniscient
narrator knows who will die and when, and he mercilessly informs us about
several deaths before they occur in the story:
Of course, I’m being rude. I’m spoiling the ending, not
only of the entire book, but of this particular piece of it. I
have given you two events in advance, because I don’t have
much interest in building mystery. Mystery bores me. It
chores me. I know what happens and so do you. It’s the
machinations that wheel us there that aggravate, perplex,
interest and astound me.13
So we know about Hans Hubermann’s death beforehand: “We’ll
give him seven months. Then we come for him. And, oh, how we come.”14
Reinhald Zucker’s death is also unavoidable because Death pronounces it:
He was twenty-four. When he won a round of cards, he
gloated – he would hold the thin cylinders of tobacco to his
nose and breathe them in. ‘The smell of victory,’ he would
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The Concept of Death in Children’s and Juvenile Literature
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say. Oh, and one more thing. He would die with his mouth
open.15
However, probably the most powerful foreshadowing of loss is that
of Rudy’s death: “One day, Liesel,” he said, “you’ll be dying to kiss me.”16
How one can be calm and relaxed being frequently reminded of ever-present
loss and dying? This technique would be rather distressing if it were not
balanced somehow. That is achieved through the reader’s constant awareness
of Liesel’s possible “bad” death. In the state of permanent loss of characters
we expect her death as well. Even more when Death predicts again: “Yes, it
was a great night to be Liesel Meminger, and the calm, the warm and the soft
would remain for approximately three more months. But her story lasts for
six.”17 What a cathartic relief when the reader finds her dying a good death as
an old lady in Australia.
5.
The Power of The Book Thief
I usually recommend and lend books which I really like to my pupils
and students who then often give me the feedback on the experience with the
book. I lent The Book Thief to a fifteen-year-old student who told me that it
was the only book which made him cry. I do not claim that a worthy book
must inevitably make its readers cry, but my student’s confession
persuasively proved that The Book Thief is a narrative of enormous power.
Notes
1
G Avery and K Reynolds (eds), Representations of Childhood Death,
Macmillan Press LTD, London, 2000, p. 8.
2
ibid., p. 8.
3
M Zusak, The Book Thief, The Bodley Head, London, 2007, p. 329.
4
ibid., p. 331.
5
ibid., p. 373.
6
ibid., p. 25.
7
ibid., pp. 339 – 340.
8
ibid., p. 565.
9
Avery and Reynolds, op. cit., p. 6.
10
Zusak, op. cit., p. 359.
11
ibid., p. 21.
12
G Scarre, Death, Acumen, Stocksfield, 2007, p. 19.
13
Zusak, op. cit., p. 263.
14
ibid., p. 139.
15
ibid., p. 493.
16
ibid., p. 56.
Maria Kissova
67
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17
ibid., p. 524.
Bibliography
Avery G. and K. Reynolds (eds), Representations of Childhood Death.
Macmillan Press LTD, London, 2000.
Barley, N., Dancing on the Grave: Encounters with Death. John Murray,
London, 1995.
Morra J., M. Robson and M. Smith (eds), The Limits of Death. Manchester
University Press, Manchester & New York, 2000.
Reynolds, K., ‘Fatal Fantasies: the Death of Children in Victorian and
Edwardian Fantasy Writing’, in Representations of Childhood Death. G.
Avery and K. Reynolds (eds), Macmillan Press LTD, London, 2000, pp. 169188.
Scarre, G., Death. Acumen, Stocksfield, 2007.
Warren, J., Facing Death. Oxford University Press, New York, 2004.
Wyatt, R. ‘Art as Afterlife. Posthumous Self-Presentation by Eminent
Painters’, in Remember Me. Constructing Immortality. Beliefs on
Immortality, Life and Death. M. Mitchell (ed), Routledge, New York &
London, 2007, pp.193 – 207.
Zusak, M. The Book Thief. The Bodley Head, London, 2007.
Maria Kissova is a Ph.D. student and a lecturer at the department of English
and American Studies at the Faculty of Arts at the University of Constantine
the Philosopher in Nitra, Slovakia. Her doctoral research concentrates on
specific aspects of children’s literature translation which has been a central
topic of a few papers presented at Slovak and international conferences. Her
interests cover a wide spectrum of literature, art, cultural studies as well as
interdisciplinary studies combining the above-mentioned fields.
The paper is a part of the KEGA3/6468/08 project: Teaching Intercultural
Awareness through Literature and Cultural Studies.
The Confrontation with Death from Rilke to Heidegger
Jacob N. Graham
Abstract
The 20th century played host to a remarkable and revealing, philosophical
attention to death. Martin Heidegger, the herald and impetus for such
attention, disclosed to the West compelling reasons why death is not only
worthy of our thought, but perhaps, alongside being and in direct relation to
it, necessarily thought provoking. Heidegger showed us that death is not an
object of our fear, but rather a reality that we live and may authentically take
over for ourselves. However, Heidegger was not without an important
predecessor (indeed, a German predecessor): Rainer Maria Rilke.
Whether in his poetry, stories, or most candidly and plainly in his personal
letters and correspondences, Rilke’s work is not short on food for thought
concerning death. Though Rilke’s approach is, of course, markedly different
from Heidegger’s, there are noteworthy similarities to be found in the
insights provided by both of them. Rilke, too, quietly and carefully brought
the seriousness and gravity of death to light. Death, again, is not something to
be feared, but a mystery in and toward which we find our being. Death, as it
were, is able in some sense to grant life; while a life fully lived is a life lived
in a solemn recognition and realization of death.
Through a philosophical analysis of a short story and excerpts from Rilke’s
letters, the inextricable relationship between being and death will be
explored, while peripherally addressing Heidegger for points of clarification.
In such an analysis, it is almost inevitable that the traditional western views
on death must be at least partially addressed to demarcate Rilke’s position
from that of the culture in which he found himself. It will be seen that Rilke’s
insights provide a more authentic posture toward death; a posture moulded by
truth and the fullness of human being.
.
Key Words: Heidegger, Rilke, Being, Death, Possibility, Impossibility.
*****
1.
Introduction
Philosophy is sometimes too complex. When it is, it has strayed too
far from the simplicity of its beginning, its source. Other times, however, we
mistake the difficulty of its simplicity for complexity; what is most simple is
often for us most difficult. We are. We exist. We die. Are these not the
simplest, and yet the most difficult realities to accept, to bear, let alone
understand? Yet, the greatest of thinkers have tended, in one way or another,
to these immense simplicities. Heidegger’s monumental Being and Time is
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notoriously difficult, particularly in English. But this difficulty should not be
mistaken for complexity. The difficulty is rather a product of the great
simplicity of that toward which his thought tended; namely, being and death.
Heidegger’s language often springs from the truth of being and death and
therefore is necessarily difficult, but perhaps, simple.
Heidegger, however, had his predecessor; a predecessor also
speaking within and from his own German tongue. He was the poet, Rainer
Maria Rilke. I would like to discuss Rilke’s thoughtful confrontation with
being and death as found in selections from his personal letters.1 However, I
will begin with a brief and no doubt crude discussion of Heidegger’s thought
as found in Being and Time, so that we may then approach Rilke’s thought
from philosophical grounds. I will not, for sake of time, discuss in any detail
Heidegger’s analysis of Rilke’s poetry in the former’s What Are Poets for?,
nor do I aim for the sake of academic pedantry to merely highlight
connections between Heidegger and Rilke, or argue for Rilke’s profound
influence upon Heidegger’s thought. I only mean to pull from the well of
thought belonging to two of the greatest thinkers in the 19th and 20th centuries
in order to help us along the way to thinking being and death more seriously
and soberly.
Already, I have geared us toward thinking being and death. Does the
conference this week not call for papers only on death? Why do I insist on
both being and death? I argue, with the help of Heidegger and Rilke, that
death cannot be thought without being. “Death,” says Heidegger, “is a way to
be.”2 Indeed, we take our deaths over for ourselves as soon as we come to
be.3 What is the meaning of this? Is death not the opposite of being, or simply
put, non-being? Already we find ourselves in an apparent quandary; more
precisely, we find ourselves in the mystery of being and death. We do
ourselves harm if we consider death to be an intellectual “problem” that by
dint of effort we might one day solve. It is, rather, a mystery that we must
live.4 But it is not my task to leave these statements as they stand. Let us
delve further into what has been said.
It is no mere problem of language that we find ourselves saying, “is
not death non-being?” The very fact that we necessarily resort to saying
“death is” heightens the mystery in which we find ourselves. We may already
notice that the language we hear speaking about death finds its locus in being.
Death is a way to be, says Heidegger. This “is” is unavoidable. When we
speak of death, we speak of death in and from being. But what Heidegger has
said is more than a commentary on language. Heidegger says, if I may
paraphrase it in an un-Heideggerian manner, that we live our deaths. Death is
a way to be, once again, and it is a way to be that we take over for ourselves
as soon as we are. By virtue of being at all, we are being our deaths.
Death, for Heidegger, is not some event in which one day or another
each of us must partake. “Death is not something not yet present-at-hand, nor
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is it that which is ultimately still outstanding…Death is something that stands
before us - something impending.”5 Death is not “out there” somewhere,
waiting to one day blithely harvest our ripened lives. Death is always with us,
there for us, impending upon our being; not intrusively or morbidly, but as
part of who we are. Our death is for us a possibility, but it is not a possibility
outstanding, a possibility outside us or without us, a possibility among
possibilities; but rather, it is a possibility of our very being - a possibility that
is here with us, and impending.6 “Death is the possibility of [our] absolute
impossibility.”7 But, being in this possibility of the impossibility of our
being, we are able to stand before ourselves, disclosed, in our “own most
potentiality-for-Being.” We are able, in the face of our deaths, not only to
recognize, but realize (make real for ourselves), the possibility of our
impossibility - a possibility that we are, a possibility that we live.
The more unveiledly this possibility gets understood, the
more purely does the understanding penetrate into it as the
possibility of the impossibility of any existence at all…It is
the possibility of the impossibility of every way of
comporting oneself towards anything, of every way of
existing.8
Further, my death is my own; no one can die my death for me. Even
if someone were to take a bullet for me, and dies as a result, this lifesaver has
died his own death, and has not died my death for me. My death is still there
for me, ever present, as who I am, and as the possibility of my no longer
being able to be. Thus, with my death as my own, understanding and
realizing the possibility of my impossibility “individualizes” me “down to”
myself.9 Death, as my possibility, allows me to see myself in my own most
potentiality-for-being, and in fact, this possibility of my impossibility is what
grants me my own most potentiality-for-being.10 My death brings me face to
face with myself, when I see it as the possibility of my impossibility, and I
am then able to take myself over in an authentic way. “Holding death for true
does not demand just one definite kind of behaviour for [us], but demands
[us] in the full authenticity of [our] existence.”11 In coming face to face with
the end of who I am, I am most able to see who I am and who I am able to be.
Though this is only a quick and crude gloss of Heidegger’s analysis
of death, we must let this suffice for our discussion of Heidegger. Let us now
see what Rilke has to offer for our thinking.
2.
Rilke and Death
Rilke’s poetic approach to death carries no less force or gravity than
the rigor of Heidegger’s philosophical endeavour. In its own way, the
seriousness and lived insightfulness that permeates Rilke’s thought perhaps
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allows our thinking death more breathing room. Though we will not see the
sort of rigorous analysis of death in Rilke that we see in Heidegger, we
nevertheless see a thoughtful language that not only likely informed
Heidegger’s thought, but we see in Rilke a thoughtfulness which deserves our
utmost attention, whether the attention manifests in strict philosophical
thinking or contemplative reflection. In addition, we find in Rilke an explicit
acceptance of, and confident attitude toward death, whereas such an attitude
can only be implied from Heidegger.
For Rilke, too, death is intimately part of life. “Death is the side of
life that is turned away from us and out of our light’s reach.”12 And again,
“death is only an unsparing way of placing us on intimate and trusting terms
with that side of our existence that is turned away from us.”13 Death is here
treated as the half of our life (notice the necessary placement of death within
being) which is dark, unknown, but not entirely removed from the reaches of
our understanding; and it is shown to be especially close to a way of life that
entrusts itself to itself, and thus reaches into death. But this half, as I have
called it, is in no way distanced from or out of reach of life.
I do not mean to say that one should love death. But one
should love life so unreservedly and without any calculation
or deliberation that death (the half of life that is turned away
from it) is at all times unwittingly included in and loved
along with life.14
Here in Rilke, we have seen a definitive turn toward the acceptance
of death as death, but also of death as that side or part of our lives that is
generally held remote from us, but is actually in great proximity to us; even if
this proximity is shrouded in mystery. If we are not careful with the last
passage quoted, we may rashly conclude that Rilke’s focus is on life, with
death following close behind on the shirttails of this focus. Rilke, however, is
not suggesting a sort of love that privileges life over death, or a temporally or
causally successive love that “first” loves life, and so “then” must also love
death. Rather, Rilke urges a unity of life and death such that, loving the life
that we most clearly see, hear, feel, and to some degree understand here, will
always, even if unknowingly include a solemn love for that side of life that is
as yet unclear to us.
But to be clear, neither is Rilke suggesting that death is merely some
other life, or perhaps, a portal into an afterlife. When we refer to death as
“that side of life…” we do not mean that it, in itself, is also a kind of life.
Instead, Rilke is recognizing that our view of death is not a distant, removed
view, but that it is a view founded in being - a being, as it were, surrounded
by the possibility of its own impossibility. Death never leaves us, never takes
its rest from us, and we never escape death. But I insist, as I think Rilke and
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even perhaps Heidegger might also insist, that asserting the proximity of
death does not necessitate a morbidity or brooding disposition on our behalf.
Rather, to truly think death is to think life in its fullness; full, because at its
limit in death.
Life and death are joined. This means that death cannot be thought
outside life. We cannot somehow pry ourselves free of life to think death.
Rilke poignantly highlights this jointure:
It is possible that death is infinitely closer to us than life
itself…What do we know of it! Our effort (this had become
increasingly clear to me over the years, and my work has
maybe only this one purpose and task: to bear witness to
this realization, which so frequently overwhelms me
unexpectedly and always more impartially and
independently…maybe more like a vision, if that does not
sound too conceited)…our effort, I believe, can aim only at
presupposing the unity of life and death so that it may
gradually prove itself to us…Believe me that death is a
friend, our most profound friend, maybe the only one who is
never, never deterred by our actions and indecision…and
this, you understand, not in the sentimental-romantic sense
of a denial of life, of the opposite of life, but our friend
especially then when we most passionately most
tremblingly affirm our being-here, all that happens, nature,
love…Life says always at the same time Yes and No. Death
(I implore you to believe it!) is the actual yes-sayer. He says
only: Yes.15
I have here included such a lengthy passage not only for its poignancy, but
also because it is essential to understanding Rilke’s confrontation with death.
Rilke goes so far as to say that the presupposition of the unity of life and
death has perhaps been his life’s work. His work, he says, has born witness to
this realization. The proximity of death to life is a reality we must realize - it
must be made real to us, not denied by us. To follow Rilke and Heidegger, a
denial of death is essentially a denial of life and the fullness or authenticity of
that is our greatest possibility in life.
Rilke’s so-called “unity of life and death” is not a unity of two
objects or things that stand in qualitatively equal relation with one another.
Nor are life and death identical. To presuppose or even consider life and
death as standing enjoined in unity does not mean that we must insist upon
any shared identity of life and death. “How tremendous both life and death
are as long as one does not incessantly consider both of them to be a part of
one greater whole while making hardly any distinctions between them.”16
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Again, we would be too hasty in concluding that Rilke has spoken contrary to
what he regards as the unity of life and death. That we can call life and death
united does not preclude making any thoughtful distinctions between them.
When a couple is united in marriage, we could hardly strip either party of his
or her individuality. To the contrary, it may well be that the closer this couple
grows, the more starkly distinctions regarding the individuality of each
person could be drawn. In short, distinctions do not build walls between those
things, which are considered distinctly. Likewise, to say that death and life
are enjoined to one another in unity does not mean they are numerically one
or identical. They are perhaps infinitely different, but the differences do not
prevent their closeness, their jointure. They are enjoined to one another so
inseparably that we cannot genuinely think one without - whether explicitly
or implicitly - the other.
Rilke suggests that, if this unity is presupposed by us, it may
gradually prove itself to us. It is not a unity that, once realized, we can then
lay up in the store-room of all the other knowledge and information we’ve
gained for ourselves in this so-called information age. By its very realization,
it is made real to us as a reality that we must live. It is a reality that we are
able to realize so long as we are open to it; perhaps so long as it is
presupposed by us. And gradually, as it becomes more real to us, it proves
itself to us. It proves itself to us not in an argument or logically ordered
propositions and assertions, but by confronting it through our being.
3.
Conclusion
Rilke calls death a “friend” but is quick to note that he intends this
friendship not in a romantic sense, or certainly not in a favouring of death
over life. Rather, this profound friend might be called a friend because it is
not put off by our indecision, or even our ignorance or denial of death itself.
It is always there for us. It is especially there for us when we are here most
fully. When we, as Rilke says, affirm our being, our life, it is precisely then
when death stands there with us most clearly and audibly saying “yes” to our
yes-saying. In our very affirmation of being, we solemnly, quietly, and
perhaps even unwittingly affirm death. We affirm our being in its fullness,
right up to its limit, and at the limit of our being, we breathe confidently and
most self-assuredly into the abyss of death. Thus, the unity of this friendship
grows, and death becomes more and more the wholly other, yet the other that
is joined to this being.
In being and in life, however, we tend to waiver. We are often
pulled in the various directions of our everyday lives; sometimes directions
that seem more undirected than directed. It is the business of the day that
reigns, and the busy-ness of the streets, of work, of the latest news that often
slyly steals our attention. And perhaps even more surreptitiously sneaks into
our lives the voices that appeal to the adventurous side of us telling us to
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“seize the day,” or “live for the moment.” Such attitudes and statements,
though pretending, even to the point of self-conviction, to bring us to a
fullness of life often lead us further into a muddled, misdirected path that
takes us further from ourselves and a truly full or authentic life. But even in
such cases, death has not left our side, even when we are not aware of it, or
have yet to realize it.
Death’s proximity to our lives, to our being, is not a cause for
brooding or despair. It is rather a reality that we confront in our most genuine
hour, our most far-reaching thoughts. Our understanding peers into the
darkness of this mystery, so that the light it does shed is shed on our very
being; because it is only through and in our very being that we are able to
think death at all. Heidegger tells us that death is a way to be that we take
over as soon as we are.17 As we are, so are we in a close proximity with our
death. But, the more fully we are, the more fully we take care in and of this
life, the more fully and richly we live it and love it, the more, in short, that we
affirm this being, the more we are able to see the quiet, solemn yes-saying of
our own death that is always there for us. It is death, which, by its very
nature, grants us a limit by which to live. It is not the foolish or charlatan way
of “living for the moment,” but of living to our utmost capacity as human
beings. Thus, Rilke is able to say:
You have to live life to the limit, not according to each day
but according to its depth…one ought to turn the most
extreme possibility inside oneself into the measure for one’s
life, for our life is vast and can accommodate as much
future as we are able to carry.18
Notes
1
These selections are chosen from R M Rilke, Letters on Life, U Baer (ed
and trans), Modern Library, New York, 2005.
2
M Heidegger, Being and Time, J Macquarrie and E Robinson (trans),
Harper & Row Publishers, San Francisco, 1962, p. 289.
3
ibid.
4
The difference between a “problem” and a “mystery”’ is this: a problem
stands over against us as something that by its very nature contains the
possibility of being solvable (of course, this does not necessitate its being
solved). The mystery, on the other hand, is that in which we find ourselves.
This spatial language is no metaphor; it is real, and unavoidable. We find
ourselves in our being, and this being is mysterious. We are enshrouded in
mystery.
5
ibid., pp. 293-294.
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6
‘For one thing, death as possible is not something possible which is readyto-hand or present-at-hand, but a possibility of Dasein’s Being.’ ibid., p. 305.
7
ibid., p. 294.
8
ibid., p. 307.
9
ibid., p. 308.
10
‘If Dasein stands before itself as this possibility, it has been fully assigned
to its ownmost potentiality-for-Being’. ibid., p. 294.
11
ibid., p. 310.
12
Rilke, Letters, p. 121.
13
ibid., p. 115.
14
ibid., p. 111.
15
ibid., p. 112.
16
Ibid., p. 13
17
(Original German text): ‘Der Tod ist eine Weise zu sein, die das Dasein
uebernimmt, sobald es ist.’ ibid., p. 245.
18
Rilke, Letters, p. 13-14.
Bibliography
Heidegger, M. Being and Time. J Macquarrie and E Robinson (trans), Harper
and Row Publishers, San Francisco, 1962.
Rilke, R. M. Letters on Life. U. Baer (ed and trans), Modern Library, New
York, 2005.
Jacob N. Graham is currently a graduate student in Philosophy at Duquesne
University in Pittsburgh, Pennsylvania, U. S.A.
Burial Law as Viewpoint towards Death
Wim Cappers
Abstract
Few researchers examined the way in which the first signs of the secularisation
of western society during the second half of the eighteenth and the nineteenth
century brought about the taboo towards death. Burial Law is an important
source to investigate this change.
Physicians became the exponents of a way of living that was orientated towards
improvement of life on earth. They focused on two themes. First, from the
investigation of dead bodies it became clear that it is difficult to pinpoint the
dividing-line between life and death. Second, a burial should not be postponed
too long because of hygienics. The government used the medical ideas on dying
and death to improve the health care and public order. This is illustrated with
the activities of the Society for Rescuing the Drowned, founded in Amsterdam
in 1767 and the fight against a malaria epidemic in Groningen during the years
1826-1827.
By investigating the enforcement of the law, one gains an insight into the
acceptance of medical ideas by the people who did not have the right to vote.
Therefore, the study of Burial Law can give insight into the medicalisation of
death in the entire country.
Key Words: Secularisation, medicalisation, taboo, burial law, apparent death,
drowning, cemeteries and hygienics.
*****
1.
Preface
Salzburg, the place of this conference, is famous for the Salzburger
Festspiele. During the last edition, Don Giovanni was conducted. In this famous
opera of Mozart who was born in Salzburg, Don Giovanni seduces Dona Anna
and kills her father, the Commendatore. Later on, Don Giovanni visits his grave
and invites the statue on the grave for a dinner. At last, the statue, which
resembles the Commendatore, visits the house of Don Giovanni and asks him to
better his life. Don Giovanni refuses and thereupon the flames of hell
decompose the body of the seducer.1
It’s interesting that the libretto with the stories on the revival of a dead
person and the definitive destruction of all life by means of fire was written in
1787 when the enlightened Joseph II reigned over the Austrian empire. These
themes were well known in popular culture. My investigation concentrates on
the problem of apparent death and the decomposition of corpses around 1800.
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How did the people react when the government tried to regulate death by means
of law?
However, first I shall explain why I use burial law as a central source.
Then I will explicate how physicians and other medical orientated opinion
leaders made the prevention of apparent death and relocation of cemeteries, the
two important themes of the Dutch Burial Law of 1869. I will illustrate this
method of investigation with two examples. In each case I will concentrate on
the question how the medical opinion leaders and the political authorities dealt
with the reaction of the people.
2.
Introduction
Why, then, does burial law take such a central place within my
investigation? Roughly speaking, an examination of the historiography learns
that most historians tried to answer the question how the de-Christianisation of
the attitude towards death in western society started in the early modern period.
On the other hand, sociologists and psychologists have written many books on
death as a taboo during the twentieth century. However, it is surprising that few
researchers examined the way in which the first signs of secularisation of
western society brought about this taboo during the nineteenth century.2
Until 1800, the Catholic church - and later on the Protestant churches managed to Christianize the attitude of the people towards death to a large
degree. Not the belief in ghosts wandering around on earth after death, but the
faith in the transition towards heaven or hell became the main point of attention.
Nevertheless, the churches had to make some concessions to the people. So, the
Catholic councils of the first centuries after the birth of Christ were forced to
Christianize popular customs like the burial of the deceased near the grave of a
martyr. These places became a fairly safe guarantee for salvation. However,
suicides and other excommunicated people were banned from the churchyard.
On the other hand, during the sixteenth century the Protestant synods tried to
banish Catholic habits like praying for the salvation of the dead. According to
their belief, only God could decide who was to be saved or damned.3
During the second half of the eighteenth century, in addition to priests,
vicars and the people, a fourth group, the physicians began to express their
opinion on death.4 Of course, they had urged special measures towards burying
the dead in case of a plague during earlier centuries. Now, they developed a
more systematic approach towards a safe and hygienic disposal of the dead. So,
in the age of Enlightenment, medical opinion leaders became the exponents of a
way of living orientated towards improvement of life on earth.
The medical view towards death focused on two themes. First,
investigation of dead bodies learned that it is very difficult to pinpoint the exact
dividing-line between life and death. After all, life seemed to leave the body
only gradually. After a person had stopped breathing, it seemed that parts of the
body like nails and hair continued to grow for a while. Therefore, according to
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the physicians, only the smell of decomposition indicated that someone had
really died. The possibility of being buried alive was considered to be so great
that only doctors should certify dead.
On the other hand, a burial should not be postponed too long because a
decomposing body was a danger to the living. Above all, the medical opinion
leaders warned against the habit to bury the dead in and around churches. The
repeated opening of the graves could spread miasmata that caused diseases
among churchgoers and local residents. Accordingly, physicians and others
pleaded the relocation of cemeteries outside cities and villages.
At first, the medical opinion leaders obtained little hearing within
Dutch society because of the costs, force of habit and disbelief in the correctness
of their ideas. This hardly changed in 1795, when the French helped to establish
the Batavian Republic as a unitary state where politically like-minded persons
took control. Just during the period 1827-1869 the government made laws that
prescribed the draw up of a death certificate by a doctor before someone was
buried and the relocation of cemeteries outside the built-on area. At the same
time the administration had to reckon with religious and financial interests of the
different denominations by allowing the relocation of ecclesiastic cemeteries and
the compensation for the loss of funeral revenues. The well-to-do were allowed
to place monuments on the new graves.
By investigating the enforcement of these laws, one gains an insight
into the acceptance of the medical ideas by the people who did not have the right
to vote. Therefore, the study of the passing and the enforcement of the Burial
Law and other relevant laws over a long period provide insight into the
medicalisation of death in the entire country.5
3.
The Society for Rescuing the Drowned
Next, I illustrate the use of burial law as view-point towards death with
two examples. The fight against apparent death shall be illuminated by the
activities of the Society for Rescuing the Drowned, hereafter referred to as the
Society.6 This society was founded in Amsterdam in 1767. It is not an accident
that death because of drowning occurred quite often in a city containing many
canals, few lighting and handrails and almost no citizens who could swim.
Before the founding of the Society, a person falling into the water nearly always
drowned. Naturally, some bystanders brought a victim ashore, but they saw to it
that his feet remained in the water. According to old regulations, the court had to
examine the possibility of murder or suicide first. Others tried to resuscitate a
drowning person. However, believing that the victim had water in his stomach,
these bystanders rolled him over a barrel or hang him on his feet. Usually, these
methods did not contribute to the recovery of the victim.
In 1767, the Society began to propagate a different approach of
persons, who fell into the water. In accordance with the latest medical insights,
they argued that the dread of being buried alive paralleled the fear of being
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drowned. Both victims were apparently dead and should be resuscitated without
delay. Therefore, the bystanders should help a drowned person first and warn the
court later. People should realize that a drowned person was not necessarily the
victim of a crime but a patient in the first place. Furthermore, the Society
pleaded a different treatment. Recent medical research had made clear that a
drowned person did not have water in the stomach but in the lungs. Accordingly,
he should not be ill-treated by rolling him over a barrel or hanging him on his
feet, but his respiration should be cured.
The ten inhabitants of Amsterdam who founded the Society had several
means at their disposal to reach this goal. First of all, they published a few
articles in the Dutch spectatorial periodical, The Philosopher, to propagate the
resuscitation of the apparently drowned. Furthermore, it was a great help for the
Society that political authorities in all parts of the Republic approved of its
insistence on immediate help. They agreed that the court could be warned later.
Moreover, as well-to-do men, the initiators furthered their case with the promise
that would-be rescuers could count on a medal, sometimes combined with a
financial reward. The Society described precisely how the resuscitation should
take place. To this end, the initiators, of whom only one was a physician, chose
methods that every layman could apply. The tobacco fumigator was the most
important instrument. With this apparatus tobacco-smoke could be blown into
the anus of the victim. This procedure was thought to stimulate the lungs.
At first, the initiative of the Society, which was supported by the
political authorities, seemed a great success. The first reward was given to a
layman who saved someone's life with an improvised tobacco fumigator. On
second thought, the results fell short. Although the Society distributed thousands
of pamphlets all over the country, there were signs again and again that the
people were not willing to help a drowned person. In 1769 F. H. Bronkhorst, a
surgeon from Rhenen, was called to attend Cornelis van den Brink, who had
fallen into the water in the village of Opheusden. After Bronkhorst had tried to
revive Van den Brink in vain, he presented the Society with a bill of 19.12
guilders. Since this total nearly reached the maximum permitted indemnification
of 21 guilders, the directors asked for a specified account. Presently, it became
apparent that the cost of the bribes and the liquor that were necessary before the
people of the town of Opheusden would help led to such a steep bill. The
Society repaid Bronkhorst for his expenses in the Van den Brink case, but asked
him to pay more attention to his expenses in the future.
The people of Opheusden and elsewhere seem to have had good reason
for their unwillingness to help. Of course, they were religious people, who
simply had faith in God and thought no one could help a drowning person.
Above all, the popular belief in ghosts living in the water was probably still
wide-spread. Therefore, helping an unlucky person could bring misfortune. It is
remarkable that the directors of the Society did not try to disprove this popular
belief. It’s likely that this misunderstanding between the enlightened culture of
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the directors and the popular culture of the people contributed to the moderate
success of the Society for Rescuing the Drowned.7
4.
The Relocation of Two Cemeteries in Groningen
The relocation of cemeteries will be exemplified by the measures taken
by the political authorities in the fight against a malaria epidemic in the city of
Groningen during the years 1826-1827.8 Until then, the dead of this city in the
north of the Netherlands were buried in and around the churches within the town
ramparts. Two originally Catholic parish churches, the Martinikerk and the Akerk, were located in the old centre. After the establishment of the reformed
religion in 1594, the third parish church, the Noorderkerk, was built within the
town-development. Together with the Southern Churchyard, laid out in the same
period, they were the main burial places. The sites, where executed civilians and
soldiers were buried, lay outside the community south of the town and on the
Jacobijnen bastion in the northeast.
In 1826, the question, if cemeteries had to be laid out outside the builton area for hygienic reasons, was urgent. The year before, a commission of
physicians and scientists had advised the government that this was indeed
necessary. While the political authorities still had not made a decision, a malaria
epidemic broke out in the swampy area around Groningen in June. The farmers,
who normally visited the town to do business, began to avoid the place for fear
of contagion. The collapse of commerce was understandable. At the end of the
year, ten percent of the 28,000 inhabitants of Groningen had died.
The poor were especially stricken. Within eight weeks 700 of them
were buried on a section of the Northern churchyard. Therefore, in September
the governor of the province ordered the burial of the poor in cemeteries outside
the city. Since the local authorities could not find a useful plot outside the town
ramparts at first, they considered the use of the Jacobijnen bastion for a moment.
This ground was situated high and full of fresh air. Nevertheless, they rejected
the idea. Until 1767, this bastion was a burial place for military criminals and
now and then the plot was still used as such. The poor would not accept a
cemetery there.
At that moment, the magistrate even tried to cancel the costly project.
By now, the poor were buried on the entire Northern churchyard. Furthermore,
according to the local politicians the stench did not come from the Northern
churchyard but from the polluted water of the nearby canal, the Boterdiep. The
city council couldn’t convince the state authorities. On the contrary, the situation
deteriorated. In November, the Department of the Interior ordered that all
deceased should be buried on the churchyards from the first of December. Now
the magistrate began to confer with the churchwardens to avoid commotion
among the grave owners. It was agreed that the owners should get a grave of the
same value in one of the new cemeteries.
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In 1827, the local government finally bought two suitable plots north
and south of the city. Due to the haste, these so-called Northern and Southern
cemeteries were laid out straight ahead. Not a beautiful garden but a precise
division of the graves and the five classes to prevent disorderly burials and
unrest among the well-to-do was the main object.
During the summer of 1827 the malaria epidemic broke out again.
When graves that were filled the year before were opened on the Northern
churchyard, the governor demanded the burial of the poor in the new cemeteries
beginning the first of September. Two months later, all the deceased were buried
outside the town ramparts. In the meantime, the central government had reached
a decision with regard to a nationwide law. Before 1829 each place with more
than 1.000 inhabitants should have a cemetery outside the built-on area.
As we have seen, the hygienic view towards the burial of the dead
prevailed. Nevertheless, the local government had to reckon with the opinion of
the rich and the poor. It was impossible to bury the poor on a cemetery where
criminals were interred.
I hope to have shown that investigating burial law produces insight
with regard to constructing a history of the medicalisation of the attitude towards
death in The Netherlands. Enlightened ideas on dying and death had to reckon
with popular believe in ghosts and a decent burial.
Notes
1
P Stefan, Don Giovanni: Die Opernlegende von Don Juan, dem Versucher
und Sucher, Herbert Reichner Verlag, Wien, Leipzig and Zürich, 1938, p. 25.
A Rosenberg, Don Giovanni. Mozarts Oper und Don Juans Gestalt, Prestel
Verlag, München, 1968, 290-292.
2
T Walter, ‘Three Ways to Arrange a Funeral: Mortuary Variation in the
Modern West’, Mortality, vol. 10, August 2005, pp. 173-192.
3
P den Boer, ‘Naar een geschiedenis van de dood. Mogelijkheden tot
onderzoek naar de houding ten opzichte van de dode en de dood ten tijde van
de Republiek’, Tijdschrift voor Geschiedenis, vol. 89, 1976, pp. 161-201.
4
P Ariès, L’homme devant la mort, Éditions du Seuil, Paris, 1977, pp. 347399, 468-513.
5
W Cappers, ‘Op zoek naar zekerheid omtrent de dood: Totstandkoning en
uitvoering van de Begrafeniswet van 1869 in Nederland’, Groniek, vol. 21,
1987, pp. 98-109.
6
H M Brokken and W Th M Frijhoff (eds), Idealen op leven en dood:
Gedenkboek van de Maatschappij tot Redding van Drenkelingen 1767-1992,
Stichting Hollandse Historische Reeks, Den Haag, 1992, pp. 1-101. W
Cappers, ‘Money and Medals for Saving the Drowned: The Financial Factor
in the Dutch Discourse on Apparent Death during the Second Half of the
Wim Cappers
83
______________________________________________________________
Eighteenth Century’, in Curing and Insuring. Essays on Illness in Past
Times: The Netherlands, Belgium, England and Italy, 16th-20th Centuries, H
Binneveld and R Dekker (eds), Verloren Publishers, Hilversum, 1992, pp. 8394. W P R A Cappers, ‘Aardse begrenzing van bloeddorst en ademnood: De
vampier als fysiologische pendant van de drenkeling’, Holland, vol. 26, 1994,
pp. 35-62.
7
W P R A Cappers, ‘Lasten en baten rond het redden van drenkelingen. De
financiële factor binnen het Nederlandse vertoog over schijndood in de
tweede helft van de 18e eeuw’, Tijdschrift voor Sociale Geschiedenis, vol. 17,
1991, pp. 271-294.
8
M Ramaker, ‘In de ban van de beet: De malaria-epidemie in de stad
Groningen in 1826’, Gronings Historisch Jaarboek, 1998, pp. 66-81.
Bibliography
Ariès, P., L’homme devant la mort. Éditions du Seuil, Paris, 1977.
Boer, P. den, ‘Naar een geschiedenis van de dood: Mogelijkheden tot
onderzoek naar de houding ten opzichte van de dode en de dood ten tijde van
de Republiek’. Tijdschrift voor Geschiedenis, vol. 89, 1976, pp. 161-201.
Brokken, H. M. and Frijhoff, W. Th. M. (eds), Idealen op leven en dood:
Gedenkboek van de Maatschappij tot Redding van Drenkelingen 1767-1992.
Stichting Hollandse Historische Reeks, Den Haag, 1992.
Cappers, W., ‘Op zoek naar zekerheid omtrent de dood: Totstandkoning en
uitvoering van de Begrafeniswet van 1869 in Nederland’. Groniek, vol. 21,
1987, pp. 98-109.
Cappers, W. P. R. A., ‘Lasten en baten rond het redden van drenkelingen: De
financiële factor binnen het Nederlandse vertoog over schijndood in de
tweede helft van de 18e eeuw’. Tijdschrift voor Sociale Geschiedenis, vol. 17,
1991, pp. 271-294.
Cappers, W., ‘Money and Medals for Saving the Drowned: The Financial
Factor in the Dutch Discourse on Apparent Death During the Second Half of
the Eighteenth Century’, in Curing and Insuring. Essays on Illness in Past
Times: The Netherlands, Belgium, England and Italy, 16th-20th Centuries. H.
Binneveld and R. Dekker (eds), Verloren Publishers, Hilversum, 1992.
84
Burial Law as View-Point Towards Death
______________________________________________________________
Cappers, W. P. R. A., ‘Aardse begrenzing van bloeddorst en ademnood. De
vampier als fysiologische pendant van de drenkeling’. Holland, vol. 26, 1994,
pp. 35-62.
Ramaker, M., ‘In de ban van de beet: De malaria-epidemie in de stad
Groningen in 1826’. Gronings Historisch Jaarboek, 1998, pp. 66-81.
Rosenberg, A., Don Giovanni. Mozarts Oper und Don Juans Gestalt. Prestel
Verlag, München, 1968.
Stefan, P., Don Giovanni: Die Opernlegende von Don Juan, dem Versucher
und Sucher. Herbert Reichner Verlag, Wien, Leipzig and Zürich, 1938,
Walter, T., ‘Three Ways to Arrange a Funeral: Mortuary Variation in the
Modern West’. Mortality, vol. 10, August 2005, pp. 173-192.
Wim Cappers specializes in the history of death in the Netherlands. He
works at the Centre for Thanatology at the Radboud University, Nijmegen.
To Death - To Life: Grounding Sigurd Lewerentz and Erik
Gunnar Asplund’s Tallum Cemetery
Courtney D. Coyne-Jensen
Abstract
Few built forms concretise a society’s attitudes, philosophies and rituals of
death as markedly as the design of its municipal cemeteries. These
topographies explicitly embody the predominate “face(s) of death” within the
wider culture, symbolically and literally. In 1915, Swedish architects Sigurd
Lewerentz and Erik Gunnar Asplund won the Stockholm South Cemetery
Competition; this “Woodland Cemetery” being the first in a series of the
city’s 20C suburban, municipal cemeteries. Despite its pre-determined extra
moenia location, their design - entitled Tallum meaning “pine” - exists as an
extraordinary precedent: a cemeterial work endeavouring to counterpoise
modernity’s prevailing tendencies to banish death (and the dead) from daily
life. During the last decades, much research has been published on Tallum.
However, the majority focuses more on determining stylistic and formal
affinities, rather than on the primary understanding of the ground for the
scheme itself within the broader socio-cultural context of the time. This paper
will examine the architects’ profound pre-occupation with the site’s actual
ground, and the ways this is (re) articulated to (re) consider linkages inbetween the living and the dead. Through a probing of this tensional
topography, the argument shall be made that this pre-occupation becomes
aligned with the modern attempt to re-establish a more meaningful existence
via a more authentic and rigorous attachment to the ground itself. In short, we
speak of the need for a more grounded and authentic reality (mode of being).
The primary vehicle for situating Tallum will be through a discussion
including the cemetery as “socio-political ground”, “primordial ground”, and
“Christian ground”. Here, “ground” must be understood, foremost, in the
ontological sense; as the Heideggerian notion of ground, as the embodied
side of the lived-world, and as the support and setting for articulation.1
Key Words: Tallum, Woodland Cemetery, Lewerentz, Asplund, primordial
ground, ontological, death, burial
*****
1.
The Reassessment of ‘Ground’ in Socio-Political Reform
A. Hygiene and Aesthetics: Denial of Death [19C Burial Reform]
In the Church-State nation of Sweden, socio-political reforms and
burial reforms are historically and indivisibly tied. Since the Middle Ages,
there have been three major burial reforms in Sweden: banning ad sanctos
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burial (1783); modifying the Lutheran doctrine to permit cremation (1882);
planning the first suburban municipal cemetery (Stockholm North, C.G.
Blom-Carlsson, 1887). All these were determined foremost by postenlightenment concerns of efficiency, hygiene, aesthetics, and economy. The
underlying aim was banishing the face of death from any aspects of daily life.
Père Lachaise Cemetery (Paris, 1804), with its extra moenia sitting,
was the main precedent for Stockholm North: mimicking a secular world of
leisure, where all thoughts of urbanity’s chaos were to be forgotten amidst
nature’s sanctity, and where death itself was to be hidden beneath a
rationalised, hygienicised, sublime, park-like aesthetic. It reflected and
concretised (Swedish) society’s predominate anxiety and denial of death, and
desires to suppress the very fact of human finitude. This period produced not
only a physical gap between the realms of the living and the dead, but more
critically, widened the gap in the ontological continuum. All this, however, is
not to say there was not a high concern for death. Contrarily, society was
seemingly obsessed with death - with keeping it out of sight and sanitised.
Death, or rather a being-toward-death, had been rejected by life, and with this
a sense of wholeness was lost.2
B. Regeneration and the Search for Authenticity [20C Burial Reform]
In early 20C Sweden, the social climate was characterised by a
general feeling of World dissolution, or groundless-ness.3 Industrialisation,
war, and the disappearance of any secure canon(s) contributed to a
breakdown in the ontological continuum, including a general awareness of
the unreplaceability of the actual ground of the earth. This was made most
explicit in the period’s writings, for example in Nietzsche’s “crisis of the
spirit”, and Rilke’s Worpswede.
By the time Lewerentz and Asplund submitted their winning “Tallum”
proposal for the Stockholm South Competition (1915), society’s previous
sentiments of self-doubt had been considerably transposed by a revival of
historical roots in State and Church. Swedish society experienced renewed
self-consciousness, and collective-awareness of the need for increased sociopolitical and spiritual reformation(s). Church and State were united to
establish a ground for the betterment of culture; characterised by flexible,
anti-hierarchical social structures and an over-all more informal lifestyle.
Burial reform was one of the major issues collaborated upon: planning new
cemeteries, coupled with the reanimation of the practise of cremation, and
thus an overall change in society’s attitude(s) toward death. The campaign‘s
motto was jämlikhet, meaning “equality” and “sameness”; and as a part of
this, all citizens were guaranteed a Lutheran burial by cremation. With this,
death and the dead - once cast out of everyday life - were again included in
society’s search for a more meaningful and authentic existence.
Courtney D. Coyne-Jensen
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Until the Helsingborg Crematorium Competition (1914), this new
recognition of death had occurred chiefly through the auspices of social
reforms, and the cemetery as an institution was still rationalised; death and its
need for inclusion still pursued solely as socio-political constructs. The
Helsingborg Competition is key, as it provided the first architectonic
response to the socio-political desires of establishing an equalising, authentic
ground, simultaneously embracing life and death. Architecture and landscape
were embraced as the primary vehicle realising the desired socio-culturalspiritual evolutions. The belief was that to elevate the culture, the approach to
architecture had to be transformed, and if this were done, it could provide a
rejuvenation - even a salvation - of culture.4
The Helsingborg design significantly shaped Stockholm South’s
brief, which called for an end to romanticised articulations of cemeteries. The
new cemetery was to embody optimism and regeneration; renewal occurring
individually and collectively - in death and in life. The previous period’s
rationalisation and hygiene obsessions were now transformed towards
jämlikhet. More significantly, the brief prescribed a psychological-spatiotemporal sequencing of spaces; where the mourners - confronting and
accepting death - progress from darkness to light, low to high, built to
natural,…from life to death…to new life.5 This psychological/emotive cycle
of mourning was introduced as the necessary reciprocal to function(alism).
The living, as well as the dead, were the point of departure in this new
approach to cemeterial design.
Lewerentz’s scheme6 was amidst the winning Helsingborg entries
displayed at the 1914 Baltic Exhibition, and it was here, standing before his
model entitled ‘To death—to life’, that Asplund and Lewerentz would meet
and agree to collaborate on the Stockholm South Competition.7
2.
Probing the Authenticity of Tallum’s Primordial Ground
Stockholm South’s site was formerly a sand and gravel pit, with a
prominent bedrock hill and a vast pine forest. In their Tallum proposal,
Lewerentz and Asplund strove to not only further the programmatic ideals of
the Helsingborg Competition, but also to maintain and enhance as many of
the site’s inherent qualities as possible: using the granite ridge and forest as
their constant points of reaffirmation and return. For the architects, this was
to preserve, improve, and re-discover the (archê)typical, primordial Swedish
landscape.8 Nature, as primordial ground (forest and mound), was understood
as authentic because it was perceived as being prior to the present - or any
other - culture. It was seen as the means for recovering the depths of
(Swedish) tradition, and thus a more grounded existence. The site’s existing
ground, as primordial ground, was seen as the more grounded representation
of the ontological continuum; as the means and receptacle for recovering an
ontological understanding of World.
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In their proposal, all things human-made are subordinated to the
presence of the ‘primeval’ forest and mound. The pines are selectively,
minimally thinned into smaller burial glades, and all buildings and individual
graves are woven into the enveloping pines. Nearly all paths and roads follow
the undulating topography; and the few formal, axial ‘ways’ are subtly
articulated, interconnecting and approaching the chapels. In all cases,
pathways are either narrow slices through the forest or earth-bound paths
lined with trees and/or graves. A retaining wall formed from the site’s natural
stone defines the cemetery’s boundary with suburbia.
A. Forest (and Clearing)
The importance of the forest is manifest not only in Tallum’s
physicality, but also in the design’s naming: tall meaning ‘pine’. Although
previous research notes National Romantic affinities to the naming,9 Tallum
must be understood foremost, in the context of this paper, in its most primal
sense: as pine. Read as such, it is the architects’ unspoken yet adamant
declaration to reaffirm the land’s primordial pine forest and pine tree.
The architects’ proposal preserved so much of the existing forest
that the jury’s one main objection was the pines’ total dominance; monotony
and uniformity. The call for “wider and more open clearings”10 and a more
formalised architectonic reworking of the ground, deserves careful
consideration, for it reflects the time’s wider cultural currents, externalising
how society’s conception of nature (embodied in the jury’s comments) was
informed primarily by the modern fear and avoidance of death. The fact that
the jury envisioned the forest’s omnipresence as potentially “merciless and
frightening” speaks of society’s tendency to equate nature - uncultivated
nature - with death, melancholy, and the sublime.11 Despite beginning
transformations in societal views, nature was still perceived, on the whole, as
a sanitary aesthetic mask, holding death’s inevitability at bay. The jury’s
comments were related more to purely functional and aesthetic approaches
than an ontological one.
If the architects were looking to the pine in its most primitive
essence12 - as tree and forest, as both symbol of the pagan World Tree
(Yggdrasil)13 and symbol of the primeval forest (Urskog) - then it can be
argued that, for them, Tallum was perceived as the ultimate regenerationdomain. Tallum, as pine, stands for both the paradigmatic notion of the
individual tree (symbolic of all vegetation), and for the forest made of many
trees (symbolic of nature’s eternal, regenerative properties). In Tallum dwells
the tension of belonging partly to the paradigm of the forest and partly to the
actual forest itself. In Tallum one is confronted with death, so as to come to
terms with death, and ultimately to renew attitudes towards life.
The architects’ championing of the primordial was not a means of
combating or creating an Ersatz for urbanity; as it was for Romanticism’s
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philosophising-poets and artists. They were clearly receptive to the era’s
art,14 however they departed from it by not representing nature and man in
ominous opposition. While Tallum’s forest recalled the modes of being of
Sweden’s earliest peoples, it also approved and introduced the reality of the
human-fabricated world of modern culture into its continuum. To maintain,
and move within, Tallum’s primordial ground was not entirely a nostalgic
longing for the past, but rather was about seeking/supporting an ontological
mode of being. Like ancient Viking grave-fields, it was about living with,
and accepting, the reality of death; death as an extension of life.
The architects were not positing or planting an attack of nature over
culture,15 but were preserving, recovering, and privileging what they saw to
have always been there: primordial ground in illo tempore.16 Moving in
relation to, and within, a horizon of a rich mytho-poetic past,17 Tallum’s
forest was regarded as sacred by virtue of its tradition - one long preceding
human history and extending before the gods.18 As hallowed ground, the
primeval forest’s sacred depths were sought as dwelling place(s) by the
gods.19 By minimally clearing the land, it is as if the architects were silently
proclaiming - reminding - that salvation and authentic being-in-the-world are
situated foremost in the deep past of primordial ground, not solely in the
historical past of cultivated ground alone.
It is important to consider the three conditions where clearings are
introduced into Tallum’s forest: [1] in the smaller burial glades; [2] in the
areas of the crematorium complex and chapels; [3] in the area surrounding
the ‘Grove of Remembrance’ mound, extending to the Chapel of the Holy
Cross and crematorium complex. In the first two instances, the forest is
prudently carved into. When it became necessary to remove some pines - to
situate graves, buildings, or provide more light to the forest floor - deciduous
trees were replanted nearby. This replanting could be read as an attempt to
hold the human-fabricated world of culture at a distance. Yet, since the
reforestation was in itself cultivation, it must instead be perceived as a way of
reintroducing cultivated ground into primordial ground, and life into the
realm of death/rebirth. “Original” tree(s) and re-forested tree(s), the symbolic
and the literal, co-habitate in an agonistic field of synthesis and conflict.
Deciduous and coniferous bodies represent the temporal/mortal and the
eternal/primordial. Nature’s cycles come to the fore as reminders of the
equality had in the necessary death of all “back into those things from which
they came” 20; the equality in life/death…social and cosmic jämlikhet.
The third and most consequential clearing - between the “Grove of
Remembrance” mound and the Holy Cross Chapel and crematorium complex
- establishes the possibility for a constant movement, both actual and
symbolic, between death (represented in both the deceased body and the
buildings as a receptacle of death) and new life (represented in the mound,
grove, and nature’s regenerative properties). Figure and field are set into a
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dialogue through the ground. This clearing yields absolute prominence to the
mound and its symbolism of new life; while the chapel and crematorium
complex sit in the valley, symbolic of death. The architecture mediates the
boundary between forest and clearing. Like the burial glades, this clearing which makes way for the quasi-cultivated, quasi-urbanised nature of the
mound and grove - also represents a welcoming of the site’s primordial
ground on civic terms.
B. Mound (and Valley)
Even more than with(in) the forest, it was in the actual ground of the
site itself - most readily in the “Grove of Remembrance” mound’s situation that the architects struggled to establish a basis for an ontological
understanding of ground and more authentic mode of being. In the mound,
recalling Scandinavia’s prehistoric burial tumuli (dommarringa)21and the
borough moot (tingställa),22 the renewed attitude toward death and the search
for jämlikhet are given their most articulate - and archaic - expressions. Like
the ancient tumuli, Tallum’s mound symbolises regeneration within the earth;
the preservation and regeneration of single bodies as much as the communal
body.
The Holy Cross Chapel rests in the clearing’s valley; the gravel pit’s
former site. The ground’s undulating topos (a descent begun at the mound)
flows into the chapel’s concave floor/ground. At the chapel’s nadir lies the
catafalque, where the deceased is lowered for cremation at end of the funeral
rite. This descent-point is defined by a void into the earth’s darkness.
Reciprocal to this downward movement is the mound’s skywards movement.
These antipodes are physically connected by the topography’s unbroken
curvature, and visually by the chapel façade’s massive opening. It is as if this
gesture signifies that as the body descends in the chapel, its soul
simultaneously ascends through the aperture at the centre of the
Remembrance mound’s grove. The valley, being linked with death, holds all
things corporeal in her bosom, while the mound rises as a symbolic harbinger
of regeneration/rebirth. This two-way tensional dynamic between
valley/mound (earth/sky), is brought into equilibrium through the ground’s
continuity. The topography’s ascent - from chapel, to mound, to tree(s) embodies the ritualised movement from funeral, to burial, to resurrection, as
well as the progression from the fear of death to the promise of regeneration.
This notion of equilibrium should also be linked back to a
discussion of equality, and the fact that the mound was designed to not only
be seen, but also to be seen out from; to be accessible by mortals. Like
ancient tingställar, Tallum’s mound can also be seen as a “sacred centre,”23
encouraging human participation. Tallum’s mound is not intended as a
privileged seat solely for the Divine. Being mimetic of pagan tingställar, it is
on occasion meant to be co-habitated by mortals, affording them the
Courtney D. Coyne-Jensen
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possibility of momentary communication with the dead and/or Divine. At
Tallum, mourners are encouraged to meander to the mound’s apex and stand
amidst the grove - and this must ultimately be seen as a gesture of jämlikhet.
Nevertheless, the fact the architects articulated the mound to imply
that cosmic connections can occur via the individual alone - devoid of
culture’s greater structure, which for example enabled intercession at the time
of tingställar - reflects modernity’s24 lack of proper mediation in general. The
design of Tallum’s mound affords absolute freedom to the individual. Yet,
with this emancipation also comes the onus of having to mediate the World
alone.25 Perhaps it is exactly this plight - a need for a more fully mediated
understanding of World - that the architects were actually challenging us to
remember and experience with(in) Tallum’s mound.
On one level, the mound’s grove speaks of a jämlikhet found in the
harmonic tension between primordial and cultivated (socio-political) ground.
The architects retained the site’s primordial topography, yet cultivated its top
with a clearly human-made, square-formed grove. On a deeper level, the trees
speak of an equality inherent in human finitude. Standing solemn and
dignified, the grove presides over Tallum’s entirety. Each tree, standing
surrogate for the absent-present elders of Sweden’s primordial past, mediates
between earth and sky.26 It can thus be argued that the architects have
situated these deciduous trees principally as reminders of cosmic justice27 and
jämlikhet. The trees’ branches weep ground-wards, as if to communicate remind - that all things arise from, and return to, the earth. Each tree, as
arbiter, is Time. The law they proclaim - waning occurs following a fixed
span of growth, then death balances birth - is silently manifested in nature’s
continuous temporal pendulum of life, death, renewal…
3.
The Absence of an Authentic Ground in Modern Christianity
Christian iconography and symbolism in Tallum’s design are
minimal and unfulfilled. Because the architects privileged the site’s
primordial ground as the principal medium of symbolic representation, the
notion of Christian ground is ambiguous and fragmentary. Thus, Christian
ground must be discussed, as the architects dealt with it in praxis, not so
much as ground, but as a series of fragments within the wider, primordial
topography. From the competition sketches to the realised design,
Christianity (as an institution) is reduced to a handful of biblical place names
and dogmatic, ecclesiastical freestanding objects within the site’s primary
clearing. To reach a deeper understanding of the ontological implications of
situating Christian eschatological fragments within the greater context of a
primordial understanding of nature-as-regenerator, Tallum’s Christian ground
must now be discussed in terms of two major fragments: [A] “The Way of
the Cross”; [B] “The Resurrection Monument”.
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A. The Way of the Cross [The First Major Fragment]
Lewerentz’s “Way of the Cross” competition sketch depicts a
narrowly winding footpath, slowly ascending through the burial glades’
mysterious darkness. At the path’s beginning stands a large, leaning, wooden
cross. Simultaneously Christian and pagan, the path can be seen to fuse the
Via Dolorosa28 and Via Appia,29 within the primeval forest. Representations
of all levels of the ontological continuum - graves, mourners, cross, trees, etc.
- are intended to coexist within the forest’s greater regenerative body.
The cross’ situatedness can be read as the architects’ declaration that
Christian redemption and rebirth are to be understood only as part of the
primordial’s deeper promise of salvation. According to the sketch, it is within
the forest, moving ritually towards the chapel, where death can truly be
confronted, loss accepted, and the hope of new life (re)instilled. Lewerentz
represented the cross as a tree-amongst-trees, within the forest’s greater
entity. It is as if the Garden of Eden’s “original tree”, which later became
Christ’s crucifix, is still metamorphosing - via nature’s regenerative cycles into becoming a perfectly upright, mediating tree once more.
The location and articulation of the cross and path in Lewerentz’s
competition sketch subsequently underwent several revision. When Asplund
was later appointed sole responsibility of designing the Holy Cross Chapel
and crematorium, he also inherited the dilemma of “The Way of the Cross”.
Asplund’s situating of the cross became even more groundless: being
transformed at one stage into a granite obelisk, and in another completely
removed. The uncertainly can be seen as being indicative of the place of
Christianity within Sweden’s cultural climate at the time.
Numerous schemes later, Asplund eventually returned to the cross,
and the path again named “The Way of the Cross”. As realised, it externalises
the architects’ anxieties in dealing with the Christian fragment within a
wholly other(wise) framework: where true authenticity and salvation were
seen embodied in the depths of primordial ground. The realised Way, like the
competition sketch, slopes slowly upward towards the chapel. Sinking into
the ground, grass pushes up between the irregular paving stones. Like the
forest and mound, this path is concurrently primordial and cultivated ground.
Unlike Lewerentz’s sketch, the realised Way is axial and devoid of
its forested setting. The once leaning, wooden cross has become a perfectly
upright, monolithic, black granite cross. It has become “The Great Cross” yet signifies neither the path’s beginning nor end. It stands prominently
ambiguous and free-floating, just before the great portico, in tension between
the Holy Cross Chapel and the mound. The materiality of “The Great Cross”
is inherited from its transitory design phase as a monolithic obelisk. More
importantly, its overly-explicit monumental articulation should be understood
as the consequence of placing so much symbolic weight on - in - primordial
ground. The symbolism embedded in the mound’s mass could, in the end,
Courtney D. Coyne-Jensen
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only be countered with such a literal interpretation of mass as manifested in
the cross’ granite materiality.
B. The Resurrection Monument [The Second Major Fragment]
From its beginnings, John Lundqvist’s statue “The Resurrection”
was approached by the architects as a fragment. Designed in 1908,
completely independent of any connection to the cemetery, it only first came
into the realm of the public eye - and Tallum’s primordial ground - after
being displayed at the 1930 Stockholm Exhibition in a special section on
cemeterial art. Contemporary art critics heralded Lundqvist’s statue as
representing the era’s spirit and pathos, and proposed it be erected in
Tallum.30
Following the public’s favourable responses to “The Resurrection”,
the cemetery committee asked the architects to suggest a location within
Tallum. Again faced with the problem of the Christian fragment, devoid of
any contextual ground, the architects struggled for almost ten years before
ultimately locating the monument where it stands today: at the centre of the
great portico’s impluvium. Like the need to be utterly literal with “The Way
of the Cross” naming, the portico was subsequently named “Monument
Hall”. Words were again made to bear the weight - the meaning - for the
symbol, which no longer could.
The statue, pregnant with symbolisms of Christian rebirth (three
vertical figures ascend resurrected atop three horizontal purgatorio figures),
is positioned in direct reciprocity to the “Grove of Remembrance” mound.
The dialectical tension in-between these two figures’ differing notions of
salvation is held in equipoise through the continuity of the topography. The
portico is articulated as an inverted mimesis of the square-formed grove of
trees that sits atop the mound. The mound rises, yet its movement is
ultimately downward, back into the earth; as we are reminded by the trees’
weeping branches. Conversely, the portico lies in the valley with a concave
floor and a skywards-pointing roof. At the grove’s centre is a void yielding to
the ground and “salvation in the earth”; while at the portico’s centre is the
solid of “The Resurrection’s” salvation.
The overall irresolute manner in which the architects were left to
deal with Christian symbolism at Tallum illustrates modernity’s prevailing
problem in addressing the current cultural situation in any decisive way using
Christian tradition. It also reflects the dilemma arising out of the architects’
extreme privileging of the site’s primordial ground above all else. It was
almost as if the architects were positing that if they got the ground right than
they did not need any thing else. In the end, the only place left for Christian
dogma in Tallum is as a fragment - as scattered objects floating groundlessly
in the modern clearing.
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4.
Conclusion
The search for authenticity in the ground of Tallum was driven by a
state of groundless-ness. The background of such groundless-ness has been
seen in other, wider attempts to recover the ground; such as those in the
domain of early 20C socio-political and spiritual reforms, aimed at
recovering a more equalised and authentic existence. The architects, in turn,
embodied the social quest for lost ontological ground within the site’s actual,
primordial ground. The syncretic movement in-between socio-political
ground and primordial ground, as well as the general problem of
fragmentation, typifies the breakdown of a fully mediated ontological
continuum in modernity in general.
Through their extreme preoccupation with the site’s pervasive
nature, it can be said that the view was that true authenticity resides foremost
within the ground - in its most actual and primordial sense. In a most basic
sense, the salvation of culture and the means for a more grounded being were
seen lying tacit and latent in the sacrality of the earth. Due of this
understanding and the endeavours to find most meaning within Tallum’s
material ground, the ground itself was deeply invested with meaning.
However, with meaning normally comes increased articulation, at a level,
which consistently attempts to break free from the dumb and primordial; thus
neutralising the significance invested in the earth as unshaped and archaic
ground. As a result of this unremitting - almost viscous - circle, Tallum exists
as an agonistic ground of tensions, mediated by a constant interplay of
conflicts and syntheses. Within this exchange lies the fundamental dilemma
with which the architects were invariably faced.
Notes
1
M Heidegger, Basic Writings, Harper Collins, New York, 1993, pp. 171172.
2
M Heidegger, Being and Time: A Translation of Sein und Zeit, Joan
Stambaugh (trans), Harper and Row, New York, 1972, pp. 239-242; 348-350.
3
C Hallendorff, History of Sweden, Cassell and Co., London, 1929, p. 382
and 423.
4
W Kandinsky ‘Concerning the Spiritual in Art and Painting in Particular
1912’. The Documents of Modern Art, 5, George Wittenburn, New York,
1955, p. 26.
5
A Schmarsow, ‘Utdrag ur arkitekernas beskrifning till krematorie i
Helsingborg’. Teknisk Tidskrift: Arkitektur, 1914, p. 117.
6
Co-designed with former partner Torsten Stubelius.
Courtney D. Coyne-Jensen
95
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7
Asplund and Lewerentz were already collegial, having studied together at
the Klara School (1910). Prior to Tallum, both architects had practiced 7+
years, designing ecclesiastical, domestic and civic projects.
8
S Lewerentz, ‘Östra kyrkogården i Malmö’. Byggmästaren, 1928, p. 188.
9
B Johansson, Tallum: Gunnar Asplund and Sigurd Lewerentz’s Woodland
Cemetery in Stockholm, Byggförlaget, Stockholm, 1996, pp. 16-18.
10
N Blanck, ‘Täflan om utvidgning av Stockholms Södra Begrafningsplats’
in Teknisk Tidskrift: Arkitektur, 1915, p. 44.
11
E Kant, The Critique of Judgement, Clarendon, Oxford, 1978, §26.
12
Although many publications have addressed Tallum relative to primitivism
- stylistically - no research has yet looked at the word and meaning of tall in
and unto itself, in its most indigenous and essential form.
13
In the Norse Gyllfaginning, Yggdrasil is the mighty ash structuring the
cosmos, being continually destroyed and renewed. Every tree symbolises
Yggdrasil, and every forest is sacred and magical due to its mediation
between worlds. S Sturluson, The Prose Edda, University of California Press,
Berkeley, 1964.
14
Specifically, the paintings of C.D. Friedrich (1774-1840) and Prince
Eugene (1865-1947) would have been known to Lewerentz and Asplund:
Eugen’s work displayed in the 1914 Baltic Exhibition, and Friedrich’s work
widely-published.
15
O Spengler, The Decline of the West, Allen and Unwin, London, 1926; C
Constant, The Woodland Cemetery, Byggförlaget, Stockholm, 1994, p. 172.
16
M Eliade, The Sacred and The Profane, Hartcourt Brace Jovanovich, San
Diego, 1987, p. 68.
17
Concerning this return to mythical beginnings, W. Curtis, Modern
Architecture Since 1900, Phaidon, London, 1996, pp. 130-147.
18
G Bachelard, The Poetics of Space, Beacon, Boston, 1958, pp. 186-188.
19
C Tacitus, Germania, Heinemann, London, 1970, p. 39.
20
C Kahn (ed), Anaximander and the Origins of Greek Cosmology, Columbia
University Press, New York, 1960, p. 199 ff.
21
Dommarringa/domarhög/gravhög (“judgement rings/mounds”) were
Scandinavia’s Bronze and Iron Age burial mounds, which co-functioned as
judgement courts. N. Herlitz, Grunddragen av det svenska statsskickets
historia, Oxford University Press, London, 1939.
22
Tingshög/tingställa is Swedish for “place/mound of the Thing” and
“borough moot”. Svenska Akademiens Ordbok, Svenska Akademien,
Göteborg, 1999.
23
M Eliade, The Sacred and The Profane, p. 36.
24
Addressing modernity and “the modern moral predicament”, C. Taylor
notes that in modern culture two frontiers have been added to the original
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theistic one: nature and self: “A modern who recognises both these powers is
constitutionally in tension”. Sources of the Self, pp. 383-390.
25
C Taylor, Sources of the Self, Cambridge University Press, Cambridge,
1989, pp. 497-501.
26
HR Ellis Davidson, Ancient Peoples and Places: Pagan Scandinavia,
Thames and Hudson, London, 1967, pp. 108-109.
27
“Cosmic justice” implies the necessary dissolution of all things back into
their source of birth, making room for new life. There is no wastage - only
equality - in physical change from life to death. Anaximander, ‘Fragment 1’.
The Presocratics, Collier Macmillan, London, 1966, p. 54ff.
28
C Constant, The Woodland Cemetery, pp. 40-41.
29
D Porphyrios, ‘Classical, Christian, Social Democrat: Asplund and
Lewerentz's funerary architecture’. Lotus International, 38 (1983), 73.
30
G Nässtrom, ‘Utställningen: ett monument’. Stockholms Dagbladet, May
23, 1930.
Bibliography
Anaximander, ‘Fragment 1’. The Presocratics, Collier Macmillan, London,
1966.
Bachelard, G., The Poetics of Space, Beacon, Boston,1958.
Blanck,N., ‘Täflan om utvidgning av Stockholms Södra Begrafningsplats’.
Teknisk Tidskrift: Arkitektur, 1915.
Constant, C., The Woodland Cemetery, Byggförlaget, Stockholm, 1994.
Curtis, W., Modern Architecture Since 1900, Phaidon, London, 1996.
Eliade, M., The Sacred and The Profane, Hartcourt Brace Jovanovich, San
Diego, 1987.
Ellis Davidson, H., Ancient Peoples and Places: Pagan Scandinavia, Thames
and Hudson, London, 1967.
Hallendorff, C., History of Sweden, Cassell and Co., London, 1929.
Heidegger, M., Being and Time: A Translation of Sein und Zeit, Joan
Stambaugh (trans), Harper and Row, New York, 1972.
Courtney D. Coyne-Jensen
97
______________________________________________________________
_____, Basic Writings, Harper Collins, New York, 1993.
Herlitz, N., Grunddragen av det svenska statsskickets historia, Oxford
University Press, London, 1939.
Johansson, B., Tallum: Gunnar Asplund and Sigurd Lewerentz’s Woodland
Cemetery in Stockholm, Byggförlaget, Stockholm, 1996.
Kahn, C. (ed), Anaximander and the Origins of Greek Cosmology, Columbia
University Press, New York, 1960.
Kandinsky, W., ‘Concerning the Spiritual in Art and Painting in Particular
1912’. The Documents of Modern Art, 5, George Wittenburn, New York,
1955.
Kant, E., The Critique of Judgement, Clarendon, Oxford, 1978.
Lewerentz, S., ‘Östra kyrkogården i Malmö’. Byggmästaren, 1928.
Nässtrom, G., ‘Utställningen: ett monument’. Stockholms Dagbladet, May
23, 1930.
Porphyrios, D., ‘Classical, Christian, Social Democrat: Asplund and
Lewerentz's funerary architecture’. Lotus International, #38, 1983.
Schmarsow, A., ‘Utdrag ur arkitekernas beskrifning till krematorie i
Helsingborg’. Teknisk Tidskrift: Arkitektur, 1914.
Spengler, O., The Decline of the West, Allen and Unwin, London, 1926.
Sturluson, S., The Prose Edda, University of California Press, Berkeley,
1964.
Svenska Akademiens Ordbok, Svenska Akademien, Göteborg, 1999.
Tacitus, C., Germania, Heinemann, London, 1970.
Taylor, C., Sources of the Self, Cambridge University Press, Cambridge,
1989.
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Courtney D. Coyne-Jensen, Architect M.A.A. / Ph.D. Independent
architecture and urban design professional (CPH, DK), and Lecturer at DIS,
Danish Institute for Study Abroad.
Heroic Death and Selective Memory: The U.S.’s
WWII Memorial & The U.S.S.R.’s Monument to
The Heroic Defenders of Leningrad
Susan M. Behuniak
Abstract
Just as war is a struggle to the death over conflicting values, so are war
memorials a struggle over death and its meaning. This paper focuses on two
parallel efforts to memorialise those who served during World War II (called
the Great Patriotic War in Russia): the US’s World War II Memorial in
Washington, D.C. and the USSR’s Monument to the Heroic Defenders of
Leningrad, (now St. Petersburg, Russia).
What I will argue is that both of these memorials, rather than simply
honouring the sacrifices of the dead, convey a deliberate political message:
that those who died were heroes, and that a heroic death is one in which the
sacrifice is worth it. Such a politicised agenda requires not only that
collective memory be formed and preserved by an architectural structure, but
that these mnemonic spaces also promote a forgetfulness of memories to the
contrary. In this, these two memorials, one originating within democracy and
the other within communism, demonstrate Harvey Weinstein’s point that
“memorials represent a complex nexus between politics, trauma, collective
memory, and public art.”
The paper begins with a brief discussion of heroic versus tragic death as
archetypes. Next, I examine and compare the American and Soviet
monuments with attention to how the elements of timing, geography, and
architecture/art determine what is remembered and what is repressed. I
suggest that despite their significantly different wartime experiences and
politics, both countries built triumphant renderings of the war—memorials
that celebrated heroic death while denying tragic death—to promote not only
national unity but also a patriotism based on militarism.
Key Words: War memorials, war monuments, heroic death, tragic death,
WWII, siege of Leningrad.
*****
1.
Introduction
War memorials stir more than the heart and the head to remember;
they also rouse the public to react politically. Their construction, then, comes
not just from the shaping of granite but from a desire to shape the public’s
perception of this “form of socially sanctioned death.”1 Yet, just as war is a
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struggle to the death over conflicting values,2 so are war memorials a struggle
over death and its meaning. In this, memorials have “unique symbolic power
because they invoke a sense of timelessness, awe, fear, and uncertainty.”3
They recall the “ultimate sacrifice” made by others, and so like graveyards,
they are sites where the living and the dead meet. Memorials, then, serve not
only to commemorate or mourn; they are also a “means for a community to
stabilize an event [by making] the past consequential for the present.”4
Given their intent and impact, it is no surprise that war memorials
can be highly politicised and contested sites. They are structures that demand
answers to charged questions: Who should be remembered and how? Which
events should be highlighted—or disregarded? Whether the message should
be clear, ambiguous, or even absent? When should the memorial be built and
where? What, indeed, is its purpose—to mourn, warn, consol, celebrate,
instruct, propagandise, or several of these at once?
One way to uncover the narratives contained within memorials has
been to categorize them. “Monuments,” those structures built in celebration
of victory have been distinguished from grief-laden “memorials” that
primarily reference “the life or lives sacrificed for a particular set of values.”5
Another distinction has been drawn between “traditional memorials,” i.e.,
physical structures built of stone, and “living” memorials, an ironic word
choice that erases “war” and “death” altogether. These living remembrances
include such things as memorial highways, street names, social programs,
and housing projects.6 Memorials have also been classified according to
whether they glorify, contest, or disavow an historical event or person.7
What I explore here, however, is whether war memorials stylise
death as heroic or as tragic. Tragic death is the more socially disturbing view
because it is death without a clear purpose or meaning. Its associative grief
comes from this understanding of death as disastrous—a life wasted or a loss
that was preventable. Those who die tragically are characterized as having
died too young, mistakenly, or without a justifiable cause. These dead (and
even those who survive the horror8) are victims, innocents or unfortunates,
but not heroes. In contrast, heroic death presumes the dead had both agency
and courage; the dead hero freely gives up life for a cause, and so dies for
others;9 a trop that is Christ-like. In this way, death itself is transcended
through participation in something of lasting worth.10 This depiction of death
as heroic is personally consoling, but also culturally meaningful as it
“displace(s) awareness of what is terrible” with a dis-remembering so
complete that it may at first seem impossible.11 To successfully depict heroic
death, then, memorial designs must choose from among competing war
memories those victorious images that reinforce the greatness and the
rightness of the war and, by implication, the associated deaths. Such
memorials trumpet military might rather than toll for the lives lost.
Susan M. Behuniak
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2.
The American and Soviet Memorials
To explore this theme, this paper focuses on two parallel efforts to
memorialise those who served during World War II (called the Great
Patriotic War in Russia): the World War II Memorial in Washington, D.C.
and the Monument to the Heroic Defenders of Leningrad, (now, St.
Petersburg, Russia). These two memorials, one originating within democracy
and the other within communism, demonstrate Harvey Weinstein’s point that
“memorials represent a complex nexus between politics, trauma, collective
memory, and public art.”12 Despite their significantly different wartime
experiences and politics, both the US and USSR built triumphant renderings
of the war—memorials that celebrate heroic death while denying tragic death.
To do so, these physical narratives drew on three elements: the timing of
construction, the geographic location, and the mnemonic features of the
designs that incorporated some wartime memories while “forgetting” others.
A. Timing
Although the Great War ended in 1945 it was not until thirty years
later that the Leningrad Monument was completed. The delay can be
attributed to at least two things: the all-consuming effort to rebuild the USSR,
and Stalin’s concerted effort to curtail further discussions about the war, (e.g.,
by demoting Victory Day from a national holiday to a working holiday in
1947.)13 Eventually, a tidal shift came from a mix of changing politics that
distanced and re-examined the Stalinist regime, and the approaching 30th
anniversary of Victory Day. As a result, the “cult of World War II” was
born.14
The period between war and memorial was even longer in the US.
Built in 2004, the memorial followed not only the Korean and Vietnam Wars
but also the building of their memorials; the Vietnam Veterans Memorial
(VVM) in 1982 and the Korean War Memorial in 1995. The delay in
commemorating WWII can be explained both by a post-war preference in
favour of “living” monuments (e.g., memorial highways, arenas, and
scholarships) over traditional stone monuments,15 and by a public questioning
of war in reaction to the Korean and Vietnam conflicts, neither viewed as
triumphant nor heroic. In fact, between 1970 and 1998, WWII “virtually
disappeared in US popular culture.”16 But as in the USSR, a cult of WWII
eventually did arise in the US, this time heralded by the 50th anniversary of
D-Day in 1995 and reflected by pop culture events such as Stephen
Spielberg’s film Saving Private Ryan, Tom Brokaw’s book The Greatest
Generation, and the HBO series Band of Brothers. The urgency for building
the memorial only increased with the growing awareness that the WWII
generation was dying off.17
If, as the geographer Yi-Fu Tuan reminds, “[t]he cult of the past
calls for illusion rather than authenticity,”18 in arising from the cult of the
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“Great” war, the timing was right for American and Soviet memorials that
would reflect heroic death.
B. Geography
Where, then, to place these memorials? It was only natural that
Leningrad, the city that withstood a 900-day siege, would memorialise its
own, but the specific location of the memorial was viewed from the start as a
critical decision because it would determine whose experience would be set
into stone.19 To build the memorial on the battlefront would pay homage to
the soldiers; locating it within the historic district of the city would honour
the civilians. The final decision was to build on the southern extreme of
Moskovskii Prospekt, at a site dubbed Victory Square; an ellipse of land at
the centre of a traffic circle that had been a part of a line of defence that
ringed the city (i.e., where front and city met,) and where a Triumphal Arch
had been temporarily erected in 1945 to greet the returning troops.20
Choosing a location for the WWII memorial in Washington was
perhaps an even more contentious issue since one of the proposed sites was
that of the “sacred” space of the National Mall; a two-mile promenade
spanning from the Lincoln Memorial to the Washington Monument to the
U.S. Capitol. To situate the memorial on the Mall was understood by both
proponents and opponents as establishing a “specific vision of the war and its
meaning in American history.”21 A public service advertisement featuring
Tom Hanks, the star of Saving Private Ryan, fused fiction, myth, facts, and
politics in the campaign to promote this site by quoting from the actor: “It’s
the right time. It’s the right place. Please help build [the memorial] here on
the Mall…”22 Eventually, the advocates for this prime location won. The
announcement stone to the monument left no doubt as to the symbolic
meaning of its chosen location: “Here in the presence of Washington and
Lincoln, one the eighteenth-century father and the other the nineteenthcentury preserver of our nation, we honour those twentieth century
Americans who took up the struggle during the Second World War and made
the sacrifices to perpetuate the gift our forefathers entrusted to us: a nation
conceived in liberty and justice.”23 Situating the WWII monument between
these icons, then, deliberately constructed this “victorious” war, rather than
the more problematic Vietnam or Korean conflicts, as the most significant
event of the 20th century.24
Therefore, merely the choice of location foreshadowed the symbolic
meanings of the memorials yet to be built. Both the US and USSR memorials
were strategically located for the telling of a heroic narrative: the Leningrad
monument positioned at the site where civilians and soldiers met to
successfully defend their city from invasion, and the American WWII
memorial situated between the Washington Monument, the symbol of
democracy, and the Lincoln Memorial, the symbol of unity. Given this, it
Susan M. Behuniak
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would no longer seem possible to construct these tributes to the war in tragic
terms—indeed the ground had literally been laid to erect structures that
affirmed a national identity built on military superiority.
C. Mnemonic Architecture and Forgetfulness
Shanken summarizes the challenge of designing the US memorial in
this way: “How would America commemorate a war that included genocide,
mass killings, and nuclear death”?25 The construction of the heroic narrative
of WWII was also threatened by other problematic memories: the
government’s failure to foresee the attack on Pearl Harbour, the internment of
Japanese-American citizens, the military’s discriminatory policies based on
race and gender, and the country’s original resistance to entering the war. A
similarly daunting challenge also confronted the choice of a heroic Soviet
design: how to deal with Stalin’s pact with Hitler, the lack of preparedness
for Germany’s Operation Barbarossa, the Kremlin’s policy that accepted the
starvation of Leningraders over surrender, and the cannibalism and crime that
occurred in Leningrad during the siege.26 In order that the memorials are
constructed according to national narratives of heroic death in victorious
war,27 memories such as these had to be omitted by both the American and
Soviet designs.
The use of numbers serves as a revealing example of what was to be
remembered versus forgotten. The U.S. memorial, designed by Friedrich St.
Florian includes a Freedom Wall containing 4,000 gold stars that pays
homage to the 400,000 dead American troops with the inscription: “HERE
WE MARK THE PRICE OF FREEDOM.” The memorial is silent, however,
concerning the millions of dead among allied troops and civilians of all the
involved nations—failing even to note those who died in the Holocaust,
Hiroshima, and Nagasaki. In contrast, the numbers cited in the Soviet design
are not employed to count the fallen but instead to mark the duration of the
siege: 900 days, 900 nights. In emphasizing the longevity of the siege the
focus of the memorial is on the heroism of Leningraders rather than on the
tragic deaths of an estimated one million of them. Indeed, the Soviet
monument names Leningraders as the “heroic defenders” of the city28 and not
as the victims of the war or of government policy.29 This shift in terminology
has been viewed as symbolically important; it is embraced by some scholars
as acknowledgment of the sacrifices made by the mostly female population,30
while rejected by others as romanticizing the wretched struggle of children,
women, and the elderly to survive in the midst of unspeakable conditions
caused by political decisions.31
Both memorials adopt typical heroic elements on a grand scale. The
American memorial spans 7.4 acres and incorporates the pre-existing
Rainbow Pool. Its classical design includes: two 43-foot triumphal arches that
honour the Pacific and Atlantic fronts; bronze eagles and wreaths; and a
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circular plaza with walls engraved with battle names and inspirational
quotations. Emphasizing unity on the home front, there is a ring of fifty-six
17-foot-high pillars representing the states, territories, and District of
Columbia, and a tiered ceremonial entrance lined by twenty-four bas-relief
sculptures depicting scenes of America at war.
That this triumphant monument was erected following the
construction of the austere Vietnam Veterans Memorial (VVM) speaks to the
deliberate message of the design. Whereas the competition rules for
designing the VVM required that the design make no statement about the
war,32 the WWII memorial was erected with a clear message of military
victory. This triumphant narrative has been both lauded as “simple, solemn
and dignified,”33 and disparaged as an “excessively busy design.”34 One critic
charged that the memorial embodied the architecture of the Third Reich and
faulted it as “gigantic and grandiose, bombastic and authoritarian, faceless
and monolithic.” 35 To this others added the observations: “imperial and
triumphant,”36 “Federalist Stalinist,”37 a “tasteless monstrosity,”38 and “a
shrine to not knowing or, more precisely, of forgetting.”39 Its proponents
argued that the “elegiac memorial”40 emphasizes national unity, undaunted
courage, and the effort “to liberate a world fast falling to forces of tyranny.”41
The Monument to the Heroic Defenders of Leningrad designed by
Valentin Kamensky and Sergei Speransky is equally as busy and triumphal a
memorial. There is a 48-meter obelisk, a classical design element that
connotes “imperial trophy,”42 that bears the dates of Soviet involvement in
the war, 1941 to 1945. At its base stand larger than life sculptures of a male
soldier and a male worker, unabashedly titled “The Victors.” Six sculptural
groups by Mikhail Anikushin, a witness to the siege, line the sides of the
staircase, giving human faces to the “defenders” of Leningrad: soldiers,
sailors, pilots, snipe-shooters, a female medic, foundry workers, a mother
saying farewell to her son, and civilians with shovels poised to dig trenches.
Following a stairway downward through a ring of granite, the lower level
contains the sculpture, “The Blockade,” that features the women of
Leningrad: one woman whose breasts can be seen beneath a thin fabric stands
holding a sagging child in her arms, another kneeling and cradling a younger
woman, and a third limp and shrouded being supported by a male soldier. It
is here that visitors leave red and white carnations. This sculpture documents
the suffering that is noticeably absent from its American counterpart. (It is
therefore ironic that the American structure is labelled a “memorial” although
it clearly elevates the celebration of militarism over mourning, while the
Soviet structure is termed a “monument,” a label indicative of victory
remembered.) Yet, as Kirchenbaum notes of “The Blockade” sculpture, with
the exception of the shrouded woman, this depiction of the women of
Leningrad sanitizes starvation and suffering: their faces are stoic, they are
unbowed, and their bodies are ample, even voluptuous.43
Susan M. Behuniak
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Although there is an information booth near the American
memorial, there is no museum attached to the site. In contrast, the Leningrad
monument includes a subterranean museum that contains: artefacts from the
siege; an electronic map of the front; a documentary film; two enormous
mosaics, one depicting the start of the War and the other Victory; and 900
electric candles. The mosaics and candles are religiously laden symbols in
that they co-opt the icons of the Russian church and recall the candles typical
of the “red corners” (i.e., religious display corners) in many Russian homes.
During the debate over what the design of this Soviet monument
should say, polarizing urges emerged—that victory be celebrated or that
tragedy be documented.44 During the public discussion of the proposed
designs, one architect suggested, “[t]he need for a site specific narrative that
did not try to redeem trauma with overblown images of victory.”45 The
resulting design, instead, wedded heroism to military victory, a decision
chastised by historian Nina Tumarkin as a “massive effort to obliterate
collective memory of the most horrific war in the history of humankind.”46
Although both the American and Soviet WWII experiences are
complex stories of defeat and victory, death and survival, and complicity and
courage, the memorials erected to these experiences embellish their heroic
elements. In this elevation of myth over memory, the two memorials illustrate
how catastrophic events can be suppressed so they might be canonized into
victories.
3.
Discussion and Conclusion
The connection between heroic death and successful warfare may
seem inevitable, but I want to argue that they are not. Instead, the linkage
between the two is one that is deliberately constructed to advance a particular
political agenda.
For example, the U.S. experience in WWI could also have been told
using a heroic and victorious narrative, but the commemorative memorials
told a different story. Rather than triumph, these memorials struck the theme
of healing and of lessons learned. WWI was memorialised as “the war to end
all wars” and as a promise of “never again.”47 The cultural discomfort with
the notion of celebrating the victory explains the popularity of useful, living
memorials over the building of symbols in stone48.
And although “[i]mperial countries do not usually erect monuments
that memorialise their guilt,”49 there are counterexamples of this as well. The
VVM50 in the U.S. and the Solovki Stone51 (a gulag memorial) in Russia
were built with the therapeutic objective of healing and so neither serves as a
“tool of state power.”52 Both these memorials illustrate how the tragic view
of death rejects a singular and coherent narrative of war, instead recognizing
that great loss implicitly asks us to weigh whether the cost in human life was
worthwhile.53 Whereas heroic death uses epic terms, clichés, and partial
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Heroic Death and Selective Memory
______________________________________________________________
stories to fix a narrative to which contrary facts and memories must conform,
tragic death employs a richer and multifaceted view of warfare that
encourages public mourning and reflection. These memorials show a
reverence for life and for death by inviting citizens to question the meanings
of the killings and/or the war, and how, then, to heal in order to move
forward.54
For example, Maya Lin, whose VVM design lists each name of the
war dead on a V-shaped wall of black granite, said that her work was
influenced by a sharp awareness of death as loss.55 Interestingly, this openended design that invited such reflection proved too disturbing to some, and
so additions were later added to the site that were more in line with heroic
symbolism: a flagpole and realistic sculpture of three male soldiers in 1984;
and in response to this gendered image of the war dead,56 a sculpture of
women nurses in 1993.
Whereas tragic death accommodates complicated and even
contradictory memories, heroic death depends on selective memory. Barbara
Biesecker states that consciousness is reorganized “not by way of explicit
propaganda, but by replacing and simplifying memories people actually have
with image traces of political experience about which people can have
political feelings that link them to other citizens and to patriotism.”57 The
heroic narrative is well suited to this task since the hero’s world is a onedimensional pairing of polar opposites: us versus them; victory versus defeat;
good versus evil.58 The hero, then, emerges as an uncomplicated and
“untainted” figure.59 This rendering even makes death denial possible since
heroes do not die;60 a sentiment encoded in eternal flames, granite structures,
and larger-than-life statues.
Because war memorials are indeed “self conscious attempts to
solicit public participation in the politics of the day,”61 the choice of whether
to depict death as tragic or as heroic not only determines interpretations of
past wars but also instructs present day politics on both the national and
individual levels. Again, memorials that embrace the tragedy of death not
only encourage healing but also a weighing of the price of victory. In this
rendering, neither national identity nor individual notions of citizenship are
dependent on militarism alone for meaning. In contrast, the heroic renderings
of war deaths discourage a questioning of war and instead pose an explicit
threat of future warfare by showcasing military superiority.
Both the American and Soviet WWII memorials illustrate this point.
In that each nation claimed for itself the pivotal role of having saved the
world from fascism,62 each memorial links heroic death to military success
by cultivating the belief that the greatness of a generation, a city, or a country
is due to victory in war. Such a message sanctions future warfare and
constructs citizenship as a duty to fight to the death in the next patriotic war,
or at minimum, to offer unified support at home. This distilling of wartime
Susan M. Behuniak
107
______________________________________________________________
deaths into the archetype of heroic death not only shapes an account about the
past, but sets expectations about the present and the future.
Notes
1
C A Corr, C M Nabe, and D M Corr, Death & Dying, Life & Living,
Wadsworth, Belmont, CA, 2009, p. 79.
2
C L Griswold and S Griswold, ‘The Vietnam Veterans Memorial and the
Washington Mall: Philosophical Thoughts on Political Iconography’. Critical
Inquiry, vol. 12, Summer 1986, p. 689.
3 K Verdery as quoted in B Forest and J Johnson, ‘Unravelling the Threads
of History: Soviet Era Monuments and Post-Soviet National Identity in
Moscow’. Annals of the Association of American Geographers, vol. 92,
September 2002, p. 526.
4
E Reimers, ‘Public Memorials as Communicative Tools to Construct,
Deconstruct, and Negotiate History and the Present’. Paper presented at the
Death, Dying and Disposal 8th Conference, Bath, UK, 2007, p. 1.
5
M Sturken, ‘The Wall, the Screen, and the Image: The Vietnam Veterans
Memorial”. Representations, vol. 35, Summer 1991, p. 120.
6
A M Shanken, ‘Planning Memory: Living Memorials in the United States
during World War II’. The Art Bulletin, vol. 84, March 2002.
7
Forest and Johnson, op. cit.
8
See T Des Pres, The Survivor: An Anatomy of Life in the Death Camps,
Oxford University Press, NY, 1976, p. 4; T Todorov, Facing the Extreme:
Moral Life in the Concentration Camps, A Denner and A Pollack (transl),
Henry Holt and Company, NY 1996, p. 10.
9
Todorov, op. cit.
10
E Becker, The Denial of Death, Free Press, NY, 1973, 1997.
11
Des Pres, op. cit., p.5.
12
Quoted in J Barsalou and V Baxter, ‘The Urge to Remember: The Role of
Memorials in Social Reconstruction and Transitional Justice’. Stabilization
and Reconstruction Series No. 5, United States Institute of Peace,
Washington, DC, January 2007, p. 4.
13
N Tumarkin, The Living & The Dead: The Rise and Fall of the Cult of
World War II in Russia, Basic Books, NY, 1994, p. 104.
14
Tumarkin, op. cit.
15
Shanken, op. cit., p. 130.
16
B A Biesecker, ‘Remembering World War II: The Rhetoric and Politics of
National Commemoration at the Turn of the 21st Century’. Quarterly Journal
of Speech, vol. 88, November 2002, pp. 405.
17
L Benton-Short, ‘Politics, Public Space, and Memorials: The Brawl on the
Mall’. Urban Geography, vol. 27, 2006, p. 305.
108
Heroic Death and Selective Memory
______________________________________________________________
18
Y F Tuan, Space and Place: The Perspective of Experience, University of
Minnesota Press, Minneapolis, 1977, p. 194.
19
L A Kirschenbaum, The Legacy of the Siege of Leningrad, 1941-1995,
Cambridge University Press, NY, 2006, p. 211.
20
The State Museum of the History of St. Petersburg, ‘Monument to the
Heroic Defenders of Leningrad’ Brochure, Leetsey Publishing House, St.
Petersburg, 1999.
21
Benton-Short, op. cit., p. 297.
22
Mills, op. cit.
23
Mills, op. cit., p. 209.
24
Benton-Short, op. cit, p. 323; see also Mills, op. cit., p. 217.
25
Shanken, op. cit., p. 134.
26
Forest and Johnson, op. cit , p. 432; Shanken, op. cit., p. 145.
27
Kirschenbaum, op. cit., p. 283.
28
see C Simmons and N Perlina, Writing the Siege of Leningrad: Women’s
Diaries, Memoirs, and Documentary Prose, University of Pittsburgh Press,
Pittsburgh, PA, 2002.
29
see Tumarkin, op cit.
30
See Simmons and Perlina, op. cit.
31
See Tumarkin, op. cit.
32
Griswold and Griswold, op. cit., at footnote 21, p. 718.
33
M Fisher, ‘A Memorial, Yes, But What About Its Message?’ The
Washington Post, July 22, 2000, p. B-1.
34
ibid.
35
S Kalson, ‘World War II Memorial a Classic Example of Excess’.
Pittsburgh Post-Gazette, May 30, 2001, p. B-1.
36
Judy Scott Felderman as quoted by I Molotsky, ‘Panel Backs World War II
Memorial on Mall in Washington’. New York Times, July 21, 2000, p. 13.
37
P Greenberg, ‘Monumental Mistake’. Arkansas Democrat-Gazette, May
30, 2001, p. B8.
38
R Ebert, ‘Bad Idea, Bad Spot for WWII Memorial’. Chicago Sun-Times,
May 31, 2001, p. 41.
39
H Muschamp, ‘New War memorial Is Shrine to Sentiment’. The New York
Times, June 7, 2001, p. 1.
40
Mills, op. cit., p. 216.
41
National Park Service, U.S. Department of Interior, ‘World War II
Memorial’ Brochure. Washington, D.C., 2007.
42
Sturken, op. cit., p. 121.
43
Kirschenbaum, op. cit., p. 225.
44
ibid, p. 214.
45
ibid, pp. 214-15).
Susan M. Behuniak
109
______________________________________________________________
46
Tumarkin, op. cit., p. 51.
Sturken, op. cit., p. 122.
48
Shanken, op. cit., p. 130.
49
Etkind, op. cit., p. 40.
50
J C Scruggs and J L Swerdlow, To Heal a Nation: The Vietnam Veterans
Memorial, Harper & Row, New York, 1986; Wagner-Pacifici and Schwartz,
‘The Vietnam Veterans Memorial: Commemorating a Difficult Past’. The
American Journal of Sociology, v. 97, September 1991; Griswold and
Griswold, op. cit.
51
Etkind, op. cit., pp. 51-55; Forest and Johnson, op. cit., p. 541.
52
Wagner-Pacifici and Schwartz, p. 407.
53
Griswold and Griswold, op. cit., p. 711.
54
Scruggs and Swerdlow, op. cit.; Griswold and Griswold, op. cit., p. 712.
55
Griswold and Griswold, op. cit., at footnotes 17 and 21, p. 718.
56
Sturken, op. cit., p. 131.
57
Biesecker, op. cit., p. 397.
58
Todorov, op. cit., p. 12.
59
R Wagner-Pacifici and B Schwartz, op. cit., p. 379.
60
Tumarkin, op. cit., p. 128.
61
S Cooke, ‘Negotiating Memory and Identity: The Hyde Park Holocaust
Memorial, London’. Journal of Historical Geography, vol. 26, 2000, p. 450.
62
See the statements by the National Park Service, U.S. Department of
Interior, and The State Museum of the History of St. Petersburg.
47
Bibliography
Barsalou, J. and V. Baxter, ‘The Urge to Remember: The Role of Memorials
in Social Reconstruction and Transitional Justice’. Stabilization and
Reconstruction Series No. 5, United States Institute of Peace, Washington,
DC, January 2007.
Becker, E., The Denial of Death. Free Press, NY, 1973, 1997.
Benton-Short, L., ‘Politics, Public Space, and Memorials: The Brawl on the
Mall’. Urban Geography, vol. 27, 2006, pp. 297-329.
Biesecker, B. A., ‘Remembering World War II: The Rhetoric and Politics of
National Commemoration at the Turn of the 21st Century’. Quarterly Journal
of Speech, vol. 88, November 2002, pp. 393-409.
110
Heroic Death and Selective Memory
______________________________________________________________
Cooke, S., ‘Negotiating Memory and Identity: The Hyde Park Holocaust
Memorial, London’. Journal of Historical Geography, vol. 26, 2000, pp. 449465.
Corr, C. A., C. M. Nabe, and D. M. Corr, Death & Dying, Life & Living, 6th
ed., Wadsworth, Belmont, CA, 2009.
Des Pres, T., The Survivor: An Anatomy of Life in the Death Camps. Oxford
University Press, NY, 1976.
Ebert, R., ‘Bad Idea, Bad Spot for WWII Memorial’. Chicago Sun-Times,
May 31, 2001, p. 41.
Etkind, A., ‘Hard and Soft in Cultural Memory: Political Mourning in Russia
and Germany’. Grey Room, vol. 16, 2004, pp. 36-59.
Fisher, M., ‘A Memorial, Yes, But What About Its Message?’ The
Washington Post, July 22, 2000, p. B-1
Forest, B. and J. Johnson, ‘Unraveling the Threads of History: Soviet Era
Monuments and Post-Soviet National Identity in Moscow’. Annals of the
Association of American Geographers, vol. 92, September 2002, pp. 524547.
Greenberg, P., ‘Monumental Mistake’. Arkansas Democrat-Gazette, May 30,
2001, p. B8.
Griswold, C.L. and S. Giswold, ‘The Vietnam Veterans Memorial and the
Washington Mall: Philosophical Thoughts on Political Iconography’. Critical
Inquiry, vol. 12, Summer 1986, pp. 688-719.
Kalson, S., ‘World War II Memorial a Classic Example of Excess’.
Pittsburgh Post-Gazette, May 30, 2001, p. B-1
Kirschenbaum, L.A., The Legacy of the Siege of Leningrad, 1941-1995.
Cambridge University Press, NY, 2006.
Mills, N., Their Last Battle: The Fight for the National World War II
Memorial. Basic Books, NY, 2004.
Susan M. Behuniak
111
______________________________________________________________
Molotsky, I., ‘Panel Backs World War II Memorial on Mall in Washington’.
New York Times, July 21, 2000, p. 13
Muschamp, H., ‘New War Memorial is Shrine to Sentiment’. The New York
Times, June 7, 2001, p. 1
National Park Service, U.S. Department of Interior, ‘World War II Memorial’
Brochure. Washington, D.C., 2007.
Reimers, E., ‘Public Memorials as Communicative Tools to Construct,
Deconstruct, and Negotiate History and the Present’. Paper presented at the
Death, Dying and Disposal 8th Conference, Bath, UK, 2007.
Scruggs, J. C. and J. L. Swerdlow, To Heal a Nation: The Vietnam Veterans
Memorial. Harper & Row, NY, 1986.
Shanken, A. M., ‘Planning Memory: Living Memorials in the United States
during World War II,’ The Art Bulletin, vol. 84, March 2002, pp. 130-147.
Simmons, C. and N. Perlina, Writing the Siege of Leningrad: Women’s
Diaries, Memoirs, and Documentary Prose. University of Pittsburgh Press,
Pittsburgh, PA, 2002.
The State Museum of the History of St. Petersburg, ‘Monument to the Heroic
Defenders of Leningrad’ Brochure. Leetsey Publishing House, St. Petersburg,
1999.
Sturken, M., “The Wall, the Screen, and the Image: The Vietnam Veterans
Memorial’. Representations, vol. 35, Summer 1991, pp. 118-142.
Todorov, T., Facing the Extreme: Moral Life in the Concentration Camps. A.
Denner and A. Pollack (transl), Henry Holt and Company, NY, 1996.
Tuan, Y-F., Space and Place: The Perspective of Experience. University of
Minnesota Press, Minneapolis, 1977.
Tumarkin, N., The Living & The Dead: The Rise and Fall of the Cult of
World War II in Russia. Basic Books, NY, 1994.
112
Heroic Death and Selective Memory
______________________________________________________________
Wagner-Pacifici, R. and B. Schwartz, ‘The Vietnam Veterans Memorial:
Commemorating a Difficult Past’. The American Journal of Sociology, vol.
97, September 1991, pp. 376-420.
Susan M. Behuniak is Professor of Political Science at Le Moyne College in
Syracuse, NY, where she teaches constitutional law. Her publications include
works on abortion, physician-assisted suicide, and elder rights.
Rethinking and Recognizing Genocide: The British and the
Case of the Great Irish Potato Famine
Neysa King
Abstract
Today, Irish and British historians categorically reject the notion that British
actions during the Great Irish Potato Famine (1845-1849) amounted to
genocide. While the British Government may have been unresponsive to Irish
suffering, they assert, its non-action was not a deliberate attempt to
exterminate the Irish people. This essay, however, utilizing new research in
genocide theory and a correspondingly complicated definition of genocide,
argues that the relief efforts undertaken in Ireland by the Russell
Administration from the winter of 1846 to 1849 did constitute genocide
against the Irish people.
To date, historians have paid little attention to the objectives, both stated and
implicit, of British Famine relief efforts. Much of the analysis contends that
Famine relief was a compromise between the Whig Party’s adherence to
laissez faire governance and Lord Russell’s basic human empathy. However,
if British relief is viewed in the context of Britain’s concern with the “Irish
Question,” it becomes clear that relief efforts were not designed to relieve
Irish suffering as much as to permanently reform the Irish economy. As a
result, Irish Famine mortality gradually became the avenue through which the
British pursued and attained this objective. By 1849, the forcible
displacement of poor Irish cottiers, under the guise of relief legislation,
became the major channel through which the Irish economy was remade.
Thus, the British Government deliberately facilitated Irish deaths during the
Great Famine, and therefore committed genocide against the Irish people.
This analysis of the Irish Potato Famine may serve as a case study for a new
method of analysing genocides in history as an unfolding process, rather than
a discrete and mechanical occurrence. It should be kept in mind that a
designation of genocide from the historian should not serve as a political
condemnation, but as an analysis of a recurring human phenomenon.
Key Words: Genocide, Ireland, England, potato famine.
*****
Today, the “Irish Question” is most commonly associated with Irish
nationalism, independence movements, and the IRA. However, over a
century ago, British officials and intellectuals were discussing a different
“Irish Question,” which concerned Irish economic and social regeneration.
This question was not, “who will rule Ireland?” but “What is to be done with
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Rethinking and Recognizing Genocide
______________________________________________________________
Ireland? What can be done with it?”1 A common 19th-century opinion was to
introduce capital into Ireland’s agrarian economy while restructuring
Ireland’s system of land ownership. When the potato crop failed in 1846 and
the British Government undertook relief efforts for the starving poor, Lord
Russell and his cabinet saw an opportunity in Ireland’s weakness. By using
Famine relief legislation to transform subsistence into markets and small
farming into waged labour, Russell could enact the kind of permanent change
in Ireland the British had desired for years. This article will argue that the
Russell Government attempted to marketise Ireland’s economy in the midst
of The Great Famine, and used Irish deaths as a conduit. In light of this fact, I
argue that much of Lord Russell’s legislation during the Famine can and
should be considered genocidal.
Genocide scholarship is a relatively young field. Blooming out of
renewed interest in the Holocaust in the 1980s, scholars only took a serious
interest in genocide as a broad category beginning in the 1990s. However, the
growth of a body of genocide scholarship has been severely stunted by the
glaring absences of a standard definition and a conceptual framework. Over
the last decade, legal scholars and UN Tribunals have tried several
individuals for genocide in international courts. Their work is admirable;
however, their discussions of genocide have seeped into other fields of
scholarship, especially history. This has led to an overemphasis on legal
concepts, rather than historical precedents. In particular, the concept of
intentionality has become a mainstay of genocide designations. In 1996, the
International Criminal Tribunal for the Former Yugoslavia (ICTY) stated, “a
general intent to commit one of the enumerated acts [in the Convention]
combined with a general awareness of the probable consequences of such an
act is not sufficient for the crime of genocide…[Genocide] requires a
particular state of mind.”2 This legal focus on intent has motivated historians
such as Guenter Lewy to take it up in their own definitions of genocide as
well. Genocidal intent as the ICTY defined it, however, is a tool for
prosecution, not historical inquiry. This miscommunication between lawyers
and historians has caused confusion in definitions of genocide. So much
confusion, in fact, that some have suggested throwing the term genocide out
completely. For example, Christian Gerlach states that genocide has become
an:
outdated mechanistic model based on long-term
planning…If there is one element agreed upon for the
definition of genocide, it is a long-term murderous “intent,”
which precisely contradicts the origins of a violence
emerging in complex ways through a dynamic process.3
Neysa King
115
______________________________________________________________
Yet there may be a way to coalesce the legal and historical worlds of
genocide research, and it might begin with understanding instances of this
phenomenon outside the current international legal apparatus.
When discussing definitions, viability to some extent has to hinge
on the definition’s applicability to historical events. If a definition of
genocide cannot be utilized as a tool for pinpointing and understanding past
genocides, then what is its use? In his article, “Conceptual Constraints on
Thinking about Genocide,” David Moshman reminds us that “definitions are
social conventions, not empirical truths about the world. Events are not
inherently genocidal or not genocidal. It is up to us to determine what we
mean by genocide.”4 What, then, should we look for in assigning labels of
genocide to events in the past? First, intentionality should not be thrown out
completely. However, intentionality does not necessarily mean a brazen and
barefaced campaign of extermination. Genocide can be a mere link in a larger
chain. When researching genocide in the past, it is not merely stated goals of
extermination for its own purpose that should be examined, but policies that
quietly condone the extermination of a group as a means to an end. In the
case of the Irish Famine, this end was Ireland’s economic reformation.
In the seventeenth and eighteenth centuries, the British saw the Irish
as a semi-barbaric, indolent race, living in a backwards society. However,
Ireland’s proximity to and historical relationship with Britain also bred a
certain paternalism. After the Act of Union passed in 1801, and Ireland
officially became a part of the United Kingdom, reforming Ireland’s agrarian
economy became a pressing debate in London. In the 1840s, this debate
zeroed in on issues of Irish landownership, poverty, and tenant-landlord
relations. In 1843, Tory Prime Minister Robert Peel appointed the Devon
Commission to investigate the system of land ownership in Ireland and make
suggestions for its reform. The five-volume report discusses Irish landholding
issues of tenure, consolidations, ejectments, emigration, wasteland
reclamation, and public works. Through meticulous legislation and
cooperation from the Irish people, the report stated, Britain may remove
“many or most of those partial and particular obstacles, which have hitherto
so greatly impeded the beneficial employment of labour…We are,” it
continues, “satisfied that a very beneficial change may be effected.”5 This
project to reform the Irish economy would become a primary influence on the
creation of Government relief policies during the Famine years.
John Russell became Prime Minister in June 1846. Only a month
after Russell’s premiership began, reports surfaced that a potato blight had
struck. Seventy-five percent of the crop withered, and accounts of starvation
were already surfacing from the last year’s insufficient harvest. Come winter,
Ireland would be in a state of crisis. The next month, in August, Russell
outlined his plan for Ireland in Parliament. He proclaimed:
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Rethinking and Recognizing Genocide
______________________________________________________________
We are now disposed to take advantage of the unfortunate
spread of this disease among the potatoes to establish
public works…which may be of permanent utility.6
Through the remainder of the Famine years, John Russell and his
Whig Party would enact a series of intensifying legislation designed to
reform Ireland through industry and capital. By implementing these policies
in the midst of the Famine, Russell, his Administration, and several British
intellectual circles, deliberately exploited and even accelerated the starvation
of Irish labourers.
Russell’s intention for Public Works to serve as capitalist reform
rather than starvation relief is revealed in its emphasis on task-work, that is,
payment by performance, rather than time. In a letter to Charles Trevelyan,
Colonel Jones, the Head of the Public Works project, stated:
[T]he sum to be paid for each portion of work, should be
sufficient to enable an ordinary labourer to earn from 10d.
to 1s. per day, and a good labourer, who exerted himself,
from 1s. 4d. to 1s. 6d. per day.7
Thus, in a time when workers were weakened by malnutrition,
physical exertion determined the wages they earned. In addition, if
extraneous factors such as inclement weather impeded work, the workers’
pay was deducted. In a letter to Works Commissioners, Trevelyan
recommended that on days of poor weather, half a day’s wages should be
paid to those who turn up. If the weather clears, the workers who return may
work and earn the other half.8 A normal day’s wages, around 10d, was a
starvation wage for most, and Trevelyan was aware that that many workers
had to walk several miles to and from the Works site. However, Public
Works was to run as a training ground for waged labour, rather than an aid
program. If the workers protested about wages or the nature of the work, the
program was shut down. Although there is no official report which explicitly
encourages compromising human life for the sake of economic reform, the
officially-mandated procedure of the Public Works program valued providing
relief, in the form of wages, less than extracting Irish labour. Soon, the
Russell Government would begin willingly exchanging human life for
industrial reform.
By the spring of 1847, over 700,000 people (mostly men) were
employed in the Public Works. With their extended families, this meant the
Works was supporting over 3 million people. The system, overloaded, had
devolved into chaos. On March 8, 1847, Russell stated his intentions in the
House of Lords to extend the 1838 Poor Law to Ireland, thus forcing Irish
Neysa King
117
______________________________________________________________
taxes to pay for Famine relief. Again, this action was premised as a strategy
to encourage industry and waged work. Russell stated:
I believe that in laying this burden of maintaining their own
poor on the landowners on the one hand…and on the other
giving them the means of improving the cultivation of the
soil, will cause them more readily to embrace every means
of giving greater employment to labour than otherwise.9
The Bill passed, and the Russell Administration moved to shut down
the Public Works almost immediately.
Russell’s extension of the Poor Law included three important
measures, workhouse operation, the Gregory Clause, and poor rate collection.
First, the workhouse infrastructure was in place and active prior to the
Famine. Sir George Nicholls had engineered the extension of the workhouse
welfare scheme from England to Ireland in 1838. The purpose of the
workhouse was to serve as a place of work for the able-bodied but
unemployed. However, these workers were to be supported “under such
restrictions as not to induce them to prefer it to a life of independent
labour.”10 In other words, life in the workhouse was designed to be cramped,
uncomfortable, and meager. This scheme operated under the assumption that
it was “possible to obtain a mastery over pauperism by requiring the
performance of hard and repulsive labour in return for relief.”11 In other
words, the workhouse’s poor conditions were designed as a check on the
numbers receiving government relief. Its ultimate purpose was to eventually
abolish mendicancy and encourage industry.12 It was to this, then, that
Russell assigned the Famine victims in 1847. In effect, he transferred three
million people suffering from starvation to a workhouse network designed to
accommodate roughly 100,000. Russell’s officially stated intention was to
use this system to evoke Irish industry. It was utilized specifically to serve as
a structural limitation to relief in a time of widespread need. For the sake of
Irish industrial development, then, Russell deliberately targeted part of the
Irish population for destruction, making this piece of legislation genocidal.
Second, the Gregory Clause attached to the Bill, named for MP
William Gregory who suggested it, excluded anyone who owned over a
quarter-acre of land from government relief. Therefore, those who applied for
a place in the workhouse and had over a quarter-acre of land, which was
most, were forced to give it up in order to receive aid. With the Gregory
Clause, the British Government intended to initiate the consolidation of these
small plots into larger farms, a primary aim since before the first blight. As
James Donnelly notes, the Clause’s “enormous potential as an estate-clearing
device was widely recognized in Parliament,” and it passed by a vote of 119
to 9.13 The gravity of this situation for Ireland’s small cottiers cannot be
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overstated. In normal years, that small plot of land was their only means of
subsistence. To give it up would mean certain death in the future, even if they
survived the workhouse. Many refused and starved with their families in an
attempt to hold onto their land through the Great Famine. Russell’s
Government was well aware of the cottiers’ dependency on their small plots,
as evidenced from the numerous reports, articles and Parliament discussions
on the topic.14 The ramifications of the Gregory Clause on these small
cottiers, then, were clear. This piece of legislation was designed to facilitate
the removal of small cottiers from their only means of subsistence. The death
of Irish cottiers became the channel through which farms could be
consolidated, and Ireland could be reformed. The Poor Law Extension Act
deliberately eliminated the part of Ireland’s population considered the largest
impediment to Ireland’s economic development.
In addition to the Government forcing small cottiers to abandon
their lands, the Poor Law Extension Act facilitated additional evictions
through the continued collection of poor rates. The Act, in effect, forced
landlords to forego their tenants’ rent, who clearly had nothing to spare, but
continue to pay a land tax from their own pocket. This led to widespread
evictions of tenants, escalating each year from 1847 to the early 1850s. In
1848 and 1849, the British Government took advantage of the landlords’
initiative, and enacted legislation that would assist landlords who had evicted
their tenants in selling their newly consolidated land. In these years, the
Encumbered Estates Act encouraged a tremendous amount of small cottier
evictions. In Parliament, the legislation was well received. In a memorandum
to his cabinet in March of 1848, Lord Palmerston, the Secretary of State for
Foreign Affairs, issued the statement that:
[I]t was useless to disguise the truth that any great
improvement in the social system of Ireland…necessarily
implies a long continued and systematic ejectment of
squatting cottiers.15
Eviction rates continued to increase. In 1849, 16,686 families were
evicted. The next year, the number rose to nearly 20,000.16 These Acts, then,
served as a final answer to the “Irish Question.” By encouraging landlords to
evict their tenants during the harshest years of the Famine, the British
Government had finally found the means to transform Ireland into a
capitalist, industrial nation. Although the forced removal and death of Irish
labourers were never explicitly advocated in Russell’s Government, with
these severe and precise pieces of legislation Russell and his Administration
were consciously trading Irish lives for Irish reform.
In the years after the Famine, Ireland’s cottier class had all but
disappeared. Nearly one-eighth of the population, or one million men,
Neysa King
119
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women, and children, had been wiped out. Roughly another one million had
emigrated. Back in London, British officials spoke of the successful
improvements Ireland had gained over the last four years. Several articles in
the Times expressed the same sentiment. One article read:
It seems not an unfair conclusion…that if Irishmen are true
to themselves, the country at large will not only recover,
but derive benefit from her present trouble, although at the
cost of much individual suffering.17
For the British Government and the British press, the greater good
had required individual sacrifices. After 1850, the British Government was
free to move on to an entirely different “Irish Question,” having found their
answer in the destruction of the Irish small cottier.
This paper has attempted to demonstrate that genocide can be
substantially more insidious, subtle, and routine than commonly thought. It is
often an escalating and collaborative process, rather than a discrete top-down
directive, and often holds a peripheral relation to intentionality. Committing
genocide as this paper has defined it does not require a malicious character or
an evil spirit. In other words, it does not take a Hitler or a Milosevic to
commit genocide. Rather, genocide can result from a logical and widelyaccepted rationale that gradually heightens the importance of an issue, be it
economic ideology, moral conviction, or fear of an enemy, above the value of
human life.
Notes
1
The London Times, April 14, 1846.
Quoted in Guenter Lewy, ‘Can There Be Genocide without the Intent to
Commit Genocide’? Journal of Genocide Research, 9, 4, 2007, p. 663.
3
Christian Gerlach, ‘Extremely Violent Societies: An Alternative to the
Concept of Genocide’. Journal of Genocide Research, 8, 4, 2006, p. 465.
4
ibid., p. 444.
5
Report from Her Majesty’s Commissioners of Inquiry into the State of the
Law and Practice in Respect to the Occupation of Land in Ireland, Vol. 1,
Alexander Thom, Dublin, 1845, p. 43.
6
Hansard’s Parliamentary Debates, House of Commons, August 17, 1846.
7
Irish University Press Series of Parliamentary Papers. Famine, Irish
University Press, Shannon, Ireland, vol. 6, 1968-70, p. 172.
8
ibid., p. 121.
9
Hansard’s, House of Lords, March 8, 1847.
2
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Rethinking and Recognizing Genocide
______________________________________________________________
10
Sir George Nicholls, A History of the English Poor Law, Augustus M.
Kelley, New York, 1967, p. 238.
11
ibid., p. 291.
12
ibid., p. 197.
13
Donnelly, p. 102.
14
Including Report from her Majesty’s Commissioners, vol. 1, 23; Hansard’s,
Commons, March 15, 1847, Trevelyan , pp.1-7.
15
Qtd. in Donnelly, p. 115.
16
Kissane viii.
17
ibid.
Bibliography
Donnelly, Jr., J S., The Great Irish Potato Famine. Sutton Publishing,
Gloucestershire, United Kingdom, 2005.
The Economist. 1845-1849, Boston Public Library Archives.
Foley, T. and Ryder S., (eds), Ideology and Ireland in the Nineteenth
Century. Four Courts Press, Portland, Oregon, 1998.
Goldberg, D. T., Philosophers on Race: Critical Essays. Julie K. Ward and
Tommy L. Lott (eds), Blackwell Publishing, Oxford, 2002.
Gooch, G.P. (ed), The Later Correspondence of Lord John Russell, 18401878, vol. 1, Longmans, Green and Co., New York, 1925.
Gray, P., Famine, Land and Politics. Irish Academic Press, Portland, Oregon,
1999.
Guizot, M., The Memoirs of Sir Robert Peel, Questia, Richard Bentley,
London, 1857.
Hansard’s Parliamentary Debates, Middlebury University Microform.
Irish University Press Series of Parliamentary Papers. Famine. Irish
University Press, Shannon, Ireland, 1968-70.
Kiernan, B., Blood and Soil: A World History of Genocide and Extermination
from Sparta to Darfur. Yale University Press, New Haven, 2007.
Kinealy, C., The Great Irish Famine. Palgrave, New York, 2002.
Neysa King
121
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Kissane, N., The Irish Famine: A Documentary History. National Library of
Ireland, Dublin, 1995.
Lal, V., ‘Genocide, Barbaric Others, and the Violence of Categories: A
Response to Omer Bartov,’ The American Historical Review. Vol. 103, No.
4, October, 1998, pp. 1187-1190.
The London Times, Northeastern University Electronic Archives.
Timothy M., (ed), Questions of Modernity. University of Minnesota Press,
Minneapolis, 2000.
Nicholls, Sir G., A History of the English Poor Law. Augustus M. Kelley,
New York, 1967.
Ó Gráda, C., Black ’47 and Beyond: The Great Irish Famine in History,
Economy and Memory. Princeton University Press, Princeton, 1999.
Report from Her Majesty’s Commissioners of Inquiry into the State of the
Law and Practice in Respect to the Occupation of Land in Ireland, Vol. 1
Alexander Thom, Dublin, 1845.
Said, E., Orientalism. Random House, New York, 1994.
G. Shaw-Lefevre, Peel and O’Connell: A Review of the Irish Policy of
Parliament from the Act of Union to the Death of Sir Robert Peel. Kegan
Paul, Trench and Co., London, 1887.
Trevelyan, C., The Irish Crisis. Longman, Brown, Green and Longmans,
London, 1848.
Weitz, E., A Century of Genocide: Utopias of Race and Nation. Princeton
University Press, Princeton, 2003, p. 14.
Williams, L. A., Daniel O’Connell, The British Press, and the Irish Famine:
Killing Remarks. Ashgate, Burlington, 2003.
Woodham-Smith, C., The Great Hunger: Ireland 1845-1849. Penguin Books,
London, 1991.
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Rethinking and Recognizing Genocide
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Neysa King is a PhD student in World History at Northeastern University.
She is interested in German cultural history, particularly films in postwar
West Berlin.
Death in Self-Harmers’ Eyes
Namino Kunitoh
Abstract
For many years, self-harmers were considered suicidal. However, most
modern psychiatric and sociological works show that self-harm is not a
means to commit suicide; instead, is a way of relieving feelings and
controlling oneself. Self-harmers do not harm themselves in order to commit
suicide because they know that self-harm will not kill them. For self-harmers,
self-harm is merely a tool that solves everyday problems; thus, self-harm and
suicide are different from each other. This paper shows the relationship
between self-harm and death and how self-harmers perceive death.
Key Words: Self-harm, death, young people.
*****
1.
Introduction
The aim of this paper is to examine the relationship between selfharm and death. The definition of self-harm employed in this study is
behaviour, which is deliberate, non-fatal, and meant to harm oneself.
Although self-harming behaviour has been associated with suicidal attempts
for many years, recent works, including sociological ones, illustrate other
aspects of self-harm. This study examines the relationship between self-harm
and death by analysing the data compiled from ten interviews. The results of
the data demonstrate that self-harm and suicide or suicidal attempts are
different.
This study consisted of ten interviews: each with an individual who
had demonstrated self-harming behaviour in the past or continued to do so.
The subjects were aged between 17 and 26. The interviews were conducted in
a semi-structured format wherein 14 questions were posed. Five of the said
questions with responses have been selected for the purposes of this paper.
The five questions are as follows: (1) Please give concrete examples of selfharming behaviour. Of these examples, which have you actually
experienced? (2) Do you recall your first experience with self-harm? If so,
please describe the moment of occurrence, the cause(s) of the self-harming
behaviour, and any relevant condition(s) that may have provoked this
behaviour. (3) Do you have experience with cutting and drug overdose? If so,
do cutting and a drug overdose have a similar or a different meaning to you?
(4) (for ex-self-harmers) What made you believe you could cease to harm
yourself? (5) Do you believe self-harm is closely related to death? These five
questions aim to clarify the following points: (1) ways of self-harm, (2)
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Death in Self-harmers’ Eyes
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background of the start of self-harm, (3) whether overdose constitutes selfharm, (4) (for ex-self-harmers) reasons to stop the practice, and (5)
relationship between self-harm and death. For the purposes of clarification,
the definition of an ex-self-harmer is an individual who ceases self-harming
behaviour for a period that exceeds 18 months and believes it is possible to
halt the practice completely. This study employed the grounded theory
approach and the results of the analysis are as follows.
2.
Ways of Self-Harm
The different forms of self-harm, according to the responses of this
study’s participants, are categorized into two groups: the first excludes the
employment of tools; the second includes the employment of tools. Non-tool
methods include inflicting the following upon oneself: hurling the body
against a wall, hitting, pinching, scratching by nails, and pulling hairs. As for
tool methods, cutting is the most frequently employed method, with arms or
wrists as the primary locations for cutting although some participants
included the legs. Burning and pricking with needles are additional tool
methods. All participants had engaged in cutting and some participants
engaged in banging and hitting in addition to cutting.
Participants who employed non-tool methods said that they had
done so without the relative knowledge; therefore, these subjects proceeded
almost unconsciously. In contrast, all participants had accessed information
about the methods that include tools prior to attempting them. Amongst the
various sources of information accessed were the internet, books, and
television. Some of the participants acknowledged acquiring tool-aided
methods from friends who themselves practiced self-harm.
During the interview process, participants were asked to identify
self-harming behaviour. Of the ten participants, only one included a drug
overdose in their response. However, eight of the participants had
experienced an overdose. When these eight participants were asked whether
they regarded a drug overdose as a form of self-harming behaviour after they
had given their responses to the first question, six of the eight agreed that
they considered an overdose as self-harm, and one participant replied that an
overdose might be self-harm. One participant viewed an overdose as
somewhat different from self-harm. Her response was based on psychological
information that had been acquired and ingrained in her, which defined an
overdose as non self-harming behaviour.
It is interesting to note that a drug overdose was not included in
participants’ responses when they were asked to identify self-harming
behaviour although many admitted to it being so when asked specifically
whether an overdose constitutes self-harm. This response could be indicative
of a low level of or complete lack of consciousness on the part of an
individual with respect to the harmful nature of an overdose. Although they
Namino Kunitoh
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are aware of the undermining effects an overdose imposes on their bodies, the
actual damages caused by an overdose are not taken into account. With
cutting, an individual can see wounds and, therefore, an actual location
identifies the pain. However, the harm caused by an overdose is internal and
denies the perception or depth of pain. The following examples more clearly
illustrate this.
Participant 1: “Taking drugs, well...maybe I don’t have a
clear concept of the harm in taking drugs.”
Researcher: “Is that because you can’t see the wounds?”
Participant 1: “If I were to experience some disorder of my
internal organs, I may have a sense of awareness of the
harm; but even when people tell me an overdose will lead to
disorders, I haven’t experienced any yet and I can’t see any
wounds, so it is different from cutting.”
The one participant whose answer to the first question included
overdose is an ex-self-harmer. Her last self-harming incident was about three
years ago and she believed she could halt the behaviour completely. In this
context, it was possible for the participant objectively to review self-harm
through her past related behaviour: hence, her ability to include overdose as a
form of self-harm.
3.
Background of the Start of Self-Harm
The background in which self-harming behaviour begins must
equally be evaluated. Most participants first experienced self-harm during
their teens. For some, the reasons for commencing are vague; for others, they
have detailed recollections of the occurrence. One participant was almost
unable to recall her first experience with cutting and did not believe she was
in any kind of problematic situation at the time. Some participants clearly
recalled their problems, depression, stress, or confusion. Others could not
clearly recall their first experience with self-harm yet they recollected the
presence of difficulties, anger, stress, or anxiety in their lives. Thus, these
results produced distinct groups: participants who clearly recalled the
incidents which incited their first self-harming act and others who did not.
In conclusion, there is a framework in which one initiates acts of
self-harm: negative feelings or situations incite acts of self-harm which are
employed as an outlet for these feelings, a form of self-punishment, or a
solution to problems. Therefore, given this framework and the information
already acquired regarding self-harm before their first act, an individual
chooses self-harm and the methods to commit it. However, it is interesting to
note the various reasons an individual may opt for self-harm. First, the
information gathered by those who engage in self-harm declares that these
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Death in Self-harmers’ Eyes
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acts will help to relieve pain, resolve problems, cope with stress, or attract the
attention of others. Second, most teenagers would not have many problemsolving options. Therefore, in a crisis, they must choose ways to resolve
issues from a limited number of resources. When the existing options are not
deemed enough, self-harm may appear to be an attractive alternative.
4.
Whether Overdose Constitutes Self-Harm
With respect to self-harming acts, one may wonder whether an
overdose constitutes self-harm. Researchers differ in opinion. First, the
difference between cutting and an overdose must be defined. Eight of the
participants interviewed had engaged in more than one overdose. Six of the
eight participants considered cutting to be different from an overdose, with
one participant giving both acts equal meaning. One participant equated an
overdose to a suicide attempt and not self-harm because he intended suicide
with this act. The participants’ classification of an overdose correlates to their
perception of the level of self-harm for this act. Participants who had
classified an overdose differently had a self-harm hierarchy whereby an
overdose was regarded as a stronger act than cutting. Therefore, the inability
to think clearly or lose consciousness by overdose can affect the placement of
this act within the hierarchy. Some participants, who accorded a different
meaning to an overdose than to cutting, occasionally substituted cutting for
an overdose. This occurred when they could not overdose; for instance, when
they lacked a sufficient amount of drugs or they had plans for the next day.
However, none of the participants substituted an overdose for cutting, which
remains consistent with the hierarchy for self-harm whereby drug overdose is
a stronger act than cutting.
In contrast, one participant regarded the level of self-harm for a
drug overdose as equal to that of cutting. For her, both cutting and a drug
overdose were mutually suitable means of self-punishment and an overdose
was employed as a substitute for cutting when she did not want others to see
her scars.
Therefore, does a drug overdose constitute self-harm? Six of the
eight participants agreed it did and one believed it might be self-harm. Some
participants who believed that a drug overdose was self-harm said it was selfharm by definition. One participant believed a light overdose—one that is
slightly over regulation amounts—was self-harm; whereas an individual
contemplating death and taking a heavy overdose—one that is significantly
over regulation amounts—was not self-harm but a suicidal attempt. In the
following interview, I asked other participants whether they thought the
amounts of drugs used in an overdose created the boundary between selfharm and a suicidal attempt or suicide, all of them agreed that the amounts of
drugs created the boundary. In the case of a light overdose, some participants
engaged in the act knowingly while others did so without such knowledge;
Namino Kunitoh
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however, none of the participants equated the act as a suicidal attempt or
suicide.
In his book Le suicide: Etude de sociologie, Emile Durkheim states
that one of the important factors for the definition of suicide is the knowledge
one has of the results of the behaviour.1 An analysis of the interview data
demonstrates that there is a distinguishable boundary between self-harm and
a suicidal attempt or suicide in relation to a drug overdose; in the case of
suicide, it is the knowledge that the act will result in a fatal outcome and the
clear intention to commit suicide. According to Durkheim, the intention to
commit suicide is difficult to observe. 2 This is because of the nature of
Durkheim’s study, which focuses on society rather than on individuals.
However, in this study, the number of subjects interviewed was small and
each participant could be questioned on their propensity for suicide. In
conclusion, the most important factors that distinguish an act of self-harm
from a suicidal attempt or suicide, in relation to a drug overdose, are the
knowledge of the fatal outcome of the act and the intention to commit
suicide.
In an act where there is no knowledge of the fatality of the
outcome and no intention to commit suicide, it is self-harm. In other words, if
an individual is aware that the amount of drugs consumed is over regulation
amounts, but not of a fatal or lethal dose, it is self-harm. However, if an
individual is aware that the amount of drugs consumed is over regulation
amounts, is of a fatal or lethal dose, and is taken with the intention to commit
suicide, it is not self-harm but a suicidal attempt or suicide.
When participants use an overdose of drugs to self-harm, non-fatal
amounts are employed.
Participant 2: “I know it won’t kill me. I’ve got
information about lethal doses and know the amounts that
can kill.”
Researcher: “What amount of drugs did you consume?”
Participant 3: “Sleeping pills and antidepressant
drugs...around 50 to 70, I think.”
Researcher: “Were you aware that this dosage would not
kill you?”
Participant 3: “Yes, I knew that.”
In conclusion, although suicide depends on the awareness of a fatal
outcome and the intention to commit suicide, an overdose can also constitute
self-harm. Most participants regard a drug overdose as self-harm and apply
the definition of self-harm to the latter—deliberate, nonfatal, and meant to
harm oneself.
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Death in Self-harmers’ Eyes
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5.
Reasons to Stop Self-Harm
We shall now examine the reasons ex-self-harmers ceased this
practice. Two of the ten participants interviewed had ceased the practice of
self-harm. These results may be due to the age of the participants.
Participation in the interview was limited to young individuals; the age-group
wherein self-harm is most present. As the data of the two participants is
insufficient in evidence to draw a conclusion, the information may,
nonetheless, be helpful to others who self-harm.
During the interview with one ex-self-harmer, she recounted that
her dreams for the future spurred the cessation of the practice. She worked
hard towards achieving this dream, and these efforts led to her ability to
control the urges to cut herself. The other ex-self-harmer described a change
in circumstances as the factor to ceasing the practice; having begun a parttime job, she felt needed by others and recovered her self-confidence. Both
participants followed hospital treatments consisting of drugs and
psychotherapy although they declared these efforts as unsuccessful.
Therefore, amongst the primary factors inducing the cessation of
self-harm is hope for the future, confidence, and self-respect. On the other
hand, a participant who ceased the practice of self-harm for over 17 months
indicated that she did not believe she could completely halt the practice. The
participant believed that once the habit to self-harm was acquired, she would
be capable of self-harm in the future and, therefore, unable to cease the
practice entirely. Other participants held similar opinions in that their future
behaviour would be affected by that individual’s ability to repeat selfharming acts.
6.
Relationship Between Self-Harm and Death
Is there a relationship between self-harm and death? Participants
were asked whether they believed self-harm was closely related to death;
none agreed that this was the case. Most participants believed in a certain
distance between self-harm and death: either self-harm was far from death or
self-harm was completely different from death. One participant believed selfharm was diametrically opposite to death. This response is due to the
individual’s acceptance of self-harm as a way of life.
Participants perceived a distance between self-harm and death
because the self-harming acts were not harmful enough to kill them. For all
of the participants of the interview, self-harm was not a way to die but rather
to resolve problems, cope with stress, acquire the attention of others, or
punish oneself. One participant stated, “I think I haven’t died yet because of
self-harm”; she would cut herself in the place of a heavy overdose.
A participant who believed self-harm to be different from a drug
overdose stated that cutting did not approach death whereas an overdose did;
an overdose was a form of release for her and she believed that death
Namino Kunitoh
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achieved the same effect. For her, cutting provided no such relief. She
considered cutting to be a form of self-harm, and it is clear that the
participant did not believe this self-harming behaviour approached death. In
conclusion, self-harm was not closely associated with death for participants.
Although the participants did not closely correlate self-harm to death,
one participant did indicate a relationship between the two. This response was
affected by a personal experience: the participant was hospitalised for five
days due to a very serious overdose. However, the act was not performed
with the intention to kill herself as can be witnessed by her response:
Researcher: “Have you ever harmed yourself with an
intention to commit suicide?”
Participant 4: “Never. But people say to me, “You wanted
to die, didn’t you?’”
This participant’s overdose led her near death although this was not
her intention. This experience allowed her to comprehend that it is possible to
die as a result of self-harm, even without the desire to end one’s life.
Consequently, for this participant, self-harm and death are not unrelated.
Participants were additionally asked to describe their image of death.
The answers varied. One participant described a romantic image of being
forever memorialized in the minds of others while several participants
imagined this moment as an “escape”. For some, negative images were not
associated with death; for others, negative images were clearly connected to
the event. Some described fearful or painful images of death. Interestingly,
several participants described death by suicide. Among these individuals,
opinions on the matter were divided. One participant viewed death by suicide
as the ultimate escape and one’s last resort; however, no negative images
were associated with this moment. Others maintained a negative image of
death; one participant described the event as the ultimate betrayal because
dying would entail the betrayal of family and others. The participants’ ability
to imagine death by suicide may be associated to their age; their youth may
have precluded their ability to imagine a natural death or one by illness.
Suicide may also be the closest form of death for these participants since they
include one who have attempted suicide and they maintain friendships with
others who themselves have attempted suicide. Nonetheless, the variety of
the images on death described by the participants indicates the individual
nature of each of their experiences, even with the commonality of self-harm
or suicidal attempts.
7.
Conclusion
In conclusion, self-harm is a behaviour that is not to die even though
this behaviour can extend beyond certain boundaries and approach death.
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Death in Self-harmers’ Eyes
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When cutting or a drug overdose is employed as the method to self-harm, it is
not done with the intention to harm oneself to the point of death by suicide.
Rather, many of this study’s participants described their self-harming
behaviour as an attempt to live. Self-harm is employed by the participants as
the outlet of, amongst other things, negative feelings, stress, and anger. When
an individual is aware that their self-harming behaviour will be fatal to the
point of death and acts with a clear intention to commit suicide, it is a
suicidal attempt or suicide. Therefore, self-harm and suicidal attempts or
suicide should be treated separately.
Notes
1
E Durkheim, Le suicide : etude de sociologie, Presses universitaires de
France, Paris, 1976 printing, p. 5.
2
ibid., p. 4.
Bibliography
Adler, P. A., and P. Adler, ‘The Demedicalization of Self-Injury: From
Psychopathology to Sociological Deviance’. Journal Of Contemporary
Ethnography , vol. 36, October 2007, pp. 537-570.
Beautrais, A., ‘Life Course Factors Associated With Suicidal Behaviors in
Young People’. AMERICAN BEHAVIORAL SCIENTIST, vol.46, May 2003,
pp. 1137-1156.
Brickman, B. J., ‘’Delicate’ Cutters: Gendered Self-mutilation and Attractive
Flesh in Medical Discourse’. Body & Society, vol. 10, December 2004, pp.
87-111.
Durkheim, E., Le suicide : etude de sociologie. Presses universitaires de
France, Paris, 1976 printing.
Favazza, A. R., ‘Why Patients Mutilate Themselves’. Hospital and
Community Psychiatry, vol. 40, February 1989, pp. 137-145.
Hawton, K., K. Rodham, and E. Evans, By Their Own Young Hand:
Deliberate Self-Harm And Suicidal Ideas in Adolescents. Jessica Kingsley
Publisher, London, 2006.
Kidd, S. A., ‘FACTORS PRECIPITATING SUICIDALITY AMONG
HOMELESS YOUTH: A Quantitative Follow-Up’. YOUTH & SOCIETY,
vol. 37, June 2006, pp. 393-422.
Namino Kunitoh
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Pitts, V., ‘Body Modification, Self-Mutilation and Agency in Media
Accounts of a Subculture’. Body & Society, vol.5, June 1999, pp. 291-303.
Sinclair ,J., and J. Green, ‘Understanding resolution of deliberate self harm:
qualitative interview study of patients’ experiences’. British Medical Journal,
vol. 330, May 2005, pp. 1112-1116.
Walsh, B. W., and P. M. Rosen, Self-Mutilation: Theory, Research, and
Treatment. Guilford Press, New York, 1988.
Young, R., H. Sweeting, and P. West, ‘Prevalence of deliberate self harm and
attempted suicide within contemporary Goth youth subculture: longitudinal
cohort study.’ British Medical Journal, vol. 332, May 2006, pp. 1058-1061.
Namino Kunitoh is MA student at Waseda University. She is studying
sociology and her main interest is in social deviance.
PART II
Communication Re-Imaging
Analysis of Terminally Ill Patients’ Weblogs Using the
Linguistic Inquiry and Word Count (LIWC) Program
Nothando Ngwenya, Stella Mills, and Paul Kingston
Abstract
The phenomenon of death is common to us all, yet the experience of dying is
rarely openly discussed. Patients with terminal illness receiving palliative
care are more aware of their imminent death. The impact of technological
advancement has had an effect on the way some terminally ill patients in
American and Australian hospices express themselves through the use of
weblogs as a form of therapeutic writing to journal and help interpret death.
According to the WHO’S definition of palliative care, patients’ psychosocial
and spiritual needs have to be addressed alongside their physical and mental
health needs. Using a weblog can help address mental and spiritual needs of
terminally ill patients through therapeutic writing. This paper describes the
use of the Linguistic Inquiry and Word Count (LIWC) program to analyse the
emotional, cognitive and structural components present in the blogs of five
terminally ill adult patients. The results of this study show that terminally ill
patients use a high percentage of affective words, and have a high percentage
use of the word death as a personal concern.
Key Words: Linguistic analysis, therapeutic narratives, weblogs, hospice,
terminal illness, dying, death.
*****
1.
Introduction
A. Dying and Death
Even though death is a universal human experience, responses to
this phenomenon vary across cultures and societies. Conceptualisation of
death in Western society has moved from the eighteenth century where it was
public and visible to the nineteenth century where it became an invisible and
private affair.1In the twentieth century, death became bureaucratised and the
conduct of society encouraged people to place all their faith in medical
technologies thus effectively denying death.2-5 For people to accept death as
part of nature and to deal with dying in a dignified manner, they need to
understand the phenomenon of dying and death.6 The twenty first century has
seen a slight change of attitude towards dying and death within society,
where death is becoming perceptible once more with a move towards open
awareness of death. Open awareness is when the patient, medical staff and
relatives are all aware of the patient’s impending death and can openly talk
about it.7 Taylor argued that the twenty-first century has not really embraced
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Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
open awareness, but instead has moved towards conditional open awareness.8
Field et al supported this argument by reporting on how medical
professionals were not comfortable about disclosing undesirable information
especially when it involved a terminal prognosis.9 Miyaji provides evidence
which supports this argument in research conducted with physicians in USA,
who reported that they modified information given to terminally ill patients
according to the patient’s questions and what they felt the patients needed to
know.10 All this research substantiates the view that open awareness and
honesty is still not fully practised when dealing with dying and death. The
increased mortality rate and technological innovations used to prolong life
may be well and good for today’s society but they raise significant questions
about what life, dying and death mean to people. Deconstructing or defining
the meaning of death can help people understand and deal with the practical
aspects of the dying process and more so for terminally ill patients facing an
imminent death. Talking about dying and death to terminally ill patients helps
them make meaning of their death as well as informing us about the dying
process which can assist in caring for dying patients.11
B. Weblogs and Therapeutic Writing
With the reluctance of some professionals to provide open
awareness, some terminally ill patients have found other ways to
communicate openly, through the use of technology.12 The internet has
become an important way for patients to find information and support.13
Patients using this form of communication have reported that use of the
Internet encouraged active coping and made them face their fears and has
been a personally empowering experience.14 Some critics have argued against
the use of technology in palliative care suggesting that technology is
impersonal and objective.15-17 Seely et al, go on further to suggest that
technology eliminates the personal care involved in palliative care and does
not help to heal the patient.18 In contrast to this stance, a growing body of
literature shows that internet technology does help in the process of healing
for patients.19-21 Internet-based interventions in hospices and palliative care
are proving effective for patients, caregivers and palliative care providers.22,
23
Most of the patients use the internet for e-mails, support groups or seeking
information, although there is a growing number of patients using weblogs
for communication. The weblogs referred to in this study are the journal type
web pages that have posts in reverse chronological order and function as a
two way communication by affording visitors to post comments.24 Many blog
authors claim their blogs offered them some form of catharsis although there
is no formal evidence of this; thus, this study explores the use of weblogs for
terminally ill patients. By offering a form of catharsis, weblogs are in effect
promoting therapeutic writing.
Nothando Ngwenya, Stella Mills, and Paul Kingston
137
______________________________________________________________
A growing body of literature has demonstrated the positive effects
of writing on physical, emotional and mental well-being.25-27 Writing can
help individuals to process and express their emotions. Cancer patients who
have used this mechanism of coping have experienced less cancer-related
morbidities, decreased stress and enhanced health compared to those with
low emotional expression.28 Functionalist theories of emotion suggest that
emotions can draw individuals’ attentions to their goals and concerns
prompting them to take adaptive action.29 Most research on emotional
processing and expression has utilised writing as a channel through which
people can express themselves.30,31 This is because writing is the most
appropriate method of translating emotional experience into words, therefore
being a gateway to understanding people’s underlying emotional and
cognitive processes.32
C. Language Use and LIWC
Research evidence suggests that individuals construct the meaning
of situations and experiences through the language they use.33, 34 The study of
language use is not a new concept with research as early as 1901 where Freud
purported that errors in speech reflected an individual’s deeper fears.35 The
literature on language use has continued to grow indicating the importance of
language use in understanding individuals. Ricoeur suggested that the way
we describe an event defines the meaning of the event and we use those
meanings as a bridge to reality.36 Analysis of text can help to deconstruct
these individual meanings and explore people’s emotional and cognitive
functioning.37 There is empirical evidence that suggests a link between
biological activity and function words. Research also shows that depressed
people and individuals experiencing a stressful situation use more first person
pronouns.38 Words can also help in the prediction of physiological and health
changes with the use of emotion and cognitive words being correlated with
health changes.39 By analysing the text of terminally ill patients, the
important aspects of their psychological world can be revealed helping us to
deconstruct and understand the meaning of the dying process and their
imminent death. Methods of studying language use vary from those that
make an assumption that language is contextual to those that statistically
count the words within text.40 Within the quantitative approach there are
different variations of word analysis, namely judge based thematic content
analyses, word pattern analysis and word count strategies. Thematic content
analyses have been used mainly for studying psychological phenomena
whilst the word pattern analysis is useful for determining the co-variance
across samples of text. The word count strategies make the assumption that
words convey psychological information that is independent of their semantic
context and is therefore suitable for use within this study. Computerised text
analysis programs have become widely used in the study of language use
138
Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
increasing the efficiency and accuracy of analysis .41 The LIWC (Linguistic
Inquiry Word Count) text analysis software was initially developed in the
context of Pennebaker’s work to identify words that could predict health
improvements.42 This program is now widely used in clinical psychology to
explore psychological and linguistic dimensions of language. This paper
evaluates and describes the use of the LIWC program to analyse content of
terminally ill patients’ weblogs. In contrast to previous work in palliative
care, where the investigator interviews participants, records and decodes
what is said, this paper focuses on the emotional, cognitive and structural
components of written language.
2.
Method
A. The Use of Weblogs in Palliative Care
For clarification purposes within this paper, Schiano et al’s
definition of weblogs will be applied - a weblog is a web page that is
frequently updated with posts in reverse-chronological order with the latest
post at the top.43 The present study is based on weblogs of five terminally ill
patients who have maintained their weblog for over two years. Writing
samples from the patients’ blogs were analysed using LIWC. From the
content of the blogs, the patients indicated how the Internet has enabled them
to obtain social support and express their emotions whilst discussing issues of
importance to them related to their illness and imminent death.
B. Participants
Participants were five patients with varying terminal illnesses based
in North America. Two of the patients have cancer, one has AIDS, one has
leukaemia and the fifth an undisclosed terminal illness. Three of the
participants are male and two are female. The participants are between the
ages of 31 and 53 years old with a mean age of 44 (SD = 8 years). One
participant is a visionary artist, one is a former newspaper reporter, one is a
student, one is a radio news reporter and the fifth is a journalist. Participants
have been blogging at their own initiative and convenience for at least two
years. Within their blogs, participants reported on their illness, progress of
their respective treatments and other general life issues.
C. Materials – Software
The Linguistic Inquiry and Word Count software 2007 version was
used to identify the emotional, cognitive and structural categories of the
words used within the text of the blogs.44 The default LIWC 2007 dictionary
has 4,500 words that define the word categories. One word can be part of
more than one category. The program analyses text, word by word and
calculates the percentage of words that match each of the language
dimensions or categories defined within the dictionary. If a word belongs to
Nothando Ngwenya, Stella Mills, and Paul Kingston
139
______________________________________________________________
more than one category, each of the categories is incremented if the word is
identified in the text. The output variables include general descriptors (e.g.
word count, word per sentence), standard linguistic dimensions (e.g.
pronouns, verbs, articles), and psychological constructs (e.g. affective
processes, cognitive process, social references). The results of the output
variables are listed as percentages of word use.
D. Procedure
A total of 15 blog posts by terminally ill patients were analysed.
Three posts from different stages of blogging were selected from each
participant’s blog (early, middle, and late). The posts were loaded into
Microsoft Word and edited for typographical errors. All postings were saved
as Word text files and analysed using the LIWC program. The LIWC data
were aggregated by phase and patient, and therefore for each patient, 3 data
sets corresponding to the three blog phases were available. The construct
validity of the program was assessed by comparing the LIWC results
obtained from the participants’ blogs with the norm values from the program
authors.45 The LIWC has 90 language dimensions, but for this study, only 12
dimensions that have been found to correlate with social and psychological
variables were examined in the analysis of function and emotion words. This
analysis was used to explore the participants’ social and psychological
profiles.
3.
Results
Table 1 summarises the LIWC categories relevant in this study that
were analysed. The numbers shown are the mean percentages of the total
word use from the three different phases of the blog posts that were analysed.
A comparison of this study’s results was carried out against the average
values published by the program’s authors. The LIWC 2007 authors carried
out a study to evaluate the program’s word usage across various setting
which included emotional writing, control writing, science articles, novels,
talking and blogs. The three classes of text from Pennebaker’s study are
shown in bold (Emotional writing condition; Control writing condition;
Blogs).
Analysis of Terminally Ill Patients’ Weblogs
140
______________________________________________________________
Table 1: Means for LIWC Categories
Case
1
Case
2
Case
3
Case
4
Case
5
Emotiona
lW
Contro
lW
Blogs
Word Count
(mean)
632.
33
669.
00
306.
00
959.
67
407.
00
443.00
405.00
7,304.00
Words > 6
Letters
15.7
4
15.8
3
11.1
4
19.2
0
16.2
7
13.27
13.87
14.12
Total
function
words
60.0
4
56.0
0
62.1
3
57.2
1
58.1
2
63.93
57.53
55.29
Pronouns
13.2
9
10.9
6
18.2
5
14.1
8
16.8
7
20.23
14.29
16.07
Affect
5.81
5.28
5.06
6.27
5.76
6.02
2.57
5.84
Positive
emotion
3.36
3.92
3.84
3.10
3.43
3.28
1.83
3.72
Negative
emotion
2.33
1.39
1.22
3.10
2.22
2.67
0.71
2.07
Anxiety
0.89
0.13
0.17
0.75
0.06
0.68
0.21
0.3
Anger
0.69
0.30
0.26
0.53
0.25
0.66
0.14
0.76
Sadness
0.79
0.76
0.17
1.29
0.76
0.63
0.14
0.42
Cognitive
Processes
16.3
7
15.5
4
17.3
9
16.2
3
15.2
9
19.66
14.42
15.97
0.14
0.16
0.30
0.90
0.72
0.18
0.03
0.15
Category
Linguistic
Processes
Psychologica
l Processes
Current
Concerns
Death
Table 1, shows how all the participants used a high percentage of function
words with the lowest being 56%. This corroborates with the literature which
identifies how the use of function words is diagnostic of emotional and
biological states and can also reveal personality and cognitive styles. It is also
of interest that all the participants have higher percentage use of positive
emotion words compared to negative emotion words. These effects could be
Nothando Ngwenya, Stella Mills, and Paul Kingston
141
______________________________________________________________
due to the low rate use of anger and hostility words across all the cases
analysed.
Figure 1 shows a comparison of the results from this study and the
means of three settings listed by the program’s authors - emotional writing,
control writing, and blogs.
Figure 1: Comparison with standard original values
Construct validity was carried out on the affect processes as they are most
relevant to the emotional components of words. Figure 1 visually
demonstrates how the word usage for the cases in this study are very much
similar to those carried out on emotional writing studies and general blogs. In
all three of these texts, there is a higher percentage of words counted in
affect, positive emotion and negative emotion than that counted for the
control. It is interesting to note that with the cases in this study, lower
proportion of negative emotion words were expressed compared to
Pennebaker’s emotional writing group. The control group recorded the lowest
word count in all categories with more differences to the terminally ill
patients’ group than any of the other texts. The blog group’s pattern from
Pennebaker’s findings is similar to the terminally ill patients’ pattern. It is
interesting to note that the terminally ill patients group had a higher word
142
Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
usage of death compared to all the other groups of text. These results support
the efficacy of the LIWC program in this setting.
4.
Discussion
The results of this study confirm the possibility of using the LIWC
in analysing the emotional, cognitive and structural components present in
the writings of terminally ill patients. It is a useful way of measuring people’s
linguistic characteristics. This study is preliminary work on the use of
weblogs in an end of life context, and the results encourage further
development within the subject area. Through the use of a blog as a form of
disclosure channel, the terminally ill patients had a high percentage use of
affective words, both negative emotion and positive emotion. The word usage
pattern for the terminally ill patients was very similar to the data reported by
the program’s authors for the emotional writing group and for blogs. There
were differences observed however from the control writing group and the
terminally ill patients’ word usage results. These results can be interpreted in
many ways, including the suggestion that blogs can be therapeutic and, just
like emotional writing, may have positive health benefits.46-49 This is
evidenced by the patients’ high word use of affective words mostly positive
emotion words. The LIWC has many more word categories (up to 90) that
were not used in this study that can be encompassed in future work to reveal
individual personalities and the personalities that can benefit positively from
maintaining a weblog. Previous research suggested that linguistic
characteristics can predict health outcomes; therefore the application of the
LIWC program can help to identify predictors in patients who may need
specific personal attention and possible interventions.50,51 Advice or
suggestions can be made to people to change their style of writing (e.g.
encourage the expression of positive emotions) if it helps them in a positive
way. Different kinds of information and knowledge can be gained from
examining the written words of individuals including their psychological
state and this is confirmed from the results in this study.52
Limitations of this research should be noted. The small and specific
sample used in this study means care should be taken in the generalisation of
the results to other populations. Individual differences were not analysed as
there were only five participants. The length of the messages varied between
participants and from time to time whilst the participants wrote about
anything within their blogs which produced a combination of emotional and
control writing.53 The results however seemed to corroborate the program
authors’ “norm” values which concludes that the tool was accurate in
identifying the linguistic dimensions present within the blog content.
Nothando Ngwenya, Stella Mills, and Paul Kingston
143
______________________________________________________________
5.
Conclusion
The LIWC is a simple and very flexible tool which can be modified
according to specific research needs. The dictionary can be modified or a
new one installed to suit the purpose of research. The LIWC program has the
potential to be used within other settings to help and give insight to the
psychological and emotional state of individuals. This information could be
used within a wider context for other clinical purposes.54 The study has
demonstrated that LIWC can be used to analyse terminally ill patients’ blogs
and further evaluation can be carried out according to specific research needs.
Research has suggested that cognitive words can reveal how a person thinks
and, from the cognitive processes word usage in this study, there is an
indication that terminally ill patients have a more reflective manner and
approach to life. The high percentage use of cognitive process words may be
interpreted in line with previous research which suggested that during
stressful or unpleasant situations, individuals use words that reflect cognitive
processing.55 This supports evidence that states that there is higher prevalence
of stress among terminally ill patients.
Further work will examine changes in word use over a period of
time and their relationship to psychosocial indicators used to predict health
outcomes. More work can be conducted with a larger sample size of
terminally ill patients to establish the generalisability of these findings. Other
characteristics of participants could be profiled to explore if individual
differences may have influenced the results in this study. It may also be
useful for future research to explore other categories and aspects of word
usage other than emotion words such as religion, to see if it has an influence
on how individuals understand and construct the meaning of dying and death.
Exploring non-emotion words people used whilst going through intensely
emotional experiences can reveal the principal emotion processing
mechanisms. Future work could also use objective biological markers of
health to corroborate the LIWC analysis results.
Notes
1
P Aries, The Hour of Our Death, Oxford University Press, Oxford, 1991.
R Blauner, ‘Death and Social Structure’, Psychiatry, vol. 29, 1966, pp. 378
– 394.
3
B G Glaser and A L Strauss, Awareness of Dying, Aldine, New York, 1965.
4
J W Riley, ‘Dying and the meanings of Death: Sociological Inquiries’,
Annual Review Sociology, 1983, pp.191 – 216.
5
ibid., pp. 191 – 216
6
B G Glaser and A L Strauss, op. cit.
7
B G Glaser and A L Strauss, op. cit.
2
144
Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
8
K M Taylor, ‘Telling Bad News: Physicians and the Disclosure of
Undesirable Information’, Sociology of Health & Illness, vol. 10, 1988, pp.
109 – 133.
9
D Field and G Copp, ‘Communication and Awareness about Dying in the
1990s’, Palliative Medicine, vol. 13, 1999, pp. 459 - 468.
10
N J Miyaji, ‘The Power of Compassion: Truth Telling among American
Doctors in the Care of Dying Patients’, Social Science & Medicine, vol. 36,
1993, pp. 249 – 264.
11
E L Emanuel, D L Fairclough, P Wolfe and L L Emanuel, ‘Talking with
Terminally Ill Patients and Their Caregivers about Death, Dying and
Bereavement’, Archives of Internal Medicine, vol. 164, 2004, pp. 1999 –
2004.
12
D Field and G Copp, loc cit.
13
A Meier, E J Lyons, G Frydman, M Forlenza and B K Rimer, ‘How Cancer
Survivors Provide Support on Cancer-Related Internet Mailing Lists’,
Journal of Medical Internet Research, vol. 9, 2007.
14
ibid.
15
D Thorne, ‘Adding Technology to Care – Is This Progress?’, Progress in
Palliative Care, vol. 7, 1999, pp53 - 54.
16
J C Hays, ‘High-Technology and Hospice Home Care’, Nursing Clinics of
North America, vol. 23, 1988, pp. 329 - 340.
17
D M Dush, ‘High Tech, Aggressive Palliative Care: In the Service of
Duality of Life’, Journal of Palliative Care, vol. 9, 1993, pp. 37 – 41.
18
J F Seely and B M Mount, ‘Palliative Medicine and Modern Technology’,
JAMC Canadian Medical Association Journal, vol. 161, 1999, pp. 1120 1121.
19
L Willis, G Demiris and D Parker-Oliver, ‘Internet Use by Hospice
Families and Providers: A Review’, Journal of Medical Systems, vol. 31,
2007, pp. 97 – 101.
20
K T Washington, G Demiris, D Parker- Oliver and M Day, ‘Home Internet
Use among Service Recipients: Recommendations for Web-Based
Interventions’, Journal of Medical Systems, vol. 31, 2007, pp. 385-389.
21
G W Alpers, A J Winzelberg, C Classen, H Roberts, P Dev, C Koopman
and C Barr-Taylor, ‘Evaluation of Computerised Text Analysis in an Internet
Breast Cancer Support Group’, Computers in Human Behaviour, vol. 21,
2005, pp. 361 – 376.
22
L Willis, G Demiris and D Parker-Oliver, loc. cit.
23
K T Washington, G Demiris, D Parker-Oliver and M Day, 2007, loc. cit.
24
M A Stefanone and C Y Jang, ‘Writing for Friends and Family: The
Interpersonal Nature of Blogs’, Journal of Computer Mediated
Communication, vol. 13, 2007, viewed on 27 July 2008,
http://jcmc.indiana.edu/Vol.13/issue1/stefanone.html.
Nothando Ngwenya, Stella Mills, and Paul Kingston
145
______________________________________________________________
25
C Hunt, Therapeutic Dimensions of Autobiography in Creative Writing,
Jessica Kingsley, London, 2000.
26
G Bolton, ‘Writing or Pills: Therapeutic Writing in Primary Care’, in The
Self on the Page: Theory and Practice of Creative Writing in Personal
Development, C Hunt and F. Sampson (eds), Jessica Kingsley, London, 1998.
27
J W Pennebaker, ‘Writing about Emotional Experiences as a Therapeutic
Process’, Psychological Science, vol. 8, 1997, pp. 162 – 166.
28
A L Stanton, S Danoff-Burg, C L Cameron, M Bishop, C A Collins, S B
Kirk and L A Sworowski, ‘Emotionally Expressive Coping Predicts
Psychological and Physical Adjustment to Breast Cancer’, Journal of
Consulting and Clinical Psychology, vol. 68, 2000, pp. 875 – 882.
29
N H Frijda, ‘Emotions are Functional, Most of the Time’, in The Nature of
Emotion: Fundamental Questions, P Ekman & R J Davidson (eds), Oxford
University Press, New York, 1994, pp. 112 – 122.
30
J W Pennebaker, ‘Writing about Emotional Experiences as a Therapeutic
Process’, 1997, loc. cit.
31
J M Smyth, ‘Written Emotional Expression: Effect Size, Outcome Types,
and Moderating Variables’, Journal of Consulting and Clinical Psychology,
vol. 66, 1998, pp. 174 – 184.
32
J W Pennebaker and C K Chung, ‘Expressive Writing, Emotional
Upheavals, and Health’, in Handbook of Health Psychology, H Friedman, &
R Silver, (eds), Oxford University Press, New York, 2007, pp. 263 – 284.
33
C J Groom and J W Pennebaker, ‘Words’, Journal of Research in
Personality, vol. 36, 2002, pp. 615 – 621.
34
J W Pennebaker, R J Booth and M E Francis, ‘Linguistic Inquiry and Word
Count: LIWC, 2007’, viewed on 12 February 2008, www.liwc.net.
35
S Freud, Psychopathology of Everyday Life, Penguin, New York, 1975.
36
P Ricoeur, Interpretation Theory: Discourse and the Surplus of Meaning,
Texas Christian University Press, 1976.
37
J W Pennebaker and A Graybeal, ‘Patterns of Natural Language Use:
Disclosure, Personality and Social Integration’, Current Directions in
Psychological Science, vol. 10, 2001, pp. 91 – 93.
38
C Chung and J W Pennebaker, ‘The Psychological Function of Function
Words’, in Social Communication, Friedler (ed), Psychology Press, New
York, 2007, pp. 343 – 359.
39
J W Pennebaker and A Graybeal, ‘Patterns of Natural Language Use:
Disclosure, Personality and Social Integration’, 2001, pp. 91 – 93.
40
J W Pennebaker, M R Mehl, and K G Niederhoffer, ‘Psychological Aspects
of Natural Language Use: Our Words, Our Selves’, Annual Review of
Psychology, vol. 54, 2002, pp. 547 – 577.
41
G W Alpers, A J Winzelberg, C Classen, H Roberts, P Dev, C Koopman
and C Barr-Taylor, loc. cit.
42
J W Pennebaker, loc. cit.
146
Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
43
D J Schiano, B A Nardi, M Gumbrecht and L Swartz, ‘Blogging by the
Rest of us’, CHI, 2004, ACM.
44
J W Pennebaker, R J Booth and M E Francis, loc. cit.
45
ibid.
46
J W Pennebaker, loc. cit.
47
G Bolton, op. cit.
48
J M Smyth, 1998, loc .cit.
49
C Hunt, 2000, op. cit.
50
C J Groom and J W Pennebaker, loc. cit.
51
J W Pennebaker, R J Booth and M E Francis, loc. cit.
52
J W Pennebaker, M R Mehl, and K G Niederhoffer, loc. cit.
53
J H Kahn, R M Tobin, A E Massey and J A Anderson, ‘Measuring
Emotional Expression with the Lingusitic Inquiry and Word Count’,
American Journal of Psychology, vol. 120, 2007, pp. 263 – 286.
54
G W Alpers, A J Winzelberg, C Classen, H Roberts, P Dev, C Koopman
and C Barr-Taylor, loc. cit.
55
S W Stirman and J W Pennebaker, ‘Word Use in the Poetry of Suicidal and
Non Suicidal Poets’, Psychosomatic Medicine, vol. 63, 2001, pp. 517 – 522.
Bibliography
Alpers, G. W., A. J. Winzelberg, C. Classen, H. Roberts, P. Dev, C.
Koopman, and C. Barr-Taylor, ‘Evaluation of Computerised Text Analysis in
an Internet Breast Cancer Support Group’. Computers in Human Behaviour,
vol. 21, 2005, pp. 361 – 376.
Aries, P., The Hour of Our Death. Oxford University Press, Oxford, 1991.
Blauner, R., ‘Death and Social Structure’. Psychiatry, vol. 29, 1966, pp. 378 394.
Bolton, ‘Writing or Pills: Therapeutic Writing in Primary Care’, in The Self
on the Page: Theory and Practice of Creative Writing in Personal
Development. C. Hunt and F. Sampson, (eds), Jessica Kingsley, London,
1998.
Chung, C. And J. W. Pennebaker, ‘The Psychological Function of Function
Words’, in Social Communication, Friedler (ed), Psychology Press, New
York, 2007, pp. 343 - 359.
Dush, D. M., ‘High Tech, Aggressive Palliative Care: In the Service of
Duality of Life’. Journal of Palliative Care, vol. 9, 1993, pp. 37 - 41.
Nothando Ngwenya, Stella Mills, and Paul Kingston
147
______________________________________________________________
Emanuel, E. L., D. L. Fairclough, P. Wolfe, and L. L. Emanuel, ‘Talking
with Terminally Ill Patients and Their Caregivers about Death, Dying and
Bereavement’. Archives of Internal Medicine, vol. 164, 2004, pp. 1999 2004.
Field, D., and G. Copp, ‘Communication and Awareness about Dying in the
1990s’. Palliative Medicine, vol. 13, 1999, pp. 459 – 468.
Glaser, B. G. and A. L.. Strauss, Awareness of Dying. Aldine, New York,
1965.
Groom, C. J. and J. W. Pennebaker, ‘Words’. Journal of Research in
Personality, vol. 36, 2002, pp. 615 – 621.
Freud, S., Psychopathology of Everyday Life. Penguin, New York, 1975.
Frijda, N. H., ‘Emotions are Functional, Most of the Time’, in The Nature of
Emotion: Fundamental Questions, P Ekman & R J Davidson (eds), Oxford
University Press, New York, 1994, pp. 112 – 122.
Kahn, J. H., R. M. Tobin, A. E. Massey, and J. A. Anderson, ‘Measuring
Emotional Expression with the Lingusitic Inquiry and Word Count’.
American Journal of Psychology, vol. 120, 2007, pp. 263 – 286.
Hays, J. C., ‘High-technology and Hospice Home Care’. Nursing Clinics of
North America, vol. 23, 1988, pp. 329 – 340.
Hunt, C., Therapeutic Dimensions of Autobiography in Creative Writing.
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Meier, A., Lyons, E. J., Frydman, G., Forlenza, M., & Rimer, B. K., ‘How
Cancer Survivors Provide Support on Cancer-Related Internet Mailing Lists’.
Journal of Medical Internet Research, vol. 9, 2007.
Miyaji, N. J., ‘The Power of Compassion: Truth Telling Among American
Doctors in the Care of Dying Patients’. Social Science & Medicine, vol. 36,
1993, pp. 249 – 264.
Pennebaker, J. W., ‘Writing about Emotional Experiences as a Therapeutic
Process’. Psychological Science, vol. 8, 1997, pp. 162 – 166.
148
Analysis of Terminally Ill Patients’ Weblogs
______________________________________________________________
Pennebaker, J. W. And A. Graybeal, ‘Patterns of Natural Language Use:
Disclosure, Personality and Social Integration’. Current Directions in
Psychological Science, vol. 10, 2001, pp. 91 – 93.
Pennebaker, J. W., M. R. Mehl, and K. G. Niederhoffer, ‘Psychological
Aspects of Natural Language Use: Our Words, Our Selves’. Annual Review
of Psychology, vol. 54, 2002, pp. 547 – 577.
Pennebaker, J. W., and C. K. Chung, ‘Expressive Writing, Emotional
Upheavals, and Health’, in Handbook of Health Psychology, H. Friedman
and R. Silver, (eds), Oxford University Press, New York, 2007, pp. 263 –
284.
Pennebaker, J. W., R. J. Booth, M. E. Francis, ‘Linguistic Inquiry and Word
Count: LIWC, 2007’, viewed on 12 February 2008, www.liwc.net.
Ricoeur, P., Interpretation Theory: Discourse and the Surplus of Meaning,
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Annual Review Sociology, 1983, pp. 191 – 216.
Schiano, D. J., B. A. Nardi, M. Gumbrecht, and L. Swartz, ‘Blogging by the
Rest of Us’. CHI, 2004, ACM.
Seely, J. F., and B. M. Mount, ‘Palliative Medicine and Modern
Technology’. JAMC Canadian Medical Association Journal, vol. 161, 1999,
pp. 1120 – 1121.
Smyth, J. M., ‘Written Emotional Expression: Effect Size, Outcome Types,
and Moderating Variables’. Journal of Consulting and Clinical Psychology,
vol. 66, 1998, pp. 174 - 184.
Stanton, A. L., S. Danoff-Burg, C. L. Cameron, M. Bishop, C. A. Collins, S.
B. Kirk, and L. A. Sworowski, ‘Emotionally Expressive Coping Predicts
Psychological and Physical Adjustment to Breast Cancer’. Journal of
Consulting and Clinical Psychology, vol. 68, 2000, pp. 875 – 882.
Stefanone, M. A. And C. Y. Jang, ‘Writing for Friends and Family: The
Interpersonal Nature of Blogs’. Journal of Computer Mediated
Communication, vol. 13, 2007, viewed on 27 July 2008,
http://jcmc.indiana.edu/Vol.13/issue1/stefanone.html.
Nothando Ngwenya, Stella Mills, and Paul Kingston
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Stirman, S. W. And J. W. Pennebaker, ‘Word Use in the Poetry of Suicidal
and Non Suicidal Poets’. Psychosomatic Medicine, vol. 63, 2001, pp. 517 522.
Taylor, K. M., ‘Telling Bad News: Physicians and the Disclosure of
Undesirable Information’. Sociology of Health & Illness, vol. 10, 1988, pp.
109 – 133.
Thorne, D., ‘Adding Technology to Care – Is This Progress?’. Progress in
Palliative Care, vol.. 7, 1999, pp. 53 – 54.
Washington, K. T., G. Demiris, D. Parker-Oliver, and M. Day, ‘Home
Internet Use among Service Recipients: Recommendations for Web-Based
Interventions’. Journal of Medical Systems, vol. 31, 2007, pp. 385-389.
Willis, L., G. Demiris, and D. Parker-Oliver, ‘Internet Use by Hospice
Families and Providers: A Review’. Journal of Medical Systems, vol. 31,
2007, pp. 97 – 101.
Paul Kingston is Professor of Health and Social Care and Director of the
Centre for Ageing and Mental Health at Staffordshire University, UK.
Stella Mills is Professor of Multimedia Technology, Staffordshire
University, UK and an Honorary Research Fellow in the School of
Mathematics and Statistics at Birmingham University, UK.
Nothando Ngwenya is a Ph.D. Candidate in Health Studies at Staffordshire
University, UK, where his work is focused on the use of weblogs within an
end of life context and on cyberspace therapy.
Archiving Grief: (Re) Writing
Histories in the Aftermath of Loss
Nate Hinerman
Abstract:
This paper examines how we might use personal grief archives (such as those
constructed in a classroom, explained below) as a way to study communitywide outpourings of grief and the archives they produce following tragedies
labelled as “public” and/or “national.”
The theoretical nature of this paper considers personal grief archives as a way
to reflect on death attitudes derived from various agents of socialization. In
this case, the personal archives discussed result from a series of in-class
writing assignments that include death inventories, childhood loss/early
thoughts about death diaries, questionnaires about life threatening illness and
death fears, advance directives, and ethical wills. The practical nature of this
paper considers a pedagogical mechanism to approach the events of
September 11th, 2001 in light of personally constructed grief archives. My
research will elaborate how meaning-making on the individual level in times
of loss provides a vital lens through which to consider, to critique, and
ultimately to evaluate the meaning assigned to those same events vis-à-vis
more “national” or “public” stages.
Every death, like any archive, tells a story. Sharing these stories can provide
emotional relief and promote a search for meaning. Grief archives can
function as a means to bring people together in mutual support during a time
of loss. Grief archives also assist individuals and communities to revise,
reform, and continue relationships with the deceased over time. Bonds
sustained through memories and linking objects serve as “threads of
connectedness” to those deceased whose deaths are grieved and remembered.
They also form complex (and sometimes problematic) lineages through
which individuals preserve, (re-)orient and (re-)frame their own histories/
identities within the context of a larger societal matrix.
Key Words: Grief, archive, death attitudes, national, meaning, writing,
teaching end-of-life.
*****
1.
A Research Study Provides Unexpected Results
In 2004, I began teaching a course entitled, Death and Dying.
Primarily designed for nursing students seeking to complete a core
requirement in Theology and Religious Studies, I crafted a syllabus that
addressed both the clinical and more “metaphysical” aspects of dying in the
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U.S. On the first day of class, I passed out a survey. The survey was an
adaptation of a famous assessment developed by Edwin Shneidman from the
Centre of Advanced Study of Behavioural Sciences in consultation with other
researchers at Stanford University during the early 1970s. Their survey, “You
and Death: A Questionnaire,” probes important terrain for any student (or
professor, for that matter) studying death and dying. My purpose in passing
out this questionnaire was to ascertain, in advance of any formal group
research, the exposure to and experiences of death and dying by my students.
My hope was that by reading these questionnaires at the start of our class, I
could cultivate important sensitivities to any traumatic grief encounters
potentially experienced by my students. In this way, I hoped to tailor my
lectures and our group discussions in ways that might best honour and respect
their difficult experiences of loss and bereavement. I also wanted a clue into
the general exposure my students had with death and dying. The
questionnaire results gave me this information, and much more.
Before covering some results of the survey, let me say that I have
taught this class each semester since 2004, and I still use this questionnaire to
gauge the students’ experiences with death and to calibrate initial sensitivities
to the material we must explore carefully together. Each time I give the
questionnaire, the responses follow a typical pattern with respect to six
questions in particular (discussed below). I originally developed these
particular six questions as way to help me understand the individual
perceptions of students to the events of September 11th, 2001. Although that
material is always slated towards the end of the term, I am always concerned
about how to cover this incredibly complex chapter of recent U.S. history.
So, I asked the students six specific questions to learn how they felt about
these events. Overall, 201 students took the survey in 2004. Here are the six
questions to which I am referring, and the responses I received in 2004:
75. Are you actively grieving the events of September 11th,
2001?
196- No
5-Yes
76. Do you sometimes experience confusion, disbelief,
anxiety or even depression concerning the events of
September 11th, 2001?
11- No
190- Yes
Nate Hinerman
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77. Do you sometimes experience anger or outrage
concerning the losses from the events of September 11th,
2001?
4-No
197- Yes
78. When reflecting on the events of September 11th, 2001,
do you sometimes sigh, feel an emptiness in your abdomen,
or experience shortness of breath?
32-No
169-Yes
79. When reflecting on the events of September 11th, 2001,
do you sometimes cry, or avoid talking or thinking about
those events, and those that died?
26-No
175-Yes
80. Since the events of September 11th, 2001, have you
questioned or re-examined your religious or spiritual
beliefs as a result of failed attempts to make meaning of the
losses?
34-No
167-Yes
The research I present here is “rough,” and so I will resist making
any wide-sweeping generalizations due to the informal setting in which this
information was gathered. However, given my original purposes, the exercise
proved helpful (i.e., I simply wanted basic access into how my students were
grieving and coming to terms with September 11th, 2001 so that I could teach
the topic more effectively and most respectfully). And for those basic
motives, these results proved both staggering and quite revealing. Notice
question 75 in particular. Only 5 students were aware of their active grief
response to the aforementioned events. Yet, if you look to questions 76-80,
the overwhelming majority of students reported an experience of grief. Grief
is defined most simply as the reaction to loss, and we can grieve in many
different ways: mentally (question 76), affectively (question 77), physically
(question 78), behaviourally (question 79), and even spiritually (question 80).
Even though we must proceed cautiously when interpreting the survey data,
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the results of this informal survey still communicate a simple message: so
often, we do not consciously realize we are grieving even when we are
presenting classic signs of grief. For a professor who crafted a class syllabus
where grief was a central theme, I realized (quickly) I needed a skilful
mechanism that could be individually tailored to each student to assist his/her
efforts to contact his/her experiences of grief. The rest of this paper
elaborates that mechanism I developed, which I refer to as a grief archive.
Before detailing my approach to creating grief archives, let’s consider briefly
some factors that often make it so difficult to acknowledge occasions of
active grief in the U.S.
2.
Current Attitudes toward Death and Dying in the U.S.
Many behavioural psychologists assert that many contemporary
attitudes toward death in the U.S. serve an explicitly death-denying function.1
First, there is no reason to be simple-minded: death is arguably the most
challenging of all human experiences. When we face our own mortality, or
when our loved ones die, we can be (and usually are) affected powerfully in
every aspect of our personhood. However, given the magnitude of death's
significance to living persons, it may seem odd to some that death and dying
seldom gets discussed amongst friends, family, or even health care
professionals in today’s America.2 Instead, death exists for many as a
mysterious, anxiety-producing possibility looming on life’s horizon. Given
such a perception, it’s no wonder that many avoid, repress, or deny altogether
the reality of death.3
Second, in the U.S., life expectancy continues to increase, which
obviously means Americans are living longer.4 In part as a result of advances
in life-sustaining technologies developed and perfected primarily during the
late 1950s and early 1960s, many Americans have come to view death as
something to be “mastered” (or at least controlled) through continued
technological advancements. In addition, the primary causes of death now are
slow, progressive illnesses (cancer, heart disease, liver disease) rather than
acute infectious diseases (diphtheria, syphilis, etc).5 These epidemiological
transitions have pushed end-of-life care from the home to the hospital, in part
so that the dying can be proximate to important life-extending technologies.
Resulting from these transitions, care giving at the end-of-life largely has
been (re-)assigned to medical professionals, rather than friends and family.
The impact of this migration has caused the average person in the U.S. to
have an increasingly passive role in caring for the dying.6 Even more, many
chaplains assert that a serious challenge has arisen surrounding how to
explore spiritual issues with the dying (i.e. questions of meaning, questions of
value, and questions of relationship) when the context of care they are
receiving is almost purely geared towards the biological dimension of their
personhood.7
Nate Hinerman
155
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Third, infant mortality rates have decreased dramatically over this
past century,8 and given that many who are the end-of-life no longer live at
home, the average American is unlikely to be confronted by death early on in
the lifespan as has been true for every generation prior to 1950. Furthermore,
consider the fact that one out of every six Americans changes residences
annually.9 Multi-generational homes, once the norm, are now the exception;
cities have become the chosen locus for living instead of rural environments
(many factors play into this migration). Odds are that many cannot actually
provide care to their dying loved ones even when they would like to due to
prohibitive geographic distances. On average, American families simply do
not live as close to one another as they once did.
Each of these changes in our collective attitudes toward death has
contributed to a “cultural lag” in terms of our willingness and overall
capacity to address directly issues of death and dying (including grief). For
many in the U.S., death has become a “medical failure” rather than a “natural
event.” While science tries to “tame death” on the one hand, death continues
to become increasingly more “invisible” on the other.10 The sum of these
attitudes has contributed to a special form of death denial: a state in which
death is not discussed, confronted, or directly experienced with an active and
open orientation by most in society. Instead, most take an increasingly
passive role in caring for the dying, and this trend further pushes dying into
institutional settings (and more out of mainstream view). Augmenting
“American individualism” and a privileging of patient autonomy within our
health care systems, our increasingly passive role in providing care to the
dying leaves, for many, few opportunities to reflect on and consider carefully
one's own mortality.
3.
The Rise of Death Anxiety
An unintended cost of this growing passivity in care giving for and
decreased exposure to the dying has been an increase in Americans’ death
anxiety (i.e. fear of death).11 Certainly, the events of September 11th, 2001
exacerbated such fears. Interesting research has emerged that studies the
relationship between “terror” and death anxiety. A burgeoning field within
psychology addresses squarely the consequences of death anxiety, and
hundreds of recently-conducted empirical research studies support many of
its core tenants. Known as Terror Management Theory (TMT), the common
thesis in these studies suggests that when people are confronted with or
reminded about death, the test subjects tend to demonstrate aggressive
behaviour towards those perceived as different and positively towards those
perceived as similar. Test subjects also tend to exhibit both intolerant and
aggressive behaviour towards those perceived to support immortality
ideologies different from the test subject's own. One implication from this
research posits that increases in our individual and collective death anxieties
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often render us more inclined to exhibit intolerant beliefs, attitudes, and
actions towards those perceived or labelled as “different.”12 TMT researchers
commonly cite such intolerance as advancing in four stages: accommodation,
dismissal, assimilation, and if these fail, annihilation.
TMT also asserts that people have a deep need to sustain faith in a
meaningful worldview.13 A “meaningful worldview” can be described as a
need to feel valued, protected, and ultimately, significant. Psychologists
generally might call this self esteem, but in this case the taproots extend
deeper. These meaningful constructs function securely when they are met and
unthreatened. When they are threatened, anxiety arises and the push to defend
them occurs. Building from TMT, the “mortality salience hypothesis” argues
that if culture really does provide a death-denying capacity, then alerting
people (or reminding them) about their impending mortality should induce a
greater need for these death-denying constructs of their belief systems, and
this need should be evidenced in their actions.14
Considered through the lens of these research findings, the attacks of
September 11th, 2001 serve as a compelling real life example of these
impulses to act aggressively towards others labelled as “different.”15 The
aftermath of the attacks in the media clearly posed the attacks as a clash of
American (i.e. “Christian”) and Middle Eastern (i.e. “Muslim”) world views.
At first, after the initial shock of the attacks, many felt strong feelings of
anxiety and anger. Clearly, these events served as powerful reminders to all
Americans of their mortality. Returning to the death questionnaire discussed
in the first section, the student responses to the six questions I provided
support the notion that feelings of grief continue to emerge, often from depths
below the surface of conscious awareness. Furthermore, this is precisely the
scenario in which TMT research claims the most potentially hazardous kinds
of “labelling of difference” occur (i.e., when personal anxieties about death
and the grief that accompanies loss go unacknowledged and unexplored).
4.
Creating Grief Archives
In an attempt to reach these more subterranean death anxieties, and
their corresponding grief responses, I began work on a collection of in-class
assignments designed to explore in a personal way various aspects of dying. I
initially wrote and refined one reflection for each class (so a total of 32). I
coordinated each reflection with the topic of the unit we covered in class for
that day. At the start of each class, I provide the reflection exercise to each
member of the class and they then complete the exercise (time extensions are
happily granted for students who want to think more deeply outside of class
about a particular subject). After the class completes a reflection, I almost
always notice a palpable change in the mood of the room. As we reflect
individually on our fears, anxieties, and wishes for end of life care, and
especially as we make contact with our grief, I sense a gradual “opening up”
Nate Hinerman
157
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in the overall orientation of the class to the topics of death and dying. These
exercises create a special sense of reverence, which often produces genuine,
honest moments of discussion, ones that encourage compassionate responses
to the experiences of their fellow students, and those of the authors we study.
Students do not read each other’s work. They are free to share anything (or
nothing) about their own experiences. I do read the reflections after class and
return them at the start of the next class. I treat each reflection in each
student’s burgeoning “grief archive” as I would a diary entry. I do not
pressure students to complete them in any particular way; however, I do ask
that they complete each reflection in a way that accords genuinely with their
experiences. Here is a sample list of names from the 32 reflections I
developed:
My Earliest Memories of Loss
My Losses: An Inventory
My Feelings Concerning Death
My Philosophy Concerning Death
Coping with a Life-Threatening Illness
My Fears about Death
My Values: A Worksheet
When the End is Near
Reflections on the Virginia Tech Shootings
Reflections on September 11th, 2001
My Ethical Will
My Funeral
My Wishes for Organ Donation
The very last reflection exercise we do is an advance directive. I feel
that it’s most appropriate to enter the terrain of advance planning only after
each of us has meditated on these other areas first. (I personally do each
exercise anew along with the students each term.) Once we complete the
advance directive, I have the students create some type of “vessel” in which
to house their individual grief archive reflections. Commonly, students will
design a folder with the names (and sometimes images) of those who have
died in their life. Others have created more elaborate ways to preserve their
archives. The goal with these exercises is for the students to investigate their
narratives and to explore affectively, intellectually, physically, and spiritually
their losses, and to make contact with certain aspects of grief that accompany
each case.
4.
Conclusions
I review each archive at the end of the term. I then return them for
the student to keep. Every archive, like every death, tells a unique story. I
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believe that sharing these stories can provide emotional relief and promote a
search for meaning, both individually and collectively. TMT research posits
that intolerant reactions in the face of death anxiety and grief are likely to
emerge if such experiences and feelings go unacknowledged. Seen then in
their best light, grief archives function as a means to bring people together in
mutual support during a time of loss. Although I never force students to
speak about their experiences of grief and loss, many do (and cite specific
questions in a particular reflection as the launching point for their comment).
In this way, grief archives can assist individuals and communities to revise,
reform, and continue relationships with the deceased over time. As opposed
to more Freudian notions of “attachment theory” or “grief-work models” that
attempt to help a client break bonds with the deceased and re-invest them in
something or someone else, my approach using these archives is more
narrative-based. My work in using grief archives has, in my experience,
demonstrated that bonds sustained through memories and linking objects can
serve as valued “threads of connectedness” to those deceased whose deaths
are grieved and remembered. When we make contact with our own grief
responses, we often are better active listeners to another’s story of grief.
These grief archives also can reveal complex (and sometimes
problematic) lineages through which individuals preserve, (re)orient and
(re)frame their own histories/identities within the context of a larger societal
matrix. Said differently, many students begin to notice half-way through the
term the many ways in which their respective views about death have been
shaped by agents of socialization such as peers, family, religion, political
ideology, and sometimes even the socio-economic circumstances in which
grew up. Questions of ethno-cultural identity surface throughout the course,
too, in relation to the construction of these archives. In the context of a course
on religious studies and philosophical theology, these are precisely the topics
I want to raise and address together with my students. Death, and our
complex reactions to it, has the capacity to link all of these existential
concerns together in powerfully significant ways. Grief archives not only
provide a mechanism to initiate such meaning-making, but they also serve as
an important lens through which to consider larger, more public tragedies
such as the events of September 11th, 2001, and all those labelled “public” or
“national.” Grief archives reveal the variety of reactions we have to death,
and allow us to cultivate vital sensitivities to differences, broadly conceived,
as well as refine our lenses of critique with regard to how certain memorials
archive collective losses.
Nate Hinerman
159
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Notes
1
See S Solomon, J Greenberg, and T Pyszczynski, ‘A Terror Management
Theory of Social Behaviour: The Psychological Functions of Self-Esteem and
Cultural Worldviews’, in Advances in Experimental Social Psychology, M P
Zanna (ed), vol. 24, San Diego, Academic Press, 1991, pp. 91-159.
2
C Shilling, ‘Modernity, Self-Identity and the Sequestration of Death’,
Sociology: The Journal of the British Sociological Association 27 (3), 1993,
pp. 411-431.
3
In an effort to avoid extremes, we must both accept and deny death. Talcott
Parsons expressed the American attitude towards death well when he wrote,
“[rather than deny death] modern societies bring to bear every possible
resource to prolong active and healthful life, and come to accept death only
when it is inevitable.’ Cf. T Parsons, ‘Death in American Society: A Brief
Working Paper’, American Behavioural Scientist 6 (9), 1963, pp. 61-65.
4
‘Deaths and Death Rates’, Historical Statistics of the United States, 2006, p.
74.
5
R N Anderson, ‘Leading Causes for 2000’, National Vital Statistics Reports
50 (16), Hyattsville, MD: National Centre for Health Statistics, 2002, p. 8.
Also, see ‘Resident Population by Age’, Statistical Abstract of the United
States: 1999, p. 869; and ‘Death and Death Rates by Leading Causes of
Death and Age: 2000’, Statistical Abstract of the United States: 2002, p. 82.
6
J J Farrell, Inventing the American Way of Death, 1830-1920, Philadelphia,
Temple University Press, 1980.
7
T E Quill, ‘Initiating End-of-Life Discussions with Seriously Ill Patients:
Addressing the “Elephant in the Room”’, JAMA, 284, 2000, pp. 2502-2507;
and T E Quill, Caring for Patients at the End of Life: Facing an Uncertain
Future Together, New York: Oxford University Press, 2001; also see M J
Silveira, A DiPiero, M S Gerrity, & C Feudtner, ‘Patients' Knowledge of
Options at the End of Life: Ignorance in the Face of Death’, JAMA, 284,
2000, pp. 2483-2488. Also see J Lynn, ‘Learning to Care for People with
Chronic Illness Facing the End-of-Life’, JAMA, 284, 2000, pp. 2508-2511.
8
U.S. Census Bureau, ‘Expectation of Life at Birth’, Historical Statistics of
the United States, Colonial Times to 1970, Washington, D.C., Government
Printing Office, p. 55; and Statistical Abstract of the United States: 2006,
126th ed., Washington, D.C., Government Printing Office, 2006.
9
Cf. ‘Mobility Status of the Population’, Statistical Abstract of the United
States: 2006, p. 29.
10
D Callahan, ‘Frustrated Mastery: the Cultural Context of Death in America
- Caring for Patients at the End of Life’, Western Journal of Medicine 163
(3), 1995, pp. 226-230.
11
Cf. E Becker, Denial of Death, New York, Free Press, 1973, pp. 1-75.
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12
See ‘An Interview with Dr. Sheldon Solomon and Dr. Tom Pyszczynski:
Symbols: Jumping the Spatio-Temporal Gap to Make the Unreal Real’, ESI
Special Topics, November 2005. The Interview transcript can be found here:
http://esi-topics.com/terrorism/interviews/SheldonSolomon.html.
13
S Solomon, J Greenberg, and T Pyszczynski, ‘A Terror Management
Theory of Social Behaviour: The Psychological Functions of Self-Esteem and
Cultural Worldviews’, in Advances in Experimental Social Psychology, ed.
M. P. Zanna, vol. 24, San Diego, Academic Press, 1991, pp. 91-159.
14
J Greenberg, S Solomon and T Pyszczynski, ‘Fear of Death and Human
Destructiveness,’ The Psychoanalytic Review, vol. 90 (4), August 2003, 457474.
15
T Pyszczynski, S Solomon, and J Greenberg, ‘In the Wake of 9/11: The
Psychology of Terror’, in American Journal of Psychiatry, vol. 160 (5) May
2003, 1019-1023.
Bibliography
Anderson, R. N., ‘Leading Causes for 2000.’ National Vital Statistics Reports
50 (16). Hyattsville, MD: National Centre for Health Statistics, 2002, p. 8.
Becker, E., Denial of Death. New York: Free Press, 1973, pp. 1-75.
Callahan, D., ‘Frustrated Mastery: the Cultural Context of Death in America Caring for Patients at the End of Life’. Western Journal of Medicine 163 (3),
1995, pp. 226-230.
‘Deaths and Death Rates’. Historical Statistics of the United States, 2006, p.
74.
‘Death and Death Rates by Leading Causes of Death and Age: 2000’.
Statistical Abstract of the United States: 2002, p. 82.
Greenberg, J., Solomon, S., and Pyszczynski, T., ‘A Terror Management
Theory of Social Behaviour: The Psychological Functions of Self-Esteem and
Cultural Worldviews’, in Advances in Experimental Social Psychology, M P
Zanna (ed), vol. 24, San Diego: Academic Press, 1991, pp. 91-159.
–––, ‘Fear of Death and Human Destructiveness’. The Psychoanalytic
Review, vol. 90 (4), August 2003, pp. 457-474.
Nate Hinerman
161
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–––, ‘In the Wake of 9/11: The Psychology of Terror’. American Journal of
Psychiatry, vol 160 (5) May 2003, pp. 1019-1023.
‘Mobility Status of the Population’. Statistical Abstract of the United States:
2006, p. 29.
Parsons, T., ‘Death in American Society: A Brief Working Paper’. American
Behavioural Scientist 6 (9), 1963, pp. 61-65.
‘Resident Population by Age’. Statistical Abstract of the United States: 1999,
p. 869.
Statistical Abstract of the United States: 2006, 126th ed. Washington, D.C.:
Government Printing Office, 2006.
U.S. Census Bureau, ‘Expectation of Life at Birth’. Historical Statistics of the
United States, Colonial Times to 1970. Washington, D.C.: Government
Printing Office, p. 55.
Nate Hinerman is on the faculty at the University of San Francisco where he
teaches courses in death and dying as well as religious studies. He is also
Chair of the San Francisco Bay Area End of Life Network.
Communicating with the Dead through the Newspaper: A
Quantitative and Qualitative Analysis
Patricia L. Bromley and Mitte J.A. Nimocks
Abstract
Rituals performed immediately following a death serve important functions.
Preparing the deceased for burial, creating a means for mourners to gather,
and preparing for a funeral allow people to begin to grieve the loss.
Obituaries simultaneously notify the public about funeral plans, and
memorialise the deceased. But what purpose is served by advertisements
placed in newspapers long after someone has died? Often, these notices
appear to be directed to the deceased, as though the dead person subscribed to
the Sunday edition and would be sure to read it. The question posed in this
paper is, who writes and pays for these advertisements and why do they do it?
In this study, the content of In Memoriam advertisements was analysed via
qualitative and quantitative methods. Data reveal that such advertisements
serve several purposes, including maintaining attachment bonds, seeking
community, commemorating the deceased, and reconstructing one’s personal
belief system.
Key Words: In memoriam, newspaper, death, bereavement, obituary.
*****
1.
Introduction
Cultures have norms concerning expression of grief. A funeral,
memorial service, and/or visitation are public and expected; a newspaper
obituary invites mourners to attend. However, some mourners also place In
Memoriam (IM) advertisements in the newspaper a year or many years later.
Such advertisements are often framed as private communications to the
deceased, yet are posted in a public forum. The practice is not simply a North
American phenomenon; Alali1 examined such advertisements in Nigerian
newspapers, identifying several common features.
Though bereavement is assumed to be a private, personal
experience, it is also a social one.2 Private grief work helps one come to
accept the death.3 Reaching out to the outside world may facilitate this
process.4 Personal advertisements and “web cemeteries”5 may allow a means
to express sadness for a longer time and to a wider audience than might
otherwise be possible. Roberts’6 analysis of web cemetery guest books
reveals that 29% of entries were written by the memorial author, returning to
visit. The memorial is a public venue; postings often refer to anonymous
others, e.g., “whoever is reading this.” Almost half of visitors did not know
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the deceased, suggesting that those who post memorials and those who read
them are seeking a broader community in which to discuss grief.7
In Memoriam advertisements may represent attempts to maintain
bonds to attachment figures.8 Because attachment bonds are crucial to wellbeing,9 when death severs them, individuals may try to maintain them.
Because most separations are temporary, our tendency is to call out for the
other, to create and maintain a mental image of them10 and to fantasize about
their return.11 In the absence of ongoing physical contact with the person,
images may fade into oblivion unless preserved by the living.
Recent bereavement research has focused on the ways bonds can be
continued in adaptive ways.12 Bereaved individuals must reappraise the
meaning of the loss and somehow relocate the deceased in a world in which
they are no longer physically present. Coping involves changes in identity
(e.g., from wife to widow) and role (e.g., mastering new skills). In a sense,
the biographies of self and of the deceased are modified on an ongoing
basis.13 This is done through efforts to make sense of the death.14 Because
families create their own realities, narrative is the method by which reality is
maintained.15 Families discuss whether the death was preventable and tell
stories about the deceased, finding ways to characterize the deceased which
allow them to construct meaning.
For this study, the authors used both a quantitative analysis of the
content of IM advertisements, and a qualitative one. The quantitative analysis
consisted of frequency counts of advertisement contents. The qualitative
analysis employed Burke’s16 method of dramatistic criticism. Burke17 posited
that human action can be understood through the metaphor and language of
drama. Rhetoric may be analysed by defining the where and when (Scene),
what (Act), who (Agent), how (Agency), and why (Purpose) surrounding any
particular act or genre of acts. Burke described relationships between any two
of these elements as “ratios” referring to the balance between the two, or the
relative emphasis of each. Human acts have very different meanings based on
which of the five elements is used to define another.18
Memorials published in newspapers provide an intriguing genre for
study. Regardless of one’s beliefs regarding life after death, it is odd that a
person would communicate with a deceased loved one through a newspaper.
Does the sender of the message believe that the newspaper provides a
channel accessible to the deceased whereas other channels of communication
are not? The critical question of this study is why one would choose this form
of communication.
Applying Burke’s pentad, the Agent in IM advertisements is the
person or people who authors, submits, and pays for them. The Act is the
posting of the advertisement. The Scene is the date on which the
advertisement appears. The Agency is the advertisement itself. Determining
the Purpose is the primary objective of this study. Focusing on the Agency-
Patricia Bromley and Mittie Nimocks
165
______________________________________________________________
Purpose ratio, the ratio that calculates the relationship of means-ends19
illuminates why presumably rational humans would choose the personal
advertisements as an agency for communicating with the dead.
2.
Method
The Wisconsin State Journal (WSJ), a daily newspaper published in
Madison, Wisconsin, USA, was used in this study. The WSJ, which mainly
has a statewide readership, features IM advertisements on the Personals page
in the Classifieds section. We analysed all IM advertisements placed in the
WSJ in 2005. We tallied date of the advertisement, gender and age of the
deceased, years since death, who placed the advertisement, the apparent
audience, the occasion (e.g., anniversary of death, birthday), manner of death,
and whether a photograph appeared. The form of the advertisement (e.g.,
poem, letter) and specific contents were also tallied. Advertisements, which
appeared for several days, were only analysed once.
3.
Results
A. Features of IM Advertisements (Table 1)
In 2005, 191 IM advertisements appeared in the WSJ. Most (61.9%)
memorialised males and appeared within five years of death (55.3%). The
modal number of years since death was one (M = 5.3, range 1-25); the modal
age at death was 18 (M = 39.27, range 1-89). The vast majority (79.9%) of
authors were relatives, usually “your family.” “Mom” was far more apt to
place an advertisement than “Dad” (12.4% versus 2.1%). Advertisements
apparently placed by pets comprised 4% of the sample. The deceased
appeared to be the audience for the advertisement in 82% of cases. Some
advertisements (4.1%) were directed to the public and some (6.2%) to both
the deceased and the public. Advertisements were most commonly placed on
an anniversary of the death (52.6%) or birthday of the deceased (32%).
B. Content of IM Advertisements (Table 2)
Ads most commonly featured a photograph of the deceased and a
letter or note (57.2%) to the deceased. Poems appeared in 32% of
advertisements. Mentions of loving (81.4%), missing (62.9%), and feeling
the presence of the deceased (66.5%) were also common. Sadness (23%) and
longing for the deceased (18.6%) were less common.
Pearson correlations were computed among the variables. Age at
death was negatively correlated with presence of a photograph (r = -.16, p <
.05). Years since death was positively correlated with presence of an
information update for the deceased (r = .156, p < .05). Age at death was
negatively cor- related with mentioning the possibility of a reunion with the
deceased (r = .19, p < .01).
166
Communicating with the Dead Through the Newspaper
______________________________________________________________
Authors who mentioned loving the deceased also tended to mention
missing them (r = .38, p < .01). Mention of love correlated positively with
mention of memory (r = .15, p < .05) and of a desire for a reunion (r = .16, p
< .05). Longing was positively associated with sadness (r = .20, p <.01).
Table 1. Frequencies and Number of Instances in IM Advertisements
Feature
Gender of Deceased
Male
Female
Unknown
Number of Instances
Author of Advertisement
“Your Family”
Mother
Both Parents
Children
Wife
Dad
Pets
Husband
Others (step-relatives, names of people)
Audience
The Deceased
Deceased and Public
Public
Other
Unspecified
God
Occasion
Anniversary of Death
Birthday of Deceased
Other (Christmas, Mothers/Fathers Day,
Thanksgiving, Wedding Anniversary)
Form
Letter or Note
Poem
Birthday Greeting
Other (Epitaph, Bible Verse, Chant/Cheer)
Note: n = 191
Frequency
120
67
4
61.9%
34.5%
2.1%
96
24
12
6
5
4
4
3
3
49.5%
12.4%
6.2%
3.1%
2.6%
2.1%
2.1%
1.5%
1.5%
159
12
8
8
3
1
82.0%
6.2%
4.1%
4.1%
1.5%
0.5%
102
62
52.6%
32.0%
11
5.6%
111
63
52.7%
32.5%
7
3.6%
3.1%
6
Patricia Bromley and Mittie Nimocks
167
______________________________________________________________
C. Application of Burke’s Pentad
Scene. The date marked by IM advertisements is significant;
advertisements were most commonly placed on an anniversary of the death,
publicly marking the significance of that day. Birthdays comprised the
second largest category of dates, with other special occasions less frequently
recognized. Recently deceased people are most commonly memorialised,
suggesting that grief work provides a means of maintaining a relational bond
after death but that the bond relaxes with time, for many people. It may feel
strongest on the anniversary of death and at holidays.
Act. The Act is to send a written and visual message. Nearly always,
this message was addressed to the deceased, though a few were directed to
the public. The presence of photographs in 80% of advertisements suggests a
visual reminder is important. The format was commonly a letter or note to the
deceased and the most common message was an expression of love for the
deceased, frequently coupled with the message that the deceased was missed.
Approximately half of advertisements referred to memories of the deceased.
Half mentioned being conscious of time elapsing since the death. Many
included wording suggesting that those placing advertisements felt the
presence of the deceased, e.g., “Your spirit lives within us.” This supports the
theory that the bereaved wish to maintain relationship with the dead.
Table 2: Instances of Specific Features of Advertisements
Feature
Number of Instances
Percent
Loving
Feeling the Deceased is Present
Missing
Time Passing
Memories of the Deceased
Making Sense of the Death
Sadness
Longing
Imagining the Deceased Now
Reunion with the Deceased
Idealization of the Deceased
Instructions
Update on Family Events
Thanks
Manner of Death
Warning
Note: n = 191
158
129
122
98
94
52
46
36
33
30
28
28
19
16
7
6
81.4%
66.5%
62.9%
50.5%
48.5%
26.8%
23.7%
18.6%
17.0%
84.4%
14.4%
14.4%
9.8%
8.2%
3.5%
3.1%
168
Communicating with the Dead Through the Newspaper
______________________________________________________________
In more than 25% of advertisements the writer seemed to be creating
a narrative to make sense of the death. A reunion was suggested by
approximately 15% of authors and idealization of the deceased in about the
same percentage. Thus, the Act appears to weave together words and images
reflecting closeness to, and regard for, the deceased.
Agency. Placing an advertisement in a daily, regional newspaper, to be
posted on a specific date involves planning, time, thought, and money. Such
an agency also allows for feedback regarding the message. Feedback may
come from those who read the advertisements but also may come in the form
of the agency/act itself. Workers at the paper read the advertisement, it is
published in the newspaper, and then it is delivered to the author, who then
may read it, becoming both receiver and sender of the message. Agents are
most often relatives; feedback would return to them, providing additional
opportunities for talking with others about the deceased.
Purpose. The most frequent message communicated is that the author
loves and misses the deceased. Timing of messages on significant dates
suggests the wish to communicate is strongest then.
Agency-Purpose Ratio. Considering the various reasons other types of
messages are communicated through advertisements might offer some insight
as to why a living person would choose this channel. Notices of items for sale
or items that have been lost and found are placed when the author wishes to
communicate with a person unknown (e.g., “I found your ring but I don’t
know who you are.”) This reason would not apply to the deceased, as it is
clear that this person is well-known to the author.
Another reason for placing an advertisement is to communicate with a
person whose whereabouts are unknown. This is a more logical rationale, in
that while most people know where the physical remains of a loved one are
they may feel uncertain of where the spirit or non-physical person resides.
4.
Discussion
People place personal advertisements as announcements to the
general public. In this respect placing an IM advertisement parallels other
acts that memorialise a loved one such as placing flowers at graves and
erecting roadside crosses. Advertisements may be used not to reach the
deceased effectively but as a means of communicating a message publicly.
The question becomes not, “why the newspaper?” but, “why the public nature
of this intimate communication?” Must it be public so that it may be
witnessed? An IM advertisement seeks connection with those who have
empathy with the loss and also declares that the relationship continues. A
public declaration affirms that a person lived and was important, unique, and
loved. It documents the devotion of the partner and the strength of the bond,
perhaps offering an opportunity to complete unfinished business or redefine
the relationship.
Patricia Bromley and Mittie Nimocks
169
______________________________________________________________
We therefore conclude that there is a dual audience for these
advertisements, and that the motivations for their public nature are complex.
Most IM advertisements are addressed to the deceased and serve to maintain
attachment and affirm beliefs that the relationship between the author and the
deceased is intact. Addressing the deceased publicly is a formal declaration
of love (and of one’s belief in the afterlife) to which the readership act as
witnesses. The 20% of advertisements not specifically directed to the
deceased sought community, commemorated the deceased, and rewrote
narratives.
Notes
1
A Alali, ‘Obituary and In-Memoriam Advertisements in Nigerian
Newspapers’. Omega, vol. 28, issue 2, 1993, pp. 113-124.
2
M Stroebe, H Schut, and W Stroebe, ‘Attachment in Coping with
Bereavement: A Theoretical Integration’. Review of General Psychology, vol.
9, issue 1, 2005, pp. 48-66.
3
S Freud, ‘Mourning and Melancholia’, in Standard Edition of the Complete
Psychological Works of Sigmund Freud, J Strachey (ed), Hogarth Press,
London, 1957.
4
J Archer, ‘Broad and Narrow Perspectives in Grief Theory: Comment on
Bonnano and Kaltman’. Psychological Bulletin, vol. 127, issue 4, 2001, pp.
554-560.
5
M Moss, ‘Grief on the Web’. Omega, vol. 49, issue 1, 2004, pp. 77-81.
6
P Roberts, ‘The Living and the Dead: Community in the Virtual Cemetery’.
Omega, vol. 49, issue 1, 2004, pp. 57-76.
7
P Roberts, ‘Here Today and Cyberspace Tomorrow: Memorials and
Bereavement Support on the Web’. Generations, vol. 28, issue 2, 2004, pp.
41-46.
8
J Archer, op. cit., p. 555
9
J Bowlby, Attachment and Loss: Vol. 3: Loss: Sadness and Depression,
Basic Books, New York, 1980.
10
J Archer, op. cit., p. 556
11
M Gibson, ‘Melancholy Objects’. Mortality, vol. 9, issue 4, 2004, pp. 285299.
12
M Stroebe, H Schut, and W Stroebe, op. cit., p. 49
13
M Moss, op. cit., p. 77
14
C Davis, S Nolan-Hoeksema, and J Larson, ‘Making Sense of Loss and
Benefiting from the Experience: Two Construals of Meaning’. Journal of
Personality and Social Psychology, vol. 75, issue 2, 1998, pp. 561-574.
15
J Nadeau, ‘Meaning Making in Family Bereavement: A Family Systems
Approach’, in Handbook of Bereavement Research: Consequences, Coping,
170
Communicating with the Dead Through the Newspaper
______________________________________________________________
and Care, M Stroebe, R Hansson, W Stroebe, and H Schut (eds), American
Psychological Association, Washington, DC, 2001, pp. 329-348.
16
K Burke, A Grammar of Motives, Prentiss-Hall, New York, 1945.
17
ibid.
18
J Gusfield, Kenneth Burke on Symbols and Society, University of Chicago
Press, Chicago, 1989.
19
J Gusfield, op. cit., p. 136
Bibliography
Alali, A., ‘Obituary and In-memoriam Advertisements in Nigerian
Newspapers’. Omega, vol. 28, issue 2, 1993, pp. 113-124.
Archer, J., ‘Broad and Narrow Perspectives in Grief Theory: Comment on
Bonnano and Kaltman’. Psychological Bulletin, vol. 127, issue 4, 2001, pp.
554-560.
Bowlby, J., Attachment and Loss: Vol. 3: Loss: Sadness and Depression.
Basic Books, New York, 1980.
Burke, K., A Grammar of Motives. Prentiss-Hall, New York, 1945.
Davis, C., S. Nolan-Hoeksema, and J. Larson, ‘Making Sense of Loss and
Benefiting from the Experience: Two Construals of Meaning’. Journal of
Personality and Social Psychology, vol. 75, issue 2, 1998, pp. 561-574.
Eisenhandler, S., ‘The art of consolation: Commemoration and folkways of
faith’. Generations, vol. 28, issue 2, 2004, pp. 37-40.
Freud, S., ‘Mourning and Melancholia’, in Standard Edition of the Complete
Psychological Works of Sigmund Freud, J. Strachey (ed), Hogarth Press,
London, 1957. (Original work published 1917).
Gibson, M., ‘Melancholy Objects’. Mortality, vol. 9, issue 4, 2004, pp. 285299.
Gusfield, J., Kenneth Burke on Symbols and Society. University of Chicago
Press, Chicago, 1989.
Moss, M., ‘Grief on the Web’. Omega, vol. 49, issue 1, 2004, pp. 77-81.
Patricia Bromley and Mittie Nimocks
171
______________________________________________________________
Nadeau, J., ‘Meaning Making in Family Bereavement: A Family Systems
Approach’, in Handbook of Bereavement Research: Consequences, Coping,
and Care, M. Stroebe, R. Hansson, W. Stroebe, and H Schut (eds), American
Psychological Association, Washington, DC, 2001, pp. 329-348.
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Memorials in Texas and Oklahoma’. Death Studies, vol. 25, issue 4, 2001,
pp. 341-355.
Roberts, P., ‘The Living and the Dead: Community in the Virtual Cemetery’.
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Roberts, P., ‘Here Today and Cyberspace Tomorrow: Memorials and
Bereavement Support on the Web’. Generations, vol. 28, issue 2, 2004, pp.
41-46.
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Bereavement: Rationale and Description’. Death Studies, vol. 23, issue 3,
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9, issue, 1, 2005, pp. 48-66.
Patricia Bromley is professor of psychology at the University of WisconsinPlatteville.
Mittie Nimocks is professor of Communication and Dean of the College of
Liberal Arts and Education at the University of Wisconsin-Platteville.
Agencies of the Afterlife: Weblogs and Television
Shows on Death in the Netherlands
Marga Altena
Abstract
In the Netherlands, Internet sites and television shows present intimate
accounts of people dealing with death, mourning and memorialising.
Personal diaries, life stories and memorial sites reveal reflections of patients,
parents, spouses and friends. Television shows such as Over My Dead Body,
in Dutch Over Mijn Lijk, document in detail the impact of a disease, the
funeral and how the bereaved cope with their loss.
Weblogs and television shows, like any other means of communications,
reflect people's ideas and values, but they are also instrumental in the
construction of new notions and practices. Although in the Netherlands,
people are supposed to be free in the creation of funerary rites, websites and
television shows take shape in accordance with traditional techniques and
expressions.
A close “reading” of the visual and textual expressions in the weblogs and
television series of Over My Dead Body, leads to conclude that in the digital
realm people find an unprecedented freedom to shape new and personal
funerary rites, and that these modern media provide unexpected opportunities
to express spiritual feelings.
Key Words: Agency, representation, afterlife, weblogs, television shows.
*****
Sometimes, scholars can hardly believe me when I tell them about
Dutch television shows and weblogs featuring terminally ill people who
relate how they cope with death. They ask me: “Why would anyone who is
not attention craved or overly exhibitionistic, choose to expose one’s intimate
history and sorrow in a public medium?” From an academic point of view
scholars find the topic fascinating, but personally, they cannot appreciate
these weblogs and shows.
Although I can see where these reactions are coming from, (I
confess, at first, I felt very much the same), I hope to show that the “Agencies
of the Afterlife in Dutch Weblogs and Television Shows” represent a
promising research topic that sheds light on how death and dying are
perceived today. Moreover, I hope to point out that shows and weblogs on
death and dying supply innovative and authentic means for expressing what
is most dear and meaningful to people.
174
Agencies of the Afterlife
______________________________________________________________
In the Netherlands, on television and the Internet, diaries, life stories
and memorial sites reveal reflections of patients, parents, spouses and friends.
My research investigates how death and memorials are represented in these
television shows and weblogs, and what meanings of afterlife and spirituality
these images and texts convey. Fascinating questions arise about why people
feel the need to convey such messages to an unknown audience, and what
they hope to achieve by them.
Here, I focus on the television series titled Over My Dead Body, a
show that is closely intertwined with the Internet. In the television show and
on the Internet, the protagonists address the audience: during the show as
well as afterwards, they debate subjects related to the show as well as
independent topics. In my analysis, I am particularly interested in A. how the
new media of television shows and weblogs relate to traditional media in
funerary culture, and B. how three parties involved in the making - the
producers, the presenter and the protagonists - influenced the shape and
content of these media. Because of the time frame, I excluded a fourth party,
that of the television audience, which I will discuss elsewhere.
1.
Visual Traditions in Dutch Funerary Culture
It is likely that people have always needed images to remember dead
loved ones. Portraits and objects of the dead not only helped people left
behind to keep memories alive, but they also re-defined the relations of the
deceased and bereaved. Images, things both reflected and constructed, lost
and new identities, were tangible proofs of the ties between the living and the
dead.
Historical objects show the diversity and the continuous change of
funerary imagery. In the Netherlands in 1998, some 150 drawings, prints and
paintings of dead persons were accounted for in archives and museum
collections.1 These portraits represent only a small part of the total amount of
portraits made of dead friends and family, as most of these used to be
destroyed when there were no contemporaries left to remember who they
were. In Roman Antiquity, sculptured busts of deceased well-to-do citizens depicted as being alive - had a prominent place in rituals of ancestor
veneration.2 In the Middle Ages, painted and sculptured death portraits shown as if alive, as a corpse and sometimes even in decay - were still an
elite’s privilege. In the seventeenth century, portraits of the dead - presented
living and as a corpse - became affordable for the emerging class of rich
tradesmen. Although becoming unfashionable in the eighteenth century,
romanticism re-introduced death portraits.3 Images of dead people, executed
by the new medium of photography, became quite popular again in the
nineteenth century. Post mortem photos were put into cassettes and
medallions for private use, but they were also presented in photo albums and
Marga Altena
175
______________________________________________________________
exhibited in drawing rooms to be seen for visitors where they had a semipublic function.4
In the Netherlands at the turn of twentieth and twenty first century,
new funerary rituals emerged that made prominent use of popular media like
television and the internet. In 2008, television and the Internet have become
broadly accepted means of communication about dying and death.5 In
websites and weblogs people have found a platform to address delicate issues
concerning death and dying and an appreciated means to express themselves.
2.
Over My Dead Body
The television series Over My Dead Body, follows five young
terminally ill cancer patients with a life expectancy of only a few months.
These people are visited by the show’s presenter over a period of one year
resulting in a series of seven episodes. The first series that was aired in 2006
was proclaimed the best Dutch television show of the year. The second
series, aired in 2008 equalled the success of the first. To understand why the
show was so highly appreciated, we have to look at its construction,
especially at the different levels of mediation, the different agents at work in
the production of the television show and the website connected to it. In my
method, I make a distinction between: 1. the producer, here: the production
company and the broadcasting company, 2. the presenter and 3. the
protagonists, the dying people who’s stories are told.
A. The Producer/The Broadcasting Company
Over My Dead Body is made by an independent production
company called Skyhigh TV that produces television shows varying from
informative political talk shows to light entertainment, and from religiously
inspired documentaries to dating shows.6 Skyhigh TV classifies Over My
Dead Body as a “Docusoap.”7 Indeed, being a series of stories about several
people whom the viewer gets to know and identifies with, the format is not
unlike a fictional soap series. Also, the trailer presentation of the protagonists
and their “role” resembles that of mainstream fiction soap series. The trailer
introduces five young women and men, showing their portraits, names, ages
and the diseases they endure. Each 30 minutes episode begins with a voice
over giving an update of previous happenings, as if revealing the
development of a fiction plot. The show concludes with a preview of
upcoming events. These are elements of a format the viewer knows from
soap series.
Despite the similarities in shape and format, the “docu” element in
this “Docusoap” prevents it from having the reception of a regular soap
series. The harsh realities the viewer is confronted with are such that it is
impossible to watch the show with the carelessness of trivial entertainment.
Although the “cliff hanger” invites the audience to “stay with the show,” web
176
Agencies of the Afterlife
______________________________________________________________
comments from the audience reveal that the emotional impact each sequel
evokes, prevents people from following the stories as faithfully as they would
with fiction shows.
In the (still) pillarised Dutch television landscape, the noncommercial broadcasting company of BNN, which presents Over My Dead
Body, regards itself a rebel. Serving a predominantly young public, the topics
of BNN shows cover the work and social life of youngsters while exploring
the boundaries of the acceptable. As the Dutch audience was already used to
so-called real life television shows such as Big Brother - a Dutch inventionin which people live together, fight or have sex, the next taboo to be
conquered was a show on how people die. Broadcasting company BNN,
initiated by Bart de Graaff who himself died after a long disease, claims a
particular interest in young people who despite a physical disability or a
disease try to realize their ideals. In this respect, Over My Dead Body, a
confronting television show about young terminally ill people making the
most of life, meets the BNN aims perfectly. Next to that, BNN, declares itself
particularly interested in the Internet.
B. The Presenter
Each episode of Over My Dead Body is a compilation of events
taken from the daily life of each protagonist. To make distressing events
acceptable for a large audience, the images are combined with up beat music,
and difficult moments, such as a disappointing hospital visit, are alternated
with happy moments like a colourful good bye party.
Presenter Patrick Lodiers has several interconnected roles to play.
He explains to the audience what the show is about and what can be expected
from the next episode. Next to this traditional mediating role, the presenter
seems to function as a friend or even a “buddy” of the protagonists. He visits
them and asks intimate, even impertinent questions about their physical
condition, about the disease and about how they cope with the prospect of
having to die soon. The topics and the combined roles he plays make Lodiers
take a more reserved attitude towards the protagonists than is customary
among the self-proclaimed “forward” attitude of BNN presenters.
Sometimes, when confronted with sudden emotional events, the program
format offers Lodiers no structure for how to react, making improvisation
necessary. Left to himself, he is forced to act, spontaneously it seems, as a
“real life” friend, as when Lodiers appears to be shocked when confronted
with the fact that he won’t see a protagonists alive again. The raw realism of
these moments and the suggested spontaneity of the presenter’s reaction
endears him to the public and contributes to the documentary quality of the
show.
The complexity of the show’s subject becomes clear when the
show’s format is adapted to the presenter’s needs. After the sudden death of
Marga Altena
177
______________________________________________________________
one of the protagonists, the presenter makes an emotional statement for the
television audience using the hand held camera usually operated by the
protagonists. Also on the show’s Internet page, the presenter reflects on his
personal feelings. When after the second series, Lodiers decided not to
commit to the moderation of the third series, he explained himself on
television shows and on the Internet, discussing the “very heavy” impact the
moderation of the series has had for him. On these occasions, the role of the
presenter has evolved into one not unlike that of the protagonists.
C. The Protagonists
A striking characteristic in Over My Dead Body is the strong agency
displayed by the protagonists. Although in the first series presented as
“guests,” as if they were making a short appearance in a talk show, the five
terminally ill people are obviously much more than that. It’s their story that
the show and the website focus on - making them protagonists - and it’s their
choice of how it is performed - making them “creative consultants” or maybe
even “producers.” In the series and in the Internet diaries, their choices
dominate the shape and content to an extent unique for non-professionals
appearing on television. The protagonists define both the range of the topics
the presenter is allowed to touch upon and what can be shared with the
audience. The reflections of the protagonists are given attention in a way that
is unique for the sound bite driven television culture of today. Clearly,
discussing the topic of death supplies ordinary people with a media power temporal and in agency - unseen before. For example, a young woman is
portrayed in the process of composing and recording a love song for her
husband that is also a farewell song. Both the song and the televised
production of it constitute a memorial for herself and her love that would
otherwise would not have been made. Through her participation in the show
and her creative input, the woman is able to leave her husband and family a
unique and personal memorial.
The example also touches upon the question as to why people don’t
make filmed memorials themselves, since handy cams have become broadly
accessible. However, next to the required skill to produce a film or create a
weblog, the terminally ill usually need to save their energy to cope with
everyday life and to deal with the illness and its treatment.
A major attraction of television shows and websites is the
opportunity to contact fellow patients and others who understand the
experiences of the protagonists. In their reactions, fellow sufferers and
sympathizers offer much needed recognition, support and appreciation.
Protagonists repeatedly confirm that they are strengthened by the weblog
messages. Therefore, it’s not surprising that the website communication
between the protagonists and the audience, as well as among the protagonists
themselves, far exceeds the duration of the television show.
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Agencies of the Afterlife
______________________________________________________________
A conspicuous element is that the protagonists of Over My Dead
Body all show themselves strongly aware of the impact their death will have
for their friends and family. Regularly, their actions and worries concern the
way they will die, the preparation of their funeral and how their bereaved will
remember them. All the protagonists are troubled by the prospect of causing
grief. A young man declares that he does not even allow himself to fall in
love because for this very reason. Another protagonist is himself relieved
when his family and friends are able to “celebrate life” at his farewell party.
At moments like these, the felt responsibility by the protagonist for the
bereaved is very apparent.
Concerns about the afterlife emerge when the protagonists and their
spouses discuss how they imagine themselves after one of them will be dead.
People declare that they think the dead person will “still be there” to watch
over their loved ones as a guardian angel. Next to that, the protagonists
advise their spouses to have a good life after they have gone, and they even
discuss the possibility of a new spouse for the future widow or widower. In
making public reflections like these, Over My Dead Body functions as a
documented consent, a public recognition of the partner’s future choices of
life.
3.
Conclusion
After comparing conventional expressions of Dutch funerary culture
with shows and weblogs like Over My Dead Body, it is safe to argue that
these new media opened up funerary imagery in providing the opportunity
for individual persons – non professionals in funerary culture and media
culture - to create a televised and digital memorial of themselves, a
mediatised self-portrait. Instead of traditional funerary portraits of both
deceased and living people as solemn remembrances, the “celebration of life”
and the making of the memorial have become central. In modern television
culture, the forceful agency of the participating protagonist particularly
stands out.
Both television series and weblogs create innovative platforms for
the terminally ill and their loved ones to express heartfelt emotions and to
contact fellow sufferers and others. These are media that deserve recognition
as instruments of agency in obtaining (self) appreciation for individual
protagonists and their audience, as well as in the creation of new, “real life”
relationships.
Notes
1
B Sliggers (ed.), Naar het lijk: Het Nederlandse doodsportret 1500-heden,
Walburg Pers, Zutphen, 1998, p. 7.
Marga Altena
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2
R Bianco Bandinelli, Die römische Kunst: Van den Anfängen bis zum Ende
der Antike, CH Beck Verlag, München 1975, pp. 43-65.
3
B. Sliggers (ed.), Naar het lijk: Het Nederlandse doodsportret 1500-heden,
Walburg Pers, Zutphen, 1998, p. 15.
4
J Coppens, M Altena, S Wachlin, Het licht van de negentiende eeuw: De
komst van de fotografie in de provincie Noord-Brabant, Eindhoven, 1997, pp.
23, 34, 36.
5
J Enklaar, Onder de groene zoden: De persoonlijke uitvaart. Nieuwe
rituelen in rouwen, begraven en cremeren, Alpha, Zutphen, 1995; M Bot,
Een Laatste Groet. Uitvaart- en rouwrituelen in multicultureel Nederland,
Marrie Bot, Rotterdam, 1998; R L Grimes, Deeply into the Bone: Reinventing Rites of Passage, University of California Press, Berkeley, 2000; C
Wouters, ‘The quest for new rituals in dying and mourning’, Body & Society
vol. 8, 2002, pp. 1-28; P van den Akker, De dode nabij. Nieuwe rituelen na
overlijden, Dela, Tilburg, 2006.
6
http://skyhightv.tv/, viewed on August 21, 2008.
7
The televised ‘in memoriam show’ of I Miss You, in Dutch Ik mis je, is a
Skyhigh production for the Evangelistic Broadcasting Company.
Bibliography
Akker, Van den, P., De dode nabij. Nieuwe rituelen na overlijden. Dela,
Tilburg, 2006.
Bianco Bandinelli, R., Die römische Kunst: Van den Anfängen bis zum Ende
der Antike. C. H. Beck Verlag, München 1975.
Bot, M., Een Laatste Groet. Uitvaart- en rouwrituelen in multicultureel
Nederland. Marrie Bot, Rotterdam, 1998.
Coppens, J., M. Altena, and S. Wachlin, Het licht van de negentiende eeuw:
De komst van de fotografie in de provincie Noord-Braban. Eindhoven, 1997.
Enklaar, J., Onder de groene zoden: De persoonlijke uitvaart. Nieuwe
rituelen in rouwen, begraven en cremeren. Alpha, Zutphen, 1995.
Grimes, R. L., Deeply into the Bone: Re-inventing Rites of Passage.
University of California Press, Berkeley, 2000.
Sliggers, B. (ed.), Naar het lijk: Het Nederlandse doodsportret 1500-heden.
Walburg Pers, Zutphen, 1998.
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______________________________________________________________
Wouters, C., ‘The Quest for New Rituals in Dying and Mourning.’ Body &
Society, vol. 8, 2002, pp. 1-28.
Marga Altena is a historian of visual culture at the Radboud University
Nijmegen. She researches films, tv shows and weblogs on death and dying.
PART III
Ethical Re-Imaging
Physician-Assisted Suicide and the Supreme Court:
A Decade in the Life of a Constitutional Issue That’s
“Not Dead Yet”
Arthur G. Svenson and Susan M. Behuniak
Abstract
Our research examines the legal and constitutional questions underpinning
the conflict over physician-assisted suicide between state and national
governments in the United States, each laying claim over sovereign
prerogative to decide this end-of-life issue. We advance the following thesis:
informed by the Supreme Court’s ruling in Gonzales v. Raich (2005), that on
constitutional grounds the Controlled Substances Act pre-empted California’s
law legalizing the intrastate, non-commercial consumption of marijuana for
medicinal purposes, if Congress had the legislative will to explicitly
criminalize a physician’s prescription of admittedly interstate and
commercial substances to assist in the suicides of others, the resulting
constitutional question whether Congress had exceeded its Commerce Clause
power would be resolved in favour of Congress, not state law contrary to it.
Key Words: constitution, physician-assisted suicide, medical marijuana,
supreme court, federalism, commerce clause
*****
1.
Introduction
In its landmark resolution of Washington v. Glucksberg,1 the United
States Supreme Court rejected constitutional arguments to nationalize a right
to physician-assisted suicide (PAS). In that case, the Court reasoned that if
such a right were to be established in our federal system of government,
advocates for its legalization would have to prevail in the “earnest and
profound debate about the morality, legality, and practicality of physicianassisted suicide” in their respective states.2 As Justice O’Connor explained in
her concurring opinion, “[s]tates are presently undertaking extensive and
serious evaluations of physician-assisted suicide and other related issues
[emphasis added]. In such circumstances, ‘the...challenging task of crafting
appropriate procedures for safeguarding...liberty interests is entrusted in the
‘laboratory’ of the states...in the first instance.’”3
Among all state laboratories, Oregon’s produced the nation’s first
voter-approved initiative legalizing PAS in 1994,4 an experiment that was
successfully repeated in 1997 following a state legislature-driven effort aimed
at its repeal.5 In the decade since Oregon’s Death With Dignity Act (DWDA)
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became effective, 341 qualified Oregonians have died after having selfadministered a lethal dosage of physician-prescribed drugs.6 Efforts to
legalize PAS in other states have occurred but none successfully.
As if encouraged by the Glucksberg holding—and as if inspired to
do so on O’Connor’s cue in particular—state laboratory experiments on
“other related issues” continue to occur. Among those issues that most
closely parallel PAS is the “profound and earnest” debate over the
legalization of medical marijuana (MM). Just two years after Oregonians
initially adopted their DWDA, advocates of MM scored their first legislative
victory when, in 1996, a voter-approved initiative codified California’s
Compassionate Use Act (CUA);7 since that time, twelve other states have
adopted similar measures.
Discouraged and uninspired by state initiatives legalizing PAS and
MM, opponents of both have long observed that an “earnest and profound
debate about the morality, legality, and practicality” of such policies has also
occurred at the national government—and decades prior to the Oregon and
California experiments; moreover, “extensive and serious evaluations” of the
“health and general welfare of the American people” explain why Congress
adopted the Controlled Substances Act (CSA) of 1970.8 Among its many
provisions that aim at “drug abuse prevention and control,” PAS and MM
opponents stress that the language of the CSA, accompanying administrative
rules attached to it over time, and, of course, the Constitution’s Supremacy
Clause of Article VI, conspire to neuter state legislative enactments contrary
to it, including (1) Oregon’s DWDA, since federally-approved drugs may not
be used for purposes prohibited by the CSA, and (2) California’s CUA, since
drugs prohibited by the CSA may not be used for purposes other than
federally-approved research.
Nearly a decade after state-inspired PAS and MM movements took
root, the Bush Administration navigated legal arguments to quash Oregon
and California laws all the way to the Supreme Court: in 2005, Gonzales v.
Raich9 sustained arguments that Congress’ Commerce Clause power, on
which the CSA is based, pre-empted state laws legalizing MM; in 2006,
however, Gonzales v. Oregon10 held that the Justice Department’s
interpretation of the CSA, aimed at prohibiting PAS, was not authorized by
the plain language of the law.
Our research provides a comparative analysis of the Supreme
Court’s resolution of national-state conflicts central to the PAS and MM
cases. In section one, an overview of Oregon’s DWDA, California’s CUA,
and Congress’ CSA is presented to isolate the core legal strategies developed
in Washington to nationalize prohibitions against PAS and MM. In section
two, the Court’s holdings in Raich and Oregon are vetted. Three overarching
themes of constitutional interpretation generated by the Raich Court are
revealed. First, even in the absence of specific statutory findings, Congress
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could have had a “reasonable basis” to conclude that California’s legalization
of intrastate, non-commercial MM would have had a “significant effect” on
marijuana’s illegal interstate market. Second, the “outer limits” of Congress’
Commerce Clause power were categorically not at play in sustaining the
reach of the CSA to intrastate, non-commercial production and consumption
of marijuana for medical purposes; with the nearly universally venerated
Wickard v. Filburn11 serving as Raich’s precedential touchstone, the Court
concluded that “new era” case law clearly justifies the imposition of the
Government’s “final word” on MM in California. Third, not a word in Raich
casts doubt on the constitutionality of the CSA in toto, which, the Court
concludes, is “a concededly valid statutory scheme,”12 controlling activities
“quintessentially economic” in nature.13 In section three, we argue that in the
wake of Raich’s overarching themes, the life of Oregon’s DWDA is gravely
imperilled, and so it is despite Oregon’s thumping of the Bush
Administration over PAS. Our thesis is this: if Congress had the legislative
will to amend the CSA explicitly criminalizing a physician’s prescription of
admittedly interstate and commercial substances to assist in the suicides of
others, the resulting constitutional question whether Congress had exceeded
its Commerce Clause power would be resolved in favour of Congress, not
state law contrary to it.
2.
Physician-Assisted Suicide, Medical Marijuana, and the
Controlled Substances Act
In the early 1990’s, prohibitions against PAS and MM existed in
every state; in some, however, opinion polls indicated that the legalization of
such activities might be tolerated albeit on a very limited basis. Thus, for
drafters of PAS and MM initiatives, narrowly crafted exceptions to existing
bans emerged as central legislative strategies. In both instances, opposition
forces sounded a similar theme of alarm: the “slippery slope”—and one that
played out in a host of variations.
For PAS opponents in Oregon, the slippery slope conjured up
unimaginable images of paradise lost. Should even the most narrowly and
carefully crafted exception to assisted suicide be legalized, a “parade of
horribles” would follow, from physician-assisted deaths of terminally-ill
patients, to physician-assisted, even physician-administered deaths of patients
with debilitating not terminal conditions, and ultimately to the horror of the
very real-world killing fields of Nazi Germany. For MM opponents in
California, the slippery-slope argument was ubiquitously applied. Such a law
would “provide new legal loopholes” negatively impacting on the state’s
prosecutorial efforts of drug dealers, marijuana as a “gateway drug” would
cause youth to experiment with and to grow increasingly dependent upon
more powerfully addictive and deadly drugs, and fears, too, about marijuana-
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prescribing physicians who would unwittingly or otherwise become
practitioners against whom the “war on drugs” is waged.
To counter slippery-slope theme and variations, the PAS initiative in
Oregon and the MM initiative in California were written with language that
proponents believed would satisfy voters without compromising their state’s
respective interest in protecting the sanctity of life—drug free.
In the case of Oregon’s DWDA,14 those who qualified for suicide
assistance became a narrowly circumscribed group, and the means available
to facilitate “a humane and dignified” death were restricted to one, the selfadministering of a prescription drug, making mercy killing of any sort still
illegal. To qualify for PAS, a patient had to be an adult resident of Oregon
who is “capable” of making health-care decisions, and who is dying from a
terminal illness, i.e., one that is “incurable and irreversible” and will “within
reasonable medical judgment, produce death within six months.” The
patient’s condition needed to be confirmed by both attending and consulting
physicians, and should either physician suspect that the patient suffers from
any “psychiatric or psychological disorder, or depression causing impaired
judgment,” professional counselling is mandatory. The patient’s decision to
die had to be made voluntarily, requiring two oral requests for assisted
suicide separated by no less that fifteen days, as well as a written request
witnessed by two persons attesting that “the patient is capable, acting
voluntarily, and is not being coerced to sign the request.”
California’s CUA15 was drafted to counter “slippery-slope”
arguments as well. The two purposes central to the initiative were these: first,
“[t]o ensure that seriously ill Californians have the right to obtain and use
marijuana for medical purposes...recommended by a physician...in the
treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma,
arthritis, migraine, or any other illness for which marijuana provides relief”;
and second, “[t]o ensure that patients...are not subject to criminal prosecution
or sanction”—an immunity also applicable to physicians. To achieve these
purposes, the CUA carved out limited exceptions to existing state law
otherwise prohibitive of both marijuana possession and cultivation: neither
prohibition, the CUA stipulated, would “apply to a patient...who possesses
and cultivates marijuana for the personal medical purposes of the patient
upon the written or oral recommendation or approval of a physician.”
On November 8, 1994, Oregonians approved the state’s DWDA by
a narrow 2% of the vote; and when, on November 4, 1997, the state
legislature mandated that a second canvassing of voter sentiments occur, the
Act was approved again, this time by a startling margin of 20%. California’s
CUA was also approved, by 56% of the voters, on November 5, 1996. While
proponents rejoiced, those having lost these battles sought to win the war in
Washington. For this purpose, members of the congressional and executive
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branches looked approvingly—and hopefully—toward the Controlled
Substances Act of 1970.
The CSA was designed to consolidate existing federal drug statutes
to bring a unified and comprehensive regulatory approach to the “illegal
importation, manufacture, distribution and possession and improper use of
controlled substances [that] have a substantial and detrimental effect on the
health and general welfare of the American people.”16 Congress passed the
Act pursuant to its constitutional grant of power to regulate
“Commerce...among the several States.” Significantly, however, the Act’s
regulatory scope included the intrastate manufacture, distribution, and
possession of controlled substances, and for three primary reasons: first,
“[l]ocal distribution and possession of controlled substances contribute to
swelling the interstate traffic in such substances”;17 second, “it is not feasible
to distinguish, in terms of controls, between controlled substances
manufactured and distributed interstate and controlled substances
manufactured and distributed intrastate”;18 and third, “[f]ederal control of the
intrastate incidents of the traffic in controlled substances is essential to the
effective control of the interstate incidents of such traffic.”19
The Act groups all controlled substances into one of five schedules:
schedule I drugs are those for which no accepted medical use has been
established, and with which only tightly-supervised, federally approved
research is permitted; schedules II through V include drugs with proven
medical benefits, arranged in descending order based upon an assessment of
the substance’s relative degree of risk to “the health and general welfare of
the American people.” The controlled substances “prescribed” by Oregon
physicians to hasten a patient’s death, pentobarbital and secobarbital, are
located in schedule II; the controlled substance “recommended” by California
physicians to comfort the ill patient, marijuana, is located in schedule I.
The argument to neuter PAS embraces combinations of sections of
the CSA plus an administrative interpretation of a Justice Department
regulation appended to the Act in 1971. The Act empowers the Attorney
General to suspend or revoke a physician’s drug-prescribing license for
professional behaviour deemed “inconsistent with the public interest.”20 The
Act stipulates that the Attorney General’s determination of the “public
interest” shall be guided by a number of factors, including “compliance with
applicable State and local law” and “factors as may be relevant to and
consistent with the public health and safety.”21 Most significantly, physicians
can only distribute controlled substances with a “written prescription.”22 In
1971, then-Attorney General John Mitchell authored an administrative
regulation intended to enhance the “efficient execution” of the prescription
language of the Act: accordingly, “[a] prescription for a controlled substance
to be effective must be issued for a legitimate medical purpose”.23 The
ultimate piece in the CSA argument was provided by President Bush’s
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Attorney General John Ashcroft, whose administrative interpretation of
Mitchell’s regulation—the “Ashcroft Directive”—was announced on
November 9, 2001. Wrote Ashcroft: “I hereby determine that assisting
suicide is not a ‘legitimate medical purpose’...and that prescribing,
dispensing, or administering federally controlled substances to assist suicide
violates the CSA.”24
The statutory challenge to MM stems from fewer and seemingly less
ambiguous sections of the CSA; moreover, no “administrative interpretation”
of an “administrative regulation” is seized upon as Washington’s knockout
weapon. The CSA classifies “marihuana” as a Schedule I drug because of its
“high potential for abuse,” and the absence of any currently accepted medical
use”.25 For opponents, then, the legal argument against MM rested on secure
ground: although California law exempted MM from the criminal code, the
CSA clearly embraced no such safe-harbour. Moreover, that Congress had
stipulated in the Act to “findings and declarations” that connected “local
distribution and possession of controlled substances” to interstate commerce
redoubled the optimism of MM critics that their arguments would persuade
even the most ardent supporters of states’ rights on the federal bench.
3.
MM, PAS, and Federalism: The Supreme Court Decides
Those seeking to nationalize a prohibition against PAS invoke the
CSA to demonstrate not that the drug prescribed to induce death is forbidden,
but that the purpose of the prescription is; those seeking to nationalize a
prohibition against MM invoke the CSA to demonstrate not that the purpose
of the “recommendation” is forbidden, but that the drug itself is. Of the two
issues, the legal struggle between national and state governments over MM
arrived at the Supreme Court first.
A. Gonzales v. Raich (2005)
The Drug Enforcement Administration (DEA) raid in Butte County,
California, that precipitated the constitutional question in Gonzales v. Raich
occurred on August 15, 2002; federal agents seized a number of marijuana
plants, in compliance with authority under the CSA, cultivated and consumed
by Angel McClary Raich, in compliance with the state’s CUA. Raich had
“been diagnosed with more than ten serious medical conditions, including an
inoperable brain tumour, life-threatening weight loss, a seizure disorder,
nausea, and several chronic pain disorders.”26 Raich consumed marijuana as
medication since thirty-five prior prescriptions were either ineffective or
caused intolerable side effects. Her doctor’s prognosis? “[F]oregoing
marijuana treatment may be fatal.”27 Having been deprived of her medical
lifeline by the DEA, Raich brought suit against Attorney General Ashcroft,
later Roberto Gonzales, claiming that the CSA as applied to California’s
CUA was unconstitutional.
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A Federal District Court rejected Raich’s claim for a variety of
reasons, including (1) explicit prohibitions in the CSA against marijuana;28
(2) congressional findings that intrastate and interstate manufacture and
distribution of controlled substances were indistinguishable, making both,
therefore, subject to federal control;29 and (3) “by the weight of precedent”
validating the Act itself.30 To that court’s astonishment, a divided 9th Circuit
reversed its judgment on appeal. The appellate court’s conceptualisation of
the “class of activity” that Washington sought to extinguish served as the
keystone to the resolution of the case: that class, the Court explained, was
“the intrastate, non-commercial cultivation and possession of cannabis for
personal medical purposes as recommended by a patient’s physician pursuant
to valid California state law.”31 Governed by the specificity of this “class of
activity,” the Court asserted that MM “is, in fact, different in kind from drug
trafficking”: first, the marijuana Raich consumed is cultivated “us[ing] only
soil, water, nutrients, growing equipment, supplies and lumber originating
from or manufactured within California”;32 and second, Raich’s “medicinal
marijuana...is not intended for, nor does it enter, the stream of commerce,”
and no part of her consumption of it is commercial.33 Therefore, since the
linkages between MM and interstate commerce “are, indeed, attenuated...we
find the CSA, as applied to [Ms. Raich] is likely unconstitutional.”34
The Supreme Court announced its decision in Gonzales v. Raich on
June 6, 2005. By a whopping 6-3 vote, the judgment of the 9th Circuit was
reversed: intrastate and non-commercial MM, “never more than an instant
from the interstate market,” observed Scalia,35 was subject to federal control.
For dissenting Justices O’Connor, Thomas, and Chief Justice
Rehnquist, losing the battle over medical marijuana was a bitter pill to be
sure, most especially since Justices Scalia and Kennedy apparently
abandoned the twin precedents of United States v. Lopez (1995)36 and United
States v. Morrison (2000)37 that all five had forcefully advanced to restrict the
regulatory scope of Congress’ commerce clause power.
Lopez involved the constitutionality of Congress’ “Gun-Free School
Zones Act of 1990,” that made it a federal crime to possess a firearm within a
designated parameter surrounding public or private schools. For the Court,
Chief Justice Rehnquist maintained that congressional commerce power
extends to “three broad categories of activity”: first, to “regulate the use of
the channels of interstate commerce”; second, “to regulate and protect the
instrumentalities of interstate commerce, or persons or things in interstate
commerce, even though the threat may come only from intrastate activities”;
and third, “to regulate those activities having a substantial relation to
interstate commerce, i.e., those activities that substantially affect interstate
commerce.”38 In light of category three, Rehnquist concluded that Congress’
Act was unconstitutional since it had “nothing to do with ‘commerce’ or any
sort of economic enterprise”.39 In Morrison, Congress’ “Violence Against
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Women Act of 1994” was challenged, and similar tensions over the
appropriate scope of congressional commerce power reappeared. With Lopez
as his guide, Rehnquist clarified several “significant considerations” in
determining when intrastate activities “substantially affect” interstate
commerce, the third Lopez category. Among these considerations—for
purposes of both PAS and MM adjudication as matters will unfold—two
emerged prominently: first, whether the statute in question actually regulates
commerce; and second, whether the link between the regulated activity and
the significant effect on interstate commerce is “attenuated.” Guided by
these considerations, Rehnquist concluded that “[g]ender-motivated crimes of
violence are not, in any sense of the phrase, economic, and the link between
“the cost of crime” and “national productivity” is so attenuated that if the link
is not rejected “Congress might use the Commerce Clause to completely
obliterate the Constitution’s distinction between national and local
authority”.40
According to Justice O’Connor, then, the Raich majority of 2005
had succeeded in obliterating the nation-state distinction “without any proof
that the personal cultivation, possession, and use of marijuana for medicinal
purposes, if economic activity in the first place, has a substantial effect on
interstate commerce and is therefore an appropriate subject of federal
regulation.”41 As for dissenting Justice Thomas, if “the majority is to be taken
seriously, the Federal Government may now regulate quilting bees, clothes
drives, and potluck suppers throughout the 50 States...mak[ing] a mockery of
Madison’s assurance...that the ‘powers delegated’ to the Federal Government
are ‘few and defined,’ while those of the States are ‘numerous and
indefinite.’”42
For six justices, however, the line separating enumerated national
powers and those reserved to states had not been breached. Far from it, as
Justice Stevens admonished: in light of the Court’s nullification of the
GFSZA in Lopez, the “statutory scheme that the Government is defending in
this litigation is at the opposite end of the regulatory spectrum.”43 True,
admitted Stevens, the Government’s case against California’s legalization of
MM lacked detailed findings establishing a meaningful nexus between
intrastate, non-commercial MM, and marijuana’s illegal interstate market.
But the expectation of detailed findings from Congress “is not only
unprecedented, it is also impractical.”44 As a general rule, Stevens opined,
“Congress cannot be expected (and certainly should not be required) to
include specific findings on each and every substance contained [in the CSA]
in order to satisfy the dissenters’ unfounded scepticism.”45
How, then, did Stevens manage to demonstrate that California’s
legalization of intrastate, non-commercial MM had a “significant effect” on
interstate commerce when Congress had not done so itself? Said Justice
Stevens: “We need not determine whether respondents’ activities, taken in
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the aggregate, substantially affect interstate commerce in fact, but only
whether a ‘rational basis’ exists for so concluding.”46 In this way, because the
product is “fungible,”47 because the war on drugs persists despite lawenforcement efforts,48 because “care givers” will not stop the production of
marijuana when a care-giver’s patient either recovers or dies,49 and because
California has established no limit on the permissible amount of marijuana a
patient may possess,50 the Court could fairly conclude that Congress could
have had a “reasonable basis” to believe intrastate, non-commercial MM has
a significant effect on that drug’s $10.5 billion illegal interstate market.51
“The notion,” Stevens reasons, “that California law has surgically excised a
discrete activity that is hermetically sealed off from the larger interstate
marijuana market is a dubious proposition, and, more importantly, one that
Congress could have rationally rejected.”52
Finally, that Congress could have had a “rational basis” for
imposing the final word on state legalization of MM does not signify that
Congress has pushed its regulatory power “beyond the ‘outer limits’ of [its]
Commerce Clause authority.”53 Noting that the Government has had nearly a
century’s worth of experience with drug regulation,54 the Stevens majority
contends that its ruling is not only consistent with Lopez and Morrison, but
its similarities with Wickard v. Filburn55—the mother of all Commerce
Clause cases—are “striking.”56 Justice Stevens: “In both cases, the
regulation is squarely [emphasis added] within Congress’ commerce power
because production of the commodity meant for home consumption, be it
wheat or marijuana, has a substantial effect on supply and demand in the
national market for that commodity.”57 Even Justice Scalia in his concurring,
“more nuanced” opinion, presses the point that no “violation of state
sovereignty of the sort that would render this regulation ‘inappropriate’ [has
occurred in Raich], —except to argue that the CSA regulates an area typically
left to state regulation.”58
In sum, the Raich message was quite clear: first, Congress could
have had a “rational basis” to trump state law legalizing intrastate, noncommercial medical use of marijuana;59 second, the ruling squares with a
century of “new era” case law60 that “firmly establishes Congress’ power to
regulate purely local activities that are part of an economic ‘class of
activities’ that have a substantial effect on interstate commerce”;61 and third,
the CSA is “a concededly valid statutory scheme.”62 If the democratic forces
at work in the creation of the CSA failed to account properly for the
independent judgments of sovereign state governments, then, as Stevens
concludes, the “voices of voters...may one day be heard in the halls of
Congress.”63
For all that PAS and MM have in common as experiments “in the
‘laboratory’ of the states,” since state legalization of MM is pre-empted by
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federal prosecutors enforcing the zero-tolerance reach of the CSA, would a
similar holding apply to Oregon’s defence of PAS?
B. Gonzales v. Oregon (2006)
The statutory question presented to the Supreme Court in Gonzales
v. Oregon was framed in this way: “[W]hether the CSA allows the United
States Attorney General to prohibit doctors from prescribing regulated drugs
in use in physician-assisted suicide, notwithstanding a state law permitting
the procedure.”64 Unlike the conflict over MM, that the PAS question as
framed raised no constitutional issues ultimately proved decisive.
Oregon’s challenge to the Ashcroft Directive triumphed in Federal
District Court,65 and again, in a divided Court of Appeals.66 In both cases, the
Ashcroft Directive was invalided solely on statutory grounds. After a careful
and pithy review of the language, legislative history, and relevant case law
associated with the CSA, the District Court claimed that “Congress did not
intend the CSA to override a state’s decision concerning what constitutes
legitimate medical practice, at least in the absence of an express federal law
prohibiting that practice [emphasis added].”67 As for the Attorney General’s
role in acting to supersede Oregon’s legalization of PAS, the Judge sounded a
note of astonishment: “[t]o allow an attorney general—an appointed
executive whose tenure depends entirely on whatever administration occupies
the White House—to determine the legitimacy of a particular medical
practice without a specific grant of such authority [emphasis added] would be
unprecedented and extraordinary.”68 On appeal, the Circuit Court sustained
this holding and did so for virtually the same reasons.
In a 6-3 ruling, the Supreme Court affirmed Oregon’s claims that the
language of the CSA did not authorize the Ashcroft Directive. According to
Justice Scalia, in dissent, “The question before us is not whether Congress
can do this, or even whether Congress should do this; but simply whether
Congress has done this in the CSA.”69
Central to the Government’s case that Congress had authorized the
Attorney General to criminalize PAS involved its reliance upon a rule set
down in Chevron U.S.A., Inc. v. Natural Resources Defence Council, Inc.70
As Cass Sunstein explains, Chevron is widely regarded “as a kind of counterMarbury,”71 meaning, to paraphrase Chief Justice Marshall, “[i]t is
emphatically the province and duty of the [bureaucracy] to say what the law
is.”72 Lawrence Tribe describes the Chevron rule in this way: “if the statute is
silent or ambiguous with respect to a specific issue, the question of the Court
becomes ‘whether the agency’s answer is based on a permissible construction
of the statute; that is, whether the agency’s interpretation is ‘reasonable,’ or
‘rational’ and consistent with the statute.”73 For this reason, Tribe explains,
“Chevron comes close to installing agencies...as mini-congresses and minijudiciaries at the same time.”74 What, then, would make the Ashcroft
Arthur G. Svenson and Susan M. Behuniak
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Directive “reasonable,” worthy of Chevron deference? A number of factors,
the Government maintains. First, the CSA expressly grants authority to the
Attorney General to “promulgate and enforce rules, regulations, and
procedures...for the efficient execution of his functions under the CSA”.75
Second, the CSA authorizes the Attorney General to suspend or revoke a
physician’s drug-prescribing license for professional behaviour “inconsistent
with the public interest.”76 And third, according to Attorney General
Mitchell’s regulation of 1971, only prescriptions for a “legitimate medical
purpose” promote “the public interest.” Was it, therefore, unreasonable for
Attorney General Ashcroft to conclude that PAS is not a “legitimate medical
purpose” when (1) 49 states and the federal government “emphatically
oppose assisted suicide”;77 when (2) “leading organizations of the medical
profession, including the American Medical Association, American Nurses
Association, and the American Psychiatric Association, consider PAS
“fundamentally incompatible with the physician’s role as healer”;78 and when
(3) as the Court made clear in Washington v. Glucksberg (1997) “in almost
every western democracy–it is a crime to assist a suicide”?79
For the Court’s majority, however, the powerful Chevron rule is
applicable only when the interpretation is “promulgated pursuant to authority
congress has delegated to the official.”80 In Justice Kennedy’s opinion for the
Court, the CSA narrowly restricts the Attorney General’s rulemaking
authority to matters over “the registration and control of...listed chemicals.”81
True, the registration provisions empower the Attorney General to grant and
revoke a physician’s prescriptive license, but in doing so a number of factors
must be considered, among them “the State’s recommendation [and]
compliance with state, federal, and local laws regarding controlled
substances”.82 Since the Ashcroft Directive relied on none of these factors,
and more, since its aim was not the “control” of a drug (“to add a drug...to a
schedule”83) but to “define standards of medical practice,”84 Kennedy
concluded that Chevron deference was not warranted. As such, “The idea that
Congress gave the Attorney General such broad and unusual authority
through an implicit delegation in the CSA’s registration provision is not
sustainable.”85
In an enormously revealing concluding observation, we believe,
Justice Kennedy opines that although “regulation of health and safety is
‘primarily, and historically, a matter of local concern, there is no question
that the Federal Government can set uniform national standards in these
areas.”86 And what is required of Congress if it chooses to occupy an area of
“health and safety”? Simple, he explains: “[Congress] does so by explicit
language in the statute.”87
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4.
Physician-Assisted Suicide in the Wake of Raich
Because of Raich, state law legalizing MM no longer immunizes
state citizens form federal prosecutors enforcing the zero-tolerance reach of
the CSA, even into the intraparcel connection between the backyard
production of marijuana and the front room consumption of it to palliate pain
and/or to dodge death. But Oregon’s victory only a year later seemed
uncomfortably unfinished since in its journey through federal courts none of
the prevailing opinions could be read to have foreclosed the possibility that
Congress could act constitutionally to prohibit PAS.
Assume that Congress had the legislative will to ban the use of
controlled substances in PAS, and to do so Congress amended the CSA by
either (1) expressly prohibiting such a use, or (2) expressly delegating to the
Attorney General the necessary rulemaking authority to distinguish legitimate
vis-à-vis illegitimate medical uses of controlled substances. Could Oregon
prevail against Congress arguing that either amendment is situated beyond
even the “outer limits” of the Commerce Clause power? We think not, and
for reasons advanced in Raich.
Proponents of MM and PAS assert that surgically-drafted
exemptions from the regulatory scope of the CSA are justified: in
California’s case because the marijuana in MM is intrastate and noncommercial, not because control over the practice of medicine is a sovereign
state power; and in Oregon’s case because the control over the practice of
medicine is a sovereign state power, not because controlled substances used
by physicians and pharmacists to hasten death are intrastate and noncommercial. That Oregon seeks to distance itself from Raich on the grounds
that “the practice of medicine” exists “at the heart of the states’ historic
police powers” is, to be sure, a distinction with a difference, but that
difference, we argue, only weakens Oregon’s case further.
Both Lopez and Morrison invalidated laws of Congress because
neither regulated economic activities that significantly affected, in an
unattenuated fashion, interstate commerce. Raich involved intrastate, noncommercial activities that the High Court held Congress could have had a
“reasonable basis” to believe possessed a “significant effect on interstate
commerce”—and without “piling assertion upon assertion” to establish that
the nexus was not attenuated. If Congress prohibited the use of a controlled
substance for a purpose explicitly deemed illegitimate, or explicitly delegated
that authority to the Attorney General, then the Court would be evaluating the
constitutionality of an act that controls substances because they are both
interstate and commercial—and Oregon agrees, having stipulated to the fact
that “it is likely that the drugs in question have travelled in interstate
commerce.”88 In its defence, Oregon contends that the amounts of controlled
substances used in PAS are “unremarkable,”89 and “would be insignificant by
any measure.”90 In this way, Oregon relies on Lopez and Morrison to
Arthur G. Svenson and Susan M. Behuniak
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conclude that it is just not possible that the practice of PAS could have “a
significant effect on interstate commerce.” But Raich counsels otherwise:
quoting from Maryland v. Wirtz,91 the Court reaffirms that where “a general
regulatory statute bears a substantial relation to commerce, the de minimis
character of the individual instances arising under the statute is of no
consequence.”92 Wirtz to Oregon: Since the CSA regulates “quintessentially
economic [activities],” the trifling amounts of controlled substances ingested
in PAS are of no concern to the Supreme Court.
In the wake of Raich, add one more similarity to those that exist
between MM and PAS: in the end, we believe, Congress could triumph over
both. And perhaps yet another similarity, too. Conceivably, a thought similar
to Steven’s final comment in Raich might one day serve the Supreme Court
in a concluding paragraph of a decision that validates a congressional law
criminalizing PAS: if democratic forces at work in the creation of the CSA
failed to carve out a sovereign role for state governments to determine for
themselves what is a “legitimate medical purpose,” then “the voices of
voters...may one day be heard in the halls of Congress.”93
Notes
1
Washington v. Glucksberg, 521 U.S. 702 (1997).
ibid, p. 735.
3
ibid, p. 737.
4
Oregon Death With Dignity Act, Ballot Measure 16, 8 Nov. 1994.
5
Oregon Ballot Measure 51, 4 Nov. 1997.
6
Oregon Department of Human Services, Summary of Oregon’s Death with
Dignity Act-2007, March, 2008, p. 2.
7
California Compassionate Use Act, 5 Nov. 1996.
8
Controlled Substances Act, 21 U.S.C. §§ 801 et seq.
9
Gonzales v. Raich, 125 S. Ct. 2195 (2005).
10
Gonzales v. Oregon, 126 S.Ct. 904 (2006).
11
Wickard v. Filburn, 317 U.S. 111 (1942).
12
125 S. Ct. 2195, 2209 (2005).
13
ibid, p. 2211.
14
Oregon Death With Dignity Act, Oregon Revised Stat. §127.800-127.995
(1994).
15
California Compassionate Use Act, Cal. Health and Safety Code, §11362.5
(1996).
16
Controlled Substances Act, 21 U.S.C. §801.
17
ibid, §801(4).
18
ibid, §801(5).
19
ibid, §801(6).
2
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20
ibid, §824.
ibid, §823.
22
ibid, §829.
23
21 C.F.R. 1306.04.
24
Dispensing of Controlled Substances to Assist Suicide, 66 Fed. Reg.
56607, 9 Nov. 2001.
25
ibid, §812(b)(1).
26
Raich v. Ashcroft, 352 F. 3d 1222, 1226 (9th Cir. 2003).
27
ibid.
28
Raich v. Ashcroft, 248 F. Supp. 2d 918, 920 (N. D. Cal 2003).
29
ibid, p. 926.
30
ibid, p. 925.
31
Raich v. Ashcroft, 352 F. 3d 1222, 1228 (9th Cir. 2003).
32
ibid, p. 1226.
33
ibid, p. 1228.
34
ibid, p. 1234.
35
Gonzales v. Raich, 125 S. Ct. 2195, 2219 (2005).
36
United States v. Lopez, 514 U.S. 549 (1995).
37
United States v. Morrison, 529 U.S. 598 (2000).
38
United States v. Lopez, 514 U.S. 549, 558 (1995).
39
ibid, p. 561.
40
United States v. Morrison, 529 U.S. 598, 674 (2000).
41
United States v. Raich, 125 S. Ct. 2195, 2221 (2005).
42
ibid, p. 2236.
43
ibid, p. 2210.
44
ibid, p. 2208.
45
ibid.
46
ibid.
47
ibid, p. 2206.
48
ibid, p. 2214.
49
ibid.
50
ibid, p. 2215.
51
ibid, p. 2208.
52
ibid, p. 2213.
53
ibid, p. 2212.
54
ibid, p. 2202.
55
Wickard v. Filburn, 317 U.S. 111 (1942).
56
Gonzales v. Raich, 125 S. Ct. 2195, 2206 (2005).
57
ibid, p. 2207.
58
ibid, p. 2220.
59
ibid, p. 2208.
21
Arthur G. Svenson and Susan M. Behuniak
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60
ibid, p. 2205.
ibid.
62
ibid, p. 2209.
63
ibid, p. 2215.
64
Gonzales v. Oregon, 126 S. Ct. 904, 911 (2006).
65
Oregon v. Ashcroft, 192 F. Supp. 2d 1077 (D. Or. 2002).
66
Oregon v. Ashcroft, 368 F. 3d 1118 (9th Cir. 2004).
67
Oregon v. Ashcroft, 192 F. Supp. 2d 1077, 1084 (D. Or. 2002).
68
ibid, p. 1092.
69
Gonzales v. Oregon, 126 S. Ct. 904, 939 (2006).
70
Chevron U.S.A., Inc. v. Natural Resources Defence Fund, Inc. 467 U.S.
837 (1984).
71
C R Sunstein, ‘Chevron Step Zero.’ Virginia Law Review, vol. 92, 2006, p.
190.
72
Marbury v. Madison, 5 U.S. 137, 177 (1803).
73
L Tribe, American Constitutional Law, Vol. I, Foundation Press, New
York, 2000, pp. 993-994.
74
ibid, p. 997.
75
Controlled Substances Act, 21 U.S. C. §871(b).
76
ibid, §824.
77
Petition for Writ of Certiorari, United States Supreme Court, Docket No.
04-623, 9 Nov. 2004, p. 4.
78
ibid, pp. 4-5.
79
ibid, p. 7.
80
Gonzales v. Oregon, 126 S. Ct. 904, 916 (2006).
81
ibid, p. 917.
82
ibid, p. 918.
83
ibid, p. 917.
84
ibid.
85
ibid, p. 921.
86
ibid, p. 923.
87
ibid, p. 924.
88
Brief for Respondent State of Oregon, United States Supreme Court,
Docket No. 04-623, 18 July 2005, p. 43.
89
ibid.
90
ibid, p. 45.
91
Maryland v. Wirtz, 392 U.S. 183 (1968).
92
Gonzales v. Raich, 125 S. Ct. 2195, 2206 (2005).
93
ibid, p. 2215.
61
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Bibliography
Behuniak, S. M., and A. G. Svenson, Physician-Assisted Suicide: The
Anatomy of a Constitutional Law Issue. Rowman & Littlefield Publishers,
Lanham, MD, 2003.
California Compassionate Use Act, Cal. Health and Safety Code, §11362.5
(1996).
Chevron U.S.A., Inc. v. Natural Resources Defence Fund, Inc. 467 U.S. 837
(1984).
Controlled Substances Act, 21 U.S.C. §§ 801 et seq.
Gonzales v. Oregon, 126 S.Ct. 904 (2006).
Gonzales v. Raich, 125 S. Ct. 2195 (2005).
Marbury v. Madison, 5 U.S. 137, 177 (1803).
Maryland v. Wirtz, 392 U.S. 183 (1968).
Oregon Death With Dignity Act, Oregon Revised Stat. §127.800-127.995
(1994).
Oregon Department of Human Services, Summary of Oregon’s Death with
Dignity Act-2007, March, 2008.
Oregon v. Ashcroft, 192 F. Supp. 2d 1077 (D. Or. 2002).
Oregon v. Ashcroft, 368 F. 3d 1118 (9th Cir. 2004).
Raich v. Ashcroft, 248 F. Supp. 2d 918 (N. D. Cal 2003).
Raich v. Ashcroft, 352 F. 3d 1222 (9th Cir. 2003).
Sunstein, C. R., ‘Chevron Step Zero’. Virginia Law Review, vol. 92, 2006,
pp. 187-249.
Arthur G. Svenson and Susan M. Behuniak
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Svenson, A. G., ‘The Last Rites for States’ Rights: Graveside Struggles
between States and Congress Over Physician-Assisted Suicide’. The Social
Science Journal, vol. 40, 2003, pp. 109-127.
Tribe, L., American Constitutional Law, Vol. I. Foundation Press, New York,
2000.
United States v. Lopez, 514 U.S. 549 (1995).
United States v. Morrison, 529 U.S. 598 (2000).
Washington v. Glucksberg, 521 U.S. 702 (1997).
Wickard v. Filburn, 317 U.S. 111 (1942).
Arthur G. Svenson is David Boies Professor of Government at the
University of Redlands, California, and Susan M. Behuniak is Professor of
Political Science at Le Moyne College, New York; they are co-authors of
Physician-Assisted Suicide: The Anatomy of a Constitutional Law Issue.
The Ethics of Patient Non-Treatment
Lloyd Steffen
Abstract
That illness, disease or handicap should ordinarily receive treatment through
the resources of modern medicine is not controversial. In fact, agreement can
also be reached that refusal to treat such individuals constitutes a moral
wrong. But this presumptive moral view for treatment is not absolute, and
certain medical situations provoke refection on the possibility that nontreatment might be a morally justified, even if death is a foreseen
consequence. Appealing to the ethic behind just war thinking, which lays out
a justice consideration to guide moral reflection, this paper considers the
justice-related criteria that would allow for possible "justified non-treatment"
of severely handicapped patients. This "just war"-related way of doing ethics
offers a new contribution to ethical theory while providing practical guidance
on the issue of patient non-treatment. Three examples of relevant medical
conditions are examined, including dystrophic epidermolysis bullosa, a
disorder afflicting newborns in which touch is excruciatingly painful. The
examples present medical conditions where non-treatment presents itself as a
humane and caring medical option and a justifiable practice so long as certain
justice conditions are met, including non-treatment in the patient’s best
interest, the judgment that life is a burden, that no reasonable hope of
enjoying the goods of life is possible, and others. Non-treatment is
sometimes regarded as justifiable action but only if the direct intention to end
life is excluded from the description. The paper supports non-treatment as
justifiable in certain circumstances but questions the honesty of insisting on
such a description when the foreseen and inevitable consequence of nontreatment is death.
Key Words: Medical ethics, patient non-treatment, just war thinking,
severely handicapped newborns, medical assistance in dying.
*****
1.
Introduction
Are there ever good and sufficient reasons for deciding not to
provide medical treatment to persons because of the severity of their medical
condition? Different ethical points of view will yield different ways of
responding to this question, but that in itself raises the question for moral
philosophy: What are the ethics resources available to help rational people of
good will address such an issue, and how adequate are those resources for
guiding us through a difficult moral controversy?
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The Ethics of Patient Non-Treatment
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Patient non-treatment raises issues requiring ethical clarification,
and I propose here to approach this medical ethics question by invoking an
ethics resource that I think holds some new possibilities for thinking about
practical solutions for this difficult problem. The resource to which I refer is
itself related to a tradition of thinking we associate with “just war.” That
tradition, I shall argue, is not itself an ethic and thus not a solution to the
medical ethics issue before us—but it appeals to an ethic, and the ethic to
which it appeals can be extracted and shown to be relevant to clarifying the
ethics of patient non-treatment. I will extract and defend this ‘just war’
related ethic, then turn to the specific problem of patient non-treatment to see
if, in fact, this ethics resource offers practical help in the moral effort to
figure out what, in such a case, is the good, right, and fitting thing to do.
2.
An Ethic
Our traditions of ethics in the West, and I will address only Kantian
deontology and utilitarianism, will often but not always lead rational persons
of good will to the same ethical conclusion - and there is some comfort in
that; but the approach is subject to critique due to demonstrable inadequacies.
Kantian deontology, which is devised as a form of non-consequentialist
thinking, can express a form of moral absolutism that yields a counterintuitive moral rigidity. And it is often asked of utilitarianism whether its
focus on determining “the greatest good for the greatest number” by
calculating consequences is impractical since the consequences of any action
can never really be fully anticipated. By stressing consequences to the
exclusion of intentions, the utilitarian fails to establish grounds for any
intrinsic value beyond the calculation principle, thus jettisoning any
possibility for basing ethics decisions on concerns for human rights or even
the intrinsic value of persons themselves.
The “just war tradition” has been handed down from Cicero, through
Augustine, Aquinas and the Spanish philosophers Suarez and Vitoria and
others is best known as a set of criteria to be satisfied when considering a use
of military force. The suppressed premise in this “natural law” tradition is
that war is an evil and as such is much to be avoided, but attendant to the
theory is the other suppressed premise that war may be necessary to defend,
preserve and promote important values and justice concerns that are at the
core of specific conflicts. The just war tradition has identified “criteria” that
must be applied to specific situations and circumstances; and these criteria
must be “satisfied” if a use of military force is to be justified. Those criteria
would today include the following:
Legitimate authority
Just cause
Lloyd Steffen
203
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Right intention and announcement of that intention
Preservation of values that could not be preserved without
use of force
Last resort
Reasonable hope of success
Two other criteria govern action within conflict itself:
a non-combatant immunity provision, and
a proportionality requirement that any use of force be
proportionate to the end of bringing about peace.
This list of criteria identifies particular concerns related to the idea
of establishing justification for uses of military force in a war, but the
“theory” is sufficiently thin that it does not present any normative
understanding for how these criteria are to function. An ethic that conforms
to the moral point of view will take others into account and express concern
for their well-being (beneficence); acknowledge universal applicability, so
something good for one person to do is good for anyone similarly situated to
do (universalizability); it will observe a principle of impartial justice, and
also articulate a consistent set of normative principles.1 The just war criteria,
despite being justice-related, do not, by this standard, constitute an ethic.
That is why "just war" thinking seems so malleable and why it is so easily
used to support - and justify - almost any prospective use of force.
Yet this just war framework does appeal to an ethic, and what is
required is the articulation of a common moral agreement, a presumption to
which all rational people of good will could assent, and I would articulate it
like this: ordinarily, we ought not use force to settle conflicts. This rather
simple idea asserts a normative principle of universal applicability
concerning the reality of conflict and the good, right and fitting action that
should be undertaken when conflicts arise; furthermore it entails an implicit
concern for beneficence since human well-being is reasonably advanced by
not using force to settle conflicts, and it asserts the presumptive non-use of
force as the just mode of settling them.
Just war is, as an ethic, not a justification for war, but a justification
for allowing an exception to the normative principle that force ought not
ordinarily be used to settle conflicts.
This underlying normative action guide is never articulated as the
foundation for deliberation in classic just war thinking - yet it is the
foundation for just war as an ethic. The ethical approach modelled by just
war can be applied as an ethic relevant to issues beyond war and the use of
force; and it is from this assertion that I am led to consider the specific
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The Ethics of Patient Non-Treatment
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concern of this paper - patient non-treatment. What would an ethic of just
non-treatment, modelled on this just war ethic, look like, and how would it
function?
3.
Just Non-Treatment: Criteria and Cases
A. Criteria
In considering the issue of patient non-treatment, end of life and
beginning of life situations are not equivalent morally speaking. The
possibility exists that patients at the end of life can exercise a non-treatment
option by an express directive to medical care-givers, or by advance
directives to withdraw or withhold medical intervention as specified physical
conditions warrant, or by creating a proxy process for deciding non-treatment
options (both withholding and withdrawing). Given the possibility that
individual patients can opt for non-treatment as an exercise of personal
autonomy, the more difficult cases worth considering are those involving
beginning of life, by which I mean severely handicapped newborns.
Morally speaking, rational people of good will can be expected to
express common agreement on this basic moral norm, or presumptive action
guide: ordinarily a newborn facing medical difficulties and even handicaps
should receive “standard of care” medical treatment, including palliative
care in terminal situations. Medical science can in many cases successfully
intervene in neonatal medical problems to preserve life and contribute to the
neonate's eventual flourishing as a member of the moral community; so
ordinarily we ought not consider withholding or withdrawing treatment to
medically distressed persons, though there might be good reasons to consider
an exception to this common agreement. To justify an exception would
require the development, articulation and application of justice-related
criteria akin to those familiar in just war thinking.
If, in general, the moral community acknowledges an obligation to
treat rather than not treat handicapped newborns, and even Peter Singer gives
evidence of supporting this view,2 the question arises: are there justified
exceptions and what conditions would have to be met so that medical help
could be withdrawn or withheld justifiably and the neonate patient allowed to
die? This question is now my focus.3
A "just non-treatment" ethic begins with a moral presumption that
distressed patients, including handicapped neonates, ought ordinarily to be
treated. But several reasonable, justice-related conditions could, if satisfied,
allow for consideration of non-treatment. These conditions or criteria include
the following:
1.
The life of the neonate patient is deemed clearly a
burden to the infant itself.
Lloyd Steffen
205
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2.
The intention to withdraw or withhold treatment must
be to serve the best personal, social and spiritual
interests of the patient.
3.
Descriptions of the patient’s medical condition must
establish both severity and futility of treatment. The
determination must be made that the prospects of
enjoying the goods of life, including the very basic
good of life itself, is negligible. No reasonable hope
that the neonate will flourish as a functioning human
being in relationship to others exists; and there is little
hope that medical intervention will raise the medical
condition to even the most minimal level required for
flourishing. Medical intervention will, to the contrary,
contribute to the burdens that patient must bear rather
than relieve those burdens.
4.
The decision to withdraw or withhold treatment is
patient-centred and not determined by the burdens the
patient imposes on others - the medical staff, the
family or society at-large.
5.
The decision must be made by those who represent the
various interests of the patient including family,
physicians, medical care personnel, and spiritual
advisers.
6.
By withdrawing (or withholding) treatment one is
trying to preserve respect for the good of life rather
than diminish it, and non-treatment will reasonably
accomplish this end.
By satisfying these criteria, the presumption that a severely
handicapped newborn should be medically treated may be lifted, the
accumulation of reasons amounting to this: that doing so is in the best
interests of the neonate and is justified. These criteria acknowledge standard
of care so that pain management, to the extent pain can be determined, is
always in order, even if it hastens the death of the neonate.
B. Cases
Several medical conditions might allow for consideration of justified
non-treatment. Individual cases must be assessed, but some medical
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conditions are more likely to provoke consideration of non-treatment. Let me
mention three.
1. Consider a rare skin disease called dystrophic epidermolysis
bullosa of the recessive form. Newborns afflicted with this do not
live past five years of age, and life is marked by intractable pain
which then requires heavy sedation - that is life: pain or heavy
sedation with Demerol, which puts the neonate in a stupor. Babies
afflicted with this find dressing and bathing excruciating
experiences, even screaming in anticipation of such activity. Here is
a description from ethicist Richard C. Sparks:
The quality of life open to this child is either so
irremediably pained or else so doped up that
should life sustainers be required or treatment
become necessary for pneumonia, infections or
other curable diseases, one might opt to forgo
these efforts in the patient's holistic best interests,
hoping for an earlier and easier rather than a
belaboured and painful dying process.4
2. Next consider the condition of hydraencephaly, a birth where the
newborn presents an open cranial vault, has no brain present, and
only remnant tissue. According to Black’s Medical Dictionary,
neonates with this condition are “born with defects of skull and
absence of brain . . . the brain stem and cerebellum are atrophic. If
pregnancy goes to term the infant dies rapidly.”5 A woman can
know early in pregnancy that she is carrying an anencephalic baby,
and if they come to term these neonates have “no cognitive activity
or relational potential. Death is usually imminent within hours, days,
weeks.”6
3. A third condition, the infant version of amyotropic lateral
sclerosis or ALS (Lou Gehrig disease), is Werding-Hoffman
disease, “a progressive, relentless and totally irreversible” condition
that creates a “locked in state” of paralysis that simulates coma but
normal consciousness is preserved. Werding-Hoffman can cause
both extreme physical and psychological suffering. Neonates require
incubation in ICUs, respirators, IV fluids, and feeding tubes.
Questions arise about the pain and discomfort level of the afflicted
neonate, but clearly the care givers - parents, neonatal ICU nurses
and physicians - are concerned about any actions that might increase
the pain and suffering of the neonate.7
Lloyd Steffen
207
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These then are three conditions that raise the possibility of neonatal
or perinatal patient non-treatment. We must take note of this commonplace
reality. A serious birth defect is often accompanied by other physical
anomalies, and sometimes it is the combination that is at issue even if
individually one defect might not rise to the level of justifying nontreatment.8
4.
Discussion
If we apply the six criteria to the three cases listed above, we can see
how the criteria guide making a justified exception - or not.
The hydraencephelitic presents a severe and futile medical
condition. No reasonable possibility exists that corrective medical
intervention would ameliorate the medical situation. The neonate lacks the
brain structures necessary for the possibility of relationship, identity, and
becoming the subject of experience; and although the neonate is a member of
the human species, the moral community rightly does not confer upon it
personhood. The just non-treatment criteria could be applied and a decision
not to treat made in the best interests of the patient. Non-treatment poses no
reasonable issue of disrespect for the value or good of life itself.9
The dystrophic epidermolysis bullosa case as described seems to be
so catastrophic, amelioration by treatment so unlikely, and futility so present,
that the criteria for just non-treatment could be satisfied. The description of
the disorder given above does not fit all possible cases of the disorder, but in
this particular description, life itself is a burden to the neonate due to constant
excruciating pain on the one hand, being doped up in a stupor on the other.
Author Richard Sparks suggests that this condition begs the very question of
reasonable patient non-treatment. Applying the criteria supports lifting the
presumption against non-treatment - the physical condition is hopeless and
futile, withholding treatment is reasonably in the patient’s best interest, and
the decision to withhold treatment should be made for patient-centred reasons
by those entrusted with the neonate's interests. Assessing the value of the life
of the neonate provokes the non-treatment option: that life is not a gift but a
terrible burden - the decision not to treat is a tragic decision, of course, but
the burden of life is so great that that non-treatment seems a humane course
of medical action.
In a journal of clinical medical ethics, Dr. Robert Echenberg, a
neonatologist, presented a case study of Werding-Hoffman in the context of a
perinatal ethics committee confrontation with the disorder. Eichenberg relates
how the ethics committee attempted to consider the concerns of the patient,
the parents, and the community of care-givers, which included ICU nurses,
whose bonding with the infant positioned the nurses to "became most
qualified to assess the neonate's levels of comfort or suffering."10 Echenberg
writes that much was unknown about the nature of pain or suffering being
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experienced by the newborn - if the newborn could even be said to be
experiencing pain; he also noted that traditional ethical theories involving
"critical care decisions, logical rules, predetermined principles and commonly
trusted beliefs" were not of great help. As the committee tried to figure out
the how best to carry out the non-treatment decision, once that was deemed
medically appropriate, consensus was sought on the timing and manner of
withdrawal of treatment, and ethically, the committee needed to "be flexible
and willing to explore creative, new possibilities." Echenberg writes:
Through a process of careful interviews and a well-attended
committee discussion, we came to a firmer accord in
understanding what might be in this child's best interests, as
well as in coming to terms with withdrawal of her life
support. . . .[T]he critical care nurses . . . played a
significant and critical role. We learned, also, that it is
desirable to forge a therapeutic and healing process to ease
the pain and turmoil of the survivors.11
The infant, by the way, went into cardiac arrest and no energetic
resuscitative efforts were made to save her as had been done previously. The
physicians and nurses in attendance "allowed the baby to die without further
intervention."12
The Journal of Clinical Ethics, in which the case study appeared,
published three responses to the case presentation, and respondents criticized
the way the perinatal committee functioned, especially in its call for
consensus among caregivers about how to proceed. Specifically criticized
was the decision to allow a collective opinion of the nurses to have a huge
impact on the decision-making: "We must be sceptical of the assumption that
nurses and other caregivers can always be appropriate judges of the patient's
best interest," wrote critic Robert Truog, arguing that coercion can be
involved in consensus when someone claims authority by appeal to past
experience.13 Another critic, Robert F.Weir, argued that more attention to a
benefit and burden analysis might have prevented a technological
intervention in the first place, since the physical condition might have
deemed such intervention harmful to the patient "interfering with her future
interests, impairing her psychological welfare, or as aimless cruelty?"14 And a
third respondent argued that the emotional needs of health care personnel
ought not be a focus of moral decision making in such a case, and that
assessing the process of how judgments about the quality of life are made is
the critical ethics concept, not a technical determination of pain, which can be
manipulated and controlled.15
All the parties, Echenberg and his critics, paid attention in varying
degrees to the centrality of the patient. The committee faced a difficulty
Lloyd Steffen
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determining the extent of the neonate's pain, but all were concerned with it,
and none of the authors disputed the decision to withhold or withdraw
treatment - the issue was when and how and who has voice in the
consultation. Whereas Echenberg wanted attention paid to the caregivers
because of their involvement in the case and the attendant grief, he and the
committee did address primarily the patient and the patient's welfare - then in
the face of unknowns about what the patient was experiencing, and having
settled the justifiability of non-treatment, took a wider view about those
entering into relation with the neonate as a caregiver: the decision to
withdraw treatment was actually clear and demonstrate that the criteria of the
just non-treatment ethic laid out above were invoked, applied and satisfied.
The presumption that ordinarily even a severely handicapped newborn be
treated was observed, but then attention was given to the severity and futility
of treatment, then to the best interests of the neonate. Consultation with those
representing the patient's interests became a focus, and the role of medical
staff then became a specific issue of contention and disagreement - but
disagreement did not arise, as I read the case, concerning the patient-centred
decision not to treat the patient. The attention to the staff grief makes this
case somewhat unusual, but in a sense, even this focus does not stray from
the "just non-treatment" criterion regarding consultation, since that is what
one is supposed to do with the criterion - look into how the various parties
representing patient interest are to be involved. There can be disagreement
about if and how particular criteria are actually satisfied, but it is the
discussion and arguing in public ways that is critically important for the ethic,
and that was actually done when the case was active - and then even in its
aftermath, when in a professional ethics journal the case was once again
presented for ethics reflection and professional discussion.16 I think the
formal aspects of the “just nontreatment of neonates” ethic were observed
and conscientiously so. The decision for non-treatment was made in
consultation as being in the patient's best interest. I think this case, not only in
its presentation, but even in the accompanying criticisms of it, demonstrates
how the ethic - the just non-treatment ethic proposed here - actually works.
5.
Conclusion
I draw three conclusions from this discussion. First: The ethic
proposed here is flexible yet patient centred and grounded in the idea that
neonates, even seriously handicapped ones, should be treated. The ethic is
flexible in a way a deontological ethic is not. Just non-treatment is concerned
with the patient as an individual sufferer whose particular situation is deemed
deserving of a presumption of care due to a principled moral directive that
even handicapped newborns deserve treatment due to their status as members
of the moral community. They are not ciphers in a utilitarian calculation.
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Secondly, neonatal disability presents specific moral problems
related to how the good of life is to be evaluated along with other goods of
life. The ethic is flexible enough to suggest that the good of life must be
placed in an evaluative context with other goods, which is to say that good of
life is not an absolute good, but a good-in-relation with other goods like
bodily integrity, and the capacity for realizing a psychological identity and
thus the capacity to enjoy the other goods of life (friendship, aesthetic
enjoyment, abstract reasoning). When these other goods are catastrophically
compromised by physical defect or deformity in particular situations, the
good of life can be called into question by applying the justice criteria of the
just non-treatment ethic. The determination can be made that not all life is
worth living. Moreover, rational people of good will, exercising practical
reason in accord with an ethic like that suggested here, must assume
responsibility for acting to advance the well-being of an individual patient
whose life may be so burdensome that withdrawing medical care trumps the
concern for preserving and promoting life.
And third: The question arises that if the life is a burden, and further
treatment is adding increased suffering, cannot the action of dispatching such
an individual by means of, say, morphine injection be considered consistent
with a standard of care, with the patient centred action of acting in the best
interests of the patient? And should scarce, expensive medical resources
continue to be expended on a futile, hopeless patient? These are questions
needing further conversation, and Peter Singer is to be applauded for forcing
them into the public arena. But on the ethic proposed here, I am of the view
that the criterion concerning action that preserves respect for the good of life
(#6) could, in this moment of societal and cultural evolution, be compromised
by physicians acting as "dispatchers" - as coming to hold the role of killers
rather than healers, even if ethical analysis might reveal that a morphine
injection that leads to death could also be described as ultimately a healing
action for a certain patient.
In the United States, we are not ready for this redescription of the
physician's role, and the best we can hope for is continued defence of
"double-effect" pain management that brings about death as a foreseen but
unintended consequence. The problem is that in more and more cases the
consequence of patient death is actually intended, and any reasonable
analysis would expose that interpretation. So are we allowing physicians to
do what is humane and morally defensible but withholding a description we
are not ready to accept - but then are we opting for a deception, even a selfdeception because the honest description is too painful for us to face? What
needs to be accomplished in health education is a reorientation that supplants
the anxiety of a public fearful of doctors becoming killers with the assurance
that doctors will act in concert with care-givers to operate out of a patientcentred, “just non-treatment” ethic. In certain extreme medical situations,
Lloyd Steffen
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dying and death are made horrendously difficult by the intervention of
technology, and what is needed is a practical ethic that sees good in easing
off the technological interventions and commends as good, right and fitting
those actions that focus on the best interests of the patients, including the
possibility of a justified course of non-treatment.
Death can sometimes be in the patient's best interest - and
deontological ethics sometimes seems to deny this by refusing to consider
direct action that would expedite death, for such would be contrary to our
duty to respect persons - can you show respect to persons by acting to
terminate their life?; and utilitarian ethics loses both the individual sufferer
and the care-giver pain in a calculus related to distributive justice where
every individual sufferer is rendered a cipher to be treated as the calculus
directs. The difficult social policy issue is whether acting in a patients' best
interest can, as a matter of “standard of care,” include action to directly
intend the death of a patient—for the reason that that is the good, fitting and
right thing to do in the patient's best interest. The just non-treatment ethic
holds out this possibility.
Notes
1
J Runzio, ‘Religion and Ethics in a Global World’, in Ethics in the Worlds
Religions, J Runzo and N M Martin(eds), One World, Oxford, 2001, p. 23.
2
See P Singer, Practical Ethics, Cambridge University Press, Cambridge,
1979, p. 132: "Defects vary of course. Some are trivial, and have little effect
on the happiness of the child or its parents; but other defects turn the
normally joyful event of birth into a threat to the happiness of the parents,
and any other children they may have." By this statement, I take it that a
neonate may be defective even beyond “trivial” and thus should receive
medical care, but some defects go to the issue of severity such that continued
pain and distress raise the question, as Singer puts it, whether the neonates
"life is worth living." This invokes the severity issue of the case I shall make,
though not necessarily the futility feature, as will be seen below. Singer also
moves beyond the “misery” factor to a broader view of utilitarian calculus,
namely, the justifiability of killing a defective haemophiliac that is bound to
create an aggregate disutility in relation to another newborn whom the
parents of the killed neonate could create to replace it, who would not
produce such disutility. I am nota utilitarian and do not agree with this
position. I raise the “misery” issue related to the assessment of the neonate's
condition to indicate that even Singer seems to recognize the moral
presumption issue here. Singer believes a severely handicapped neonate can
be aborted, but he goes further: an embryonic/fetal candidate for justified
"abortion" is one who presents a defect that may not be actually discernible
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until inspected at birth could, and on Singer's account such a neonate could
be justifiable killed, using a utilitarian calculus that takes into account the
greatest aggregate happiness. Singer provokes serious issues, but I appeal to
his argument in Practical Ethics to indicate that he does not oppose the moral
presumption, the action guide regarding patient non-treatment, important to
my argument, and even seems to support it, as it would be reasonable to do.
Admittedly he does not dwell on this feature of things because his interest is
in the hard cases and he seeks to determine what utilitarianism will allow and
should be done - and what is good to do - in cases of extreme defect.
3
I acknowledge that other questions press for attention, such as, “Is there a
moral difference between withdrawing and withholding care,” which I think
there is; and how is "allowing to die" by the decision to act in a way that
foresees death not also intend death, so that letting die might be distinguished
from “killing” and thus with active euthanasia. These questions, important
thought they be, leads us away from the specific issue of this inquiry, so let
us turn back to possible conditions that would guide justified non-treatment
of neonatal patients.
4
R C Sparks, To Treat or Not to Treat, Paulist Press, New York, 1988, p.
317.
5
‘Anencephaly’, in Black’s Medical Dictionary, 41st edition, H Marcovitch
(ed), The Scarecrow Press, Lanham, MD & Oxford, 2006, p. 39.
6
Sparks, op. cit., p. 311.
7
R. J Echenberg, ‘Permanently Locked-In Syndrome in the Neurologically
Impared Neonate: Report of a Case of Werdnig-Hoffman Disease’. The
Journal of Clinical Ethics, vol. 48 (3), Fall 1992, pp. 206-208. This case
study is followed by three critical responses.
8
The 1982 Infant Doe case in the United States involving an Indiana newborn
who was born with Down's syndrome and correctable spina bifida is such a
case. Infant Doe’s spina bifida was correctable by surgery, but the parents did
not approve the surgery option and asked that the infant be allowed to die
because they did not want the burden of a seriously retarded infant. The
parents asked the attending physician to withhold food and water from the
infant. This parental decision was upheld by an Indiana court. It is generally
agreed that the parents would have requested the necessary surgery if the
baby had not been "retarded" due to Downs, so it was not the uncorrected
spina bifida that killed Infant Doe, even though spina bifida can sometimes
be considered so serious a defect that it alone could provoke consideration of
justified non-treatment. (See Echenberg, op. cit., p. 208.) In the Infant Doe
case, the death resulted from a decision not to treat made by parents
distressed by having to contend with the mental retardation accompanying
the Down’s syndrome.
Lloyd Steffen
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9
Dispatching a neonate with this condition using, say, a morphine injection to
suppress breathing and hasten death does not seem to me to be outside the
pale of justification as action addressing the best interests of the patient.
Such action could be described perhaps as pain management rather than a
killing, but it cannot be known for certain if pain is even at issue since there
is no self to experience or integrate sensation into pain, and controversy
would arise over criterion #6—diminishing respect for the good of life itself,
a utilitarian-related criterion. But non-treatment itself does not seem morally
controversial.
10
Echenberg, op. cit., p. 208.
11
Echenberg, ibid.
12
Echenberg, op. cit., p. 207.
13
R D Truog, ‘Locked-In Syndrome and Ethics Committee Deliberation’. The
Journal of Clinical Ethics, vol. 3 (3), Fall 1992, pp. 209-10.
14
R F Weir, "Abating Treatment in the NICU". The Journal of Clinical
Ethics, vol. 3 (3), Fall 1992, pp. 211-3.
15
T . Dagi, ‘Compassion, Consensus, and Conflict: Should Caregivers' Needs
Influence the Ethical Dialectic?’. The Journal of Clinical Ethics, vol. 3 (3),
Fall 1992, pp. 214-18.
16
For all that appears to be disagreement about the "ethics" of this case
around attention to the grief reactions of staff, this case - the presentation and
the respondents, actually provides a good example of how the "just nontreatment" ethics actually works. A common agreement is reached regarding
a non-treatment course of action. That is determined evaluation of the
patient's best interests in light of the medical situation. The other criteria are
also observed, with the sticking point being the criterion that states: the
determination to withdraw treatment cannot be determined by the burdens
imposed on others, including care-givers. The discussion about the role of
nursing staff might make it appear that concern for the caregivers trumped
concern for the patient and the patient's best interests, but that is actually not
the case at least as far as the non-treatment decision goes. As much as
working for harmonious relations with medical staff on difficult cases is
much to be lauded, the just non-treatment ethic insists that the patient must be
the central focus - and I believe that was accomplished so that the dispute
then turns to how to implement the best-interest decision not to treat, which
then led to consideration of the role of care-givers. I do not see that the
neonatal patient was in anyway short-changed ethically or that the patient's
case failed to be vetted adequately through the ethical scheme I am
supporting here.
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Bibliography
‘Anencephaly’, in Black’s Medical Dictionary, 41st edition, H. Marcovitch
(ed), The Scarecrow Press, Lanham, MD & Oxford, 2006, p. 39.
Dagi, T. F., ‘Compassion, Consensus, and Conflict: Should Caregivers'
Needs Influence the Ethical Dialectic?’ The Journal of Clinical Ethics,
Vol. 3 (3), Fall 1992, pp. 214-18.
Echenberg, R. J., ‘Permanently Locked-In Syndrome in the Neurologically
Impared Neonate: Report of a Case of Werdnig-Hoffman Disease’. The
Journal of Clinical Ethics, vol. 48 (3), Fall 1992, pp. 206-208.
Runzio, J., ‘Religion and Ethics in a Global World’, in Ethics in the Worlds
Religions, J. Runzo and N. M. Martin (eds), One World, Oxford, 2001.
Sparks, R. C., To Treat or Not to Treat. Paulist Press, New York, 1988, p.
317.
Singer, P., Practical Ethics. New York, Oxford, 1979.
Truog, R. D., ‘Locked-In Syndrome and Ethics Committee Deliberation’. The
Journal of Clinical Ethics, Vol. 3 (3), Fall 1992, pp. 209-10.
Weir, R. F., "Abating Treatment in the NICU". The Journal of Clinical
Ethics, vol. 3 (3), Fall 1992, pp. 211-3.
Lloyd Steffen is Professor of Religion Studies and University Chaplain at
Lehigh University. He is the author of several books, including Holy War,
Just War: Exploring the Moral Meaning of Religious Violence, published in
2007 by Rowman and Littlefield.
What's Wrong with the Brain Death Debate?
Joseph Wang
Abstract
Since the proposal of the brain death criteria this issue has been under heavy
debate. While for most physicians brain death is really the death of a human
being (resp. human person), for some philosophers it is just the death of a
special human organ, but surely brain death is not identical with the death of
the whole human person. In this paper I argue that physicians and
philosophers are at cross-purposes. The crucial question in this debate seems
to be an ontological one: Who or what is dead if someone is brain dead? The
physicians’ answer is “the human being,” while the philosophers’ answer is
“the brain.” But if we also consider the purpose of this ontological question,
then perhaps the alleged confusions can be cleared up. In my opinion brain
death is not an appropriate answer for the ontological question, but rather it is
a regulatory principle for actions, in particular the action of the withdrawal
from therapies and the actions of making preparations for the organ
transplantation. If this is accepted, then the subject of the brain death debate
will not be the ontological question about human death, but rather a question
within an ethic of transplantation medicine.
Key Words: Brain death, organ transplantation, withholding of/withdrawal
from therapy, biomedical ethics.
*****
1.
Introduction
Until the beginning of the 20th century death - regarded from the
medical perspective - was not a subject for debate but rather a mere fact. Of
course, there were philosophical and medical treatises about death, but
“defining death” was not necessary, as death was an event that occurs on a
certain living being at a certain time. Though people already knew that the
brain had something to do with the mind and that somehow the “personality”
of a human being was tightly coupled with her brain, the brain - due to
epistemological difficulties - was not the main organ for physicians to
determine a patient's death. The heart, on the contrary, became the obvious
criterion for diagnosing the death. As far as we know, there has never been a
living person without a beating heart and every dead human being has lost
their heart functions. And since we can find out easily whether a heart is still
functional or not, the beating heart was the crucial criterion for a living
human being.
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What's Wrong with the Brain Death Debate?
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This situation has gotten more complicated since the end of the
1950's: Physicians now have means to support or even to substitute some of
the vital organ functions. Some patients who have lost their heart functions
can now be kept alive for some time. Some patients in coma who would have
died in the 19th century can now be nourished and kept alive until they
recover from their diseases. Thanks to the advances in medical science more
lives can be saved. But this means also that not having a functional heart is
not sufficient anymore for the death diagnosis; the traditional heart criterion
cannot hold any longer: There are now “living” human beings without a
living heart.
On the other hand, the downside of this development and its ethical
challenge also show their faces: Some patients, though kept alive with
technical means, never regain their consciousness: They will never be able to
make some decisions, to laugh or to cry or to take part in discussions again.
Should physicians still keep them alive as long as possible?
At least our intuition today those patients can certainly be allowed to
die. To deal with this intuition and the new “situation” new terms like “coma
depassé” 1 and “irreversible coma” 2 were introduced. The notion “brain
death” was then introduced as a medical term to describe patients who have
lost their (higher) brain functions and will (probably) never be able to live a
personal life again.
Ever since the introduction of the terms (and perhaps the
introduction of the transplantation techniques) brain death, like other
bioethical issues, has been under heavy debate. Though there are different
“flavours” of brain death criteria, I think we can safely suggest that
proponents (P) of the brain death criteria propose that human beings who
have lost their brain functions are dead, while the opponents (O) of the brain
death criteria hold that brains, but not human beings, are dead when a brain
death is diagnosed.
In my paper I want to hold a kind of middle position. I want to
emphasize the practical aspect of this debate and hope that, by doing so, I can
shed a different light on this debate. And I will come to the conclusion that
the (ontological) question whether a person, a human being, or a brain is dead
when brain death is diagnosed is not as important as the question about
(indirect) euthanasia and about the ethic of transplantation medicine.
I will proceed as follows: In the first part I want to introduce the
notion “brain death” as it is introduced by the physicians. In the second part I
want to show that the questions in debate are explicitly or implicitly
questions of ontological and/or metaphysical nature. This means that whether
a certain answer is sound for a discussant depends very much on her world
view. In the third part I want to approach the matter from a practical point of
view by analysing people's actions when brain death occurs. And in the last
section I want to compare these actions with actions, which are initiated
Joseph Wang
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when somebody has died. I will conclude that brain death debate is not an
ethical issue itself but should rather be embedded in a debate over the ethics
of transplantation medicine.
2.
What is Brain Death?
I have suggested that the notion “brain death” was introduced to
separate patients who cannot be helped from others patients for whom
physicians should do their best to save their lives. So, foremost, “brain death”
seems to be a medical term used in the medical practice and science. But
what is “brain death” anyway?
It is understandable that I cannot provide a full analysis of the
medical standard for the brain death diagnosis. What I will try to do here is to
explain the so-called four-level-model of the notion “brain death” which is
used by physicians to introduce this special term.3 At the beginning it should
be noticed that the way a term is introduced here is applicable (and even
feasible) to other medical and non-medical terms. Most medical introductions
to the notion of brain death use the four-level-model (sometimes the second
level is omitted, and then it is called the three-level-model)4. In this model a
notion is successfully introduced when four different kinds of questions can
be answered satisfyingly.
The first level/question is concerned about the subject of death: Who
or what can actually be dead? And who or what is dead if somebody is brain
dead? It seems to us that the answer to the first question is quite simple:
living beings. The second question is trickier: For P the person/the human
being is dead, but for O only the brain is dead when a brain death is
diagnosed.
The second level concerns the definition of death. According to
Moskopp “death” is (quite plausibly) the absence of life; this definition can
arguably be an empty tautology. For this definition to be meaningful a
definition of “life” must be provided. But since it is impossible to define life
with all its different aspects, it is therefore also impossible to define death.5
Interestingly the notion “brain death,” though there are different, say,
“flavours,” is well-defined in comparison. Brain death is the “irreversible loss
of the integrating function of the brain,”6 the different flavours emphasize on
different brain areas, which have lost their functions.
The third question is the question about the symptoms/
phenomenological content of the notion “brain death.” When somebody is
brain dead, how can we see this, how is this man different from the rest of us?
Typical signs of brain death are fixed pupils, no higher cerebral reflexes, no
spontaneous respirations, etc. To be sure, the so-called death signs cannot be
applied to a brain dead person.
And the last question complex is about different tests to determine or
to assure the clinical diagnosis of brain death. Physicians and medical
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What's Wrong with the Brain Death Debate?
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researches continue to improve the different methods so the results of these
tests are more specific and valid. The most prominent test is probably the
EEG showing flat lines; other tests include the ultrasonography of the carotid
arteries and the apnea-test.
To sum up, the question “what is brain death?” is answered by P in
the following way: A brain death is the death of a human being who has lost
her life and shows the following clinical signs; the brain death is conformed
by such and such tests. The same question is answered by O in a different
way: A brain death is the death of a (human) brain which has lost all its
functions; the person shows the following clinical signs and the brain death
can be confirmed with such and such tests.
As we can see: The main debate is not about the signs and the tests,
these are seldom under (philosophical) debates. We all tend to think (and I
think quite rightly) that physicians who are proficient in their jobs will know
best how the brain death can be diagnosed. And I think most people will
agree that how brain death is diagnosed is for medical researchers to be
answered; philosophers and theologians are neither capable nor suitable to
answer these questions. But aren't they capable of answering the first two
questions? The first and the second question seem to be more of
philosophical nature than of medical nature.
3.
The Metaphysical Nature of These Questions and World View
In the western philosophy tradition questions concerning definitions
and attributions are main field of philosophy. So the first two levels in the
four-level-model are of philosophical matter. To put it in an exaggerated way
one might say that regardless how advanced the medical science will be, it
will never be able to answer these questions. To show this is really the case, I
want to examine some of the arguments pro and against brain death
criterion.7
A. Some Pro Arguments
The Brain is responsible for integrating the organism. Brain - as
opposed to, say, an arm - is a special organ. While loosing an arm does not
mean to lose one's life, because an organism still exists, this is not true if the
brain is lost, for the brain is (at least according to the findings of the medical
sciences) the organ which integrates the different parts of a living being. i.e.
the living being is one because the brain gathers the different parts and puts
them into an organized whole. So if the integrating organ is missing, the
different parts of the organism are no longer connected; and their ontological
status is comparable to the ontological status of an arm cut off. And a pile of
body parts is not a living entity. Therefore the death of the brain is equal to
the death of the whole human being.
Joseph Wang
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Brain death is the death of the person. For this argument to be sound
one must first distinguish between “persons” and “human beings.” 8 The
notion “person” refers to the mind of someone, the part that is morally
relevant; while the notion “human being” refers to the corporal part, which is
morally just as relevant as any other higher animals. The person, so it seems,
is coupled (solely) with the brain, since a man stays the same person even if
his arm is cut off, but he is not the same person anymore if a larger part of his
brain is injured. Under this premise and under the premise that the person can
die at another time than her underlying human organism, obviously, brain
death is the death of the person, though the death of the organism has not yet
occurred.
B. Some Counter Arguments
On the other side, these arguments have been challenged. I want to
present some of these O-arguments.
Death of a part cannot be the death of a whole. When a part of a
whole dies, this does not mean that the whole organism is also dead. This is
obvious in case of a lost arm, so why should brain, which is also (just) a part
of an organism play such a central/vital role? Actually the organism can be
alive even without the brain, as can be seen in the case of the brain dead
persons. When other parts of the organism (e.g. the blood circulation system,
the peripheral nervous system, the endocrine system etc.) are still functional,
the patient can be kept alive for a certain time. So the death of the brain alone
is not the death of a whole organism. Besides, one day the medical science
might be so advanced that it can repair even extensive brain damage, so
people might be able to recover from the brain death (just like they can
recover now from the heart death).
The notion of personhood chosen by P is the wrong one. The notion
“person” as defined by Locke and Singer is not the only possible one. In the
Aristotelian tradition the soul cannot be separated from the body. If a notion
of personhood from this tradition (e.g. that of Boethius or of Thomas Aquinas)
is chosen, then persons cannot be dead on another time than their bodies.
Under this premise the person is not dead (because she still has the sensitive
and the vegetative functions) when her brain dies.
C. A Question of World View?
Which of the two views is the right one? It seems clear that they
cannot be both right, and it seems that both sides are sound and not
unreasonable. There are good arguments both for and against the thesis that
the human being is dead when he is brain dead. How can we take position?
For the first argument pair (integrating function of the brain vs.
living function of the body) it seems that whether one is a P or an O depends
on her personal judgment whether a human being is a composition integrated
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by some very important instance (brain), or whether she thinks that the
organism is per se a whole and its parts cannot exist for themselves.
And for the second argument pair (Lockean personhood vs.
Aristotelian personhood) it seems that whether O appeals one by P or
depends on her opinion about the notion of personhood. If one thinks that the
mental capacities are essential for human personhood, then she will tend to
think that brain death is a criterion for the death of a human person. If she
thinks that a human person must consist of both parts, the mind and the body,
then brain death will just be the death of a part of a human person, but it will
not be the death of the person herself.
As we can see here, whether P or O is sound depends on one's
personal attitude toward some philosophical issues. Of course the opponents
could shift the subject of debate from the brain death to philosophical
anthropology, but this would not be a debate on ethics, but on world views.9
And we don't have clear criteria for determining which world view is better
than others. Therefore we probably cannot justify our opinion in this matter
universally.
If this analysis is right, does it mean that we have to give up the
endeavour to find out the right answer? I will suggest another approach
instead.
4.
The Practical Approach to “Brain Death”
As we have seen, the level 3 and level 4 questions are not under
philosophical debate. Rather they are instructions on how to determine the
brain death. They are justified through practical aspects and background
theories. Though they can be subject to debates themselves, these debates are
mostly debates on scientific accounts. Whether a certain test is suitable for
determining brain death is not a philosophical issue, but a medical one. Based
loosely on Bridgman and Muck10 we can call them operational analysis of
the notion “brain death.”
Are these tests then out of philosophical questions then? Not quite.
In my opinion, even from a moral philosophical point of view at least three
questions can be asked:
1.
Can the executions of these operations for testing brain death
morally accounted for?
2. What does the notion “brain death” serve for?
3. Do we really need it?
As we can see, these questions do not touch the ontological debate
directly. To be able to answer the first question we do not need to know what
is dead if a brain death test is positive, but we should know who is involved,
how the test is performed and whether the actions are morally right or not.
Joseph Wang
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To give an example, the cerebral angiography for the determination
of brain death is controversially discussed. What is out of the question is that
with this method the blood flow in the brain can be measured. There are
though moral concerns: According to Rabl this test does not aim on a therapy
or a treatment of a patient and may even cause brain death itself; therefore
this method should not be used in the daily routine and should only be
applied under special circumstances. 11 As can be easily seen, the moral
philosophical debate is not on the subject of the ontological bearer of brain
death but on the cost of the action and whether it will make sense or not.
The second question is more interesting. The answer to the question
“do we will need a certain notion?” depends - at least if we interpret the later
Wittgenstein in a certain way - on what we can do with it. The “mere”
description of brain death is not enough to give a full account of it. And the
best way to see how a notion can be used is to analyse its usage in human
actions.
I think we can agree on that the medical use of this notion is the
most important one. We can actually see how the actions of physicians
change when “brain death” is diagnosed. For examples I want to point out
three different types of actions which are initiated when the diagnosis “brain
death” is for sure: Withholding of/withdrawing from therapy, psychological
support for the grief of the relatives, and preparations for organ
transplantations. As far as I can see, these are typical actions connected with
brain death.
A. Withholding of and Withdrawal from Therapy
The first type concerns all kinds of withholding and withdrawing
from therapy. Physicians do not try to cure the patient anymore, if they find
out that she is already brain dead. Is this morally justified?
As to my observation that if brain death has been diagnosed, letting
the patient die is normally morally justified. If there is one condition under
which the passive euthanasia is justified, then it must be in case of brain
death. Physicians agree that treating a brain dead person is a futile action;
therefore we can safely retreat from therapy and let the brain dead patient die.
B. Psychological Support
When brain death is diagnosed, physicians usually also start with the
psychological support for the relatives. While only a few studies - at least to
my observation - on this subject have been done, most physicians seem to
suggest that, since the death has already occurred (or is inevitable), we can
already provide psychological support for the bereaved. Common sense
among physicians prescribes that we should give no false hope and that the
family and friends of the patient should be given the right information that
the patient is gone, though he is yet warm and breathes.
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I think most physicians, even when they are not P, will support the
suggestion that psychological support for the grief can be started when the
death is inevitable. There might be some slight differences between P and O
in their own ways to provide the necessary support, but I think these
differences will not be greater than the difference between two different
supporters (resp. opponents) of brain death criterion.
C. Preparations for the Transplantation
I have not touched the subject of transplantation yet because I
wanted to focus on brain death and its debate. Surely we cannot evade
discussing transplantation if we are discussing brain death, but - as we saw
earlier - the definition (operational analysis) of brain death does not include
(and should not include) organ transplantations. Rather the opposite is the
case: for the operational analysis of some organ transplantations I think the
notion “brain death” is needed.
Physicians exercise different tasks to fulfil the preparation of the
transplantation. They must get the consent of the relatives; they must check
the health conditions of the patient; and they have to prepare the operation for
harvesting the organs. Are these actions morally justified? This will be the
subject for the last section of this paper.
5.
Shifting the Question from Ontology to Moral Philosophy
In this section I want to shift the ontological question “who or what
is dead when somebody is brain dead” to a debate on transplantation
medicine.
A. Brain Death is Nearly Practically Equivalent to Other Death Forms
I have pointed out in 4 that there are three types of actions, which
are initiated when brain death is diagnosed. When we compare these actions
with other actions initiated when a (normal) death of a patient is diagnosed,
we can find that in the first and the second case there are no practical
differences. When a patient has died, physicians stop the therapy and life
support mechanisms; they withdraw from therapy and naturally withhold
other therapy forms. Physicians also start the psychological support for the
bereaved when death occurs. And it is notable that there are no (heavy) moral
objections to the actions on both sides.
If this analysis is right, then the difference between death and brain
death is minimal, taken aside of the organ transplantations, i.e. although the
justifications of these actions are different between brain dead and dead
persons, the actions themselves are nearly the same. And - in case of the
withdrawal from therapy and in case of the psychological support - actions on
both sides are morally justified. So with regard of these aspects we can say
that death and brain death are - from a practical point of view - equal.
Joseph Wang
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In case of the organ transplantation, the situation is different. While
organ harvesting on a dead body seems to be morally justified, the organ
harvesting of a brain dead human being, especially the vital organs (hearts
and lungs), are under heavy debate. The reason is the following plausible
intuition: If the donor has not died, taking her organs would be an action of
killing for other's benefit; and this is morally unjustified.
B. An Ethic of Transplantation Medicine?
If this intuition is right, it seems that we do need the answer for the
ontological question, since we need to know whether a person is already dead
when she is brain dead or not. If O is right, then the heart transplantation will
be a merciful killing coupled with the benefit of saving the life of another
person. And this is morally wrong; therefore the transplantation of vital
organs should be stopped. Is this the last word?
How to justify organ transplantation morally is out of the scope of
this paper. But if the former analysis can be accepted, then we could perhaps
shift the debate from an ontological question (“who or what is dead if
somebody is brain dead?”) to the debate on organ transplantation. We need a
moral justification for organ transplantation, which does not need an
ontological debate. One possible justification of transplantation could be the
following:
In case of a patient with a valid consent for organ donation we can
assume that she is willing to give up her organs, and therefore her life, in
order to save other's life under the condition that her life cannot be saved. If
this patient is brain dead, then saving her life will be a futile task for us, for
we cannot save her life anymore. In this case, it could be allowed to take her
organs to fulfil her wish of saving other's life.
Arguments like this could be applied by an ethic in transplantation
medicine. Professionals in this field will have to deal with hard questions like
“can we give up or even take one's life under special circumstances in order
to save the life of another person?” They also have to debate the subject of
consent vs. dissent solution, on problems of organ allocations etc. In short,
this field of ethics would have to deal with moral problems associated with
actions taken in the transplanting of organs. And as we can see, the actions
and the regulations of actions are under debate, not the ontological question.
6.
Conclusion
If my suggestion in the brain death debate can be accepted, we can
(and perhaps even should) shift the debate from the heavyweight ontological
questions about the bearer of (brain) death to the ethical debate on
transplantation medicine. I think agreements can be made more easily in this
way, because discussants can argue from the practice, and arguments out of
practice can be accessed more easily for the opponents. In this way the
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consents can be achieved more quickly and there is no heavy and endless
debate over ontological frameworks, the justification of which is a more
difficult task.
Notes
1
P Mollaret and M Goulon, ‘Le coma dépassé’, Rev Neurol, vol. 101, 1959,
pp. 3-15.
2
Ad hoc Committee of the Harvard Medical School, 'A Definition of
Irreversible Coma', JAMA, vol. 205 (6), August 1968, pp. 85-88.
3
I will refer mostly to D Moskopp, 'Hirntoddiagnostik', Intensivmedizin
up2date, vol. 1, 2005, pp. 285-308.
4
E.g. in W F Haupt and W Höfling, ‘Die Diagnose des Hirntodes:
Medizinische und juristische Aspekte unter Berücksichtigung des
Transplantationsgesetzes (TPG) der BRD,’ Fortschr Neurol Psychiat, vol. 70,
2002, pp. 583-590.
5
Cf. Moskopp, op. cit., p. 295.
6
Cf. D A Jones, ‘Metaphysical Misgivings about “Brain Death”’, in Beyond
Brain Death, M Potts, P A Byrne and & R G Nilges (eds), Kluwer Academic
Publishers, Dordrecht, 2000, pp. 91-119, here p. 94.
7
Here I follow: Jones, op. cit..
8
For the Lockean notion of personhood cf. J Locke, An Essay Concerning
Human Understanding. Book II, Ch. 27. For Singer's notion of personhood cf.
P Singer, Practical Ethics, Cambridge University Press, Cambridge, 1979, pp.
72-78.
9
Cf. Muck's explication of dialogues about world views and about religious
beliefs, e.g. O Muck, ‚Zur Logik der Rede von Gott’, in Rationalität und
Weltanschauung, O Muck and W Loffeler (eds), Tyrolia-Verlag, Innsbruck,
1999, pp. 14-44.
10
Cf. P W Bridgman, 'Operational Analysis', Philosophy of Science, vol 5,
April 1938, pp. 114-131. Cf. also O Muck, 'Wahrheit und Verifikation', in
Rationalität und Weltanschauung, Tyrolia-Verlag, Innsbruck, 1999, pp. 81100.
11
Cf. W Rabl, Gerichtliche Medizin, 5th edition. Innsbruck, 2000/2001, pp. 23.
Bibliography
Ad hoc Committee of the Harvard Medical School, 'A Definition of
Irreversible Coma'. JAMA, vol. 205 (6), August 1968, pp. 85-88.
Joseph Wang
225
_____________________________________________________________
Bridgman, P.W., 'Operational Analysis'. Philosophy of Science, vol 5, April
1938, pp. 114-131.
Haupt, W.F. and W. Höfling, ‘Die Diagnose des Hirntodes: Medizinische
und juristische Aspekte unter Berücksichtigung des Transplantationsgesetzes
(TPG) der BRD’. Fortschr Neurol Psychiat, vol. 70, 2002, pp. 583-590.
Jones, D. A., 'Metaphysical Misgivings about ‘Brain Death’', in Beyond
Brain Death, M Potts, P. A. Byrne and R. G. Nilges (eds), Kluwer Academic
Publishers, Dordrecht, 2000, pp. 91-119.
Mollaret, P. & M. Goulon, 'Le coma dépassé'. Rev Neurol, vol. 101, 1959, pp.
3-15.
Moskopp, D., 'Hirntoddiagnostik'. Intensivmedizin up2date, vol. 1, 2005, pp.
285-308.
Muck, O., 'Zur Logik der Rede von Gott’, in Rationalität und
Weltanschauung, O. Muck and W. Loffler (eds)., Tyrolia-Verlag, Innsbruck,
1999, pp. 14-44.
Muck, O., 'Wahrheit und Verifikation', in Rationalität und Weltanschauung,
O. Muck and W. Loffler (eds), Tyrolia-Verlag, Innsbruck, 1999, pp. 81-100.
Rabl, W., Gerichtliche Medizin, 5th edition. Innsbruck, 2000/2001.
Singer, P., Practical Ethics. Cambridge University Press, Cambridge, UK,
1979.
Joseph Wang is a Ph.D. student at the Catholic Theological Faculty of the
University Innsbruck.
Death & Justice: An Ethical Response to Massacre
Vanessa Fredericks
Abstract
This paper applies Derrida’s “politics of mourning” to a particular event in
Polish history, namely the Katyn massacre of WWII. For Derrida, mourning
is an ongoing entrusted responsibility to the Other. It is an ongoing
responsibility to memory of the Other and a responsibility in the face of a
heritage. This work of mourning is not to be perceived as only a
responsibility to our immediate friends, but is also to be seen as a political
and collective responsibility, especially when the lives we are mourning are
lost as a result of politics. With a focus on ethics, responsibility and justice,
this paper is a way of thinking and responding to this particular massacre. It
is an attempt to break the silence that existed after the event for so long and it
is a call for justice. But what exactly is justice? Is justice a necessary part of
mourning? What is the most ethical way to mourn? What is an ethical
response to a massacre around which there has been so much silence? We can
begin to answer these questions by using Derrida’s idea of mourning as a
future-oriented memory which is dedicated to an ethical responsibility to the
trace of the Other. To be silent, to be non-responsive, is an unethical response
to this event.
Key Words: Katyn massacre, deconstruction,
responsibility, justice, law, memory, genocide.
mourning,
ethics,
*****
In this paper I will be examining an event in Polish WWII history in
light of Derrida’s notion justice. This paper is part of a larger body of work,
which deals primarily with Derrida’s “politics of mourning.” For Derrida,
mourning is an ongoing, entrusted responsibility that we, the living, owe to
the other that has passed. In instances of murder, massacre or genocide,
collectively, we are forced to ask ourselves what constitutes justice and what
an ethical response to such a death might entail. The event that I will be
discussing is the murder of around 14,000-22,000 Polish prisoners of war by
the Red Army, in what has come to be known as the Katyn massacre. The
truth about who was responsible for the crimes was covered up for fifty years
and to this day no one has been prosecuted for the crime; there has been no
official apology or any attempt to compensate the victim’s families. In this
paper I will look at how justice has not been done, how laws have been
enforced in the name of justice, and how justice is related to an inherited
memory. Deconstruction enables us to begin to talk about the question of
justice in relation to this event.
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For Derrida “the task of a historical and interpretative memory is at
the heart of deconstruction” which he describes as a “responsibility in the
face of a heritage.”1 Deconstruction makes visible our responsibility for the
inheritance of the past, the inheritance of an historical memory, which
informs our present, and in turn, the future to come. But with this memory
also comes a responsibility to question this inheritance and to critique the
implications of this memory. This is particularly important when we speak
about historical injustices and crimes against humanity. We must be vigilant
to what this memory entails and be aware that the truth is always an
interpretation. Ultimately, this responsibility in the face of a heritage is an
infinite call for justice. So what does this have to do with deconstruction
then? For Derrida, deconstruction is “already engaged by this infinite demand
of justice, for justice.”2 It is concerned with a “sense of responsibility
without limits, and so necessarily excessive, incalculable, before memory.”3
If this responsibility is without limits, it is therefore incalculable, and there is
never a moment when one can say that one has dealt with justice, or that
justice has been met.
In Derrida’s most explicit discussion of justice, “Force of Law” he
argues that it is necessary to think deconstructively about the “force of law”,
acknowledging the “performative and therefore interpretative violence” in the
founding or instituting of any law.”4 To “enforce the law” alludes to the force
that comes from within, which reminds us that “law is always an authorized
force, a force that justifies itself or is justified in applying itself, even if this
justification may be judged from elsewhere to be unjust or unjustifiable.”5
The space between law and justice must always be viewed then as anything
but a naturally occurring space. It is within this space that deconstruction
resides. The singularity of the other can never be responded to within this
space and thus it must constantly be deconstructed in response to each
singularity. Derrida argues that “each case is other, each decision is different
and requires an absolutely unique interpretation, which no existing, coded
rule can or ought to guarantee absolutely.”6 Following from this paradox,
“there is never a moment that we can say in the present that a decision is
just.”7 Deconstruction should always remain critical of legal claims to
justification. Deconstruction does not set out to dismantle the ideal itself of
law or justice, but to always remain suspicious of systems that claim to be
right or just. Justice must be situated as “the yet to come which can never be
presented.”8 For Derrida, justice is an aporia, an experience of the
impossible.9 Why should we talk about something then if its very experience
is one of the impossible? It is for this reason exactly; because justice is
impossible that deconstruction must be dedicated to the relentless pursuit of
justice. Derrida argues that is important to know that “this justice always
addresses itself to singularity, to the singularity of the other, despite or even
because it pretends to universality.”10 Justice is caught in this double-bind of
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responding to the event each time, as a singularity, but also must be dedicated
to the unveiling of universal injustices. Justice can never be really possible
then and it is for that very reason that we must continue to think new ways
through current injustices, continue to question obstructions of justice, and be
critical of the ways in which justice is regulated through laws and legal
systems.
However impossible it may be though, justice “if such a thing exists,
outside or beyond law, is not deconstructible. No more that deconstruction
itself, if such a thing exists. Deconstruction is justice.”11 For Derrida, justice
sits outside of anything that can be called law. Laws can be enforced, they
can be interpreted. Legality is a construct, but justice exists before and
outside it, it is above and beyond it, therefore it is not deconstructible. The
point of insisting on the indeconstructibility of justice is not to reduce the
notion of justice to an unattainable ideal, but to insist on the deconstructibility
of the law and to constantly deconstruct injustices made possible by legality
or political systems. It is to draw our attention to the very precarious nature of
law, to be constantly open to the singularity of the other, and to the tensions
between this singularity and universal claims to justice.
It is important to note how Derrida’s notion of justice is derived from
Levinas’ concept of justice, which he makes explicit in the following
quotation:
Levinas says somewhere that the definition of justice... is the
relation to the other. (Totality & Infinity: 89). That is all. Once
you relate to the other as other, then something incalculable
comes on the scene, something which cannot be reduced to the
law or to the history of legal structures. That is what gives
deconstruction its movement, that is, constantly to suspect, to
criticize the given determinations of culture, of institutions, of
legal systems, not in order to destroy them or simply cancel
them, but to be just with justice, to respect this relation to the
other as justice.12
Our responsibility to the other is immeasurable, it is infinite, and it is
constantly in this state of movement, of moving towards something-to-come.
A deconstruction of laws, cultures or events needs to keep in mind this
vigilance to the other as justice. Our ethical relation to the other stems from
this justice. A law, or an institution that does not respect the otherness of the
Other, that does not open itself to the possibility of the Other is not just. An
ongoing deconstruction of these laws and ideals is a way of continually
negotiating this justice, calling for and to justice. If justice is to be defined in
relation to the other, then murder or massacre is the most extreme example of
an injustice towards the other.
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With this in mind, I will briefly outline the Katyn massacre. The
word “Katyn” has recently come to represent the massacre of 14,000–22, 000
Polish men made up of generals, army officers, policemen, teachers and
professionals, taken prisoner by the NKVD (Soviet secret police) in the
Spring of 1939. The prisoners were kept in three separate prisoner of war
camps, and were subsequently executed and buried in three separate mass
graves in the Ukraine. The executions took place in 1940 under Stalin’s
orders, and the first of the mass graves at Katyn were discovered by German
soldiers in 1943. It is because the graves at Katyn were the first to be
discovered that the word “Katyn” has now come to refer to all the massacres.
Between 1940 and 1943 the whereabouts and fate of the prisoners was kept
from the victim’s families. In relation to a deconstructive ethics, how are
these massacres an injustice of our responsibility to the other? In one sense,
murder, massacre is an injustice to the other; it is a violation of human
vulnerability. War however, is an institution, which justifies killing. The
detainment and execution of the Polish prisoners of war was justified through
the institution of war. It was an organised crime made possible through the
legal and conceptual framework of war. I must emphasise here that the
prisoners of war detained and murdered in these camps were not just
members of the army but also policemen, teachers, and professionals.
“Civilians”, if you will. But then again, this is a distinction validated through
the discourse of war, as if the worth of human life can be determined by its
relationship to war. What further added to the injustice of this massacre was
the continued obstruction of justice, which was supported by legal systems
and political infrastructures.
The first public mention of the Katyn graves was made by the
German news agency Trans-Ocean on 11 April 1943. The following day this
was countered by a pro-Soviet Polish language broadcast from Moscow
which claimed the accusations where German propaganda. Exhumations
were conducted under German supervision by both the International Red
Cross (IRC) and the Polish Red Cross (PRC). Both concluded that the names
of the officers who were missing from the Soviet POW camps correlated with
the victims identified at Katyn. They also noted that newspapers and diaries
found on the corpses dating from spring 1940 pointed to Soviet guilt. The
Soviets did not accept this and on the 13th of January 1944 a special Soviet
commission was set up for investigation of the site. It was chaired by chief
surgeon of the Red Army, Nikolai Burdenko, so is commonly referred to as
the Burdenko Commission. The Burdenko Commission focused on rejecting
the conclusions and evidence cited in the 1943 report of the IMC
(International Medical Commission). It argued that the Polish prisoners of
war had fallen into German hands and were executed by the Germans
between July and September 1941. An extract of the report was presented as
evidence in the Nuremberg war Crime Trials. The Soviet charges against the
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German Nazi leaders included the murder of the Polish officers at Katyn. The
Katyn case was not listed in the final IMT verdicts, and although no one was
officially cleared of responsibility for the massacres, neither was anyone
officially charged for the massacres. This was enough for the Soviet
government, and up until mid-April 1990, all Soviet governments and official
publications claimed that the Soviet Union had won its case on Katyn at
Nuremberg. From then on the Katyn report of the Burdenko Commission was
always presented and cited in Soviet media, encyclopaedias and history
books, until the official admission of Soviet guilt in 1990. This fabricated yet
official and legal case for justice was used as a means to obstruct truth,
justice, and cultural memory. Not only was the Burdenko Commission used
to prevent justice being done to the memory of the deceased and to the
victim’s families, but it was also an injustice to the Russian cultural memory
as the inherited memory of Katyn was a lie, one which was supported by a
legal document and sustained by the repetition of this lie in other mediums.
In post-war communist Poland, under direct orders from the
Kremlin, the very word “Katyn” was forbidden. Children of the Katyn
victims were forbidden to speak publicly about the cause of their father’s
deaths. To do so they risked losing their jobs, being denied access into
schools or universities, or even jailed. The law in this case, was used to
obstruct truth, justice and memory. Justice is not always about trial and
punishment. There is an injustice in not being allowed a culture of mourning.
In not being allowed to speak of the dead, the victim’s families were denied
access to the language of mourning.
In 1988 Mikhail Gorbachev’s glasnost [open discussion] policy led
to the relaxation of censorship in Poland, resulting in growing pressure for
the truth on Katyn. Gorbachev’s policy of glasnost led to the opening of
some state archives to three Russian historians who had a significant impact
on the uncovering of the truth of Katyn (Yuri Zoria, Valentina Parsadonova
and Natalia Lebedeva). In 1989 they found previously unknown documents
on the Polish prisoners of war including archival materials on the Polish
POWs held in the three camps which corresponded with the names of the
dead officers compiled by the Germans in 1943. The truth was finally
announced on the 13th of April 1990, fifty years after the event. Derrida
argues that justice, “however unpresentable it may be, doesn’t wait. It is that
which must not wait.”13 A just decision “is always required immediately,
‘right away.’”14 Thus this admittance of guilt was an important step towards
justice, but it had to wait. The inherited cultural memory of Katyn was a
memory that was haunted by the failures of governments and laws to bring
justice to the perpetrators of the crime. After fifty years of lies, denial and
enforced censorship laws, an admittance of guilt is not enough, it is not
justice. German President Roman Herzog apologized to the Polish nation in
August 1994 for German crimes committed in Poland during WWII. There
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was talk in Poland about the need for an official Russian apology for the
Katyn massacre and of compensation for the victim’s families. Boris Yeltsin
objected to both of these demands but he did agree that a memorial should be
built at Katyn. A Polish-Russian agreement was signed in 1994 in which the
Poles agreed to maintain Russian war graves in Poland and vice versa, and a
Polish-Ukrainian agreement was signed which led to the opening of three
cemeteries in 2000 at Kharkov, Katyn and Miednoye (the three burial sites of
the executed officers). Although this was a significant step towards
implementing a culture of mourning around this crime, it did not put an end
to the Katyn question. Documentation is still lacking on Stalin’s motives and
timing for the decision to execute, the whereabouts of the prisoners held in
NKVD prisons of Western Ukraine and Western Belorussia are still
unknown, and there has still been no official apology for the crimes
committed at Katyn. Thus there are still questions unanswered, truths to be
uncovered and injustices to respond to. Justice is yet to come.
On the 11th of March 2005 the head of the Russian-Katyn
investigation, Aleksandr Savenkov, announced that the investigation was
closed and that no one would be condemned because all members of the
wartime Politburo were dead. He concluded that there was no evidence that
genocide had been committed against the Polish nation. Although this
statement caused outrage in Poland15, it was supported by the institution of
Russian law. For one thing, the concept of genocide was absent from Russian
criminal legislation until January 1997. How can one respond to the
singularity of an event if the language of genocide, murder, or ethics is not
universal? The Russian government did update their criminal code in the late
1990s to bring it closer to international standards. The new criminal code
qualified as criminal the “cruel treatment of prisoners of war or civilians” and
also the “planning, preparation, unleashing or conduct of aggressive war.”16
Article 10 of the new code however, stated that punishment for these crimes
did not apply to crimes committed before the code entered into force making
it legally impossible for those responsible for the executions to be prosecuted.
The new code also followed Russian legal tradition in not allowing the
prosecution and judgement of criminals no longer living. This is another
example of a legal obstruction of justice, an interpretation of what constitutes
justice and how justice should be carried out. Both the new Russian code and
Russian legal tradition are contrary to Article 6 of the IMT Charter as well as
Article 2 of the 1968 international convention on the inapplicability of the
statute of limitations to war crimes and crimes against humanity.17 However,
though it may be the law within the international tribunal not to have a statute
of limitations on war crimes, is there really any justice in prosecuting
someone after they are dead? Do we owe justice to the memory of the
perpetrators? What the Katyn case does highlight though is the urgency of
justice, and what Derrida means when he says that a just decision is required
Vanessa Fredericks
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immediately. If justice cannot wait, then can it ever be too late for justice?
Justice is related to an inherited memory and because of that there is justice
in having the truth about these crimes brought to light. Justice can be done to
the memory of the deceased, and to those who are left to mourn, to inherit
that memory.
Another obstacle to reconciliation over Katyn is that there is a
conflict of historical memory between the Russian and the Polish people.
Most Russians find it difficult to admit the truth about the Stalinist years as
most still view him as a great war leader who liberated Eastern Europe from
German occupation.18 On the 31st of December 1999 Yeltsin’s appointment
of Vladimir Putin as his successor, brought with it new hopes of a PolishRussian reconciliation over Katyn. Putin however, “ejected a comparison of
Stalinist repressions with Nazi German genocides.”19 Once again we have a
conflict of inherited memory and of an interpretation of the concept of
genocide which is obstructing justice. In Poland, the fight for justice appears
to have come to a standstill. A Polish investigation, announced on 30
November 2004 is unlikely to bring closure since the Russian Main Military
Prosecutors office denies the committee access to most of the documents
gathered in its own investigation. Polish President Lech Kaczyński stated in
July 2006,
It is not the role of [the] prime minister to lead fights over
the past. I want my government and myself to form a group
that works for the future. We leave these fights to the
historian for the time being.20
It is interesting to note here the separation of anxieties about the past
from the concerns for the future. Derrida argues that we inherit the past, and
with this inheritance comes responsibility. We inherit the cultural memories
of the past and these memories inform the future. The Katyn question is a
complicated historical blank spot in the cultural memory of both the Polish
people and the Russian people. But the issue of justice is still unanswered.
Derrida argues that “Justice remains, is yet, to come, à venir, it has an, it is à
venir, the very dimension of events irreducibly to come.”21 And it is the case
with Katyn that justice is yet to come, an apology is yet to come, the full truth
about this event and other Stalinist war crimes is yet to come.
The failure of legal systems and governments to respond to justice
over the case of Katyn demonstrates the volatile space between law and
justice. The numerous attempts to bring justice to the crime have been aided
by legal structures. With the admittance of guilt in 1990 there was some
justice in being able to talk about these deaths and in being allowed to visit
the graves of the murdered officers. It remains to be seen whether there will
ever be justice in the form of reparation or apology for the crimes committed
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at Katyn. But If Derrida has taught us anything about justice, it is to remain
vigilant to the call of justice. An injustice would be the perpetuation of
silence in response to this event. Perhaps there is some justice in being
allowed to talk about the event, to name the event. Perhaps there is justice in
being allowed to visit the graves. Perhaps justice will continue to haunt the
inherited cultural memory of Europe. “‘Perhaps’, one must always say
perhaps for justice.”22
Notes
1
J Derrida, ‘Force of Law: The “Mystical Foundation of Authority’’’, in
Deconstruction and the Possibility of Justice, D Cornell, M Rosenfeld and D
G Carlson (eds), Routledge, New York & London, 1992, p 19.
2
ibid., p. 19.
3
ibid., p. 19.
4
ibid., p. 13.
5
ibid., p. 5.
6
ibid., p. 23.
7
ibid., p. 23.
8
C D’Cruz, ‘Responding to a Heritage: Justice, Deconstruction and
Injunctions of Marx’, Social Semiotics, vol. 6 (2), 1996, p. 170
9
Derrida, op. cit., p. 16.
10
ibid., p. 20.
11
ibid., pp. 14-15.
12
J Derrida cited in J Caputo, Deconstruction in a Nutshell: A Conversation
with Jacques Derrida, Fordham University Press, New York, 1997, p. 17-18.
13
Derrida, op cit., p. 26
14
ibid., p. 26.
15
A M Cienciala, N Lebedeva, and W Materski (eds), Katyn: A Crime
Without Punishment, Yale University Press, New Haven & London, 2007, p.
289.
16
ibid., p. 261.
17
ibid., p. 261.
18
ibid., p. 262.
19
ibid., p. 261.
20
ibid., p. 264.
21
Derrida, op cit., p. 27
22
ibid.
Vanessa Fredericks
235
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Bibliography
Caputo, J., Deconstruction in a Nutshell: A Conversation with Jacques
Derrida. Fordham University Press, New York, 1997.
Cienciala, A.M., N. S. Lebedeva, and W. Materski (eds), Katyn: A Crime
Without Punishment. Yale University Press: New Haven & London, 2007.
D’Cruz, C., ‘Responding to a Heritage: Justice, Deconstruction and
Injunctions of Marx’. Social Semiotics, vol. 6 (2), 1996, pp. 159-177.
Derrida, Jacques, ‘Force of Law: The “Mystical Foundation of Authority”’,
in Deconstruction and the Possibility of Justice, D Cornell, M Rosenfeld and
D G Carlson (eds), Routledge, New York & London, 1992, pp. 3-67.
Levinas, E., Totality and Infinity: An Essay on Exteriority. A. Lingis (trans),
Duquesne University Press, Pittsburg, 1969.
Vanessa Fredericks is a Ph.D. candidate in the department of Critical &
Cultural Studies at Macquarie University in Sydney, Australia. The focus of
her research is Derrida’s politics of mourning and Polish history during and
after WWII. She is currently working as an editorial assistant on a Derrida
concordance and glossary to be published by Edinburgh University Press.
Kantian Obligatory Suicide: Further Developments
Dennis R. Cooley
Abstract
Although the topic causes many to feel an intuitive moral repulsion and
anger, the issue of morally obligatory suicide duties for the soon to be
demented needs philosophical attention, especially given new information
about the number of people who will be afflicted. The Alzheimer’s
Association estimates there are already 5.1 million Americans with
Alzheimer’s, and predicts 7.7 million will have the disease by 2030. Given
the situation’s emotive impact and the difficulty changing fundamentally held
beliefs and ideologies, an objective discussion of what to do needs to begin as
soon as possible.
Using a modified interpretation of Kant, I defend the position that some of
the soon to be demented have a moral duty to themselves to end their lives
before they lose their moral agency against some of its most important actual
and potential objections.
Key Words: Dementia, duty, Kant, suicide.
*****
1.
Introduction
In “Crimina Carnis and Morally Obligatory Suicide” and “A
Kantian Moral Duty for the Soon to be Demented to Commit Suicide,” I
argued for the controversial position that Kant believed that some suicides are
moral duties.1,2,3 The justification for such an anti-traditionalist position can
be found in a suicide maxim that can be consistently willed as a law of nature
by agents in certain situations and several of Kant’s examples in which he
claimed that some people had a duty to kill themselves rather than surrender
their humanity. The suicide obligation’s three conditions are that the agent
has a moral life worth preserving, he is in a situation in which he can save his
human dignity only by sacrificing his physical life, and he can perform the
action with the right mental states, including primarily good intentions,
motives, attitudes, and respect. In situations meeting all the conditions, the
agent owes it to his moral self to die physically before his other life ends.
Of course, such a controversial interpretation of Kant’s position was
bound to draw fire on many different grounds, especially due to the soon to
be demented component. I will leave to one side the issue of whether or not
my interpretation captures the true spirit of Kant’s ethics to focus on some of
the more difficult, and therefore more interesting, objections to the overall
position. First, Kant’s argument is based on what a totally rational agent
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would do in the circumstances, which is antiquated at the very least, if not
positively wrong. Second, a duty to commit suicide might make it less likely
for the agent to perform the action because she does not want to be told what
to do, especially when it comes to ending her physical life.4 I will consider
and respond to each of these in turn.
2.
Kant’s Cold Morality
The first major criticism of a suicide duty is that Kant’s morality is
based on what a purely rational agent would do in the same circumstances.
The main trouble for this position is if an agent does not have emotions as
part of what it is to be a person and morality, then she cannot make decisions
as a person in the first place. Kant’s rational person is an entity who cannot
choose between the pricking of his thumb and the destruction of the world
because he does not have emotion to care about which one occurs. This
oversight is a serious one because the ignored emotions are what allows us to
bridge the gap between the purely descriptive “is” in order to get to the moral
“ought.”
The solution to this problem is not difficult to discover: although
rationality plays a significant function in ethics, it is not a primary role. I
contend that the same conclusion about suicide obligations can be achieved
without going to the extreme of formulating an ethical theory based upon a
person unable to understand ethics in any real way. A reasonable person
standard combining rationality and the emotions underlying morality works
better than a rational person standard. A reasonable person rationally analyses
the data available to her in each particular situation she is in, and incorporates
all relevant facts about the external world society’s rules, practices, and
customs; rules and responsibilities associated with specific roles the agent is
playing at the time; claims that others have on the agent and the agent has on
others; value of all foreseeable consequences; and all other relevant factors
into her decision process.5 At the same time, she is someone whose decision
procedure has the belief that morality is “a creative, cooperative enterprise
whose end is to better the world by trying to realize in ourselves and others
nurturing goods such as caring, considerateness, compassion, sympathy, and
love.”6 The reasonable person can be generally characterized as a rational,
caring, considerate, compassionate, sympathetic, and loving individual who
understands the internal and external moral factors involved in the situation,
and makes her decisions accordingly.7 This is the person by which we should
be judging actions and obligations, and I take it as a given that each moral
agent is obligated to strive to be a reasonable person and act as one.
It is a difficult argument to prove that reasonable people would
confirm the existence of a suicide duty for every person who will become
demented in his lifetime. After all, it is hard for people to agree on many
trivial matters much less one of the most important actions some people must
Dennis R. Cooley
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take. However, I do not have to prove that all reasonable people will agree
that there is a duty, only that some will and that the duty exists for at least
some people, viz. individuals who do not have any extenuating circumstances
that justify them staying alive without their moral life. There are many
individuals who are embedded in positive relationships with others that have
or should have accepted what will happen and understand the decision,
although if they are caring, they will regret that it needs to be done. These are
the individuals who have the suicide duty.
The duty to die for dementia patients is an obligation to oneself that
recognizes that morality is internal and does not rely solely on the
consequences of the agent’s action. Recall that people can act in such a way
that they sacrifice their humanity while still retaining their ability to make
choices. Suppose that an agent, while trying to murder a good, innocent
person, misses his intended target and accidentally shoots a terrorist who
would have killed many other good, innocent people the next day had he
survived. Unless we are unrepentant consequentialists, the fortunate accident
is still morally wrong because it was an attempt to kill someone who did not
deserve it.8 What makes the agent blameworthy in this case is not merely the
murder attempt, but his decision to try to kill another. This conclusion is
borne out by the fact that even if he had been prevented from acting on his
decision by circumstances beyond his control, we would still say that he
degraded himself by being a person who would commit such an action.
Granted that those with dementia causing diseases are not evil as are
would be murderers, when an agent does not select suicide, she devalues
herself regardless of the beneficial consequences of her position. First, her
last goal as a moral person and agent cannot be to squeeze out as much time
as a rational creature as one can, but to write her final narrative in a way that
is consistent with the moral life that she has led.9
In addition, each moral agent has to recognize and understand the
impact of her actions on all those affected by them so that she can respect
each for the end he is in himself. This group of people includes not only those
with whom she has caring and nurturing relationships, but others in society as
well. To treat them as she should, when a moral agent is confronted with her
dementia prognosis, she must ensure that her final decision is made for the
right reasons. That is, her intentions, motives, attitude, and other relevant
mental states must be primarily good. In the case of a person who remains
alive as a sacrifice for deserving loved ones, all indications are that the
person can do the right thing by ending her life or continuing her body’s
existence. In other cases, the behaviour is identical but the choices are
defective due to bad motives, intentions, attitude or relevant mental states,
e.g., the person who knows her family will be destroyed emotionally and
financially caring for her but selfishly chooses to place the burden on them
anyway. For actions failing to meet the necessary mental conditions, the
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person makes herself a worse person than she otherwise would have been in
matters of utmost importance. That is, she degrades herself, and the level of
her degradation depends on the severity of the bad inner states. Therefore, in
the absence of extenuating circumstances, each person owes it to herself to
end her life to preserve who she is as a moral person and to respect all others
affected by her actions.
Some have raised the issue of harm caused to the suicide’s loved
ones of a suicide as being sufficient to defeat any duty to kill oneself. Rabins
states that “the family and friends of those who commit suicide are often
permanently and grievously damaged when a loved one or close acquaintance
commits suicide, whether or not there was a ‘good reason.’”10 If we respect
others for the ends that they truly are, this line of reasoning suggests, then we
should not cause them unnecessary, excessive harm by killing ourselves.
Moreover, provided that the injuries suffered are likely to be lessened or
avoided altogether, the individual would have an obligation to stay alive for
as long as she can.
There are three plausible arguments, which when taken together,
provide an adequate response to this criticism. First, the suicide duty is not
absolute because there are a number of individuals who may permissibly stay
physically alive while losing their moral agency for the interests of others.
Perhaps their families need more time to accept the inevitable and this
inability to understand and accept is not caused by some moral defect they
have, such as being self-centred or wilfully uninterested in the well-being of
others. In these situations, the person sacrifices herself by losing her identity
as a moral agent after the dementia sets in, but retains her human dignity
while she lives as a moral agent due to the fact that her action is noble rather
than venal or worse. She does not lose her dignity by trying to stay alive as
long as she can and leaving the burden of taking care of her on her loved ones
and society that causes her to deserve a lower moral status. Rather she stays
physically alive for others because she cares for them. This exception fits in
with Tong’s notion of death as a gift given to loved ones.11 Although Tong
would disagree that there is a duty to die, in these rare conflict situations,
there are two competing alternatives, which if they did not exist
simultaneously for the agent, would be duties. In these cases, the agent may
select either and still do the right thing.
There are two other ways to respond to the unethical harm through
grief argument. First, if there is a duty to oneself to die, then the harm caused
to others is permissible. No one ever said that doing the right thing, especially
in difficult situations such as these, leaves everyone with a positive or neutral
outcome. Suppose two people – Person A and Person B - are stranded in a
blizzard with only enough food to keep one of them alive. Furthermore,
assume that the food is owned and has been brought by Person A. If Person A
eats it, then what she does harms Person B by killing/allowing him to die
Dennis R. Cooley
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from starvation. However, Person A has done nothing wrong in preserving
her life, even though she unintentionally caused B pain, suffering, and death.
It might not have been her duty to stay alive, since she could have acted
altruistically by sacrificing herself and given the food to Person B, but her
action was morally permissible. Therefore, the mere existence of severe harm
to others does not entail that anyone was treated illicitly.
Second, and more importantly, the existence of a great deal of
permanent and grievous damage to people as the result of some suicides does
not establish that they ought or have a right to feel this way. It is the
naturalistic fallacy to derive an “ought” from an “is,” as has been pointed out
by many over the years. Therefore, to prove that the harm is illicit requires us
to investigate the reasons why these individuals suffer these feelings.
I contend that any permanent and grievous damage felt by them is
the partial result of social learning. We are raised and reinforced by society to
believe that death and suicide are always very bad things. There also seems to
be an underlying belief that those diagnosed with a dementia causing illness
are fragile victims requiring full paternalistic protection from themselves and
others. Something similar is seen in Slavoj Zizek’s analysis of NATO actions
in Kosovo:
What we encounter here is again the paradox of
victimization: the Other to be protected is good in so far as
it remains a victim…the moment it no longer behaves like a
victim but wants to strike back on its own, it magically
turns all of a sudden into a terrorist/fundamentalist/drugtrafficking Other.12
A victim who takes control of his life and throws off others’ paternalism
causes such discomfort to those wanting to help him that he is labelled as a
danger. This is one of the reasons why claiming that those who will be
demented have a duty to kill themselves is so controversial. By rejecting the
helpless victimhood paradigm, the suicide duty challenges fundamental social
beliefs about the status of those diagnosed with dementia causing diseases.
However, what is socially learned can be unlearned. The ancient
Greeks, for instance, did not view suicide and death in the way that many of
us do. They thought it base and ignoble to place a heavy burden on society or
family if doing so is only to give a short extension of life to one citizen.13
Given that social attitudes have changed, it follows that unless we are full of
hubris, we cannot merely assume that our contemporary views about suicide
and death are superior measures of morality. In fact, they might be unjustified
if a better social belief is available to us.
If we changed our society in such a way that people accepted suicide
as a rational, honourable action, then much of the damage caused to those left
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behind by it would not occur. I am not arguing that there will never be
painful emotions such as regret, remorse, guilt, and grief - some legitimately
felt while others are not - but that understanding why the person did what she
did as a right action can alleviate much of it in the same way that those
emotions are reduced when families and friends are part of the process when
patients refuse further treatment for their illnesses. Instead of allowing
oneself to succumb to the disease, the person ends her life at the time and in
the circumstances she controls, which if the family respects and cares for her,
might be tragic and laudatory to them rather than causing them permanent
damage. The suggested alteration to social beliefs could create a society that
is much better than the one we have. Instead of people being wracked by
guilt, overburdened with emotional and financial costs, or incurring other
avoidable expenses, there can be a loving society in which caring support is
given and the person ends her life in a right way.
3.
Moral Duties, Stultification, and Comfort
Although much can be made of the stultifying effect of moral
obligations on people who do not like to be told what to do, especially after
they are diagnosed with a dementia causing disease, having a suicide duty
might be beneficial to the individual’s mental state in a variety of ways.
First, it provides certainty at a chaotic time. If suicide is merely permissible
or a right, people have to struggle with whether or not they will commit.
Since it is permissible to go either way, then they do not know what to do.
Mandatory suicide, however, takes the decision out of their hands. It is made
for them, and all they have to do to remain good people is for them to
perform their duty. The result is that instead of the emotional turmoil
generated by suicide being merely permissible, with a proper frame of mind,
there can be a sense of calm and acceptance of fate much the same way many
dying from cancer and other terminal diseases finally come to acquiesce to
the final outcome. They are unhappy about the situation and would change it
if they could, but their tacit acceptance has given them peace of mind.
A suicide duty can be a comfort in other ways as well. As Dena
Davis writes, “people have a strong interest in ending their lives with a final
chapter that is consonant with the narrative as a whole.”14 That is, some
individuals desire to die in a way that reflects how they lived. They do not
wish to be someone slowly but certainly progressing to the state of former
personhood in a living body, who must rely on others for massive support,
regardless of what might be in the latter’s best interests. Rather these agents
want to end their physical life as a person and take a vital, in opposition to a
passive, role, which allows them to remain “active and dominant.”15
This particular requirement to end one’s own life leads to an alleged
problem that has been raised by some critics. There is not a clear moment
when a patient progresses from full self-hood to being a former person.
Dennis R. Cooley
243
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Given this lack of clear definition and the value of being a person, it would
be wrong, according to them, to end one’s life too early. Since the dignity of
a person’s humanity must be preserved no matter what the cost to her
physical life and to maximize her time as a person, she should passively
allow the dementia to render her a different person or a former person.
The objection, however, arises from a basic misunderstanding of my
time-line and the internal nature of the ethical. There is not an exact right
moment when the death must occur. Further diagnoses have to be sought to
provide sufficient evidence of what will happen to the person so that she can
make an informed decision about when to end her life. After that, the person
has to settle her affairs, including bringing those who care for her into the
process of her end of life. Finally, since the person does not become
demented overnight, she has the opportunity to live fully as a person for as
long as she can, as long as she knows there is a limitation to her time. When
her disease has progressed far enough so that recovery is impossible but she
is still assured of being a full person, then she has the duty to end her life.
So, the suicide duty either exists or it does not for a person - that is an
either/or proposition - but her window for action is limited to an acceptable
range of time.
4.
Conclusion
The existence of a duty to commit suicide for those who will be
demented is controversial. It challenges fundamental beliefs about death,
suicide, and the vulnerable in ways that make many uncomfortable, and some
fear the loss of hard earned respect and rights for those who have been
oppressed or are especially at risk of exploitation. However, if it is
understood in the proper way as a loving, caring act that respects all those
affected by it, the obligation can be seen as beneficial to those who will have
to perform it, their loved ones, and society in general. It might be hard to
accept, but as health care resources become further stretched, many would
prefer having such a duty based on the respect for themselves and others
rather than becoming a statistic in a utilitarian calculation of who should die
and who should live.
Notes
1
D Cooley, ‘Crimina Carnis and Morally Obligatory Suicide’, Ethical
Theory and Moral Practice, vol. 9 (7), 2006, and ‘A Kantian Moral Duty for
the Soon to be Demented to Commit Suicide’, American Journal of
Bioethics, vol. 7(6), 2007, pp. 37-44.
2
Christine Korsgaard’s work on Kant and lying served as an inspiration for
this argument. C M Korsgaard, ‘The Right to Lie: Kant on Dealing with
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Evil’, in Ethical Theory, J Rachels (ed), Oxford University Press, New York,
1998, pp. 530-53.
3
Rosamond Rhodes seems to believe that my interpretation of Kant is
accurate, while others do not. R Rhodes, ‘A Kantian Duty to Commit Suicide
and Its Implications for Bioethics’, American Journal of Bioethics, vol. 7 (6),
2007, pp. 45-7.
4
There are four other criticisms in the unabridged paper.
5
R L Holmes, Basic Moral Philosophy, Thomson Wadsworth, Belmont,
2007, pp. 227-228.
6
ibid., pp. 228-229.
7
Given the complexity of situations and the range of reasonable people,
different reasonable people can justifiably come to different conclusions in a
particular situation and each is correct. In the great majority of instances,
there is not one right answer, but many.
8
I am not implying that anyone deserves to be murdered.
9
Dena S. Davis’ work was very helpful in rethinking suicide as a positive
action ending a life.
10
P V Rabins, ‘Can Suicide Be a Rational and Ethical Act in Persons with
Early or Pre-Dementia?’, American Journal of Bioethics, vol. 7 (6), 2007, pp.
48.
11
R Tong, ‘Duty to Die’, in Is There a Duty to Die?, J M Humber and R F
Almeder, (eds), Humana Press, Totowa, 2000, pp. 152.
12
S Zizwk, The Fragile Absolute, Verso, New York, 2000, p. 60.
13
G Pence, The Elements of Bioethics, McGraw Hill, Boston, 2007, p. 237.
14
D Davis, ‘Why Suicide Is Like Contraception’, in Physician Assisted
Suicide: Expanding the Debate , M P Battin, R Rhodes, and A Silvers (eds),
Routledge, New York, 1998, p. 115.
15
D Davis, ‘Rational Suicide and Predictive Genetic Testing’ The Journal of
Clinical Ethics, Winter, 1999, p. 318
Bibliography
Cooley, D., ‘Crimina Carnis and Morally Obligatory Suicide’. Ethical Theory
and Moral Practice, vol. 9 (7), 2006, ISSN: 1386-2820.
____, ‘A Kantian Moral Duty for the Soon to be Demented to Commit
Suicide’. American Journal of Bioethics, vol. 7(6), 2007, pp. 37-44.
Davis, D., ‘Why Suicide Is Like Contraception’, in Physician Assisted
Suicide: Expanding the Debate , M. P. Battin, R. Rhodes, and A. Silver
(eds), Routledge, New York, 1998, pp. 113-122.
Dennis R. Cooley
245
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____,‘Rational Suicide and Predictive Genetic Testing’. The Journal of
Clinical Ethics, Winter, 1999, pp. 316-23.
Holmes, R. L., Basic Moral Philosophy. Thomson Wadsworth, Belmont,
2007.
Korsgaard, C. M., ‘The Right to Lie: Kant on Dealing with Evil’, in Ethical
Theory, J Rachels (ed), Oxford University Press, New York, 1998, pp. 53053.
Pence, G., The Elements of Bioethics. McGraw Hill, Boston, 2007.
Rabins, P. V., ‘Can Suicide Be a Rational and Ethical Act in Persons with
Early or Pre-Dementia?’. American Journal of Bioethics, vol. 7 (6), 2007, pp.
47-9.
Rhodes, R., ‘A Kantian Duty to Commit Suicide and Its Implications for
Bioethics’. American Journal of Bioethics, vol. 7 (6), 2007, pp. 45-7.
Tong, R., ‘Duty to Die’, in Is There a Duty to Die?, J. M. Humber and R. F.
Almeder (eds), Humana Press, Totowa, 2000, pp. 133-58.
Zizwk, S., The Fragile Absolute. Verso, New York, 2000.
Dennis R. Cooley is Associate Professor of Philosophy and Ethics at North
Dakota State University and Associate Director of the Northern Plains Ethics
Institute.
PART IV
Experiencing Re-Imaging
“I’d Rather Be Home All My Life”:
Older People and Place Care at the End of Life
Eileen Sutton and Joanna Coast
Abstract
In the UK death is now most likely to occur at the end of a long life. The UK
government has developed a National End of Life Care Strategy1, which was
published in June 2008. This aims to improve the quality and equity of
service provision and consider which service models are most likely to
achieve these objectives. A focus of much research on end of life care
originating from the UK has been the mismatch between where most people
say they would like to die (at home), and the place where the majority of
people actually die (in hospital). This is reflected in current government
policy, where there appears to be a shift to moving care of the dying back
into the community. This paper presents evidence from a qualitative research
study that seeks to discover the preferences of older people for care at the end
of life. Issues surrounding independence, dependency, personal identity and
the meaning of home are explored and the extent to which preferences may
change along the dying trajectory are considered.
Key Words: Older people, death and dying, end-of-life, end of life,
preferences, home, place of death.
*****
1.
Introduction
The population of the United Kingdom is ageing and, according to
estimates based on the 2001 census, in 2005 there were more than 11 million
people of state pension age and over, with over a million and a quarter over
85 years of age.2 Of the half a million people who die each year in England
two thirds are over the age of 75 years.3 In 2004 the government introduced a
National End of Life Care Programme, the main stated aim of which is, “To
improve the quality of care at the end of life for all patients and enable more
patients to live and die in the place of their choice”.4 Initiatives such as the
Liverpool Care Pathway and the Preferred Priorities for Care were also
introduced as part of the drive to improve care for the dying.
Place of death has been the focus of much research originating from
the UK, recent survey research revealing that a substantial amount of people
say they want to die at home.5 The results of a telephone survey published in
2003 found that 56% of respondents expressed a preference to be cared for at
home when they were dying, 24% preferred a hospice, 11% at hospital and
4% a nursing home.6 Nevertheless, it should be noted that older people are
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less likely than younger people to say they want to die at home. However,
this may be connected to concerns around the availability of unpaid care to
support death at home.
Research evidence on place of death, however, reveals that there is a
mismatch between where people say they would like to die and where they
actually die. So despite around 56% preferring a home death, in reality only
18% die at home.7 The number of hospice deaths are relatively low and
research has shown that older people and those from lower socio-economic
backgrounds are less likely to receive specialist palliative care services, either
at home or as an inpatient in a hospice.8 Home deaths in the UK are declining
and Gomes and Higginson estimate that less than 1 in 10 people will die at
home by 2030, and this has huge implications for service provision. 9
The growing preference for a home death is reflected in current
government policy, where there appears to be a move to support death within
the community. This will involve coordination of health, social care and
voluntary service providers, along with those of unpaid carers. The National
Council for Palliative Care has, however, noted that joint working to
facilitate service provision between primary care trusts and local authorities
is not always effective.10
2.
Research Aims
The main aim of this research study has been to discover the things
that are most important to people when they are dying, and to attempt to
develop distinct attributes or features of care at the end of life. These
attributes are being utilised in the development of a measure for the economic
evaluation of health and social care interventions at the end of life.
3.
Research Methods
Qualitative in-depth interviews were conducted with 23 older people
living in the South-West of England from three distinct groups:
General population aged 65 and over (11)
Older People living in residential care (7)
Older people receiving palliative care (5)
These groups were selected to facilitate comparisons and explore
changing preferences along the dying trajectory. The interviews were
informant-led and respondents were initially questioned on their experiences
of the death of a loved one and then asked what things they thought would be
most important to them when they were dying. A topic guide for use in
interviews was developed following a review of current literature in the area
of end of life care to aid probing of relevant issues. The interviews were
Eileen Sutton and Joanna Coast
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recorded and transcribed verbatim. Data was then subjected to thematic
content analysis with the aid of the Software package Atlas Ti©. Following
analysis of initial interview data and development of attributes, second-stage
interviews were conducted with 12 of the original participants in order to
refine the wording of the attributes and ensure their relevance to the
population group studied. Pseudonyms for participants are used in all study
reports.
4.
What Is Important To Older People?
Analysis of initial interviews and follow-up interviews with 12 of
the original participants revealed seven main areas which older people
thought would be important to them when they were dying:
Dignity – maintaining your dignity and self-respect
Autonomy – having a say in decisions that affect your
life and care
Physical suffering – freedom from significant pain or
discomfort
Emotional suffering – freedom from worry or distress
Affection – being with people who care about you
Support – having the help and support you need
Completion – having an opportunity to make the
preparations you want to make
5.
What Do Older People Say
The older people, particularly those from the general population
group, spoke about the importance of being able to remain in their own
homes for as long as they possibly could. But what is it about home that
makes it the preferred place of death? Frank here mentions one factor, which
was the sense of achievement which some experienced from having bought
and maintained their home. There was also a sense of continuity that their
home represented. Perhaps they had lived there for a long time and raised a
family there:
Frank/72/GP: I’m staying here until I get carried away. I’ve
worked hard and paid for it, and this is my abode and I’m
quite happy with it.
Clive/68/GP: As far as I’m concerned I’d rather be at home
all my life than anywhere else.
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Home could also be a source of memories, perhaps of times shared
with loved ones who had died:
Joan/67/GP: You’ve got your memories you know.
Beatrice, who lived alone at the time of the follow-up interview as
her husband had recently died, had a house full of her needlecraft work and
ornaments, such as a gift sent for her 50th wedding anniversary by her brother
who lived in Canada, whom she would probably never see again:
Beatrice/86/GP: My son said “You’ve got a load of old tat
[rubbish] Mum.” I said “Yes, but it’s my tat. It means a lot
to me.”
In this way their home was seen to reflect their personal identity and
life history. Some respondents also mentioned that they felt comfortable at
home, not only with familiar environments or possessions, but also with their
regular day-to-day routines:
Eric/81/GP: One thing I appreciated when I got home [from
hospital] I thought “Oh isn’t it lovely to get in this bed.”
Joan/67/GP: It’s nice to spend the time with things around
you that you’re familiar with, with a routine that you’re
familiar with…with the things that you like the best.
So, being at home was linked to the importance of maintaining a
certain level of independence. Being able to do what they wanted to do when
they wanted to do it:
Beatrice/86/GP: If I want to go and dig the garden I can
say: “Oh I’ll go and do ten minutes in the garden.”
Whereas in a care home you’re regimented: “You sit there
until we bring you a drink” or “You sit there until it’s
dinner time”…I don’t want that.
Being self-reliant was also linked to maintaining a sense of dignity
and it was difficult for some to think about a time when they would no longer
be able to complete day to day tasks, in particular looking after their personal
care.
Eric/81/GP: I can do everything I want to do, and I don’t
have to rely on people. That’s important, not having to
Eileen Sutton and Joanna Coast
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rely…Well I wouldn’t like other people in my home, you
know…I do like company but somebody, you know, doing
all the intimate things, like doing my…cleaning the house
for me, and that’s my job.
Another important aspect of being at home was being able to spend
time with people they cared about and who cared for them, or being able to
give support their loved ones. For example, Monica was worried about how
her husband, who had major health problems, would cope if she died:
Monica/74/GP: I think he [husband] worries about dying. I
think he, I don’t think he knows what he’s going to do
without me if, you know what I mean?
However, Shirley, a palliative care patient, explained that her
husband had learnt to cook, wash and iron in order to care for her during her
illness, but that now that she was feeling better it was important to her that
she could return to her former role:
Shirley/72/PC: When I came out of hospital he [husband]
done everything I mean, he cooked the food and he’s never
cooked in his life [laugh]…And all the washing, ironing he
did. But now I do that cos I got better.
Increased dependency as older people move along the dying
trajectory can impact on their ability to remain at home. Consequently some
of the older people interviewed had made adaptations to their homes so that
they could remain there as long as possible:
Beatrice/86/GP: And I had this extension built for my
convenience, with no help from anybody. And there’s a
shower and toilet there, you know, because I have difficulty
getting upstairs.
For Beatrice this had involved using a substantial amount of her
personal savings to pay for adaptations. The complexities of supporting those
with complex needs to remain at home to die can be prohibitive, or as
Thomas found, can result in changing the nature of the home environment,
making it feel more like a hospital setting, lessening feelings of comfort and
normality derived from being at home:
Thomas/83/GP: One of the Social Services came round,
and I said, “Was there anything?” And she went away, and
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came back, and she said, “Yes we’ve got this
gadget.”…We’d bought some odd things, like the stair lift,
which is still there, and a bath lift. Because starting off we
had just a frame across the bath and a little seat, and she
could lower herself onto it, but then her arthritis got so bad
that she couldn’t push herself out of the thing, so we got
this, and this inflatable thing is made by the same firm.
Some of the respondents recognised that, depending on the type of
care needed, it might not be possible to remain at home to die, if specialist
community care was unavailable:
Joan/67/GP: If it was a question that you needed to be
drained, well obviously you’ve got to go into hospital and
be drained; you’ve got to go into hospital to get your
medication.
Others, like Rose, who attended her local hospice as a day patient,
explained how she was supported to stay at home by a service providing her
with oxygen supplies:
Rose/81/PC: Oh I couldn’t live without it [home oxygen
service]. I wouldn’t be alive without it. It does help the
breathing. I mean it enables me to stay home.
Clive, however, raised the issue of potential age discrimination in
service provision:
Clive/68/GP: I think the older you get the more dismissed
you are today of all the facilities which you could expect in
your life.
The importance of choice is emphasised in much UK health and
social care policy documentation. Nevertheless, some of the respondents in
this study appeared to be resigned to a declining quality of life when they
were dying:
Phyllis/74/GP: Maybe that’s what the end of life is, maybe
all these luxuries like these that we have during our life, we
don’t have them at the very end.
Eileen Sutton and Joanna Coast
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Clive/68/GP: Choice is a small word with a huge
meaning…and the ability to invoke it depends on so many
other factors.
Concerns regarding the quality and availability of out of hours
support and home nursing care were also expressed:
Margaret/74/GP: I feel it should be expanded [home
nursing care]…but I think this is where money from the
NHS should be used to enhance the house service.
Another very important issue was a fear of being a burden to their
loved ones if they could not maintain their independence:
Peter/72/GP: I don’t want to be a burden to anybody
Some expressed concerns about the availability of carers and the
consequent impact on the choices open to them at the end of life:
Hilda/83/PC: I’ve no daughter-in-law, my son is divorced
from his wife, he’s got two teenage children. So
that…there’s no females to do any helping. My sister is 74
and she lives in London so she’s not…ever so well.
So…I’ve got to think ahead to think, you know, what I’ve
got any choice what I want.
It can be difficult for family members to provide all the care that is
needed when someone is dying. Pamela, who lived at her daughter’s house
with her husband and grandchildren, explained that despite supporting her
mother’s wish to die at home she didn’t want to die at home herself, as she
was worried about the impact upon her grandchildren:
Pamela/68/GP: I would not want to die at home…when my
mother died she died in the room up there, right. And we’d
got all the family here, and we had the Marie Curie nurses
here, and she had the hospice nurses here…we were with
her all the time. But when she actually died and they took
her away, my grandchildren were 13 and 11 at the time,
and they were a bit worried about going past the room…it
was always, [sharp intake of breath] “She died in here.”
There was always that little bit of edge.
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For some, like Agnes, there had come a time when they recognised
that they could no longer continue to live at home:
Agnes/90/RC: I think for everyone it’s important to stay in
your own home as long as possible, but we all know, what
well at least most of us are wise enough to realise the time
has come when we’re not possible to stay in our home on
our own. We’re too much of a responsibility to other people
and therefore we should make a decision about what it is
more convenient for everyone
So what about the alternatives to dying at home? Many of the study
respondents related experiences of poor hospital care, experienced when their
loved ones were dying, or when they had been admitted for acute care:
Hilda/83/PC: In a general hospital, everybody’s always so
rushed and I think when you’re coming, you know, to the
end of your life you just want it to go, you just want to go
out gently, not to feel that, well I mean they can’t do it in
the hospitals cos they’re all so understaffed and overworked.
There were concerns about lack of dignity and privacy, issues of
cleanliness and hospital acquired infections, and poor staff communication
skills. These experiences had convinced them that hospital was not the place
that they wanted to die. However, as noted above, it is the place where most
people do die. A lack of assistance to unpaid carers supporting someone
dying at home often leads to unnecessary emergency admissions to hospital
in a crisis situation, for example, if someone is suffering from severe
breathing problems. A recent audit of care of the dying in hospitals in the UK
recognised the need for substantial improvement in the care for the dying in a
hospital setting.11
Similar experiences of poor nursing home care for their relatives
meant that some respondents were determined not to be admitted to a nursing
home:
Rose/81/PC: We were talking about retirement homes,
selling the house and I said “No way, I’m not selling my
house to go into a retirement home where I couldn’t be
happy.” I told them at [hospital] “You’d kill me in a
month.”
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However, other respondents were very happy living in her nursing
home, like Winnie who hoped to remain in her current home until she died:
Winnie/97/RC: Oh yes. I hope I’m still here when I pop
off…Well I don’t think I’d want to be shifted when I was
pegging out.
The palliative care patients interviewed were universally
complementary about the care that they received when they attended the day
hospice, particularly the personal nature of the care they were given and the
respect and understanding they received from staff, in addition to its pleasant
surroundings, making it a “home from home.” This meant that they were all
happy that they might eventually die as an inpatient there:
Caroline/65/PC: If my husband can’t deal with me, come
the end of this illness, cos it will get worse very quickly this
illness. I said “I wouldn’t mind at all coming here
[hospice].” You know I’m quite happy about it.
Pamela/68/GP: Well my father died in [hospice], and that
was absolutely, you couldn’t have had any better care than
he had there. That was, it was absolutely superb.
However, as noted above, older people and those with a non-cancer
diagnosis are less likely to receive hospice care and there are also issues of
geographical differences in the availability of provision, in addition to
funding concerns for maintaining or expanding capacity, as a high percentage
of hospice funding originates from charitable sources.
6.
Conclusions
Many of the people from the general population group expressed a
preference to remain at home until they died, for various reasons such as a
sense of continuity, comfort, familiarity, autonomy and being able to be with
people they cared for and who cared about them. These factors were seen to
contribute to maintaining an individual’s sense of identity and dignity at the
end of life. However, the older people realised that increased levels of
dependence as they become older and perhaps increasingly frail or unwell,
might mean that this might not be possible.
The realisation of their preference for home care was often
dependent upon the availability of unpaid care or service provision to support
their choice. Respondents were also worried about imposing what they
considered to be an unacceptable burden upon their loved ones or carers.
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Poor experiences of hospital or nursing home care made them
concerned about the type of care they might receive when they were dying, if
they could not remain at home. A recent audit of care of the dying in hospital
recognised that much work still needs to be done to improve service
provision in this area and efforts to improving training for care home staff are
also underway. Nevertheless, it is unclear how equality in access to service
provision can be achieved. What should recognised, however, is the influence
of the uncertainty of the dying trajectory and difficulties in prognostication at
the end of life, which in turn have an impact on prioritisation and
identification of needs.
The instigation of a national End of Life Programme in the UK and
the introduction of policies such as Liverpool Care Pathway for the Dying
Patient and the Preferred Priorities for Care Tool, to record people’s
preferences for care, are aimed at improving people’s experience of dying.
Increasing funding for end of life care services and further research in this
area has also been announced. It remains to be seen if policy changes,
combined with increased funding for services such as hospice at home will
enable more people to be able to die in the place of their choice in the future,
or whether efforts to improve hospital or nursing home care will be
successful and change people’s preference for care at the end of life. What is
important, however, is that service provision whether institutional, or in the
home should aim to help older people to maintain their own personal identity
and dignity when they are dying.
Notes
1
Department of Health, ‘End of Life Care Strategy: Promoting High Quality
Care for All Adults at the End of Life’. Department of Health, London, 2008.
2
National Statistics, General Household Survey: Results for 2005, viewed on
1 November 2008,
<www.statistics.gov.uk/downloads/themecompendia/GHS05/GeneralHouseh
old Survey2005.pdf>.
3
National Audit Office, ‘End of Life Care’. London, Stationery Office, 2008.
4
National Health Service, National End of Life Care Programme, viewed on
1 November 2008, <http://www.endoflifecareforadults.nhs.uk/eolc/>.
5
I J Higginson, Priorities and Preferences for End of Life Care in England,
Wales and Scotland, National Council for Palliative Care Services, London,
2003.
6
ibid.
7
ibid.
Eileen Sutton and Joanna Coast
259
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8
GE Grande, MC Farquhar, SIG Barclay, and CJ Todd, ‘The Influence of
Patient and Care Age in Access to Palliative Care Services’. Age and Ageing,
vol. 35, 2006, pp. 267-273.
9
B Gomes and IJ Higginson, ‘Where people die (1974-2030): Past Trends,
Future Projections and Implications for Care’. Palliative Medicine, vol. 22,
2008, pp. 33-41.
10
National Council for Palliative Care, End of Life Care: A Commissioning
Perspective, Lavenham, Lavenham Press, 2007.
11
Marie Curie Palliative Care Institute Liverpool and the Royal College of
Physicians, National Care of the Dying Audit – Hospitals 2007, London
2007.
Bibliography
Angus, J., Kontos, P., Dyck, I., McKeever, P., and Poland, B., ‘The Personal
Significance of Home: Habitus and the Experience of Receiving Long-Term
Home Care’. Sociology of Health and Illness, vol. 27, 2, 2005, pp. 161-187.
Department of Health. ‘End of Life Care Strategy: Promoting High Quality
Care for All Adults at the End of Life’. Department of Health, London, 2008.
Gomes, B., and Higginson, I. J., ‘Where People Die (1974-2030): Past
Trends, Future Projections and Implications for Care’. Palliative Medicine,
vol. 22, 2008, pp. 33-41.
Gott, M., Seymour, J., Bellamy, G., Clark, D., and Ahmedzai, S., ‘Older
People’s Views About Home As a Place of Care at the End of Life’.
Palliative Medicine, vol. 18, 2004, pp. 460-467.
Grande, G. E., Farquhar, M. C., Barclay, S. I. G., and Todd, C. J., ‘The
Influence of Patient and Care Age in Access to Palliative Care Services’. Age
and Ageing. vol. 35,2006 pp. 267-273.
Higginson, I. J., Priorities and Preferences for End of Life Care in England,
Wales and Scotland. National Council for Palliative Care Services, London,
2003.
Marie Curie Palliative Care Institute, Liverpool and the Royal College of
Physicians, National Care of the Dying, Audit – Hospitals, 2007.
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______________________________________________________________
National Audit Office, End of Life Care. London, Stationery Office, 2008.
National Council for Palliative Care, End of Life Care: A Commissioning
Perspective. Lavenham Press, Lavenham, 2007.
National Health Service, National End of Life Care Programme, viewed on 1
November 2008, <http://www.endoflifecareforadults.nhs.uk/eolc/>.
National Statistics, General Household Survey: Results for 2005, viewed on
1st November 2008,
<http://www.statistics.gov.uk/downloads/themecompendia/GHS05/GeneralH
ousehold Survey2005.pdf.>
Eileen Sutton is a Research Associate at the University of Bristol,
Department of Social Medicine. Her research interests focus on end of life
care and the provision of complementary therapies in state cancer care.
Joanna Coast is Professor of Health Economics at the University of
Birmingham. Her research interests include decision-making in health care,
with particular focus on rationing and care for older people.
Waiting for Death: An Exploration of Suicide and
Old Age in Ireland
Christine De Largy
Abstract
For some older adults, later life is a time of physical pain, psychological
distress and dissatisfaction with present and, in some cases, past aspects of
life. Increasingly there is evidence that suicide is one of the methods of
escape for older adults. Suicide is rarely, if ever, caused by any single event
or reason. It results from many factors working in combination, which
produce feelings of hopelessness and depression. Thus the aim of this paper
is to explore the prevalence of older adult suicide in Ireland and the factors
that are associated with older adult suicide in Ireland, and also to examine the
adequacy of prevention programmes specifically designed for older adults.
Key Words: Older adults, suicide, risk factors.
*****
1.
Introduction
It may be that the gods are merciful when they make our
lives more unpleasant as we grow old. In the end, death
seems less intolerable than the many burdens we have to
bear.
(Sigmund Freud)
Suicide has been glorified or condemned through the ages and the
debate continues even today. Meanings attributed to suicide and notions of
what to do about it have varied with time and place.1 The majority of older
people have a lifetime’s experience with which to face, in a positive way, the
various changes that occur at this stage of their lives. For some older people
these challenges can be immense and tremendous strain is placed on their
ability to cope effectively. So why do some people confront the conflicts that
are posed by ageing, while others choose to escape? For some, escape is the
preferred alternative from what maybe a time of physical pain, psychological
distress and dissatisfaction with present, and or past experience in life. Some
older adults experience ageing as a time of loss, loss of social status and selfesteem, loss of physical abilities and death of friends and loved ones.
Nevertheless, in the face of loss, some older people have the capacity to
develop new adaptive strategies while others may feel hopeless about making
changes to improve their lives and so engage in a variety of self-destructive
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behaviour such as isolating themselves, alcohol abuse, drug abuse or suicide.
Some perceive their issues and conflicts as too great to be coped with. They
see what could be termed as a “solution” with respect to medication and
treatment as an insufferable compromise.2 In this research paper I intend to
investigate the factors that motivate older adults to die by suicide and what if
any, would be the advantages of prevention programmes designed
specifically for older adults. I will also explore Physician Assisted Suicide
which has been legalised in some European countries and examine whether
this is an acceptable option for older adults.
2.
Settings
A. International Setting
The World Health Organization3 estimated in 2002, in the year 2020
there will be approximately 1.53 million people who will die by suicide,
according to current trends. Suicides by age globally are as follows: 55%
from age 5 to 44 years and 45% from age 45 years and over. Whenever
figures on suicide are presented or discussed, there is always someone to
question their reliability, insisting that in many places and due to several
reasons that suicide is hidden and that the real figures must be much higher.
The prevalence of hopelessness or suicidal ideation in elderly people varies
from 0.7 up to 17% in different studies (depending on the strictness of criteria
used worldwide). Suicide rates have increased by 60% over the last 50 years,
and the increase has been particularly marked in developing countries.4
Although reported suicide is now among the three leading global causes of
death among young people aged 15-34 years, the majority of suicides are
reported in adults aged 60 years and over.5
Fig 1 Distribution of suicides rates (per 100 000) by gender and age,
2000
Christine De Largy
263
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B. Irish Setting
In Ireland, the population profile is currently changing, albeit at a
relatively slow pace, from a young, low dependency population to an ageing
one. Currently 45.3% of people over 65 years live in rural areas and
approximately 27% of people aged 65 years and older live alone.6 In a short
space of time, Ireland moved from being a highly integrated society with
shared values which regulated the way of life to a more consumer orientated
society; where communities have become less integrated and traditional
values are no longer deeply held or widely shared.7 This reduced integration
has coincided with increased urbanisation as reflected in the 2002 census
figures which report that 60% of the total population is now living in urban
areas, representing an urban population increase of 10% since 1996.8
As in all other European countries, suicide in Ireland is more
common in men than in women. The specific types of life events most
pertinent to suicide in later life differ from those of younger victims. 9, 10, 11
Interpersonal discord, financial and job problems, and legal difficulties are
more typical of suicides in young and middle adulthood, while isolation,
loneliness and chronic illness are typical in suicides in later life. In Ireland,
450 people over the age of 65 died by suicide between 1991 and 2001, of this
figure 73% were male and 27% were female. Psychiatric illness is present in
over 71% of older people who die by suicide with many of these individuals
suffering from depression.12 In 1995 12% of all deaths from suicide occurred
in people over 65. Among older people a higher incidence of suicide is
evident among males, people living alone, who are either widowed or single
and therefore who may be lonely and socially isolated, people in low socioeconomic groups, the ill (either physically or mentally), and the bereaved.
Figure 2. Annual Male and Female Suicide Rate, by age, per 100,000
population (2000-2002 average)
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3.
Methodology
I chose to interview individuals who work closely with older people
in distress. This provided me with an opportunity to gain insight into the
points of view of the participants. A qualitative interview approach allows for
an exploration of a sensitive topic and for the meaning, value and
interpretation of that topic to be fully explored by the interviewee as well the
interviewer. Following a review of the Irish context with respect to suicide in
later life, the following interviewees were desirable:
A Suicide Prevention Officer – because of experience
with the topic.
A Director of a support organisation i.e. Samaritans.
Although this is a very small sample within qualitative interviewing it is
about depth of understanding. The interviews were semi-structured and
informed consent was received for audio recording In addition an extensive
literature review was conducted to inform the topic guide and to provide a
representative context for suicide in later life. The data from the interviews
was transcribed verbatim. From a content analysis of the transcriptions,
several common themes emerged.
Isolation/Loneliness
Financial Strain
Depression
Chronic Illness
The findings of the interviews will be discussed with reference to
the international and national literature in the following section.
4.
Findings and Discussion
Ethnographic studies13, 14 have indicated that in pre-industrial
societies suicide was a form of death-hastening treatment especially when it
resulted from direct social manipulation. Previous research suggests that
suicide is rarely, if ever, caused by any single event or reason. Rather, it
results from many factors working in combination, which produce feelings of
hopelessness and depression. Eleven per cent of the Irish population are over
the age of 65 and 3.5% of suicide rates in Ireland occur in the over 65-age
bracket. It is difficult to determine whether the number of suicide rates have
increased in Ireland in recent years due to previous under-reporting.
According to a recent report by the Health Research Board, older adult
suicide rates in Ireland are now among the lowest worldwide.15
Christine De Largy
265
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A Finish study conducted by Heikkinen and Lönnqvist found that
although the rate of suicide was higher among the elderly than the nonelderly, living alone was not peculiar for the elderly; nor were elders living
alone at any more significantly higher risk for suicide than their counterparts
living with others. While personality factors in suicide in older people have
received limited research attention, they seem to be less frequent in older
suicide victims than in younger age groups. There also still exists a negative
stigma associated with depression in many rural communities, where it is
seen as weak to admit that you can't cope or are finding things hard. It's
particularly difficult for men to admit that they need help, and when they do
the services just aren't available to them.16
There has been very little research conducted on suicide in later life,
Physician Assisted Suicide or Euthanasia in Ireland and while this paper
represents exploratory research, it may help to provide a little insight into the
area of older adult suicide. We assume that there is under-reporting of suicide
in Ireland. The republic of Ireland was the last country in western Europe to
decriminalise suicide in 1993. We could speculate that this was due to the
close links between the Church and State and the perceived stigma associated
with suicide. Acceptance levels for both Euthanasia and Suicide are relatively
low in Ireland but support for Euthanasia has moved slowly but steadily
upwards over time. There have been rapid evolutions internationally in
attitudes and practices about death and dying over the last decade. Physician
Assisted suicide was legalized in Oregon, USA in 1997 and in the
Netherlands, voluntary active and physician-assisted suicide are available
solutions to end-of-life situations. One quarter of Irish people would choose
euthanasia to allow them to die, according to the findings of a poll by
irishhealth.com:
“If I was told I had cancer or some other serious illness, I
would like to have the option to go for euthanasia”. (Quote
from poll)
“Euthanasia, if I'm displaying any sign of dementia and I
guess suicide when I don't want to live any more and my
family is grown”. (Quote from poll)
Life events commonly associated with elderly suicide can be the
death of a loved one, physical illness, pain, social isolation, loneliness and
major changes in social roles such as retirement. In older people, particularly
among older men, psychiatric illness (most notably depression), certain
personality traits and physical illnesses are associated with an increased risk
of suicide. Social isolation, loneliness and being divorced, widowed or single
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also increase the risk of suicide for older men. Reduced help seeking and
remoteness from services can put older people further at risk, although it
must be noted that isolation is not simply just a matter of distance and can
occur in the context of many living arrangements. The findings from risk
factor research have significant implications for the design and
implementation of effective suicide prevention strategies, as the elimination
of risk factors should lead to a reduction in suicide rates. Risk factors for
suicide among older adults differ from those among the young. Several
factors relative to those over 65 years will play a role in future suicide rates
among the elderly, including growth in the size of the population; health
status; availability of services, and attitudes about ageing and suicide. From
2000 to 2005, suicide rates among isolated Irish elderly living in rural areas
have increased by 30 percent. The Samaritans reported a corresponding
increase in calls to their hotline from elderly isolated from friends and family
who have little time for their older relatives.17 “The future tends to be on the
decline for older people, more hope for a young person” (Director of
Services). The Report of the National Task Force on Suicide,18 which informs
the direction of suicide prevention activities in Ireland, identified older adults
as a high-risk group. A recommendation of the report was to improve
recognition of the risk of suicide in older people, improve treatment of
depression, and to address the psychological needs of older people by
counselling and social intervention. Current prevention endeavours focus
mostly on detecting or treating the acutely suicidal individual however they
may not impact significantly on public health or lower elderly suicide rates.19
While there has been some encouraging preventative initiatives considered in
the literature, due to the lack of controlled studies, small sample sizes, and
weak design and evaluation methods, it has been difficult to evaluate the
impact of these initiatives.20 In the context of Ireland there have been several
key milestones in suicide initiatives.
1993
1995
1996
1998
2000
The passing of the Criminal Law (Suicide) Act resulting in the
decriminalisation of suicidal behaviour.
The National Suicide Research Foundation (NSRF) was established.
The National Task Force on Suicide was established.
The Irish Association of Suicidology (IAS) was set up.
The National Task Force on Suicide Report was published and the
National Suicide Review Group was set up.
The National Parasuicide Registry (to be known as the
National Register of Deliberate Self Harm) was established.
Department of Justice, Equality & Law Reform published the
Review of the Coroner Service that expanded the role of the Coroner
to include investigation of the circumstances of death.
Christine De Largy
267
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2005
Reach Out: National Strategy for Action on Suicide Prevention
(2005-2014) was published and the National Office for Suicide
Prevention (NOSP) was established.21
Any strategy that promotes a community response to suicide
amongst any group young or old would be very welcome (Director of
Services).
Of course, developing a strategy is only the first step. Effectively
implementing this Strategy is the real challenge. At the third annual Suicide
Prevention Forum held recently, Dr Jimmy Devins TD, Minister for
Disability and Mental Health, said:
We as policy makers working in the area of suicide
prevention need to foster a culture where people in distress,
at whatever stage in their lives, won't hesitate to seek help, a
culture that recognises the signs and signals of distress and
is willing to help, and that focuses early in life on
developing good coping skills and avoiding harmful
practices.22
This is quite evident in the research findings on suicide prevention outlined
by the Suicide Prevention Officer.
[S]o the chance then is through our work in suicide
prevention to create learning environments and education
and information where people can identify those signs in
older people and respond (Suicide Prevention Officer, HSE)
As yet there is no universally accepted model or conceptual framework of
how to define and apply prevention measures for reducing suicide, and
attempted suicide, in the elderly.23
Those best equipped to inform the global communities and have a
more positive impact on those who will suffer in the future, are survivors of
suicide. The development of effective prevention strategies, and ultimately
the reduction of suicide morbidity and mortality in later life, will result from
an improved understanding of risk factors and their interactions. Greater
integration and co-ordination are required in the area of research so that we
can understand more deeply the personal and social circumstances that lead
to suicidal behaviour in this country. There is often difficulty moving from
awareness and knowledge to implementation of practices that have been
shown to be helpful.
In recent years however, there have been many local, regional,
national and international efforts to promote positive attitudes towards mental
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health issues. These efforts have been developed in the context of anti-stigma
campaigns, health promotion strategies and mental health awareness
campaigns. However there is no single intervention or approach that will, in
itself, adequately challenge the problem of suicide in Ireland. A strategic
framework is required to assist all of us in identifying actions we can
undertake in a coordinated way, through partnership working between
statutory, voluntary and community groups and individuals, supported by
Government.
Everyone has a role to play in suicide prevention. In Ireland, recent
years have seen the development of important policy documents on suicide
prevention – Reach Out, 2005 and on mental health – A Vision for Change,
2006. A fundamental principle underlying both of these policies is the
development of whole population approaches to mental health. If these
policies are to be successfully implemented in full, then ongoing
improvement at every level of Irish society is needed in relation to awareness
of, and attitudes to, mental health. The stronger and broader the support and
collaboration on suicide prevention, the greater the chance for the success of
a public health initiative. Arising from the interviews and a review of the
literature, it may be helpful to consider the following when developing a
suicide prevention strategy for older people:
Promotion of efforts to reduce access to lethal means
and methods of self-harm.
Eliminate stigma and discrimination
Promote and support recovery
Promote Awareness that Suicide is a Public Health
Problem that is preventable by increasing the degree of
cooperation and collaboration between and among
public and private entities that have made a
commitment to public awareness of suicide and suicide
prevention.
Develop and implement strategies to reduce the stigma
associated with being a consumer of Mental Health,
Substance Abuse, and Suicide Prevention Services.
Implement training for recognition of at-risk behaviour
and delivery of effective treatment.
Promote and support research on suicide and suicide
prevention as enhanced understanding taken from this
research will lead to better assessment tools, treatments,
and preventive interventions.
Christine De Largy
269
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We have talked so far about prevention strategies but what about the
individuals for whom prevention is not an option. Is the next step in a
strategy for suicide prevention for older adults in Ireland to investigate
whether Physician Assisted Suicide or Euthanasia would be a viable option
for older adults who want to “die with dignity”? However, this is beyond the
scope of this paper and requires careful consideration and future research.
5.
Conclusions
The ageing of populations worldwide means that the absolute
number of suicides in elderly people is likely to increase. Society has long
held the view that growing old is equated with misery and this has been
reflected in literature, mythology and societal attitudes.24 Despite progress
resulting in improved conditions of environment and length of life, old age
remains the poorest phase of life. Elderly people have a higher risk of
completed suicide than any other age group worldwide. Despite this, suicide
in elderly people receives relatively little attention, with public health
measures, medical research, and media attention focusing on younger age
groups.25 Suicide in elderly people is a complex and multifaceted
phenomenon. Suicide and suicidal behaviour are societal problems and
society needs as a consequence to alter social policies to deal with the risk
factors for suicide. Effective action to prevent suicidal behaviour requires the
cooperation of the whole community.
Suicide in the elderly remains a neglected subject receiving little
interest and research attention. The role of primary care services in suicide
prevention is of considerable interest. Most studies report substantial levels of
contact: 40–70% of elderly suicides seeing their general practitioner (GP) in
the 30 days preceding their death, and between 20 and 50% attending in the
preceding week. This raises the important issue of effective intervention at a
time when the individual is particularly vulnerable. The importance of
training and education programmes for GPs in the recognition and treatment
of depression as a means of reducing the suicide rate. Prevention of elderly
suicides requires a number of approaches ranging from social assistance and
improved training of care providers to more acceptance and valuing of older
persons by society. I think suicide prevention is really probably in its infancy
in Ireland but at the same time a lot of these steps are being taken by
communities now to respond and not feel powerless (Director of Services)
It has been documented that older people are rarely consulted with
respect to policy development in the Health and Social Care sector. This also
appears to be the case in terms of discussions on suicide. While there has
been a conscious effort to develop and enhance prevention strategies, there
are no strategies specifically targeted at older adults. However one must ask
is this necessary, do the figures necessitate a prevention strategy specifically
designed for older adults? Is a suicide prevention strategy that incorporates
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all ages sufficient? Clearly, the view of the future in old age differs from that
in younger persons. Older persons have lived a long time, and compared to
younger persons have less time facing them. Death is closer. The uncertainty
and fear of death, the oft-felt inability to influence their own dying, a certain
weariness of life, confront the older adult. There is only one obligatory in life
from which there is no escape and that is to die, is to die by suicide, to die
before one’s time?
The Roman philosopher Seneca tells us we make many mistakes
about death:
we assume death is bad,
we assume death later is better,
that a longer life is better than a shorter life
that death is something that happens to us rather than
something we control.
Seneca argues that a self embraced death like suicide is not a premature end
to a complete life. However in 1897, Emile Durkheim, the French sociologist,
published the influential text, “Suicide.” His central hypothesis is that when
social conditions fail to provide people with the necessary social goals and
rules, at the appropriate levels of intensity, the most vulnerable individuals
will consider suicide. These ideas have been examined and supported, thus
the role of social integration in the prevention of suicide has been purported
for over one hundred years.
Suicide is due to a complex interaction of social, environmental,
biological and cultural factors operating in an individual’s life. Cultural
beliefs, social standards, gender bias, educational problems, income levels,
living status, growing aspirations, pressures of modern life, the need to excel
and compete in the modern world, employment issues, marriage-related
factors, interpersonal conflict due to disturbed family relations, breakdown of
family values and systems, terminal or serious illness, social isolation and
death of a loved one, are all capable of initiating suicidal thoughts. Some of
the factors that were highlighted during the course of the research were that
factors for suicide among older persons may differ from those among the
young. The great medical discoveries of our time have benefited mainly the
younger age groups. While I started this paper to investigate the motivations
of older adult suicide I have found that there is no easy answer to the enigma
associated with suicide. This was evident in my findings, suicide is a
multifaceted phenomenon. However, Seneca does makes the point that a self
embraced death like suicide is not a premature end to a complete life;
therefore are we programmed to believe that death is bad, is there such a
Christine De Largy
271
______________________________________________________________
thing as a good death and is to die by suicide a good death? Human beings
are unique, as are their reasons for suicide.
Suicide will become the preferred mode of dying because it
enables a person to control the time, place, and
circumstances of doing so.26
Notes
1
The Substance Abuse and Mental Health Services Administration's
(SAMHSA) http://mentalhealth.samhsa.gov/ accessed April 2008.
2
R C Atchley and A S Barusch, Social Forces & Aging: An Introduction to
Social Gerontology, 10th edition, Thomson/Wadsworth Publishers, Belmont,
CA, 2004.
3
WHO, http://www.who.int/mediacentre/news/statements/2007
(accessed on 21st January 2007).
4
H O'Connell, et al, “Recent developments: Suicide in older people”. British
Medical Journal, 329(7471), 2004, pp. 895-899.
5
WHO, op. cit.
6
National Strategy for Action on Suicide Prevention 2005-2014. Reach Out,
HSE, Dublin, 2005. Published by the Health Service Executive 2005, ISBN
0-9551181-0-7.
7
ibid.
8
Central Statistics Office.
9
S S Carney, C L Rich, P A Burke, and R C Fowler, ‘Suicide over 60: The
San Diego study’. Journal of the American Geriatrics Society, 42, 1994, pp.
174–180.
10
Y Conwell, M Rotenberg, and E D Caine, ‘Completed suicide at age 50
and over’. Journal of the American Geriatrics Society, 38, 1994, pp. 640–
644.
11
M E Heikkinen and J K Lonnqvist, ‘Recent life events in elderly suicide: A
nationwide study in Finland’. International Psychogeriatrics, 7, 1995, pp.
287–300.
12
National Office for Suicide Prevention (Annual Report 2006) Health
Service Executive, Published September 2007, ISSN: 1649-881X
http://www.nosp.ie/annual_report_2006.pdf.
13
A P Glascock, and S L Feinman, ‘Social Assert or Social Burden:
Treatment of the Aged in Non-Industrial Societies’, in Dimensions: Ageing,
Culture, and Health, C L Fry (ed), Praeger, New York, 1981.
14
L W Simmons, The Role of the Aged in Primitive Society, Yale University
Press, New Haven, CT, 1945.
272
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15
HRB Overview Series, ‘Suicide, Attempted Suicide and Prevention in
Ireland and Elsewhere’. Health Research Board, Dublin, Ireland, 2008, ISSN
Number: 20090161
16
M M Henriksson, M J Marttunen, E T IsometsaÈ, M E Heikki-nen, H M
Aro, K I Kuoppasalmi, and J K Lonnqvist, ‘Mental disorders in elderly
suicide?’. International Psychgeriatrics, 7, 1995, pp. 275 and 286.
17
Global Action on Aging,
http://www.globalaging.org/ruralaging/world/index.htm.
‘‘Isolation’ Blamed for 30 Percent Jump in Suicides by Elderly’, Shane
Hickey, Independent, Ireland, November 12, 2007.
18
Report of National Task Force on Suicide, Department of Health and
Children, Dublin, Ireland, 1998.
19
E D Caine and Y Conwell, ‘Suicide in the elderly’. International Clinical
Psychopharmacology, 16 (Suppl. 2), 2001, pp. 25-30.
20
ibid.
21
Houses of the Oireachtas, Joint Committee on Health & Children, Seventh
Report. The High Level of Suicide in Irish Society, July 2006.
22
Department of Health and Children www.dohc.ie.
23
Caine and Conwell, op. cit.
24
Aware www.aware.ie (accessed on 22nd January 2008).
25
H O'Connell, et al., op. cit.
26
M Battin, ‘Voluntary Euthanasia and the Risks of Abuse: Can We Learn
Anything from the Netherlands?’. The Journal of Law, Medicine & Ethics,
Volume 20, Issue 1-2, 1992, pp.133-143
Bibliography
Atchley, R. C. and A. S. Barusch, Social Forces & Aging: An Introduction to
Social Gerontology, 10th edition, Thomson/Wadsworth Publishers, Belmont,
CA, 2004.
Aware, accessed on 22nd January 2008, www.aware.ie.
Battin, M. ‘Voluntary Euthanasia and the Risks of Abuse: Can We Learn
Anything from the Netherlands?’. The Journal of Law, Medicine & Ethics,
Volume 20, Issue 1-2, 1992, pp.133-143.
Bryant, C., Handbook of Death and Dying, Sage, London, 2003.
Caine, E. D. and Y. Conwell, ‘Suicide in the elderly’. International Clinical
Psychopharmacology, 16 (Suppl. 2), 2001, pp. 25-30.
Christine De Largy
273
______________________________________________________________
Carney S. S., C. L. Rich, P. A. Burke, and R. C. Fowler, ‘Suicide over 60:
The San Diego study’. Journal of the American Geriatrics Society, 42, 1994,
pp. 174–180.
Cattell, H., ‘Suicide in the elderly, Advances in Psychiatric Treatment’. The
Royal College of Psychiatrists, 6, 2000, pp. 102-108.
Conwell Y., M. Rotenberg, and E. D. Caine, ‘Completed suicide at age 50
and over’. Journal of the American Geriatrics Society, 38, 1990, pp. 640–
644.
Crisis, The Journal of Crisis Intervention and Suicide Prevention (2/07) Vol
28/Number 2/2007.
Central Statistics Office.
De Leo, D., G. Carollo, and M. Dello Buono, ‘Lower suicide rates associated
with a Tele-Help/Tele-Check service for the elderly’. American Journal of
Psychiatry, 1995, pp. 632-634.
Department of Health and Children, www.dohc.ie.
Glascock, A. P., and S. L. Feinman, ‘Social Assert or Social Burden:
Treatment of the Aged in Non-Industrial Societies’, in Dimensions: Ageing,
Culture, and Health, C. L. Fry (ed), Praeger, New York, 1981.
Global Action on Aging,
http://www.globalaging.org/ruralaging/world/index.htm
‘‘Isolation’ Blamed for 30 Percent Jump in Suicides by Elderly’, Shane
Hickey, Independent, Ireland, November 12, 2007.
Heikkinen M. E., and J. K. Lonnqvist, ‘Recent life events in elderly suicide:
A nationwide study in Finland’. International Psychogeriatrics, 7, 1995, pp.
287–300.
Henriksson M. M., M. J. Marttunen, E T IsometsaÈ, M E Heikki-nen, H M
Aro, K I Kuoppasalmi, and J K Lonnqvist, ‘Mental disorders in elderly
suicide?’. International Psychogeriatrics, 7, 1995, pp. 275 and 286.
Houses of the Oireachtas, Joint Committee on Health & Children, Seventh
Report. The High Level of Suicide in Irish Society, July 2006.
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HRB Overview Series, ‘Suicide, Attempted Suicide and Prevention in Ireland
and Elsewhere’. Health Research Board, Dublin, Ireland, 2008, ISSN
Number: 20090161.
http://www.healthyplace.com/communities/depression/related/suicide_3.asp
http://www.irishhealth.com/poll, accessed 5th May 2008.
Ilinka, H., B. D. Onwuteaka-Philipsen, A. van der Heide, P. J. Kostense, G.
van der Wal, and P. J. van der Maas, ‘Refused and Granted Requests for
Euthanasia and Assisted Suicide in the Netherlands: Interview Study with
Structured Questionnaire’. British Medical Journal, 321(7265), 2000, pp.
865–866.
Irish Association of Suicidology, accessed January 2008, www.ias.ie,.
Karatu, K., ‘Towards A Socio-Economic and Demographic Theory of
Elderly Suicide’, Uppsala University, 2004,
http://www.soc.uu.se/research/gerontology/abstracts/diss_2004-3.html.
Kennelly, B., ‘The Economic Cost of Suicide in Ireland’. Crisis, Vol. 28(2),
2007, pp. 89-94.
National Office for Suicide Prevention, (Annual Report 2006), Health
Service Executive, September 2007, ISSN: 1649-881X
http://www.nosp.ie/annual_report_2006.pdf.
National Strategy for Action on Suicide Prevention 2005-2014. Reach Out,
HSE, Dublin, Published by the Health Service Executive, 2005, ISBN 09551181-0-7.
National Suicide Research Foundation of Ireland, www.nsrf.ie, accessed in
November 2007.
O'Connell H. et al, ‘Recent developments: Suicide in older people’. British
Medical Journal, 329(7471), 2004, pp. 895-899.
Report of National Task Force on Suicide. Department of Health and
Children. Dublin, Ireland, 1998.
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275
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Roscoe, L. A., ‘The Many Faces of Physician-Assisted Suicide’. Journal of
Ageing and Identity, 3, 1998, pp. 35-48.
Schmitz-Scherzer, R., ‘International Perspectives
Reflections on Cultural Influences on Aging and Old-Age Suicide in
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Simmons, L. W., The Role of the Aged in Primitive Society. Yale University
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(SAMHSA), accessed April 2008, http://mentalhealth.samhsa.gov/.
World Health Organization (WHO), accessed on 21st January 2007,
http://www.who.int/mediacentre/news/statements/2007 .
Christine De Largy is a Development Officer at the Irish Centre for Social
Gerontology at the National University of Ireland Galway.
To Worship God or Celebrate a Life:
Conflicting Scottish Perspectives on Funerals
Glenys Caswell
Abstract
From a staunch Presbyterian standpoint, the purpose of a funeral is the
worship of God; there is nothing useful to be said about the deceased because
her fate is already decided. From a secularist point of view the only approach
to a funeral that seems rational is to treat it as a celebration of the life of the
deceased.
For the majority of Scots today, the Presbyterian perspective has come to
seem too limiting and even, perhaps, uncaring. Increasing numbers are
making the decision to have a secularist funeral, which often precludes any
reference to religious beliefs. However, for many both the Presbyterian and
the secularist positions are too extreme, and they are seeking something that
combines elements of both.
In Scotland today a growing number of practitioners, many of who are
Church of Scotland ministers, are seeking a middle ground. They are
endeavouring to conduct funerals that simultaneously recognise the
individuality of the deceased, while also allowing the minister to maintain his
own integrity of belief. This sometimes makes for an uneasy balance between
the elements that compose a funeral, and can require sensitive or complex
negotiation between the parties involved.
It appears the traditional authority of the Christian religion is being eroded,
while the importance of the reflexive individual increases. This paper
suggests that this is an example of the coexistence thesis, in which traditional
practices continue alongside, and inform, new ways of doing things, thus
producing a bricolage of old and new ways.
Key Words: Funerals, games model, secularisation, Christianity, humanism,
coexistence thesis.
*****
Since the Reformation, Scotland has been a protestant country with
the Church of Scotland, a Presbyterian denomination, as the established
church.1 This does not mean, of course, that other religions and other
Christian denominations have not been represented among Scotland’s
population, and different regions of the country have differing religious
histories. However, Presbyterianism has been dominant for the last four
centuries, represented by several churches, such as the Free Presbyterian
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______________________________________________________________
Church of Scotland and the Free Church of Scotland, as well as the
established Church of Scotland.
The religious picture is beginning to change in the twenty-first
century, however. In the United Kingdom census taken in 2001, which is a
compulsory survey of all people resident in the country on a specific night, in
Scotland as a whole, 27.5 percent of respondents claimed to have no religious
beliefs. This figure increased to almost 37 percent in the capital Edinburgh,
and reduced to less than 12 percent in Stornoway on the Isle of Lewis.2 A
survey carried out in 2005 for a Glasgow based newspaper supports the view
that church membership and attendance is dropping in Scotland, but also
suggests that this does not necessarily mean that the population no longer has
any form of spiritual or religious beliefs.3
The question this picture raises for this paper is this: how does such
a changing pattern of practices translate into action when it comes to
funerals? For adherents of faith groups, the decision, when it comes to what
kind of funeral to have, is straightforward. The Free Presbyterian Church of
Scotland, for example, conducts funerals on the basis that their purpose is the
worship of God, and all the elements of the worship are based on that
premise. Free Presbyterian funerals, therefore, do not talk about the deceased
and contain only prayers, scriptural readings and psalms.
The Humanist Society of Scotland, on the other hand, founded in
1989, provides secular funerals for those of no religious faith. These start
from the assumption that a funeral should be a celebration of the life lost, and
have as their only rule that there should be no reference to religion in terms
of words, music or symbols.4 But what about the high percentage of
individuals in Scotland today who do not belong to a religious group, but
would not necessarily count themselves as secular humanists either: to whom
do they turn?
I have chosen to focus this paper on one particular aspect of this
issue, so that by drawing on data from a sociological research project, this
paper explores one possible answer to the question of where people turn for
help when it comes to the conduct of a funeral. Qualitative interviews were
carried out during 2007 in three different locations in Scotland, with
professional informants involved in the arrangement and conduct of funerals.
A typical Church of Scotland funeral today is a blend of religious elements
such as scriptural readings, prayers and hymns, with secular facets such as a
tribute or eulogy to the deceased, the playing of secular music and
sometimes-secular readings such as poems.
Despite what the figures might suggest, and the apparent
secularising of Scotland, the Church of Scotland, as an institution, conducts
more funerals in Scotland today than any other group. Ministers in the church
conduct two different kinds of funeral. Firstly they take funerals for their
church members, whom they can assume had a certain level of religious faith.
Glenys Caswell
279
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The second kind of funerals the ministers take are what they tend to call
parish funerals. These are for people who are not members of the institutional
church, but who live in the geographical parish served by a particular
minister. Sometimes the minister will not know the people involved at all,
and he can make no assumptions about their levels of religious belief or
knowledge. As representatives of the national church, Church of Scotland
ministers have a duty to conduct a funeral for anyone living in their parish
that makes such a request of them, unless they have a good and sufficient
reason to refuse such a request.5
During the course of interviews it became apparent that, particularly
for ministers of the Church of Scotland, the planning of a funeral can
sometimes be a complex negotiation between the minister’s own faith and
sense of religious integrity and the expectations of an increasingly secularised
society as represented by the bereaved. Although played out in individual
funerals and the relationships that develop between ministers and the
bereaved, the current state of Scottish funerals is also a manifestation of the
broader social forces that are at work today. Twenty or thirty years ago, in the
context of a funeral, the minister made all the decisions and all the content
was religious in nature. Today, however, according to one Church of
Scotland minister who was interviewed as part of the study, “you’ve still got
families who want to leave everything to the minister, but a lot of families
now want some sort of participation” and, in addition to this, the expectation
on the part of ministers themselves is that they will meet with the bereaved in
order to plan together for the funeral.
One way of beginning to tease out the various factors at work when
ministers and the bereaved plan a funeral together is to make use of Elias’s
games model as an analytic tool. In its simplest form, Elias’s model describes
a situation where a strong player in a game plays against a weaker player.
The game has rules by which both players must abide, and the weakness of
his opponent gives the strong player a distinct advantage; so much so that he
can even force his opponent to behave in certain ways. Most games,
however, are played between opponents who are more equal in strength as
players, or between groups rather than individuals. Elias suggests that his
games model provides a way of making relations between individuals and
groups simpler, so that it is possible to observe where the power in a given
situation lies, and how this influences people’s actions. Power, according to
Elias, is not a static thing that a person either has or does not have, it is a
process and access to it in a particular relationship can ebb and flow between
participants.6
At first sight it might seem as if the minister, as an educated man or
woman and a representative of the established church backed up by centuries
of respect held by the population for the ministry, would be in control of the
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______________________________________________________________
situation. However, as so often is the case with appearances, this is inaccurate
and the situation is a great deal more complex than this.
In virtually all cases, the minister will visit the bereaved in their own
home; as this research respondent expressed it, “I make an arrangement to
see the next of kin, almost always I go round to the house that they're in,
rather than them coming here, so they're comfortable.” In this meeting
between minister and bereaved there are social rules at play, and these rules
are intensified by two factors. Firstly, the general expectation is that the
bereaved will be treated sensitively by all professionals with whom they have
dealings in the process of arranging and carrying out the funeral. They have
suffered a loss and other people should hold this in mind when interacting
with them. Following on from this, expectations about the behaviour of a
minister of religion are high under normal circumstances, but when in a
bereavement situation they are even higher. The minister is expected to listen
to what the bereaved have to say, to be sympathetic and sensitive to their
situation.7
The bereaved, that is, have the power, which their particular
circumstance confers upon them, and the normal social rules of interaction
are adjusted accordingly. An individual who is grieving may express that
grief in a restrained way, for the Scot is not expected to weep and wail, and
the minister is expected to be able to deal with that and not exacerbate the
situation. So the rules of interaction are such that in this encounter the
minister is constrained to a greater extent than usual, while the bereaved are
less constrained than usual in what is considered to be acceptable behaviour.
It is often the case for a parish funeral that the bereaved will come
into contact with the minister through the funeral director. Funerals in
Scotland usually take place within a week of death, and sometimes within
three or four days, so there is a certain pressure to make the necessary
arrangements. Funeral directors, therefore, are usually keen to get in touch
with whoever is going to conduct the service, and will offer to do this on
behalf of the family. Where the family has no strong idea about whom this
should be, the funeral director will often suggest, and contact, the parish
minister. The bereaved family, therefore, does not necessarily have a great
investment in having this particular minister, or even perhaps this particular
denomination, involved in the funeral. This gives them the power of being
able to go elsewhere if they dislike how the minister relates to them or the
things he suggests for the funeral. This does put the family in quite a strong
position, although many probably do not realise this, and would not even
consider going elsewhere once first contact is made, as their grief can make
them feel bewildered.
For many ministers, however, funerals represent the one point of
contact they have with many parishioners and their only opportunity to
present the church to those who do not attend religious worship. One minister
Glenys Caswell
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interviewed described his intention of leaving mourners with “a wee bit more
of a sense of otherness to help them cope, not to be evangelical, but maybe in
time to enable folk to think beyond themselves.” This is a contact with wider
society that the Church would be reluctant to lose.
One arena in which the minister is in a stronger position than the
bereaved is when it comes to his or her power as the holder of expert
knowledge, and as an expert in the conduct of funerals. While bereaved
families may require more than one funeral over the course of time, the
likelihood is that they will not be doing it very often. The minister, on the
other hand, plans and conducts funerals as part of his employment. Parishes
differ, of course, in the number of deaths, and ministers differ in the number
of funerals they conduct, but the probability is that a Church of Scotland
minister will conduct funerals regularly. This means that he knows from
experience what makes a good funeral, what is effective and what is not; he
knows the kinds of choices that other bereaved families have made; and he
can offer this expertise to bereaved families who call on his services.
Often when a minister meets with a bereaved family there will be a
number of family members present, it is rare although not unknown for one
person alone to be planning a funeral. For the family, if they are united they
can provide a source of support for each other and an increase in their power
as compared to that of the minister. If, however, as sometimes happens, the
family are divided amongst themselves, then this can provide an advantage to
the minister, in terms of control of the situation.8 The minister has a further
advantage in that he has a clear idea of his religious beliefs and what is
required to maintain his integrity. There is, however, a distinct possibility that
disparate members of the grieving family will have differing beliefs, and that
some of the beliefs they hold will be sketchy and vaguely formed. The holder
of a clear focus is a game player with more power than a player with a hazy
focus.
This paper is not suggesting that ministers and bereaved families
approach the planning of a funeral service as if it were a power game. What it
is suggesting, however, is that Elias’s game model can aid in separating out
the strands of the interaction during which a funeral is organised.9 That the
balance of power shifts between minister and the bereaved suggests that there
will be dialogue between them, and this dialogue can be the harbinger of
change. Ministers may carry forward to their next funeral something that one
bereaved family has requested or suggested, thus gradually changing his
practice, while members of the family may find themselves induced to think
more deeply of spiritual matters.
Families often turn to the church at a time of bereavement because
the funeral director suggests it, and they do not know where else to turn.
Historically, the Church of Scotland has held the dominant position in the
conduct of funerals, and its ministers are still the experts in the field. That
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dominant position, however, may be considered under threat, given the
decrease in church membership and attendances, and the increase in the
number of secular humanist funerals, which grew by 618 per cent between
1998 and 2003 to approximately 2 per cent of the total number of funerals
carried out in Scotland.10
Some bereaved people who approach their parish minister have clear
ideas about what they wish to be included in the funeral, and sometimes this
leaves little room for religious expression. Ministers interviewed expressed
different views on this. Some have a baseline from which they do not deviate;
their funerals will always include at least a prayer or a Bible reading. Other
ministers, however, said that they would never refuse a funeral and are
content to conduct one without any overt religious references at all; they
believe they are able to maintain the integrity of their faith without saying the
words aloud.
What the games model analysis has illustrated, I hope, is that the
negotiation of a funeral context and content is no longer a matter of a
minister of religion saying, “this is how it is going to be.” The traditional
authority of the church has been eroded, and people no longer necessarily
accept the meta-narrative represented by it, so that it no longer controls
funerals. But if the church does not control funerals, neither does the family.
Contemporary Scottish funerals are conducted in a social atmosphere that
prioritises the individual and today; the Church of Scotland minister must be
more sensitive to the social norms of the society in which he or she lives, and
be prepared to enter into negotiations with the families who come to him for
help.
At times of what sociologist Anthony Giddens calls “fateful
moments”, such as a death, individuals still call on the traditional authorities
of the past to help them deal with the event.11 The Church of Scotland,
therefore, still has a significant role in the conduct of funerals, alongside
bereaved families, who are expected to be involved in the planning of the
funeral if not its conduct. This current way of arranging funerals is an
amalgam of past, traditional religious practices, and new ways based upon
the acceptance of the deceased as a unique individual. Sometimes this works
well and produces a funeral that both the bereaved and the minister feel
comfortable with, but occasionally it makes for an unhappy blend of religion
and secular elements. It comes about through negotiation and represents an
example of the coexistence thesis, whereby the demands of tradition and the
desires of the individual find a possibly restless home together.12
Glenys Caswell
283
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Notes
1
C G Brown, Religion and Society in Scotland since 1707, Edinburgh
University Press, Edinburgh, 1997, p. 17.
2
Registrar General for Scotland, Scotland’s Census for 2001: Key Statistics
for Settlements and Localities Scotland, General Register Office for Scotland,
Edinburgh, 2003.
3
J Cunningham, ‘Scotland’s Religious Revolution Revealed’, The Herald
(Glasgow), June 6, 2005, p. 6.
4
Humanist Society of Scotland, ‘To Celebrate a Life’, in Humanist Society of
Scotland Leaflets, 4 March 2008, viewed on 9 October 2008,
http://www.humanismscotland.org.uk/index2.php?option=com_docman&gid
=8&task=doc_view&Itemid=126
5
A G McGillivray, Introduction to Practice and Procedure in the Church of
Scotland, 2nd Edition, Church of Scotland, Edinburgh, 2001.
6
N Elias, What is Sociology?, Columbia University Press, New York, 1970,
pp. 80-103.
7
E Goffman, Behaviour in Public Places, The Free Press, New York, 1963.
8
Elias, op. cit., p. 83.
9
ibid., pp. 80-103.
10
C G Brown, Religion and Society in Twentieth-Century Britain, Pearson
Education Limited, Harlow, 2006, p. 317.
11
A Giddens, Modernity and Self-Identity, Stanford University Press,
Stanford, 1991, p. 202.
12
P Heelas, ‘Introduction: Detraditionalisation and its Rivals’, in
Detraditionalization, P Heelas, S Lash and P Morris (eds), Blackwell,
Oxford, 1996, p. 7.
Bibliography
Brown, C. G., Religion and Society in Scotland since 1707. Edinburgh
University Press, Edinburgh, 1997.
_____, Religion and Society in Twentieth-Century Britain. Pearson Education
Limited, Harlow, 2006.
Cunningham, J., ‘Scotland’s Religious Revolution Revealed’. The Herald
(Glasgow), June 6 2005, p. 6.
Elias, N., What is Sociology? Columbia University Press, New York, 1970.
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To Worship God or Celebrate a Life
______________________________________________________________
Giddens, A., Modernity and Self-Identity. Stanford University Press,
Stanford, 1991.
Goffman, E., Behavior in Public Places. The Free Press, New York, 1963.
Heelas, P., ‘Introduction: Detraditionalization and its Rivals’, in
Detraditionalization, P. Heelas, S. Lash, and P. Morris (eds), Blackwell,
Oxford, 1996.
Humanist Society of Scotland, ‘To Celebrate a Life’, in Humanist Society of
Scotland Leaflets, 4 March 2008, viewed on 9 October 2008,
http://www.humanismscotland.org.uk/index2.php?option=com_docman&gid
=8&task=doc_view&Itemid=126
McGillivray, A.G., Introduction to Practice and Procedure in the Church of
Scotland, 2nd Edition. Church of Scotland, Edinburgh, 2001.
Registrar General for Scotland, Scotland’s Census for 2001: Key Statistics
for Settlements and Localities Scotland. General Register Office for Scotland,
Edinburgh, 2003.
Glenys Caswell is a final year doctoral student in the Department of
Sociology at the University of Aberdeen in Scotland. Her research is an
exploration of contemporary Scottish funeral practices.
Quasi-Widowhood: Crossing Boundaries of
Marriage, Divorce, and Death
Jacque Lynn Foltyn
Abstract
I use myself as a source of data to examine social boundaries traditionally
erected around the dying, the dead, and the bereaved - and marriage and
divorce. In 2005, for a six month period, I, a married woman became the
primary support and sometimes sole caretaker of my dying ex-husband. I
went through inpatient hospice with him and he died in my arms. Treated as
“the wife” by hospice staff and his medical colleagues (he was a surgeon), I
was referred to as “the wife,” and made decisions like a wife, i.e., Last Rites,
cremation, disposal of property, and dispersal of his cremains. People
insisted, “You do not need to do this. Most people would not.” While
socially I had the choice to stay away, morally and emotionally I did not. His
family were deceased or not available, he had no children, and he was single,
divorced a second time. While my ex had many friends, he viewed me as his
primary relationship. First love, first wife, and first ex-wife, I was
transformed into something more than all of these statuses. I became a quasiwife and a quasi-widow, a person with a difficult to articulate social
status/position in a society where too often social relations are so fragile that
people die alone. As ex-wife and a married woman, I violated many social
norms that are well-patrolled in contemporary western culture. For a time, I
found myself the “wife” of two men. My current husband, also a physician,
supported me through the caretaking journey, which was also considered
“remarkable.” While a death researcher, before my ex’s death I had
experienced death only as an abstract problem not a part of life. This paper is
an exploration of caretaking and bereavement that cross social and
institutional boundaries and its focus is personal transformation.1
Key Words: bereavement, cancer, caretaker, death, disenfranchised grief,
divorce, ex-spouse, grief, quasi-widow, quasi-wife.
*****
1.
Introduction
As a death researcher, my usual work is as a social theorist studying
representations of death in art and popular culture. This is a very different
paper for me, opening up research, as well as personal, possibilities.
When a couple divorces, they dissolve their marriage but not
necessarily their emotional attachment. The bonds that connected them as a
couple are not easily left behind; common children, personal histories,
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unresolved issues, and memories can tie a couple emotionally decades past
their divorce.2 As the divorce rate has climbed over the past several decades,
there has been a gradual recognition by grief counsellors, clinicians, death
educators, and academics that the divorced are likely to feel bereft when an
ex-spouse dies and may need help dealing with their grief.3
Described in the death studies literature as a “double-loss,” “loss
within a loss,” or “hidden sorrow,” grieving an ex-spouse is classified under
“unusual bereavement situations”4or, more commonly, “disenfranchised
grief.” Disenfranchised grief is marginalized or culturally unacceptable grief
that is not socially legitimised or supported, and that may not be openly
acknowledged or publicly mourned. Every society has conventions about
socially permissible grief, including some grievers and excluding others.5
The literature about how an ex-spouse reacts to the deaths of a
former mate is extraordinarily small, a seeming confirmation of their
disenfranchisement.6 Articles and self-help advice published by death
educators, clergy, therapists, journalists, and bloggers have focused on topics
such as: (1) their complicated grief and their ambivalent relationship to the
deceased;7 (2) reasons for mourning;8 (3) how their grief differs from that of
the widowed9 or the divorced;10 (4) their substance abuse;11 (5) how they are
barred from visiting and from caretaking roles;12(6) their lack of access to
medical information about the dying ex;13 (7) exclusion from funerals,
headstones, or obituaries;14 (8) the closure some feel when an ex-spouse
dies;15 (9) alternative ways to “pay respect”;16 (10) proper etiquette when
extending condolences toward former in-laws;17 (11) current spouse reactions
to their mourning;18 (12) discussing the death with offspring from the
dissolved union;19 (13) financial implications;20 (14) lack of social support
from clergy, therapists, and/or work environments;21 and (15) ways that death
counsellors and educators and the community can assist with grief
management, validate emotions, and allow the disenfranchised griever a
public place in the community of mourners.22
In this exploratory study, I take a different tact. I use myself as a
source of data to examine how the social boundaries traditionally erected
around the dying, the dead, and the bereaved - and around marriage and
divorce - can be surprisingly fluid in an era in which divorce rates are high,
family relations are less rigidly defined, and people through no fault of their
own find themselves dying alone. I focus not on my grief—which is real, but
on my social roles as a divorced and remarried woman attending to her dying
and then dead former husband.
.
2.
Relevant History
“Jacque, this is Matt, and I have really bad news. I have cancer and
it’s a really bad one.” The day was March 19, 2005, and Matt, my former
husband, a physician himself, was telling me that he had advanced metastatic
Jacque Lynn Foltyn
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neuroendocrine pancreatic cancer. After my stunned disbelief that Matt, a
man in vibrant mid-life, at the height of his career as a reconstructive and
plastic surgeon, had been diagnosed with a cancer that would very likely kill
him, I replied, “I will help you through this. I promise. I will not abandon
you. You are family.”
Matt and I were 18 years olds, living away from home in university
dormitories when we met. Inseparable from the start, we married at age 20.
While we were married, we completed undergraduate degrees and entered
graduate school - Matt medical school and residency, and I a Ph.D. program
in sociology. Teenagers when we fell in love, by the time we parted 12 years
later, we were casualties of marrying “too young” and growing apart as we
constructed individual adult identities and value systems.23 Our post divorce
years were relatively - but not always - friendly, and we each eventually
remarried. Since we had no children together, were geographically separated
after Matt moved to another state, and were busy with our new families and
respective careers, our contact became less frequent.
In the autumn of 2002, Matt called to tell me that his second
marriage had ended. We resumed a closer friendship, and I became Matt’s
confident during his acrimonious second divorce. I felt compassion for Matt
and was still fond of him. After all, we had a shared history and had literally
“grown up together,” each growing an inch in height during our marriage.
The fact that Matt had almost no family support influenced me, as well. His
father had died the previous year, his mother was hospitalised with organic
brain disease, and his sister and he were estranged. Matt’s brother had a busy
career, lived a great distance away, and was going through his own marital
difficulties; they were not always, as Matt put it, simpatico.
Henry, my husband, a Swedish national, did not contest our renewed
contact. We talked of it often, discussing how fortunate we both were to be
on such good terms with our ex-partners. Henry noted that we were folding
Matt into “the family constellation.”
3.
The Dying, Death, and Posthumous Journeys
Matt was hospitalised several times in the next six months. I was in
the recovery room when he opened his eyes after an eleven-hour surgery and
visited him nearly daily through those first and subsequent hospitalisations. I
was on his family visitor list, and he squeezed my hand tightly when sutures
and drains were removed painfully from his abdomen.
When Matt was not hospitalised, he stayed in the guest house of a
friend, for his surgery and treatment were in a city and state different from
where his own home was located. We were in contact each day by phone or
in person, and I accompanied him to pre-op and post-op medical
appointments, progress checkups, and chemotherapy sessions. For a period of
several weeks, I lived with Matt in his guest house accommodations,
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assisting him and his professional care and nursing teams. When it became
nearly impossible for him to eat, I prepared special foods for him and learned
to administer IV Total Parenteral Nutrition (TPN). I massaged his back and
feet, trying to take his focus away from his pain. I also took care of his
beloved dogs, a constant source of concern for him. Later, I worked with a
hospital social worker, working to have Matt admitted to a skilled nursing
facility (SNF) near my marital home.
With Matt’s knowledge, I consulted with his medical team about all
aspects of his medical care. Behind the scenes, I demanded—and obtained—
an immediate appointment with another oncologist, when the SNF physician
told me that Matt was dying, belonged in a hospice, and that the three chemo
regimens he had endured had not made a dent. When the new oncologist
examined him and told him forthrightly that that he was entering the last
weeks of his life, I cradled Matt in my arms and wept with him. Straight from
the oncologist’s office, he was driven by ambulance to a world-class hospice.
Before I arrived, he had designated me as his family and “gatekeeper.” I was
with Matt when he signed, “do not resuscitate” papers and when his
physicians explained his pain management regimen and what to expect in the
dying process. I spent the last weeks of Matt’s life with him, 12-24 hours a
day, supporting him emotionally and offering him companionship. We
pondered the mysteries of human suffering, dying, and death. Throughout, I
had the full support of not only my husband, but my university dean, who
allowed me additional leave time.
As Matt’s hospice gatekeeper, I honoured his wishes about who
should be allowed to visit or call him. (His brother would later say that I
protected him like a lioness protects its cubs). The hospice gave my
telephone number to sometimes a dozen people a day, who called me at
home, seeking information - and consolation. Matt’s step-mother, the widow
of his father, was an overnight guest in our house for a week. I had long talks
with his estranged sister and second ex-wife, two people that Matt did not
want to see. I was delivery person for documents that needed Matt’s
signature, served as scribe for his final bequests, and met with his lawyer.
Though Matt was not a Catholic, I arranged for him to receive Last
Rites when he asked a chaplain to tell me that he wanted them. I stood by his
hospice bed as the priest anointed him with oil and sang to him, in this
ancient ritual now known as Sacrament of the Anointing of the Sick. In the
final days of his life, Matt collapsed his visitor list to one name, mine. “You
know me better than anyone does,” he told me, noting that my presence was
soothing rather than a burden, unlike that of some well-meaning visitors.
“I’m the one who is dying and I’m the one who is comforting them. I can just
be myself with you.” “I’m sorry to put you through this,” he apologized on
several occasions. “Don’t worry about me. I’m a “death researcher.” I can
handle it. If I can’t handle it, who can?” I would retort, making him smile.
Jacque Lynn Foltyn
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Several hours before he died, Matt slipped into a coma. In those
hours, I moistened his mouth with a sponge; read him poetry, humorous
essays, and psalms; played his favourite music; and told him how much I
loved him and that it was okay for him let go and leave me. When the
hospice nurse explained that his brain was shutting down and that he no
longer needed the oxygen feed, I gave her permission to take the tubes away.
My parents, his former in-laws, and I were the only individuals present when
Matt took his final breath on September 4, 2005, five-and-one-half months
after he had been diagnosed with cancer. He died in my arms, and I felt his
last heartbeat against my chest. I, not the hospice, informed his brother of his
death. Soon after Matt died, my sister, his former sister-in-law, arrived.
Crying, we arranged his body in a position of peaceful repose and gathered
up his belongings to take home. We left before Matt was put in a body bag, a
visual memory I did not want to have.
Days before, working with hospice staff, I had selected the
crematorium where Matt’s corpse would be burned. Ten days after his death,
I picked up his cremains and drove him home. In an addendum to his living
trust, Matt had requested that I keep his ashes until a time when his brother,
his stepmothers, and I could meet to scatter his ashes. He asked me to be one
of three speakers at his large memorial service and requested that I go
through, distribute, and dispense with his personal property, together with his
brother and father’s widow. Listed as Matt’s former wife, I appeared in
newspaper obituaries as one of his survivors. I wrote the obituary for his alma
mater, and the hospice sent me notifications of monetary gifts to the hospice
made in Matt’s name, to which I responded with thank-you letters. My
opinion was sought by school of medicine trustees who wished to rename a
major medical scholarship after him.
To mark the first anniversary of Matt’s death, my sister and I drove
his cremains 400 miles to Big Sur, on the beautiful California central coast,
the location where he wanted his ashes dispensed. There, I led his brother and
two stepmothers in a ritual ceremony commemorating his life, before we took
handfuls of what remained of him and released him into the sea.
4.
Quasi-Wife and Quasi-Widow
As Matt’s ex-wife, I was enfranchised, rather than disenfranchised
on all levels of his dying, death, and posthumous journeys, an atypical
finding in the death studies literature. Divorce changes rather than ends many
relationships,24 and my involvement in Matt’s dying changed our relationship
yet again. I found myself functioning as a “quasi-wife” and as a “quasiwidow,” fulfilling caretaking, social, cultural, and institutional roles
traditionally associated with a wife. As I performed these roles, a remark I
frequently heard from friends, colleagues, death educators, and hospital and
hospice staff, was “you don’t have to do this. Most people wouldn’t,” to
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which I would respond, “of course, I have to do this. It makes me sad to think
that you think that most people would not.” Such remarks, conveyed with
wondering praise rather than disapproval, were not meant to marginalize me
but rather to socially locate me, for there was no word or conceptual frame to
describe this unfamiliar role. No wonder some hospice workers started to
refer to me as Matt’s wife, even when they knew I was his “ex” and I
reminded them of my marital status.
While they were correct that I was not socially or legally obligated
to assist Matt, not doing so was not a morally or emotionally viable option
for me. I was unwilling to disenfranchise myself, for Matt needed a family
member and that family member was me. First love, first wife, and first exwife, I was transformed into something more than all of these statuses when I
became Matt’s quasi-wife and quasi-widow, a person with a difficult to
articulate social status in a society where social relations are so fragile that
people too often die alone.
As a married person I violated well-patrolled social norms about
marriage in contemporary western culture. So did Henry, my husband, who
supported me through the caretaking journey, which was frequently referred
to by others as “remarkable.” A physician who has experienced all matter of
deaths and complicated family relations in Sweden, Henry attempted to help
Matt, too, by reviewing his case and researching other possible medical
regimens. His compassion is illustrated by his response when I asked him
whether he was bothered by the amount of time I was spending with Matt.
“He needs you now. He is dying. There is plenty of time for us. You have
two husbands now.”
As a caretaker of my dying ex-spouse I am part of a larger, little
documented or understood social trend, increasingly seen by hospice workers
and medical personnel, of divorced individuals returning as caregivers of
their dying ex-spouses.25 As the family institution grows more fragile, people
have fewer or no children, and as families geographically disperse and grow
smaller, divorced people may fine themselves not only single at the time of
death but alone as well. Had I not stepped in, Matt would have died without
people present he thought of as family. In response to the increasing numbers
of people dying without family, there is a growing social movement in which
volunteers are trained by hospice personnel to comfort individuals who might
otherwise die alone.26
The fact that hospice counsellors reached out to me while Matt was
dying and called me for weeks after his death, urging me to avail myself to
their bereavement services (which I did) demonstrates that some death
educators are heeding the recommendations Doka made back in 1986, that
they “be attentive to the difficulties of the ex-spouse.”27
Although there are obvious limitations posed by using myself as a
source of data, my experience highlights the need for more research into this
Jacque Lynn Foltyn
291
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subject. From my story, we can conclude that individual circumstances
matter extremely in such cases, enfranchising some while disenfranchising
others. I am expanding this exploratory study, and have already conducted
one in-depth interview with a divorced single woman who, like me, became
involved in end-of-life care of her ex-husband.
Before Matt’s dying and death, death for me was an abstract
problem not a part of life. For both of us, his dying was a time of grieving,
healing, and working through of complicated emotions. It was a period of
reconciliation, of revisiting our youths and establishing a satisfying mid-life
relationship. During Matt’s final journey, we honoured a bond that would not
be broken, no matter what social mores dictate. We were united even after
death did us part.28
Notes
1
For Matthew and Henry.
S Moss and M Moss, ‘Remarriage: A Triadic Relationship’. Conciliation
Courts Review, vol. 4, 1980, pp. 15-20.
3
K J Doka, ‘Loss upon Loss: The Impact of Death after Divorce’. Death
Studies, vol. 10, 1986, pp. 441-449.
S Scott, ‘Grief Reactions to the Death of A Divorced Spouse’, in Death:
Completion and Discovery, C. Corre and R. Pacholski (eds), Association for
Death Education and Counselling, Lakewood, 1987, pp. 107-116.
4
J Beder, Voices of Bereavement: A Casebook for Grief Counselors, BrunnerRoutledge, New York, 2004.
5
K J Doka (ed), Disenfranchised Grief: New Directions, Challenges, and
Strategies for Practice, Research Press, Champaign, 2002.
6
S Scott, ‘Grief Reactions to the Death of a Divorced Spouse Revisited’.
Omega, vol. 41, 2000, pp. 207-219.
7
Beder, op.cit.
Doka, ‘Loss upon Loss’, op. cit.
K J Doka, Disenfranchised Grief: Recognizing Hidden Sorrow, Lexington
Books, Lexington, 1989.
Scott, ‘Grief Reactions to the Death of A Divorced Spouse’, op. cit.
S Scott, ‘Death of a Divorced Spouse: The Survivor’s Dilemma’, in Divorce
Shock: Perspectives on Counseling and Therapy, A Tiemann, B Danto, and S
Gullo (eds), The Charles Press, Philadelphia, 1992, pp. 59-67.
8
Scott, ‘Grief Reactions to the Death of a Divorced Spouse Revisited’, op.cit.
9
Doka, ‘Loss upon Loss’, op.cit.
10
Beder, op. cit.
11
Scott, ‘Grief Reactions to the Death of a Divorced Spouse Revisited’, op.
cit.
2
292
Quasi-Widowhood
______________________________________________________________
12
Doka, Disenfranchised Grief: New Directions, op. cit.
Hospice of the Valley, in Grief Healing Discussion Groups, 20 March
2004,
viewed
on
3
October
2008,
<http://hovforum.ipbhost.com/index.php?showtopic=175>.
14
Doka, Disenfranchised Grief: Recognizing Hidden Sorrow, op.cit.
Doka, Disenfranchised Grief: New Directions, op. cit.
E Seymour, ‘The Two Words Missing from Robin Cook’s Headstone’, in
Elleeseymour.com, 9 January 2007, viewed 2 September 2008,
<http://elleeseymour.com/2007/01/09the-two-words-missing-from-robincooks-headstone/>.
15
Beder, op. cit.
M Glazer, ‘How Do You Mourn an Ex-Spouse? Self-Improvement/GriefLoss’, in Ezine Articles, February 18, 2007, viewed on 4 October 2008,
<http://ezinearticles.com/?How-Do-You-Mourn-An-ExSpouse?&id=459347>.
16
H I Smith, ‘Does My Grief Count? When Ex-Family Grieve’. Illness,
Crisis, & Loss, vol. 14, 2006, pp. 355-372.
17
J S Holder and J Aldredge-Clanton, Parting: A Handbook for Spiritual
Care Near the End of Life, University of North Carolina Press, Chapel Hill,
2004.
‘Social Etiquette and Good Manners. Death of an Ex-Spouse’s Mother’, in
AllExperts.com, 10 August 2007, viewed on 20 August 2008,
<http://en.allexperts.com/q/Social-Etiquette-Good570/indexExp_25849.htm
18
Hospice of the Valley, op. cit.
Scott, ‘Grief Reactions,’op. cit.
Smith, op. cit.
19
Glazer, op. cit.
20
Doka, Disenfranchised Grief: New Directions, op. cit.
21
Doka, ibid.
Hospice of the Valley, op. cit.
J Kamerman, ‘Latent Functions of Enfranchising the Disenfranchised
Griever’. Death Studies, vol. 17, 1993, pp. 281-287.
22
Beder, op. cit.
Doka, Disenfranchised Grief: Recognizing Hidden Sorrow, op. cit.
Kamerman, 1993, op. cit.
Smith, op. cit.
23
BR Karney and TN Bradbury, ‘The Longitudinal Course of Marital Quality
and Stability: A review of Theory, Method and Research’. Psychological
Bulletin, 1995, vol. 118, pp. 3-34.
S P Morgan and R Rindfuss, ‘Marital Disruption: Structural and Temporal
Dimensions’. American Journal of Sociology, vol. 90, 1985, pp.1055-1077.
13
Jacque Lynn Foltyn
293
______________________________________________________________
L White, ‘Determinants of Divorce: A Review of Research in the Eighties’.
Journal of Marriage and the Family, vol. 52, 1990, pp. 904-912.
24
Smith, op. cit.
25
M Richtel, ‘When an ex-spouse returns as caregiver’. NYTimes.com, 19
May
2005,
viewed
19
July
2005,
<http://www.nytimes.com/2005/05/19/fashion/thursdaystyles/19DIVORCE.h
tml?_r=1&pagewanted=print&oref=slogin>.
26
S Roan ‘So They don't Die Alone: Some Dying Patients Have Neither
Friends Nor Family. Increasingly, Volunteers are Filling In’. The Los Angeles
Times,
4
June
2007,
viewed
on
4
May
2008,
<http://articles.latimes.com/2007/jun/04/health/he-dyingalone4>.
27
Doka, ‘Loss upon Loss,’ op. cit., p. 449.
Bibliography
Beder, J., Voices of Bereavement: A Casebook for Grief Counselors.
Brunner-Routledge, New York, 2004.
Doka, K. J., ‘Loss upon Loss: The Impact of Death after Divorce’. Death
Studies, vol. 10, 1986, pp. 441-449.
_____, Disenfranchised Grief: Recognizing Hidden Sorrow.
Books, Lexington, 1989.
Lexington
______, (ed), Disenfranchised grief: New Directions, Challenges, and
Strategies for Practice. Research Press, Champaign, 2002.
Glazer, M., ‘How Do You Mourn an Ex-Spouse? Self-Improvement/GriefLoss’, in Ezine Articles, February 18, 2007, viewed on 4 October 2008,
<http://ezinearticles.com/?How-Do-You-Mourn-An-ExSpouse?&id=459347>.
Holder, J. S. and J. Aldredge-Clanton, Parting: A Handbook for Spiritual
Care Near the End of Life. University of North Carolina Press, Chapel Hill,
2004.
Hospice of the Valley, in Grief Healing Discussion Groups, 20 March 2004,
viewed
on
3
October
2008,
<http://hovforum.ipbhost.com/index.php?showtopic=175>.
294
Quasi-Widowhood
______________________________________________________________
Kamerman, J., ‘Latent Functions of Enfranchising the Disenfranchised
Griever’. Death Studies, vol. 17, 1993, pp. 281-287.
Karney, B.R. and T.N. Bradbury, ‘The Longitudinal Course of Marital
Quality and Stability: A Review of Theory, Method and Research’.
Psychological Bulletin, 1995, vol. 118, pp. 3-34.
Morgan, S. P and R. Rindfuss, ‘Marital Disruption: Structural and Temporal
Dimensions’. American Journal of Sociology, vol. 90, 1985, pp.1055-1077.
Moss S. and M. Moss, ‘Remarriage: A Triadic Relationship’. Conciliation
Courts Review, vol. 4, 1980, pp. 15-20.
Richtel, M., ‘When an Ex-Spouse Returns as Caregiver’. NYTimes.com, 19
May
2005,
viewed
on
19
July
2005,
<http://www.nytimes.com/2005/05/19/fashion/thursdaystyles
/19DIVORCE.html?_r=1&pagewanted=print&oref=slogin>.
Roan, S., ‘So They don't Die Alone: Some Dying Patients Have Neither
Friends Nor Family. Increasingly, Volunteers Are Filling In’. The Los
Angeles Times, 4 June 2007, viewed on 4 May 2008,
<http://articles.latimes.com/2007/jun/04/health/he-dyingalone4>.
Scott, S., ‘Grief Reactions to the Death Of A Divorced Spouse’, in Death:
Completion and Discovery. C. Corre and R. Pacholski (eds), Association for
Death Education and Counseling, Lakewood, 1987, pp. 107-116.
_____, ‘Death of a Divorced Spouse: The Survivor’s Dilemma’, in Divorce
Shock: Perspectives on Counseling and Therapy. A. Tiemann, B. Danto, and
S. Gullo (eds), The Charles Press, Philadelphia, 1992, pp. 59-67.
_____, ‘Grief Reactions to the Death of a Divorced Spouse Revisited’.
Omega, vol. 41, 2000, pp. 207-219.
Seymour, E., ‘The Two Words Missing from Robin Cook’s Headstone’, in
Elleeseymour.com, 9 January 2007, viewed 2 September 2008,
<http://elleeseymour.com/2007/01/09the-two-words-missing-from-robincooks-headstone/>.
Smith, H.I., ‘Does My Grief Count? When Ex-Family Grieve’. Illness,
Crisis, & Loss, vol. 14, 2006, pp. 355-372.
Jacque Lynn Foltyn
295
______________________________________________________________
‘Social Etiquette and Good Manners. Death of an Ex-Spouse’s Mother’, in
AllExperts.com, 10 August 2007, viewed on 20 August 2008,
<http://en.allexperts.com/q/Social-Etiquette-Good570/indexExp_25849.htm>
White, L., ‘Determinants of Divorce: A Review of Research in the Eighties’.
Journal of Marriage and the Family, vol. 52, 1990, pp. 904-912.
Jacque Lynn Foltyn is Associate Professor of Sociology and Department
Chair of Social Sciences in the College of Letters and Sciences, National
University in La Jolla, California. She researches issues in death and beauty,
and authored the Importance of Being Beautiful and edited The Corpse in
Contemporary Culture, a special issue of Mortality.
The Survivor’s Guilt: The Case of Cancer
Shulamith Kreitler, Frida Barak, and Nava Siegelman-Danieli
Abstract
The paper deals with survivor’s guilt. Survivor’s guilt is a common
phenomenon, defined as the guilt that individuals may experience if they
have emerged unharmed following natural, human or social disasters in
which others have been harmed. The purpose was to describe the
phenomenon and to study some of its correlates and consequences in the
context of the caretakers of cancer patients. The first part presents a brief
review of what is known about survivor’s guilt, and the second part presents
some findings of an empirical study the authors have done about survivor’s
guilt. The participants were 195 caretakers of cancer patients; most of whom
were interviewed and presented tests both pre- and post the patient’s death.
The study showed that survivor’s guilt is prevalent among the caretakers of
cancer patients and is related to remorse and somewhat less to depression. It
is unrelated to variables, such as the duration of having taken care of the
patient, number of deaths in the family, marital status, number of children
and religiosity but is related to intensity of care for the patient and relation to
the patient, and hence may be assumed to be rooted in deeper affective layers
of the individual’s personality. Observations about the correlates of
survivor’s guilt six months following the patient’s death support the thesis
that survivor’s guilt exerts a pro-social impact on the person’s behaviour.
Key Words: Survivor’s guilt, guilt, cancer, caretakers.
*****
1.
Review of the Literature about Survivor’s Guilt.
A. What is Survivor’s Guilt?
Survivor’s guilt or survivor’s syndrome is generally defined as the
mental condition resulting from the appraisal that a person is guilty by the
mere fact of having survived a traumatic event whereas others did not.1 It was
first diagnosed in the 1960s when several therapists identified a set of
symptoms including survivor’s guilt in holocaust survivors.2 The traumatic
events that may engender survivor’s guilt usually refer to combat, natural
disasters and significant job lay-offs, but includes also political concentration
camps, automobile accidents, wartime bombing attacks, and deaths from
disease. The others in regard to whom survivor’s guilt is felt may include
family members, friends, colleagues but also unknown strangers. There has
been some unclarity about the differential diagnosis between survivor’s guilt
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and post-traumatic stress disorder, with the result that the latter but not the
former was included in the DSM-IV. It should however be emphasized that
the two conditions differ although both may develop following a trauma.
Similarly, survivor’s guilt differs from the guilt sometimes felt by rescuers
who blame themselves for not having done enough to help others in
emergencies or the guilt that therapist may feel for their patients’ suffering.
In both of the latter cases the guilt refers to not having done something for
saving the others or alleviating their suffering whereas in survivor’s guilt the
guilt is based solely on the survival per se.
B. In which Contexts or Circumstances Survivor’s Guilt Arises?
Some investigators emphasize that survivor’s guilt hits people who
have not done anything wrong or have not done much of anything at all. In
order to better characterize the phenomenon, it is necessary to focus on the
original circumstances in which it occurs. As noted, survivor’s guilt appears
after a disaster or a trauma. The person who feels the guilt has not been hit or
affected by the trauma but there was a fair probability that he or she could
have been a victim. Further, survivor’s guilt is more frequent in people who
have suffered themselves in the circumstances in which the disaster occurred
than in those who did not. Again, it is more frequent in people who have been
somehow involved in the disaster than in those who observed it from a safe
distance. The suffering of those who feel the survivor’s guilt may have been
serious, for example, it may have involved death risk, hunger, oppression,
severe worries but in any case it was more moderate or at least ended better
than in the case of the other victims, who may have died, or undergone
imprisonment, torture or lay-off from work.
An interesting case of survivor’s guilt is described in Kurt
Vonnegut’s novel Bluebird. The protagonist Rabo Karabekian's father had
survivor guilt from witnessing some parts of the Armenian genocide by
hiding in a deserted village. In contrast, his wife who actually witnessed the
killings and pretended to be dead while hiding under corpses did not feel any
survivor’s guilt.
In regard to rescuers, the survivor’s sense of guilt may be enhanced
if the rescuer died while saving one’s life. Another example of a similar
effect would be when a soldier switches a patrol with a friend, and the friend
dies during that particular patrol. The surviving friend thinks that it should
have been him and is left with survivor’s guilt. Further, survivor's guilt has
been observed in situations that involve being put in a place where one wasn't
able to revive or otherwise prevent the death of someone one may have
loved, in short, situations where nothing can be done for the victim.
Shulamith Kreitler, Frida Barak, and Nava Siegelman-Danieli
299
______________________________________________________________
C. What are the Symptoms or Manifestations of Survivor’s Guilt?
The characteristic symptoms of survivor’s guilt include primarily
guilt and self-blame, as well as anxiety, depression, sleep disturbances,
emotional liability, loss of drive, lower motivation and morale (e.g.,
increased absences from work if the trauma was lay-offs), and sometimes
physical complaints. In general, survivor’s guilt has been related to longer
mourning periods and complicated bereavement.
D. How Common is Survivor’s Guilt?
Studies have detected survivor’s guilt in a great variety of contexts.
According to a literature review survivor’s guilt occurs in: patients after a
death takes place within a treatment setting for chronic illness;3 people who
keep their job when others are fired; homosexual men who have tested
negative for the human immunodeficiency virus whereas their friends tested
positive (“spared at random”); survivors of the Vietnam war; “survivorfriends” (bereaved friends) who have experienced the death of a close friend;4
individuals faced with the sudden death of a partner in an extramarital
relationship (secret survivors);5 after death in the family, more survivor’s
guilt in widows if the death was by suicide than by accident;6 mothers of
children who died of leukaemia; psychotherapists working with the unique
group of patients of holocaust survivors;7 in a surviving twin, or siblings of a
cancer patient child who died;8 in survivors who suffer increased guilt due to
not having completed certain courses of action prior to death of loved one
and may blame themselves for failure to achieve an appropriate death for
their loved one, or for not having perceived clues of impending death;9 in
survivors of beloved ones, more so when death has been sudden than if not.
E. What are the Reasons for or Causes of Survivor’s Guilt?
There are various theoretical approaches to survivor’s guilt that will
be briefly presented. According to Freud,10 guilt in general is the product of
intra-psychic conflicts between the superego and the ego, and can be
considered as a kind of weapon used by the superego to influence the ego's
decisions in cases that involve prohibited or tabooed id impulses.
Accordingly, survivor’s guilt would be the result of repressed impulses that
the survivor has had in regard to the deceased, such as aggressiveness, wishes
of death or tabooed sexuality (e.g., incest).
Rank,11 another proponent of psychoanalysis, considered guilt as a
function of the individuation process, originating in the infantile attachment
to mother and in the fear and anxiety over breaking that attachment.
Accordingly, guilt operates as a force that perpetuates that relationship.
Survivor’s guilt reflects the guilt over enhanced individuation resulting
inevitably from the deceased death. Hence, the ubiquity of survivor’s guilt.
According to evolutionary theorists (e.g., Trivers12) the preservation of
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The Survivor's Guilt
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relationships is vital for survival and reproduction. Hence, human guilt
emerged from natural selection because it prevented human beings from
performing destructive actions that might damage their relationships with
others. Similarly, Ausubel13 focused on the importance of maintaining the
group, and claimed that guilt always reflects an offence against the group.
According to the existential approach guilt is a normal part of
grieving, and the regressive period of mourning may revive guilty affects
from the past among predisposed vulnerable individuals. A further possibility
is that the guilt reflects the decreased sense of vitality the grievers may feel
because of their “embracing” of death, for example, by their previous
readiness to give up their own life for the deceased, their identification with
the dead one or their decreased motivation for life now that the beloved
deceased is no longer with them.
The social interpersonal approach considers guilt from the
perspective of its role in communal relatedness, supported by its biological
importance for survival and reflected in the affective responses of empathy,
belongingness and attachment. Guilt serves three broad functions for
relationships. First, it motivates relationship-enhancing patterns of behaviour,
by helping to enforce the communal norms prescribing mutual concern,
respect, and positive treatment in the absence of self-interested return.
Secondly, it may operate as an interpersonal influence technique that allows
even a relatively powerless person to get his or her way. Thirdly, guilt helps
to redistribute emotional distress within the dyad following a transgression. If
the transgressor feels guilty his or her enjoyment is diminished, and the
victim may feel better. Accordingly, survivor’s guilt helps to restore
emotional equity experienced by family members, friends, and co-workers in
regard to significant others. In this way survivor’s guilt contributes to
promoting fair, equitable, and durable relationships.
F. The Paradox of Survivor’s Guilt
Since survivor’s guilt is such a strong and clear experience, it should
lead to the commonly expected results following guilt in general. Major
among these is the tendency to be punished, or in the very least to confess to
one’s “sin,” apologize and make some kind of reparation. Acts of this kind
are assumed to alleviate the guilt. However, empirical studies have failed to
demonstrate that survivor’s guilt stimulates a wish for punishment.14 15 16 17 18
2.
The Study
This second part of the paper reports some of the findings of a study
of survivor guilt in the caretakers and family members of cancer patients.
Shulamith Kreitler, Frida Barak, and Nava Siegelman-Danieli
301
______________________________________________________________
A. Purpose
The objectives were (a) to check the frequency of survivor’s guilt in
the family members ad caretakers of cancer patients; (b) to identify emotional
and cognitive correlates of survivor’s guilt; and (c) to explore the
consequences of survivor’s guilt, i.e., whether they were punitive or prosocial.
B. Method: Participants
The participants in the study were 195 family members of cancer
patients who had been involved in taking care of the patients and had a
continuous relationship with them.
The sample of caretakers was chosen for the following reasons: (a)
the sample is potentially large and fairly homogenous in the circumstances of
contact with the deceased; (b) the sample enables testing the participants
prior to the death of the patient and following it, so as to determine the
impact of the death itself on survivor’s guilt and also to explore the
immediate as well as long-term effects of survivor’s guilt.
C. Method: Procedure
A part of the participants (n=82) were studied only prior to the
patient’s death (2-3 weeks), and the rest (n=113) both prior and after the
patient’s death (2-3 weeks) and 42 out of these also 6 months later. All
participants were recruited in oncology wards in different hospitals and
clinics in Israel.
D. Method: Tools
The participants were administered two questionnaires: (a) a
questionnaire that referred to the relationship of the participant with the
patient and the nature and reasons for possible reactions of guilt and remorse,
and reactions to it; (b) and the Profile of Mood States which assessed the
participants’ current levels of different emotions, such as depression and
anxiety, to which guilt and remorse were added.19
E. Results
The results showed that the major emotions reported by the
participants prior to the patient’s death were remorse, guilt, anger and
confusion, and following the death the major emotions were remorse, guilt,
fatigue and confusion. Hence, following the death, anger was replaced by
fatigue.
Sixty two percent of the sample reported guilt above the medium
level after the patient’s death. Guilt was higher post-death than pre-death.
Further, comparing the means of the emotional response prior and
after the patient’s death shows that that there were declines in anger, anxiety
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The Survivor's Guilt
______________________________________________________________
and energy, and increases in depression, fatigue, confusion, guilt and
remorse. Comparing the results in the first months after the death with those
six months later showed that there were significant declines in depression,
anger, confusion, anxiety and fatigue, and a slight increase in energy. Guilt
persisted as a reported emotion, but its level was lower than before.
In all stages of testing, guilt and remorse were correlated positively
and significantly (r=. 75-.82). Guilt was also correlated with depression, but
to a lower degree (r=. 61-.64). The participants who were highest in guilt
prior to the death had the highest levels of depression both before the death
and following it.
As noted, the participants were asked about the reasons for their
feelings of guilt. More than 50% referred to the following reasons for their
feelings of guilt and remorse: (a) Things they have not done in regard to the
patient but should have done; (b) Things they have done in regard to the
patient but should not have done; (c) Death wishes they have had in regard to
the patient or feeling glad/relieved at patient’s death; (d) Being/staying alive
whereas the patient is dying/dead.
Notably, most of the actions reported as done referred to the
patient’s treatment and to the period of the patient’s disease. Most of the
things reported as not done referred to the relationship with the patient,
mostly in the period preceding the time during which the participant engaged
in taking care of the patient.
The study also provided information about various correlates of
survivor’s guilt. It was found that survivor’s guilt is not related to the
duration of having taken care of the patient; having come from a holocaust
family; the number of deaths in the family in the previous five years; the
participant’s marital status and number of children; and the participant’s
religiosity (or observance of religious habits/procedures).
The following variables were found to be positively related to
survivor’s guilt: being female; being older than 60 years of age; intensity of
care provided to the patient; being a relative or friend of the deceased rather
than a paid caretaker; and closeness of emotional bond with the deceased.
As noted, 42 of the participants were available for interviewing also
six months after the patient’s death. The obtained information made it
possible to explore the long-term effects of survivor’s guilt, particularly in
regard to pro-social behaviour. Out of the 42, 30 participants had post-death a
guilt level above the medium, whereas 12 scored in guilt below the medium.
A comparison of these two subgroups showed that 76.7% of the participants
with an above-medium guilt score (i.e., 23 out of the 30) were engaged six
months after the death in pro-social voluntary work, such as collecting food
for the needy, helping victims of burglaries and robberies or taking care of
hospitalised patients. Only two participants with a below-medium guilt score
(namely, 16.7%) engaged in similar voluntary activities.
Shulamith Kreitler, Frida Barak, and Nava Siegelman-Danieli
303
______________________________________________________________
F. Some Conclusions
The findings of the study are to be considered as preliminary. The
results found so far show that survivor’s guilt is prevalent among the
caretakers of cancer patients. It is related to remorse and somewhat less to
depression, but is distinct from these two emotions. Further, the findings that
survivor’s guilt is unrelated to variables, such as the duration of having taken
care of the patient, number of deaths in the family, marital status, number of
children and religiosity but is related to intensity of care for the patient and
relation to the patient suggest that survivor’s guilt is an affective response
rooted in deeper layers of the personality. Most importantly, the observations
about the correlates of survivor’s guilt six months following the patient’s
death support the thesis that survivor’s guilt exerts a pro-social impact on the
person’s behaviour.
The more general implication of these findings is that survivor’s
guilt should not be treated as a pathological phenomenon to be reduced,
alleviated and mitigated at all costs. Rather it may be an intrinsically human
response to the occurrence of death which leads to pro-social behaviours
designed to strengthen the human bond and thereby to transcend the
existential plight of limited existence.
Notes
1
R J Lifton, Death in Life, Simon & Schuster, New York, 1967.
W G Niederland, ‘The Problem of the Survivor’, Journal of the Hillside
Hospital, 10, 1961, pp. 233-247.
3
M Vamos, ‘Survivor Guilt and Chronic Illness’, Australian and New
Zealand Journal of Psychiatry, vol 31 (4), August 1997, pp. 592-596.
4
F. Sklar and S F Hartley, ‘Close Friends as Survivors: Bereavement
Patterns in a "Hidden" Population’, Omega: Journal of Death and Dying, vol.
21 (2), 1990, pp. 103-112.
5
R W Weinbach, ‘Sudden Death and Secret Survivors: Helping Those who
Grieve Alone’, Social Work, vol 34 (1), January 1989, pp. 57-60.
6
D E McNeil, C Hatcher, and R Reubin, ‘Family Survivors of Suicide and
Accidental Death: Consequences for Widows’, Suicide and Life-Threatening
Behavior, vol 18 (2), Summer 1988, pp. 137-148.
7
Y Danieli, ‘Confronting the Unimaginable: Psychotherapists' Reactions to
Victims of the Nazi Holocaust’, in Human Adaptation to Extreme Stress:
From the Holocaust to Vietnam, J P Wilson, Z Harel, and B Kahana (eds),
The Plenum Series on Stress and Coping, Plenum Press, New York, 1988,
pp. 219-238.
2
304
The Survivor's Guilt
______________________________________________________________
8
J Woodward, ‘The Bereaved Twin’, Acta Geneticae Medicae et
Gemellologiae: Twin Research, vol. 37 (2), 1988, pp. 173-180.
9
M Porot, A Couadau, M Plenat, ‘Le Syndrome de Culpabilité du
Survivant/ The Survivor's Guilt Syndrome’, Annales Médico-Psychologiques,
vol. 143 (3), March 1985, pp. 256-262.
10
S Freud, New Introductory Lectures on Psycho-Analysis (J. Strachey
trans.), Norton, New York, 1964 (Original work published 1933).
11
O Rank, The Trauma of Birth, Harcourt, Brace, New York, 1929.
12
R L Trivers, Social Evolution, Benjamin-Cummings, Redwood City, CA,
1985.
13
D P Ausubel, ‘Relationships between Shame and Guilt in the Socializing
Process’, Psychological Review, 62, 1955, pp. 378-390.
14
M Friedman, ‘Toward a Reconceptualization of Guilt’, Contemporary
Psychoanalysis, vol. 21, 1985, pp. 501-547.
15
M L Hoffman,’Development of Prosocial Motivation: Empathy and Guilt’,
in The Development of Prosocial Behavior, N Eisenberg (ed), Academic
Press, San Diego, CA, 1982, pp. 281-313.
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H B Lewis, Shame and Guilt in Neurosis, International Universities Press,
Madison, CT, 1971.
17
C Zahn-Waxier and G Kochanska, The Origins of Guilt’, in The Nebraska
Symposium on Motivation 1988: Socioemotional Development, R A
Thompson (ed), University of Nebraska Press, Lincoln, NE, 1990, vol. 36,
pp. 182-258.
18
R F Baumeister, A M Stillwell, and T F Heatherton, ‘Guilt: An
Interpersonal Approach’, Psychological Bulletin, 1994, vol. 115 (2), pp. 243267.
19
D M McNair, M Lorr, and L F Droppleman, Manual for the Profile of
Moods States, Educational and Industrial Testing Service, San Diego, CA,
1971.
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Porot, M., Couadau, A., Plenat, M., ‘Le Syndrome de Culpabilité du
Survivant/ The Survivor's Guilt Syndrome’. Annales Médico-Psychologiques,
vol. 143 (3), March 1985, 256-262.
Rank, O., The Trauma of Birth. Harcourt, Brace, New York, 1929.
Sklar, F., Hartley, S. F., ‘Close friends as Survivors: Bereavement Patterns in
a "Hidden" Population’. Omega: Journal of Death and Dying, vol. 21 (2),
1990, pp. 103-112.
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Trivers, R. L., Social Evolution. Benjamin-Cummings, Redwood City, CA,
1985.
Vamos,M., ‘Survivor Guilt and Chronic Illness’. Australian and New
Zealand Journal of Psychiatry, vol. 31 (4), August 1997, pp. 592-596.
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Grieve Alone’. Social Work, vol. 34 (1), Jan 1989, pp. 57-60.
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Gemellologiae: Twin Research, vol. 37 (2), 1988, pp. 173-180.
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Symposium on Motivation 1988: Socioemotional Development, R. A.
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Shulamith Kreitler, a psychologist, from the Department of psychology at
Tel-Aviv University, is head of Psychooncology Research Center at the
Sheba Medical Center in Israel.
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oncology unit in the Barzilai Medical Center in Ashkelon, Israel.
Nava Siegelman-Danieli is a medical doctor, a specialist in oncology, and
head of oncology services in the Maccabi health services in Israel.
Bereaved Employees, Professional Activity and
Pain of Loss
Marc-Antoine Berthod
Abstract
When a close relative dies, what kind of relations do individuals
professionally active have with their colleagues at the workplace? How do
they live their return at work? Based on a research carried out with various
actors (directors, heads of human resources, employees, trade unionists, work
inspectors, psychologists and social workers) in about twenty medium-sized
and big companies of the French-speaking part of the canton of Valais,
Switzerland, this paper tries to answer these questions following an
anthropological approach. It presents how the bereaved employees perceive
the way their firms rationalize - or do not rationalize - the announcement of
death; organize their participation to the funerary rituals; welcome them after
their bereavement leave; manage the temporality of bereavement in their
structure. It focuses on the experiences of the bereaved employees in order to
better understand the influence of the social and professional context on the
grieving process at the workplace.
Key Words: Bereavement, workplace, professional activity, sense of loss,
intimacy, anthropology.
*****
1.
Bereavement at the Workplace
Literature on bereavement at the workplace is scarce. There is yet a
basic premise appearing regularly in the few texts that deal with this issue:
employees have neither place nor time to express grief while they are on
duty. Marcia Lattanzi-Licht assumes, for example, that:
in the workplace, the traditional standard of leaving personal
concerns at home is one that can create a sense of
disconnection or isolation for employees experiencing a
major loss.1
This educator, counsellor and consultant, refers here specifically to the
American work ethic, namely a set of values that would impose a quite frank
separation between the personal and the professional sphere on the
employees.
A similar view is defended by Regina Bento, distinguished professor
of Management at the Merrick School of Business, University of Baltimore.
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In an article dedicated to grief in organizations, she sustains that a common
norm within business companies is that “sadness and grief…should be
checked at the door; they are too heavy for the rarefied emotional atmosphere
of the workplace.”2 She draws her argument from narrations given by
bereaved individuals to show how grieving at work may be deemed
inappropriate; how grief may be refused to these employees. This happens
because firms and businesses, epitomized by hierarchical superiors and
colleagues, expect generally that the bereaved workers will get over their
grief in a relatively short - though unspecified - period of time. As Bento
reminds us, the social system simply does not always permit individuals who
want and need to grieve to do it: grief is disenfranchised, a much-celebrated
notion coined by Kenneth Doka in the late eighties.3
At the first glance, we can easily admit the existence of such a
pervasive constraint upon intimate suffering and pain in the professional
realm. Numerous persons who have coped with the loss of a close relative
while they were employed would indeed share this point of view. At peculiar
moments of their grieving process, bereaved workers have usually felt the
weight of a limit that delineates the workplace as a non-emotional arena;
moreover, this place is thought to be exempted from personal affairs. This
seems particularly true for those who resume their job after an unexpected
and sometimes brutal loss. The following short quote illustrates this feeling;
it comes from a thirty-year-old woman who suddenly lost her husband. Six
months after an accidental death, the young widow, working for an insurance
company, recalled during our research interview she had had that altercation
a few weeks ago with one of her colleagues who had complained to her about
delay in delivering statistical data for his administrative sector:
This person does not understand that my “very little
problem” - even though we are very professional - cannot
be left at the door when we arrive at the workplace. We
cannot just say: “when I am at the office, I am at the office;
and when I am at home, I am at home”. Grief is not a thing
we can put under the doormat.4
Through this comment, the grieving person laments the insensibility
she perceives in her colleague’s reaction to her personal and dramatic
situation. Reducing ironically her bereavement to a “very little problem”, she
stresses out the apparent lack of usual consideration generally due and
expected in these circumstances. From this brief example, one could be
prompt to say that grief is disenfranchised and to conclude that death is
taboo, as it is too often highlighted in the literature and relayed by a large
public.5
Marc-Antoine Berthod
309
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However, we have to be cautious with this kind of conclusion. To
my view, the above cited person is calling attention first and foremost to the
fact that the divide between the professional and the personal registers is
purely utopian: it is just an artifice we cannot believe in.6 This appears clearly
in her discourse as she caricatures such an opposition to better say that grief
is precisely at work, fully present and intertwined with her colleagues’
professional activities. As a given, her bereavement is at the heart of a new
set of behaviours which goes from avoidance to complicity; from ignorance
to overprotection. It serves to explain awkward attitudes, lacks of
concentration, extended deadlines and potential mistakes made in the
fulfilment of professional duties. There is no urge here to express more freely
or to talk about grief more openly, but a serious need to embed it in a wide
range of situations that may entangle the most unpredictable and the sheer
conventional act or word.
In writing this, I do not aim to minimize the pressure a bereaved
worker may feel at work. The point I want to address is the following:
displaying and welcoming grief and emotions are not and,7 more important,
should not be publicized anywhere, anyhow or with anybody. This is true for
the family circles or the public space as well as for any professional context.
In other words, the recognition of grief and the facilitation of its “normal”
process will constantly depend on multiple factors largely exceeding the idea
following which the social system hinders the psychological work of grief on
the motive that personal affairs are kept in the cloakroom. From the
precedent example, we could thus say that the separation between the
personal and the professional, and in a similar manner between the public and
the intimate, is discursively used - by all actors within the same firm, not only
the bereaved - to recast many sets of interactions; these are subtly modelled
by the appreciation the colleagues make about their co-worker’s grieving
process and by the way information circulates within a structure.
Following this perspective, we tried to understand how grief is
concretely configured at the workplace. We carried out a research with more
than twenty medium-sized and big companies in the French-speaking part of
the canton of Valais, Switzerland. A series of formal and informal interviews
were made with directors, head of human resources, social workers,
psychologists, psychiatrists, trade unionists, company doctors and bereaved
employees. The objective was to compare and cross conceptions, practices
and experiences of bereavement in various professional sectors.8 In this
article though, I limit my presentation to a few ideas based on employees’
perceptions of their own bereavement within their professional environments.
My purpose is more specifically centred on the ways the professional and the
personal references are combined to think about disenfranchisement of grief
at the workplace.
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2.
Acute Grief and Intimacy within the Companies
There is no complete rupture with the professional world since an
employee learns about the death of a close relative until he returns to work.
Some individuals are even called by a parent to be told of a dramatic event as
they are precisely at their workplace. In that case, they are led to share this
harsh information directly with the colleagues present at this specific
moment. Catherine, who tragically lost three close relatives during the last
decade, remembers how she heard of a new drama that occurred within her
family just a few months before our encounter:
I learned about it as I went up to the cafeteria, situated in
the last storey of the office building. My mother called:
“Catherine, you need to sit down.” This is our peculiar
formulation to announce bad news. And I said to myself:
“no, not that”…I went up and said to my colleague: “my
aunt has committed suicide”. I wasn’t able to take my lunch
break; I went back downstairs. I couldn’t even say: “I must
leave! I must go away!” I stayed behind a cupboard and
cried all my tears down. And I finished my workday.
Before Catherine could share her first emotions with her family
members, she had to express them with a couple of colleagues in her daily
professional environment. Her situation was thus instantly known and
publicized by the few secretaries - but not necessarily the whole staff - she
was working with. So the psychological shock and the intense intimate
feelings - she sought a bit of privacy behind a cupboard - this employee was
suddenly going through took place in her office. At this very early period of
grief however, nobody, as Catherine remembers, knew what to do and how to
behave. In this specific case, the death of an aunt might have appeared as not
close enough in terms of kinship to anybody to officialise the death and ask a
superior permission to leave: Catherine stayed the rest of the afternoon at her
desk.
Within the firms contacted, no procedures and no policies exist to
anticipate this kind of situations when grief starts at the workplace. Its
regulation is left to the sole appreciation of the people who are living hic et
nunc this acute moment during which the “professional” and the “personal”
patently show their indivisibility. Exceptions are to be found nevertheless
when an employee’s close relative is terminally ill: the superior and the
immediate colleagues may have been alerted to the fact that in case of
emergency or death, the employee will have to give up his task at once. In
general, this is orally agreed.
In many other situations, one learns that a death has occurred while
he is at home, on leave or on vacation. Rapidly, he tries to make sure his
Marc-Antoine Berthod
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company will be notified; but the way the information circulates is quite
sinuous. Andrea for example, who gave birth to a stillborn, sent out an SMS
from the hospital on a Saturday; among the six to ten receivers, mainly
friends, there were co-workers close to the bereaved couple. Afterwards, the
sad news quickly spread in her office - a public service - since one of them
was on duty that same day. On her side, Julia asked one of her preferred
colleagues to tell her boss about the death of her husband. The
communication followed then a snowball effect: “The head of human
resources called me as soon as possible, and I received a lot of messages of
sympathy from the direction board.”
Moreover, various social practices are linked to the professional
realm during the bereavement leave. Without going into details, I can simply
mention here mortuary visits; attendance to the funeral; sending of a letter of
condolence signed by the staff and/or the directors; announcement in the
local press. These practices are quite always codified in a more or less formal
document besides the internal policy or the collective agreement that clearly
indicates how many days an employee can take off according to his degree of
kinship with the defunct.9 Such attentions are recognized and appreciated,
even more if they appear “spontaneous” and “natural.” Julia puts it this way:
During the funeral, I was impressed by the attendance. Many
had driven from far to come in this small village. And I
couldn’t even count the people, it was so impressive. And I
saw the number two of the direction; the number one
couldn’t come as he was on vacation; the whole direction
was there, and that touched me because we are more than
1’500 employees…I think it was everybody’s will to come to
show their sympathy. That was not really “let’s organize us
and go by coach” to show that “we are there!” I really felt
that everybody followed his own approach to sustain me.
If these aspects show that a link – even tight – is often kept between
the personal and the professional, another feature has to be noted that goes in
the same direction: the return at work is almost never totally frank. This is
especially true for those employees who have suffered a sudden and tragic
loss, that is to say the main cases I am referring to in this article. Concretely,
bereaved persons try to negotiate a “smooth” return to the workplace. For
example, one may want to see his superior outside the company building, in a
restaurant, sometimes at home, to talk about the work environment before his
comeback; another will go to the office for a short period of time, in order to
see some colleagues and prepare the “official” return.
From these various insights and short descriptions pointing to the
fact that professional concerns are continuously running across intimate pain
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as soon as an employee learns about the death of a close relative, I would like
to make three main observations. First, if informed, companies try to respond
to the flexibility the bereaved may explicitly need or ask for. They seek for
arrangements - and sometimes they are forced to make them because a
certificate of incapacity has just been delivered by a doctor or a psychiatrist in scheduling the presence of the grieving employees. They tolerate short
absences and sudden changes in their work planning; or more precisely,
superiors will not blame them. If such a tolerance is currently asserted by the
directors and head of human resources we interviewed, it is perceived the
same way by most of the employees who had to diminish temporarily their
activity rate because of their bereavement. The latter perceive that a reel
effort is made in terms of management towards them, at least during the first
weeks of grief.
Second, the circulation of information - about the death, the
bereaved, the bereavement leave, the social practices related to the funeral,
the exact date of return, the potential change in work conditions - is rather
laconic and unpredictable within a firm. It is above all regulated by
interpersonal affinities: a bereaved employee may indeed choose to contact
his preferred colleague to diffuse the news; one may call a superior that he
“personally” knows or likes. Everything goes as if those colleagues function
as a rampart against unwanted, uncontrollable, and too emotional
relationships the grieving employees might have to engage with individuals
they don’t know well or appreciate. At the same time, “official” measures are
almost never taken; nothing is organized for the return at work by the
superiors, who globally confirm that point.10
Consequently, many employees assume that the others are supposed
to know about the grief situation. But nothing is really clear, all the more so
since agreements with the direction or the human resources are mostly made
on an informal and oral basis, if not on a tacit one. Such partial view is not
without blurring the co-workers’ appreciation of the grieving process.
Furthermore, the initiative of talking about grief is often left to the bereaved.
Andrea reports here what her boss told her:
She said to me: “listen, I apologize in front of you. That’s
true, I couldn’t think about going out of my office and
shout: ‘Hey, everybody, stop for a while, I have sad news
to communicate’.” And as I haven’t told her to spread the
news, she didn’t know if she had to tell or not.
That leads to my third observation: in these contexts of fragmented
communication, everybody is on the qui vive, not knowing exactly what to
do or what to say. And this is not only true for interpersonal relationships, but
also for the legal frame and the rights a bereaved employee is entitled to.
Marc-Antoine Berthod
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Grieving persons feel this embarrassment that finds expression, at times, in a
deafening silence; nonetheless, they say they understand this ill-at-ease
because they would not know themselves how to behave if they were in the
same situation. In this perspective, the intimate pain of grief is - en creux present at the workplace for an indefinite period of time. And even if some
collaborators forget rapidly about their colleague’s bereavement, grief may
stand out at specific moments, at specific places, with specific persons, for
the best as for the worst professional interactions.
3.
To Approach the Pain of Loss Needs “Tact”
Directors, head of human resources, colleagues and bereaved
employees at the same time usually hope that behaviours regarding grief at
work will be as “natural” and “spontaneous” as possible. If everybody agrees
on this principle, such a “normal” attitude is rarely adopted. A brief comment
made by a postal officer about the situation of one of her colleagues who just
lost her mother-in-law summarizes this point: “behind the scene, there is a
fair amount of chatter, but in front of the bereaved, the behaviour is not very
natural.” This remark simply shows that expression of grief - and not
necessarily its recognition - is socially controlled. Obviously, this control is
not always done by individuals who may stay mute when confronted to their
colleague’s grief: bereaved employees themselves are indeed reluctant to talk
about their own feelings and pain.
The reason for unexpressed grief at work is then twofold. First, the
bereaved may fear too much exposure in their professional relationships; they
may be put under the pressure of production and feel a potential risk of
dismissal if they cannot get through the same amount of work as before. This
argument - sometimes set forth by interviewed employees - is important for
sure. But a more crucial aspect is the inappropriateness of work conditions to
express pain: time to talk properly about grief and the defunct with a client or
a colleague is generally too short; interlocutors are not always the “good”
ones; work locations - behind a window, in an open space office or a noisy
environment - do not stimulate an outpouring. On this particular point, Bento
remarks rightly “the expression of grief in the workplace is more easily
tolerated if it does not take place in public. If one is crying in one’s closed
office, or in the bathroom, that is acceptable”.11
Moreover, grief generates trouble of concentration, a sense of
vacuity and uselessness, fatigue, as it is well described in the literature.12 All
this elements contribute assuredly to the confinement of the employee. Paul,
a thirty-one year old man who lost his father and eight months later his
mother, comments his return to work in a school office in those terms:
I was very withdrawn. I guess I didn’t have much contact;
this period was so dark…Anyway I didn’t want to expose
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all I have lived to certain individuals if we were not very
close. At the same time, I have tried to talk about my grief
with some other colleagues, but after a while I felt that it
was too straight; they were switching conversation…I
discovered that if we are not prepared for this kind of
experience, people are mostly ill-at-ease.
So the second reason comes from the co-workers’ expectations; they
wait on the bereaved making the first step. Such attitude is not without
provoking a sense of isolation; of stigmatisation even as Paul - and many
others - stresses: “I had the impression I was not really a freak, but a
curiosity; an extraordinary thing happened to me that happens usually to
others”. If this generates the feeling of being left by the wayside, it is mainly
linked to the need of privacy and to the conceptions of intimacy that
determine the expression of pain; it is not particularly specific to grief at
work, but to this fundamental inability to be “normal”, “natural” and
completely at ease when two persons exchange on grief. As the French
sociologist Patrick Baudry accurately noted:
Shall we want the people to talk about their dead as they
talk about the cars they had; the vacation sites they visited
or the good bottles they drunk? This is precisely that - this
succession of commentaries, this pose, this affectation of
learning - the denial of death.13
At the workplace, this mutual social control is framed by business
temporal norms, practical conditions in which the professional activity takes
place, and organizational opportunities to be flexible with the employees; at
least with those who suffer grief complication, knowing that such a notion
defies any easy definition.14 During an indeterminate period of time, grief is
thus potentially structuring the work interactions in the background. At
certain moments, often considered as tensed and problematic, the merging of
the intimate and of the professional is explicitly displayed, even months after
a death. In this sense, neither the colleagues nor the bereaved dare being too
familiar, too humoristic, or too ironic; this is particularly true during the first
weeks of the bereavement process. For example, Julia remembers she tried a
line of humour related to a professional imbroglio four months after her
husband died; as she says, some were pleased to see that she “had come
back” while others considered her comments as a personal attack and as a
mark of her lasting incapacity to be fully at work. Furthermore, the
interpretation one can make about such an anecdote may lead the colleagues
to ask more from a bereaved employee, professionally speaking.
Marc-Antoine Berthod
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In reverse, some grieving persons affirmed they couldn’t support
seeing other people being too expressive, too joyous, or too expansive. Paul
and Catherine notably, if they do not deem such behaviours as inappropriate,
simply reckon that they were not ready to be confronted daily to such
emotional easiness. So, once again, we see here that being “ordinary”,
“natural”, or “spontaneous” is ambiguous when it is related to grief: everyone
must guess what is the “good” moment, the “good” place, or the “good” word
to communicate: this is always challenging and demanding.15
At the workplace, people need to find a constant balance between
the essential proximity a co-worker must show to the bereaved person, and
the companies’ rules and procedures that are the same - on the paper - for all.
A useful parallel may be finally drawn here with the ideas the sociologist
Marc Breviglieri developed regarding the new requirements of a social work
system based on a contractualist management. Breviglieri sustains indeed that
one of the main difficulties a social worker is confronted to today rests on the
necessity to show his skilfulness at being within the personal and particular
story of his interlocutor without discrediting the general rule. And that
requires a sense of tact:
Tact supposes indeed the implementation of a know-how
that enables to connect a close attention to the person with
its treatment as a general case. In other words, it enables
the preservation of the accurate distance towards the
beneficiary and its support seized between two antagonistic
registers of investment and move: the one gets closer to it,
the other goes away from him by a generalization of his
case.16
Concerning bereavement at work, similar modes of interactions and
commitments seem to be in progress. The co-workers and the hierarchical
superiors for instance try to be as flexible as possible. They may well go
beyond the rules and policies - in granting a longer bereavement leave; in
asking some of the colleagues to care temporarily for the grieving employee;
in arranging his schedule - but they never ought to go below them:
misinformation or negligence regarding rules, rights and procedures will thus
appear as a frustrating discredit within the professional realm.
At the same time, there is a need to acknowledge the personal and
intimate pain of grief an employee is going through. But, as I said before, it is
always difficult to perform the helpful proximity with the grieving person,
due maybe to a principle of decency. We could then think that - in the image
of the social worker and his beneficiary - the appropriate way to talk about
grief and act with it at work will be found when rules and rights are clearly
known and communicated to the bereaved employees; when the firm
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rationalizes the frame within which the pain of a loss is going to be lived.
This could stimulate a series of informal conversations between chosen
colleagues and superiors that is generally thought to be governed by a sense
of “spontaneity” or “normality.” This kind of generalization associated to a
very personal pain may thus help to be tactful; it may prevent
disenfranchisement of grief without necessarily asking for its public
expression or its collective treatment at the workplace.
Notes
1
M Lattanzi-Licht, ‘Grief and the Workplace : Positive Approaches’, in
Disenfranchised Grief. New Directions, Challenges, and Strategies for
Practice, K Doka (ed), Research Press, Champaign, 2002, p. 167.
2
R F Bento, ‘When the Show Must Go On. Disenfranchised Grief in
Organizations’. Journal of Managerial Psychology, vol. 9(6), 1994, p. 35.
3
K Doka, Disenfranchised Grief. New Directions, Challenges, and Strategies
for Practice, Research Press, Champaign, 2002.
4
All the bereaved’ names have been changed. I translated their quotes from
French.
5
See in particular D Charles-Edwards, Handling Death and Bereavement at
Work, Routledge, London, 2005. R F Bento, op. cit., postulates also the same
idea.
6
Some years ago, Agnès Pitrou has shown that the classical separation
between sociology of work and sociology of the family is not accurate. It is
more than necessary to study mutual influences between these two spheres;
see A Pitrou, ‘L’interaction entre la sphere du travail et la sphere de la vie
familiale’. Sociologie et Sociétés, vol. XIX(2), 1987, pp. 103-113.
7
This insight was very well exposed in the pioneering work of the French
anthropologist Robert Hertz in his classical ‘Contribution à une étude sur la
représentation collective de la mort’, published in L’Année sociologique at
the beginning of the twentieth century.
8
The research, a two year-long study, was realized with António Magalhães
de Almeida, research assistant, and with the collaboration of Corinne Bonvin,
psychologist at the Center François Xavier Bagnoud that offers grief
counselling. It was financially supported by the ‘Résar’ - Réseau d’études
appliquées des pratiques de santé, de réadaption/(ré)insertion - from the
University of Applied Sciences Western Switzerland; see M A Berthod and
A Magalhães de Almeida, Le deuil au travail. Les modalités de soutien au
deuil en entreprise et leur impact sur le vécu des employés endeuillés,
research report, Sion, 2009.
9
For further details on these administrative aspects and policies, see M A
Berthod and A Magalhães de Almeida, ‘Les entreprises face au deuil de leurs
Marc-Antoine Berthod
317
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collaborateurs’, communication présentée lors de la 2ième conférence
internationale sur le temps Rupture, finitude, mort et management, Université
de Bretagne occidentale, Brest, 25 et 26 juin 2008, to be published. See also
Pratt L, ‘Business Temporal Norms and Bereavement Behaviour’. American
Sociological Review, vol. 46(3), 1981, pp. 317-333.
10
On rare occasions, it happens that a superior sends an email to all the
colleagues or announces the death - mostly when it concerns a parent, a
spouse or a child - during a team reunion. To my knowledge, this is never
formalized in firms; it rather comes from sporadic initiatives.
11
R F Bento, op. cit., 42.
12
M S Stroebe, R O Hansson, W Stroebe, and H Schut (eds), Handbook of
Bereavement Research. Consequences, Coping and Care, American
Psychological Association, Washington, 2001. For anthropological reflexions
on bereavement at work, see M A Berthod, ‘Entre psychologie des rites et
anthropologie de la perte : notes pour l’étude du deuil’. Journal des
anthropologues, vol. 116-117, 2009.
13
P Baudry, La place des morts. Enjeux et rites, Armand Colin, Paris, p. 187.
[My translation].
14
M-L Bourgeois, Deuil normal, deuil pathologique. Clinique et
psychopathologie, Rueil-Malmaison, Doin , 2003.
15
On the difficulty and the complexity of doing ‘being ordinary’, see H
Sacks, ‘Faire « être comme tout le monde »’ in J-P Thibaud (éd.), Regards en
action, Ethnométhodologie des espaces publics, A la croisée, Bernin, 2002,
pp. 201-209. I would like to thank António Magalhães de Almeida for calling
my attention to this text based on lectures given by Sacks in 1970 and 1971.
16
M Breviglieri, ‘Bienfaits et méfaits de la proximité dans le travail social’ in
Le travail social en débat(s), J Ion (dir), La Découverte, Paris, 2005, p. 227.
[My translation].
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Bereaved Employees, Professional Activity and Pain of Loss
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Marc-Antoine Berthod
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Marc-Antoine Berthod is professor at the University of Applied Sciences
Western Switzerland. He has conducted extensive fieldwork in the United
States, Puerto Rico and Switzerland; his publications are related to dying,
death and bereavement.