Understanding Dying, Death, and Bereavement, Ninth Edition
By Michael R. Leming, George E. Dickinson
Contents:
About the Authors xv
Preface xvii
CHAPTER 1 Studying Dying, Death, and Bereavement 1
Current Interest in Death and Dying 3
Why the Increased Interest? 4
The Mystery of Death 4
Terrorism 5
Ethical Issues 7
Popular Culture 8
Death Education 12
Thanatology Classes 12
Thanatology Publications 13
Mortality Statistics 15
Death Etiology and Life Expectancy 16
Gender Differences in Mortality Rates 21
Approaches to the Study of Dying and Death 22
The Biological Approach 23
The Psychological Approach 23
The Philosophical Approach 24
The Anthropological Approach 25
The Sociological Approach 25
Structural-Functional Theory 26
Conflict Theory 28
Social Exchange Theory 29
Symbolic Interaction Theory 30
Conclusion 33
Summary 34
Discussion Questions 34
Suggested Readings 35
CHAPTER 2 The American Experience of Death 37
Defining Death 39
International Definitions 40
American Definitions 41
The Meaning of Dying and Death 44
Deriving Meaning from the Audience 45
Deriving Meaning from the Situation 46
Death as a Lost Relationship 46
Creating and Changing Death-Related Meaning 48
The American Experience of Death 49
Living Death (1600–1830) 49
The Dying of Death (1830–1945) 50
The Resurrection of Death (1945–the Present) 51
Contemporary Attitudes Toward Death 54
Denial or Acceptance of Death? 54
Fearing Death? 58
Content of Death Fears 61
Death Fears 61
Relieving Death Anxiety Through Religion 63
Contemplating One’s Own Death 64
Conclusion 66
Summary 66
Discussion Questions 67
Suggested Readings 68
CHAPTER 3 Growing Up with Death/Growing Old with Death 69
Childhood 71
How Do Children Learn About Death? 71
Personal Experiences 73
Mass Media 74
Religion 77
Children’s Understanding of Death 78
Birth to Age Three 78
Ages Three Through Five 80
Ages Six to Twelve 80
Explaining Death and Dying to Children 83
Be Honest and Open 84
Avoid Euphemisms 84
Show Emotion 86
Adolescence 88
Identity Crisis and Death Anxiety 89
Media Influences 90
Learning Adult Rituals 91
Communicating About Death 92
Adulthood 93
Young Adulthood 94
Middle-Aged Adulthood 94
Panic and Denial 95
Reflection and Acceptance 96
Personal Growth 96
Older Adulthood 97
Achieving Integrity 99
Diminishing Death Fears 100
Choosing a Place to Die 103
Conclusion 104
Summary 105
Discussion Questions 105
Suggested Readings 106
CHAPTER 4 Perspectives on Death and Life After Death 107
The Need to Look Beyond Death 108
Diversity in Perspectives 110
Cross-Cultural Views 110
Religious Interpretations of Death 112
Judaism 113
Christianity 115
Islam 115
Hinduism 117
Buddhism 118
Temporal Interpretations of Death 121
Symbolic Immortality 122
Near-Death Experiences 125
Defining a Near-Death Experience 125
Explaining Near-Death Experiences 127
Conclusion 128
Summary 129
Discussion Questions 130
Suggested Readings 130
CHAPTER 5 The Dying Process 131
Death Meanings 133
Time Meanings: Dealing with the Prognosis 133
Space Meanings: Isolation and Confinement 136
Norm and Role Meanings: Expected Dying Behavior 138
Value Meanings: Reassessing the Value of Life and Death 139
Object and Self-Meanings: Accepting the Self as Terminal 139
Detachment from the Living 140
Kübler-Ross’s Five Stages of Dying 141
Social Situation Meanings: Definition of the Environment 144
Relating to the Dying Person 145
Medical Personnel 145
The Socialization of Physicians 146
Awareness Contexts 150
Family and Friends 150
The Stress of Dealing with a Dying Family Member 152
Helping Children Cope with a Dying Parent 154
Dying with Dignity 154
The Dying Child 157
Relating to the Dying Child 157
Helping the Child Cope with Dying 158
Parents of the Dying Child 160
Siblings of the Dying Child 161
Conclusion 163
Summary 164
Discussion Questions 164
Suggested Readings 165
CHAPTER 6 Living with Dying 167
Understanding and Coping with the Illness 169
The Loss of Physical Functions 169
The Loss of Mental Capacity 170
Dying of Cancer and Heart Disease 170
Cancer 170
Heart Disease 173
Treatment Options 173
Evaluating Treatment Options and Symptoms 173
Treating Drug Side Effects 175
Pain and Symptom Management 176
Pain Management 178
Managing Dehydration 180
Organ Transplantations 181
Palliative Care 184
The Hospice Movement 186
The Hospice Team 188
The Patient–Family as the Unit of Care 192
The Cost of Hospice Care 193
Public Attitudes 195
Conclusion 197
Summary 198
Discussion Questions 199
Suggested Readings 199
CHAPTER 7 Dying in the American Health Care System 201
The Medical Model Approach to Dying 202
Dying as Deviance in the Medical Setting 203
Labeling Theory 203
Deviance Results in Punishment 204
Normalization of Dying in the Medical Setting 205
Dying in a Technological Society 206
The Environment of the Dying Person 208
Hospital 208
Home 209
Nursing Home 210
Hospice Inpatient Care 211
End-of-Life Education in Medical and Nursing Schools 213
Gross Anatomy Lab in Medical Schools 214
Developing a Sensitivity to Social and Psychological Needs 216
Developing Communication Skills 216
The Cost of Dying 219
Conclusion 222
Suggested Research Topics Related to End-of-Life Issues 222
Summary 222
Discussion Questions 223
Suggested Readings 223
CHAPTER 8 Biomedical Issues and Euthanasia 225
Ethical Behavior 227
What Is Ethical Behavior? 227
Bioethicists 228
Use of the Body in Medical Research and Training 230
Organ Transplantation 231
Euthanasia 235
Sanctity-of-Life versus Quality-of-Life Debate 236
Sanctity-of-Life View 236
Quality-of-Life View 236
The Right to Die 237
Passive Euthanasia 240
Distinguishing between Ordinary and Extraordinary Measures 240
Nutrition and Hydration 241
CPR Versus DNR 242
Active Euthanasia 243
The Slippery-Slope Argument 245
Physician-Assisted Death 246
Conclusion 249
Summary 250
Discussion Questions 250
Suggested Readings 251
CHAPTER 9 Suicide and Other Sudden, Unnatural Traumatic Deaths 253
Changing Attitudes Toward Suicide 254
The Stigma of Suicide 255
Defining Suicidal Acts 257
Social Factors Involved in Suicide 258
Age, Gender, Region, and Marital Status 258
Socioeconomic and Cultural Factors 259
Opioids and suicide 262
Theoretical Perspectives on Suicide 263
Durkheim’s Theory 264
Conflict Theory 265
Dramaturgical Perspective 265
Existentialist Perspective 266
Psychological Perspective 266
Critical Sociology 267
Suicide Through the Life Cycle 267
Childhood Suicide 267
Adolescent Suicide 268
Warning Signs of Suicide 270
Explaining Adolescent Suicide 270
The Internet, Hotlines, and Suicide 272
College-Aged Students and Suicide 274
Middle-Aged Suicide 275
Older Adult Suicide 276
Causes of Suicide 278
Copycat Suicides and the Media 279
Rational Suicide 281
Other Sudden, Unnatural, Traumatic Deaths 283
Homicide 283
Accidental Deaths 287
Conclusion 289
Summary 290
Discussion Questions 291
Suggested Readings 291
CHAPTER 10 Diversity in Death Rituals 293
Understanding Death Rituals 294
Death Rituals as a Rite of Passage 294
Structural-Functional Explanations 296
Mourning Behaviors 298
Changes in Mourning Behaviors in the United States 300
Gender Differences in Mourning Behaviors 303
Customs at Death 304
Norms Prior to Death 304
Preparing the Corpse 305
Cleaning, Decorating, and Clothing the Body 306
Embalming 307
Final Disposition 311
Earth Burial 311
Cremation 312
Influence of Social Position and Gender on Death-Related
Behaviors and Rituals 314
Death Rituals of Major Religious Groups 316
Jewish Customs 317
Christianity 317
Hinduism 319
Buddhism 320
Islam 322
Conclusion 323
Summary 323
Discussion Questions 324
Suggested Readings 324
CHAPTER 11 The Business of Dying 327
The Business of Preparing the Dead 328
The Changing American Funeral 328
The Puritan Funeral 328
The Victorian Funeral 329
The Contemporary American Funeral: Meeting the Needs of the
Bereaved 332
The American Practice of Funeral Service 335
Education and Licensure 335
The Role of the Funeral Director 337
Funeral Expenses 337
Pricing Systems 338
Alternatives to the Funeral 341
New Trends in Funeral Service 345
Preneed Funerals: A “New” Trend in Planning Funerals 345
Aftercare: The Future Business Is to Be Found in Today’s
Customers 345
Funeral Services on the Internet 347
The Business of Burying the Dead 348
The Changing American Cemetery 348
The Puritan Cemetery 349
The City Garden Cemetery 349
The Rural Cemetery 350
The Lawn Park Cemetery 352
Graveyard Symbols of Death 353
Cemeteries Today 354
The Government Cemetery 355
The Not-for-Profit Cemetery 356
The For-Profit Cemetery 357
Conclusion 357
Summary 358
Discussion Questions 358
Suggested Readings 359
CHAPTER 12 The Legal Aspects of Dying 361
Establishing the Cause of Death 363
Death Certificate 363
Autopsy 366
Coroners and Medical Examiners 370
Advance Directives 371
Living Wills 371
Durable Power of Attorney for Health Care 372
Life Insurance 373
Life Insurance as Protection 375
Life Insurance as an Investment 375
Long-Term Care Insurance 376
Inheritance and Wills 376
Intestate and Inheritance 376
Wills 378
Holographic Wills 380
Probate 380
Conclusion 381
Summary 381
Discussion Questions 381
Suggested Readings 382
CHAPTER 13 Coping with Loss 383
The Bereavement Role 384
The Grieving Process 384
Normal and Abnormal Grief 386
Stages of Grief 389
Shock and Denial 389
Disorganization 389
Volatile Reactions 389
Guilt 390
Loss and Loneliness 391
Relief 391
Reestablishment 391
Disenfranchised Grief 393
Assisting the Bereaved 394
Practical Matters 396
The Art of Condolence 396
Coping with Sudden Death 396
Accidents 397
Disasters 399
Recovering from Tsunami or Typhoon 400
Murder 401
War 402
Conclusion 403
Summary 404
Discussion Questions 405
Suggested Readings 405
CHAPTER 14 Grieving Throughout the Life Cycle 407
Grieving Parents and the Loss of a Child 408
The Loss of a Fetus or an Infant 408
Fetal Death 410
Perinatal Death 411
Sudden Infant Death Syndrome 416
The Loss of a Child 418
The Loss of an Adult Child 419
Grieving Children and Adolescents 419
Loss of a Parent 420
Loss of a Sibling 421
Loss of a Grandparent 421
Grieving Adults 422
Loss of a Spouse 422
Loss of a Parent 422
Loss of a Pet 423
Dying, Death, and Bereavement in the 21St Century:
A Challenge 425
Conclusion 426
Summary 426
Discussion Questions 427
Suggested Readings 427
References 429
Glossary 461
Index 473