Week 2 Flashcards
Medicalised death
Critique of an ‘imperialist intervention’: people are deprived of their traditional vision of what constitutes health and death
Medical intervention may interrupt ‘natural’ death and may be distressing for family
Negotiation between medical professionals and family on what is desirable
The dying person may have expressed their wishes
Modern concept of palliative care
Built on openness about and acceptance of being at end of life
Autonomy of the dying person- deciding what they want to happen
Main aim is improving quality of life sometimes over quantity
Death can be in a hospice or at home rather than a medical site
Inequalities in palliative care
People from black and minority ethnic communities
Access to palliative care services less
Less likely to undertake formal advance care planning:
-different illness patterns?
-awareness of services?
-is ‘planning for death’ a meaningful concept?
Existing inequalities made greater by COVID-19
Issues for providers (and patients)
Knowledge what services are available
Referral by professionals
Inequalities
Need for interpreters, communication
Understanding particular needs/wishes
Is cultural competence the answer?
Many definitions and models of cultural competence
Involve a range of knowledge and skills and attitudes
Hard to evaluate
Focuses on individual while attitudes are embedded in workplace
Issues: health providers may feel overwhelmed, training may be too general and not helpful, culture may be foregrounded and individual preferences lost, openness/questioning recommended
The ASKED model of cultural competence
Awareness
Knowledge
Skill-integrating knowledge in clinical practice
Encounters-engaging /reflecting on transcultural interactions
Desire
Why are funerals important
Symbolic of beliefs
Important role for dead persons family
Funerals shaped by tradition (religion but also other social conventions)
Different rites even where religion is shared
Traditions can be comforting
A collective response to death
The anthropologist Robert Hertz suggested that societies respond to the rift caused by a death by a ritualistic ceremony, e.g. mourning, remembrance or a funeral
In some societies the dead person is seen as threatening until the death is marked by a ceremony
Difference between societies (Laungani & Young 1997)
Death as a private event/ open grief discouraged
Death as a public event/ displays of grief from family and others at the funeral
Large scale collective mourning
State/royals funerals
Death of a celebrity
Funeral of victims of violence- can lead to anger and further conflict
Protest marches
Death rituals
Symbolic actions performed at or after death
Common/recognisable to a society of group
Expressing the group/ society’s values
Can be linked to religion/ belief
Enabling the dead to journey on to the afterlife
Ensuring the dead will be remembered
View from anthropology
Focus on the exotic and strange in classic ethnographies
Rules around preparing and handling the body and who is involved
Dealing with fear of the dead body and returning of the spirit
Providing a safe social identity/ memorial
Functions of the ritual in general
The living say goodbye, and progress with their lives
The living feel they have been able to respect the deceased person
This includes respectfully dealing with the actual body
Alleviates feelings of guilt for survivors
May help acceptance by making death visible
Social media increasingly important after a person dies
Can a social media account be kept as a memorial and who has access
Condolences- who can contribute and how
New conventions on how to express grief
Is there a danger when ‘anyone’ can post
Diversity and the death ritual
Death rituals are often religious
Now other options are available
New dilemmas e.g. whether to wear black
But also a larger variety of religions in UK with different funeral rituals
Health providers need to engage with these
