Layers of Dying and Death PDF

Edited by
Kate Woodthorpe
Layers of Dying and Death
Papers Presented at the Fourth Global Conference:

Making Sense Of Dying and Death
Wednesday 12th July – Friday 14th July 2006

Mansfield College, Oxford
Edited by
Kate Woodthorpe
Oxford, United Kingdom

Dr Robert Fisher
Series Editor
Advisory Board
Professor Margaret Chatterjee Professor John Parry

Dr Wayne Cristaudo Dr David Seth Preston
Dr Phil Fitzsimmons Professor Peter Twohig
Dr Jones Irwin Professor S Ram Vemuri
Professor Asa Kasher Professor Bernie Warren
Revd Stephen Morris Revd Dr Kenneth Wilson, O.B.E
Volume 40
A volume in the Probing the Boundaries project
>Making Sense Of: Dying and Death=
Published by the Inter-Disciplinary Press
Oxford, United Kingdom
First Edition 2007
8 Inter-Disciplinary Press 2007
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any
form or by any electronic, mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
ISBN: 978-1-904710-39-5
EAN: 9781904710395
Contents
Introduction ................................................................................................ 3
Family-Assisted Suicide in the British Media

Daphna Birenbaum-Carmeli ............................................................ 5
Death and Dying: Making Sense of Life in Post-Soviet Cinemas

Irina Novikova ............................................................................... 13
The Living Dead as Cinematic Images of Death

Outi Hakola.................................................................................... 23
Complicated Grief
Sandra Jones .................................................................................. 31
Britain’s ‘Punk’ Mourning Culture

Gerri Excell.................................................................................... 45
The Making of ‘Good’ Memorialisation

Kate Woodthorpe........................................................................... 55
Institutional Loss: Dialectical Tensions in Coping with Major Loss

Melanie K. Finney ....................................................................... 667
Traumatic Bereavement and Coping: Implications for a Contextual

Approach
Karola Dillenburger, Montse Fargas, Grace Kelly and Rym
Akhonzada ..................................................................................... 75
Can the Dying Mourn?

Kate Powis ..................................................................................... 87
The Death of Innocents: Noncombatant Immunity vs. the Divine Foetus

Lloyd Steffen ................................................................................. 97
Do We Have Moral Obligations to the Dead?

Liz McKinnell.............................................................................. 107
Don’t Fear the Reaper: An Epicurean Answer to Puzzles about Death

and Injustice
Simon Cushing............................................................................. 117
Tele-visions of the Dying: Ghost-Seeing in the Society for Psychical
Research in the 1880s
Shane McCorristine ..................................................................... 129
“Of Death I Try to Think like This”: Emily Dickinson’s ‘Play’ with Death
Lucia Aiello ................................................................................. 139
Coming to Grips with Death: Explained and Explored in a Children’s

Picture Book
Phil Fitzsimmons ......................................................................... 149
Older People’s Preferences at the End-of-Life: a Review of the Literature

Eileen Sutton and Joanna Coast ................................................... 157
The Wholeness of a Broken Heart

Leeat Granek................................................................................ 177
Religion and Medicine in the Process of Managing Death and Dying:

The Case of Hospice Circle in Poland
Malgorzata Zawila ....................................................................... 185
Convenient Arrangements with Death

Florence Ollivier .......................................................................... 193
Death and Funerals in Sunni Communities of Turkey

Reyhan Varli Görk....................................................................... 203
The Body of Necessities in Finnish Discourse on Euthanasia

Leila Jylhänkangas....................................................................... 217
Images Of Death, Images Of Society: The Case Of Poland and Polish

Community
Emilie Jaworski ........................................................................... 229
Attachment Trauma, Sudden Death and Anticipatory Grief: the

Chamorro Sample
Stephen W. Kane and Vera de Oro .............................................. 237
Environmental Grief®: Hope and Healing

Kriss A. Kevorkian ...................................................................... 249
3
Introduction
This collection of papers originates from the fourth annual

Making Sense of: Dying and Death conference held in July 2006 at the
University of Oxford, and forms part of the on-going Interdisciplinary.net
catalogue of international multi-disciplinary dialogue into topical subject
matter. The intention of this volume is to create a snapshot of the
conference, thus the papers are presented in the form they were delivered,
providing an overview of the diversity and dynamism of both the topic
and the conference itself.
Importantly, the international flavour of the papers in this volume
illustrates the universality of experiences of dying and death. As one of the
‘universal truths’ 1 of human existence, the diversity of the papers in this
volume points to the relevance of practices and issues surrounding dying
and death to all of us, regardless of our origins or culture. As mortal
beings we cannot escape our corporeal condition, thus every society -
indeed, every individual - has to deal with dying and death at some point.
The varied manner in which this is constructed, practiced and interpreted
is illustrated by the rich accounts in this multi-disciplinary volume.
Making a contribution to a wide range of disciplinary fields of
study on dying and death, this collection is an extremely evocative
example of the dynamism and complexity of this most human of topics.
The papers in this volume are a unique mix of, amongst other things,
social research (such as Jones), philosophical debate (McKinnell),
historical description (McCorristine), death imagery (Hakola), personal
accounts (Granek), literature (Aeillo) and cultural analysis (Jaworski).
They have been arranged to demonstrate the multiplicity of issues that are
touched by death, and the global scope of the Making Sense of: Dying and
Death Conference. Each paper therefore needs to be understood as a
particular disciplinary and cultural account of dying and death, yet read as
a contribution to a wider international inter-disciplinary dialogue on death
and dying. I sincerely hope that this valuable and constructive exchange of
ideas, and the productive sharing of knowledge into this most complex
and emotive of subjects, will continue long into the future. Thank you to
all those who have contributed to this e-book, and I hope that you enjoy
the volume.
Kate Woodthorpe, October 2006.
Notes
1
Zygmunt Bauman, Mortality, Immortality and other life strategies
(Cambridge, Polity Press, 1992).
Family Assisted Suicide in the British Media
Daphna Birenbaum-Carmeli
Abstract
The paper tackles the subject of family assisted suicide through its
presentation in the British press during the 1990s. Looking for basic
characteristics of the coverage, the paper reveals a consistently supportive
stance towards family assisted suicide that is produced by depictions of
the dying persons and the perpetrators as autonomous and conscientious
individuals; by idyllic portrayals of family relations; and by praising
judges for their lenient verdicts. Presentations of the law as a dated State
system, as well as marginalization of opposing voices, further enhanced
the supportive message. The argument of the paper is that this presentation
may carry implicit political implications: in commending actors’ self-
reliance and in calling for decreased State interference in personal affairs,
the press augments the neo-liberal spirit that has come into prominence in
Britain since the 1980s. Within this context, we raise some ethical
questions regarding the broader political significance of such media
representations.
Key words: euthanasia, family, assisted suicide, Britain, press, neo-

liberalism.
Biomedicine’s commitment to preserve lives has found one of its

powerful expressions in extending the lives of terminally ill persons.
Whereas some patients are greatly assisted by such options, others may
find the resulting life conditions hard to accept. In this paper, we probe a
particular type of suicide: one that is facilitated by a close family relative.
Our interest is in the ways in which such cases and the dilemmas that they
invoke are constructed in the daily British press, and in the political
implications of these media constructions may carry.
The mass media plays a crucial role in the emergence and unfolding
of public debates. 1 It mediates the experience and the dissemination of
ideas. It influences what issues will be considered worthy of attention;
who should be held accountable and whose opinion can be dismissed; and
it suggests where potential solutions lie. Especially susceptible to the
media's influence are issues with which the audience has little direct
experience. 2 Assisted suicide is a case in point.
Assisting someone’s suicide is illegal in Britain, subjecting the
‘assistant’ to imprisonment for up to 14 years. However, studies reveal
substantial professional and lay approval of this practice, which co-exist
alongside passionate opposing views.
6 Family-Assisted Suicide in the British Media
___________________________________________________________
1. Article themes
Within this general framework, I now turn to a content analysis of
the press presentations of 3 cases of Family Assisted Suicide (FAS) that
had taken place in Britain during the 1990s. In all these cases, the sick
person had been reported to have repeatedly requested the relative to help
them die. All the prosecuted individuals had pleaded guilty and all had
eventually walked free out of court.
Beyond the difference in circumstances, journalists constructed the
reported cases in very similar ways. I will illustrate the essence of these
leitmotifs.
A. The deceased person

Articles conveyed the deceased person’s age, marital status (all
single), previous occupation and ailment. Character descriptions typically
suggested strong-willed and independent individuals, courageous
throughout their lives as well in the face of death: Jim Brady “fought like
a demon against the illness”, Janet Pitman had been “a strong-minded,
determined woman”. Annie Wilks used to be a “dignified,” “strong,”
“self-reliant,” “vibrant career woman,” “the most loving person in the
world … had a magic way with children… optimistic and happy. She
loved to …go for drives to the seaside. She also liked Shirley Bassey and
poetry”.
However, now, being bedridden, Jim “could do nothing for himself.
His family dressed his skeletal frame, took him to the lavatory, minced his
food and held his baby beaker to his lips.” Mrs. Pitman was depicted as
“crippled” and “pain-racked” and Mrs. Wilks emerged as “seeing
double… [she] could scarcely walk,” she became “frail,” “distressed”,
“confused, forgetful and started to suffer from hallucinations”. As
common in FAS reports, the finer details come from the perpetrators
themselves. Mrs. Wilks’ daughter thus described:
Mum went all aggressive with the nurses. She threw a

jug of water over one of them and head-butted a
window. It was so unlike her - I’d never heard my mum
swear or raise her voice before.
It is significant that the description was not validated by external

sources, nor was it used to question Mrs. Wilks’ mental capacity to
request euthanasia. One device to sustain this accord was to show that
Mrs. Wilks still retained some of her old ‘authentic’ self, e.g. her sense of
humour and refraining from complaints.
Daphna Birenbaum-Carmeli 7
___________________________________________________________
We regard the stark contrast that journalists constructed between
the autonomous healthy person and the dependent dying patient as
suggesting a drastic transformation rather than gradual degeneration. This
binary imagery of mind/body and health/disease constituted suicide as a
release, freeing one’s ‘trapped’ self from a failing body.
B. Perpetrators and their acts

The perpetrators were positioned as the event’s key figures,
portrayed as dignified individuals caught in unfortunate circumstances.
Factual evidence established their moral decency, e.g. their honesty in
confessing to their crime, their respectable professions, and the devoted
care that they had provided to their relatives. Fully relying on the
perpetrator's own declarations, the descriptions of the loyalty to the
deceased relative presumably removed any doubt concerning the
motivation for the act. Within this framing, assisting in suicide was
construed as “an act of mercy”; “a gift”; “the ultimate show of … love”.
Thus, Paul Brady was depicted as having “the courage to save [his
brother] from his suffering”, and Jennison was given space to portray
herself as a loving, devoted daughter:
[E]ven if I had got a life sentence, and that’s what I was

expecting, I’m glad I did what I did…I loved my mum
so very much. She wanted to die, what else could I do?
The image of moral integrity and the purity of motive was given
official validation through quotes from judges’ parallel evaluations: “the
circumstances … showed plainly that she was a caring and loving
daughter.” The prosecution’s sharing of this positive evaluation provided
still further evidence.
Formative in the justification of the perpetrators’ actions was the
explicit absence of any hesitation or regret: “I [Jennison] don't regret what
I have done. I'd never have forgiven myself for letting her be in this living
death.” The law makes Paul [Brady] a guilty man, but the family’s only
regret is that they let Jim suffer for so long.
The brief, scarce allusions almost trivialised the moral debate
surrounding FAS. Indeed, the marginalisation of the case against FAS was
consistent, with criticism relegated to one or two sentences at the end of
the piece that were not followed by any engagement with the arguments:
The Voluntary Euthanasia Society welcomed the

decision [to free Brady] and called for the law to be
changed. But a spokesman for the Roman Catholic
___________________________________________________________
Church in Scotland voiced concern at the case.
Through such fleeting comments journalists bestowed a ‘balanced’

appearance on their reports while virtually silencing the debate and
enhancing the framing of FAS as an act of familial compassion.
C. Families
Family dynamic was virtually written off by the press. Through
‘normalised’ descriptions, family relations were made to appear as purely
loving and harmonious, suggesting a lifelong closeness. Jim Brady’s death
was located in a family Christmas gathering. Mrs. Wilks’ end was framed
within a cosy weekend scene:
[She] spent Friday afternoon with Gillian, her brother

Colin and his wife. They had a few drinks and talked
about old times… we had a lovely evening. Mum
always liked a tipple, she enjoyed a sweet Martini. So
even though the doctors had told her to stop drinking,
she looked so serene that I thought, ‘Sod this’ and gave
her a glass of sherry.
These scenes of warmth paved the way for the act that was about to
follow, which could then be framed as the culmination of harmonious
family togetherness:
In each other’s arms they lay, the loving daughter and her
suicidal mother, talking about old times. Annie swallowed
her pills - two at a time - sipped her sherry and slipped
slowly into the big sleep.
The consensual impression was affirmed through reports of

relatives’ support of the prosecuted member as they made their way
through the trial: “As he left the court, Brady was hugged by his tearful
family, who had supported his actions and appeared on television to argue
his case.”
D. The State system: Law and judges

From the press, the judicial system emerged as an oppressive
apparatus that failed terminally ill citizens and tormented anguished
relatives. In some articles, especially the few that did touch upon the
broader ethico-political aspects of euthanasia, journalists would
occasionally opt for even stronger language, implying that the existing law
___________________________________________________________
was heartless to the point of absurdity (“Even sitting in the same room as
someone who kills themselves … is considered to be aiding or abetting a
suicide”).
The disapproving message was reinforced by the favourable images
of the judges, as compassionate, open-minded individuals, rising above
bureaucratic rigidity. An article on Brady’s verdict praised judges,
prosecutors and juries “[who were] prepared to perform legal sleight-of-
hand to reflect society’s compassion - by dropping charges, accepting a
lesser plea or passing a lenient sentence.”
Through such positioning of the judges alongside the ‘offenders’,
as individuals who were forced to grapple with an inadequate State system
in order to respond to human suffering, journalists were isolating the State
not only from its rank and file citizens but also from its own arbitrators.
A main vehicle for bridging this law/judges gap was the
exceptionality claim that journalists had repeatedly cited from the verdicts.
This notion served to justify judges’ leniency while allowing to avoid an
open discontent with existing law. Lord McFadyen’s comment on Paul
Brady’s verdict was typical, explicating that owing to the exceptional
circumstances of this case, the disposal must not be taken as reflecting any
general view on the part of the courts, but simply the sentence I regard as
appropriate in the individual circumstances of this case.
Journalists, too, presented each case as unique, and have never
referred to any of the preceding cases. We understand the media
endorsement of the exceptionality claim as part of its preference for
episodic framing, in which a heroic narrative and a human drama enhance
the emotional draw of the article. It also relieved readers’ own fears and
sidestepped related ethical debate.
2. Discussion
The one-sided, supportive coverage that we identified relied heavily
on the notion of the ‘normal’ family. Suggesting similarity of actors’
sentiments across the cases, this narrative replaced the idiosyncrasy and
complexity that one would expect in a real life consideration of FAS with
descriptions of wholesome harmony. As such, the articles advanced a
moral discourse on living and dying, effectively “reducing the traumatic
event to a set of standardized narratives… turning it from a frightening
and uncontrollable event into a contained and predictable narrative.” 3
From this perspective, the normal family discourse helped deny the very
trauma by toning down complexity and anxiety, and emphasising
individual heroism and beatific acts.
Another constituent of the one-sided supportive coverage was the
episodic framing of FAS, namely, reading the problem at a micro level, as
___________________________________________________________
a difficult decision made between two individuals. As the arguments
against euthanasia address broader socio-ethical issues, they are harder to
contain within an episodic framework. The concept of dignity can
illustrate the difference. Opposition to euthanasia revolves around a form
of dignity that is neither negotiable nor reducible. 4 In contrast, arguments
in favour of euthanasia turn on a concept of dignity that is personal and
can be diminished or lost. 5 Episodic framing, with its focus on the
individual, ultimately privileges personal conceptions of dignity and is
therefore structurally biased against the major claims of euthanasia
opponents.
Located in the context of late 1990s Britain, the courageous
individual narrative dove-tailed with a neo-liberal discourse of autonomy,
and a move towards a State withdrawal from caring labour. Since the
1980s, the neo-liberal rationalities that came into prominence in Britain
accorded a vital value to a self that is to aspire to autonomy, it is to strive
for personal fulfilment in its earthly life, it is to interpret its reality and
destiny as a matter of individual responsibility, it is to find meaning in
existence by shaping its life through acts of choice. 6
The decisions made by the deceased and the perpetrators could be
said to ally with this notion of the individual, as suicide became an act of
self-determination. The emphasis on self-reliance and the near
glorification of suicide further reinforced the neo-liberal accent on
individualism and, possibly, the justification of cuts in State services.
During the 1990s, neo-liberal reforms had legitimated the shrinking of
health services, reducing the number of nurses, and hospitals as well as
long term care facilities. While we are not suggesting that journalists were
intentionally promoting a neo-liberal agenda, we suggest that the British
press of the late 1990s constituted FAS in accordance with this vision. By
framing particular types of suicide within a self-assured harmonious
family narrative, family-assisted suicide emerged as commensurate with
neo-liberal ideals in terms of care, family and societal morality at large.
If our analysis is acceptable, then it raises several questions: How
do such media presentations impact on circulating views regarding FAS?
What do they imply regarding the role of relatives and the State in caring
for the terminally ill? Is the coverage in fact advancing the privatization of
death? More generally, could the glorifying of one's courage to die, in the
sensitive context of FAS, contribute - if inadvertently - to a social climate
in which people would be encouraged to ‘courageously’ end their lives?
Further enquiries into this emerging territory would hopefully help
elucidate these issues.
___________________________________________________________
3. Epilogue
On January 14, 2005, the BBC featured on its front website news-
page the story of Brian Blackburn, a 62 year old policeman who pleaded
guilty to manslaughter after having killed his wife who was dying of
cancer. The journalist quoted the husband citing his deceased wife saying
that this was the “last loving thing you could do for [me].” The judge was
quoted stating that Blackburn “had acted as a ‘loving husband’,” and then,
noting that the circumstances were exceptional, gave him a suspended
nine month sentence. The couple’s two sons emerged from the piece as
fully supportive, pledging for mercy. A description of Blackburn being
“greeted by friends and family as he left the court” sealed the report. No
opposing voices were included.
Notes
1
S.D. Reese, O.H. Gandy, & A.E. Grant (eds.). Framing public life:
Perspectives on media and our understanding of the social world.
(Mahwah, NJ: Lawrence Erlbaum, 2001).
2
M. Baum, Sex lies and war: How soft news brings foreign policy to the
inattentive public. American Political Science Review, 96 (2002), 91-109.
3
K. Tal, Worlds of hurt. (Cambridge: Cambridge University Press, 1996).
4
L. Gormally, Euthanasia and assisted suicide: Seven reasons why they
should not be legalized <http://www.euthanasia.com/sevenreasons.html>
(1997).
5
D. Pullman, Death, dignity, and moral nonsense. Journal of Palliative
Care, 20 (2004), 171-78.
6
N. Rose, Inventing ourselves: psychology, power, and personhood.
(Cambridge: Cambridge University Press, 1988).
Daphna Birenbaum-Carmeli is a medical anthropologist at the University

of Haifa, Israel. Her main interest is in the social and political implication
of medical technologies. Within this domain, she has focussed on the
subjects of reproductive medicine and genetic testing.
Death and Dying: Making Sense of Life
in Post-Soviet Cinemas
Irina Novikova
Abstract
The article focuses on how death and dying as an insistent
discursive and emotional agenda of ‘post-Soviet-Hamlets’ have been
represented in the post-Soviet Russian films of the 1990s-early 2000s.
Post-Soviet cinematic ‘hauntology’ was marked by an emancipatory
inventiveness to unsettle and re-imagine future uncertainties beyond the
spectres of the past. Gendered imageries of death and dying plotted mainly
in the father-son relationship have been central to the ‘real’ of the visual
and political re-imagination of the nation, history, borders, and boundaries
of post socialist ‘rebirth’. For my argument I will address particular
instances of filmed death in the cine-texts by Russian ‘necrorealism’,
Pavel Chukhrai, Sergei Bodrov, Aleksandr Sokurov, Andrei Zvyagintsev.
Key words: death, dying, mask, ghost, body, metanarrative, film

narrative, gender, masculinity, trauma.
The death of a hero has been among the most favourite plot
elements in cinematic storylines as it
Determines a proponent role of the beginnings and the

ends, especially the latter. Usually, the process of
thinking about reality is subjected to its discrete
partitioning, in particular, the literary plots inextricably
related to the concept of the end and the beginning.…
Just as the concept of art is connected to reality, the
understanding of a ‘text - border of the text’ is
inseparably interfaced with the ‘life - death.’ 1
The Soviet imaginary as a metanarrative that had its beginning

and its end was related to the ‘ontologization of the spectre’, the eternal
repetition of one and the same to relinquish “any hope of transcendental
transformation,” 2 and the Soviet teleology of death “turned the
mausoleum into museum.” 3 Jacques Derrida brilliantly discusses in
Specters of Marx the effect of “an ontological treatment of the spectrality
of the ghost... leading to the terrifying failure and totalitarian perversions
to which it gave rise.” 4 The ‘ontologization of the specter’ was left to the
perpetuated rituals of its mourning integrated in the Soviet cinematic
vernacular.
14 Death and Dying: Making Sense of Life in Post-Soviet Cinemas
___________________________________________________________
After the break-up of the USSR in 1991, post-Soviet cinematic
“hauntology” 5 was marked by an emancipatory inventiveness to unsettle
and re-imagine future uncertainties beyond the collapsing spectres of the
past. Although earlier, the Soviet filmmakers of the perestroika period
(1984-1991) committed themselves to what was beyond the permitted
themes and plots in the Soviet period, in particular, sexual and
necromantic. Theirs was the “necropolis” time when the deaths of the
Soviet leaders Brezhnev, Andropov, and Cherrnenko embodied the dying
of the socialist route in the metanarrative of modernity. 6 The obsession
with death and dying was central to necrorealism. 7 Evgeni Jufit, made
Hospital Attendants-Werewolves (1985), a manifesto of necrorealist
aesthetics, and his first feature length film, Daddy, Father Christmas Is
Dead (1991). Necrorealism has been interpreted as “a barely allegorical
manifestation of total social collapse and anomie, of the hypercharged
atmosphere of cynicism and doubleness” 8 diagnosed by Berkeley
anthropologist Alexei Yurchak among members of “the last Soviet
generation.” 9
In the 1990s a number of the filmmakers revolted against their
fathers’ cinematic legacy. The treatment of the phantomatic in these films
challenges the absolute privilege granted to Derrida’s patrimony of the
idol, both political and patriarchal.. One of the most recognized films of
the early 1990s, the Oscar-nominated Thief (1997) by Pavel Chukhrai, was
made as a tragic parody of his father Grigorii Chukhrai’s famous epic
Ballad of a Soldier (1959). Apart from its outstanding cinematic qualities,
the epic narrative of Ballad of a Soldier about a death of a Russian soldier
as the symbolic/Christological sacrifice for the world’s liberation from
Nazism became a medium of collective psychotherapy for millions and
millions of its Soviet female spectators, very much within the emotional
space of hope in the 1950s. The film of his son, Pavel Chukhrai is, on the
contrary, based on a singular and banal plot, subaltern to the totalizing
narratives of war heroes central to the Soviet metanarrative of Russian
hegemonic nation building and its historiography after the World War
Two. A thief Tol’an who pretends to be a military officer and a war
veteran involves a young woman Kat’a and her small son San’ka into his
plots of robbing communal flats. 10 Kat’a meets Tol’an on a train, falls in
love with a handsome and brave hero of the war. She dreams - like many
other young women of the post-war time - to become a wife of a Soviet
military officer. When she finds out that Tol’an is a thief, she still trusts
his promise to stop robbing soon for the sake of the family. However, the
family travels from town to town, rents a room in a communal flat. His
military uniform is the most valid and unquestionable ‘pass’ and evidence
of his reliability among people who agree to rent the family a room. Later
Irina Novikova 15
___________________________________________________________
he robs ruthlessly the inhabitants of a communal flat of whatever could be
of any value to be sold by Kat’a in black market. Tol’an is detained and
arrested by militia accidentally, Kat’a dies of a failed illegal abortion, and
San’ka is placed into an orphanage. He dreams that his ‘daddy’ will return
and adopt him to start a family. He runs into Tol’an several years later and
decides to kill him to revenge on Tol’an for the honour of his dead mother.
As a parallel plot, the ghost of San’ka’s dead father-soldier,
semantically central in the lexicon of the Soviet ideologue and its spectres,
emerges in some crucial episodes. The only fact that the son knows about
his true father is his mother’s story of his death because of wounds soon
after returning from the war battles the mystical character of the specter,
as a para-religious experience for San’ka, is accompanied with the
pedagogy of his adopting father, thief Tol’an of what it means to become a
real man. Tol’an becomes San’ka’s model of masculinity - violent and
aggressive. So, the boy is lost between his commitment to the memory of
his idealized dead father and enchantment with his ‘daddy’, very
masculine and brutal, at the same time, charismatic and trying to love both
Kat’a and her son. San’ka is lost between a mask that ‘mimes the living’
and the ghost that should be mimed by the living. The effect upon
San’ka’s subjectivity is born of this relation, ‘as double relation, one
should say as double social bond’. Both - the specter and the mask - are
the invincible forces and the original powers in San’ka’s subject-formation
as the double ‘ghost’ effect.
The Oedipus-Hamlet mythological convolution that plots the
psychologically complex relations between San’ka, his mother Kat’a, and
his stepfather, does not finish with the scene, when after many years of an
orphanage San’ka accidentally finds and kills Tol’an. Neither the boy nor
the spectators know whether Tol’an is really dead, or he mimics his own
death (as he was a mask all his life) on the floor of a cargo-car in a
speeding-up train, taking away his body - dead or alive - away from
San’ka. The very act of San’ka’s shooting at his ‘daddy’, a thief, a mask,
has a subversive meaning. Killing a mask as revenge becomes a terrible
loss to the boy. San’ka is attached to Tol’an, seeing himself as his son,
however, the annihilation of the mask discloses emptiness behind it,
nothingness, and absence of a real body to be buried and mourned.
‘Daddy’ can be annihilated only on condition of annihilating oneself, as a
‘daddy’ body has become inalienable part of the life of his son, his norms,
behaviour, choices, actions and body.
The third and final part of the film shows San’ka as a colonel
somewhere on the southern borders of the collapsing Soviet Union. His
childhood dream ‘like father, like son’ came true - he became a military
like his father, the ghost in the film narrative and the sacralized figure in
___________________________________________________________
the paternalist metanarrative of the Soviet ideological and political order.
However, San’ka’s gendered perception of masculinity was modelled by
the Word and Law of Tol’an. Army and prison are two allegedly opposite
forms of collective construction, control and organization of normative
(army) or deviant (prison) masculinity. However, both institutions
perpetuate Tol’an’s principle of violence and aggression. This gendered
principle of modern masculinity is central to the Oedipal father-son plot in
the complex ‘ghost’ space of Soviet history - Lenin (eternally alive),
Stalin (symbolic father), father-soldier (legend, myth, ghost), stepfather-
thief (thief) and their lost sons. The phanthomatic presence of Stalin
(father of every Soviet child) in the filmic narrative, the regular emergence
of father-legend in San’ka’s fantasies and finally, Tol’an’s ‘death’ - are
ghostly presences in the protagonist’s quest to understand himself and the
meaning/value of his life. Only in the final episode, the agonizing death of
an old alcoholic stranger whom the colonel mistakes for Tol’an (the same
tattoo of Stalin’s profile on the left side of the drunkard’s chest) becomes
the ghastly symbol of the dying political order and its narrative of
hegemonic masculinity. 11
Similarly to Pavel Chukhrai, Vladimir Khotinenko
addresses the major institutions of forming modern normative/deviant
masculinities in his famous film Muslim (1995), focusing on a dramatic
story of a mother and her two sons in a post-Soviet Russian village. The
elder brother spent time in prison; the younger took part in the
Afghanistan war and spent some time in captivity with mojaheds. Both
institutions and experiences remain beyond the film narrative when the
two brothers meet again in the house in which their father had committed
suicide by hanging himself on the hook in the ceiling. The very beauty of
typical Russian landscape -pastoral panorama of green fields, distant
churches around a quiet village, the heart and soul of the Russian
nationalist discourse since the 19th century - invites the film’s spectators
into the ideal chronotope of the missionary Russian idea, genealogically
central to the discourses and practices of Soviet Orientalism. However,
death, or its expectation, is woven effortlessly into a loose fabric of
cinematic incidents and images in Muslim. Khotinenko brilliantly
examines and deconstructs the ‘idiocy’ of village life, symptomatic not
only of the collapse of the Soviet system and its values, but of the dying
Russian Idea, a historical and nationalist metanarrative, central to the very
mechanism of Russian xenophobia.
Nikolai, an Afghanistan war hero, comes home after having been
officially declared missing in a military action for years. His arrival causes
a shock in the village community - during his captivity years he had
converted into Islam. The villagers openly hate the Muslim, Nikolai
Irina Novikova 17
___________________________________________________________
Ivanov or Abdullah, for being different, though one of their own, for
reminding them with his very presence, work and behaviour of their own
corruption. Villagers, including his own mother, want Nikolai-Abdullah to
leave as they do not want to learn and know how to deal with Otherness
not on the ‘margins’ but inside the Russian ‘pastoral’ world of today.
Nikolai’s death that he accepts with relief does not bring redemption and
hope in the end of the film.
In the film Captive of the Mountains (1996) by Sergei Bodrov a
Chechen father tries to break off the chain of deaths permeating the distant
world of his Chechen village in the mountains and the town where a
Russian army garrison stays. In the last episode of the film the father takes
a Russian young soldier, his captive, to an execution to revenge for his
son, killed by a Russian soldier during his attempt to run away from
prison.
The old Chechen man releases his captive but his attempt to
disrupt the chain reaction of men’s deaths on both sides of the conflict is
futile. The final episode directly alludes to the episode of a sanguinary
bombing of a Vietnamese village accompanied with Wagner’s music
Valkiria Riding in the legendary film Apocalypse by Francis Ford
Koppola. In Koppola’s film, the magnificent symphonic orchestration of
the politics of the sublime annihilates its objects/abjects into the gaze of
his spectatorship frozen with horror and anger. In Bodrov’s film, only
several Russian military choppers modestly emerge out of the mountains.
They fly over the head of the soldier to bomb the village. Unlike Koppola,
Bodrov does not show the bombing of the village and death of its
inhabitants. Instead, he lets his spectators enjoy the exotic and wild beauty
of a still untouched oriental landscape with a tiny village, vis-à-vis the
approaching choppers - the image on the screen before it becomes an off-
screen destroyed reality off the screen. The final sentence of the narrator
who is the former captive in the village does not leave us any hope for a
happy-end fantasy. A spectator is as helpless as the former captive soldier,
in the role of a visitor to another ‘museum’ of war and its natures mortes.
The situation of how a son perceives the death of his father
becomes the plot and narrative in Aleksandr Sokurov’s film The Second
Circle (1990). 12 The perception/recognition of father’s death by his son,
the protagonist of the film, occurs in a direct visual and tactile contact of
the son with the body of the deceased. Having lost its intentionality, the
dead father’s body is leaving life and demanding the shelter/haven in non-
being. The spontaneity, rigidity, granularity of the contact between
father’s non-being and his son’s being is an emphasized and focused
process in the film narrative. This allows Mikhail Yampolsky to argue that
Alexander Sokurov's film has introduced death in its metaphysical
___________________________________________________________
dimension into the modern Russian cinematic tradition. Sokurov
introduces a missing part in the Russian cinematic tradition - the directly
visualized work of death, the process of dying, the chronicle of
necrotransformations therefore his cinematic world finds completeness
and loses the language, thus, waiting for a new language, the son’s
language, to be imagined.
In the film The Return (2003) by Andrei Zvyagintsev the
narrative plot focuses on the return of the father to the family of mother,
grandmother and two adolescent sons Ivan and Andrei. An old photo of a
happy young family is both the imagination of a lost paradise for both
boys, and the suppression of images of the missing father in their
imagination. Will the return of the real father resurrect the lost
completeness of life?
A tower, a phallogocentric 13 metaphor of the ascension, death
and rebirth, appears in the beginning and in the end of the cinematic
narrative. The first tower is the place where the boys have to prove their
manly courage and jump into the water. The second tower on an
abandoned island is the place from which the father tries to save Ivan,
accidentally falls and is broken.
Irina Novikova 19
___________________________________________________________
The image of the tower strongly implies a rigid discourse of
masculinity, or ‘a gender corset’, meant to discipline a boyish body and
consciousness in compliance with certain schemata of man’s behaviour.
Most likely, the father in his childhood passed rituals of becoming a man,
but we never find out about his past, and what had happened to him.
However, he does not know how to become the father to his sons. His
latent traumatic experience eventually tells itself in the aggression against
his adolescent sons. He is a son of the certain social and gender order,
which had trained him in the certain system of coordinates and norms of
masculinity. He is theatrical in his hyperimperous behaviour at the dinner
table, he is obnoxious when trying to give categorical orders to his sons
(the Law of the Father), and he is violent when the boys disobey his
orders.
During the years of separation, Ivan and Andrei have
subconsciously waited for the return of their father. Three of them spend
some days on an uninhabited island, in a mutual return to each other; let it
have a tragic end. Rescuing Ivan, father perishes, and the sons have to sit
next to the body of their father in the boat while returning from the island.
Here the reality of the death of the father, the pain of the loss reveal the
changes in the boys, particularly, the rigidity and resoluteness which come
to his elder son Andrei, testifying that, at least, for him the return of the
father is real.
The Sokurov-Zv’agintsev cinematic space of death and dying is
intriguing as it focuses visualization of death in an image of a dead body
of the father. In their films the figure of the father goes on a trajectory
from deconstructing the metanarrative (Chukhrai, Khotinenko) to absolute
silence. His death as absolute silence designates a situation of a voice
transfer, igniting the reciprocal speech of the son. In other words, father
demands in his death for the similar and articulated repetition of his
words, action, narrations, as it happens with Andrei in Zvyagintsev’s
Return. All his questions to his son (or sons) become one question – the
question of his/their commitments to him as a past reality, not a returning
ghost.
The direct observation of a dead body of the father is at the same
time a metamorphosis occurring to his son/sons. Looking at the face of the
late father, the son/sons try to see, and, hence, to understand and seize, i.e.
to take advantage of mechanisms of sight and to understand, and, thus, to
connect the fact of father’s death with speech – “in time to start talking.”
The dead body of father becomes the object, which breaks the habits of
sight and looking. It becomes a chasm that demands to be sealed off, or in
other words, re-signified into certain narratives of future reality.
___________________________________________________________
Death of a male body and the spectacle of a male body dying,
mainly represented in the father-son relationship, prevailed in the post-
Soviet Russian films of the 1990s, interrelating the themes of history,
masculinity and nation, but not more than diagnostically. The shift from a
metanarrative to a metanarrative has been represented mostly in the tragic
film genres, focusing on the ‘masculinity crisis’ as effected by the
historical trauma of the late 1980s. The historical traumas are thus
translated into the historical consciousness of the transitional period into
capitalist modernity, demanding for the reconstruction of ‘authentic’,
‘lost’, ‘destroyed’ masculinity, thus, for the revival/return of the nation.
This Zeitgeist of revival/return includes the very crisis of masculinity as an
indicator of its overcoming. At the same time, the very masculine
subjectivity has been considered self-sufficient and metaphysically self-
reproductive by distancing its ‘essence’ from the former abjected
iconographies of hegemonic masculinity in the lavish objectifying and
dissecting representations of the deaths of former icons in the post-Soviet
Russian cinema of the 1990s.
Notes
1
Felicitas Becker, Knowing the Limits. Kinoeye. New Perspectives on
European Film, 10 November 2003, (5 May 2006).
< http://www.kinoeye.org/03/13/becker13.php>.
2
Boris Groys, Utopiia i obmen. (Tr. Utopia and Exchange). (Moskva:
Znak, 1993), 354.
3
Ibid., 64.
4
Jacques Derrida, The Specters of Marx. Tr. Peggy Kamuf. New York:
Routledge, 1994, 91, 97.
5
Ibid., 10.
6
Metanarrative “is a global or totalizing cultural narrative schema which
orders and explains knowledge and experience”. In John Stephens.
Retelling Stories, Framing Culture: Traditional Story and Metanarratives
in Children's Literature (1998)
7
Christina Stojanova, The New Russian Cinema, Fall 1998, (9 May 2006).
<http://www.kinema.uwaterloo.ca/sto982.htm>.
8
Thomas H. Campbell, The Bioeasthetics of Evgenii Jufit, 26 January
2006, (16 May 2006).
<http://www.kinokultura.com/2006/11-campbell.shtml>.
9
Alexei Yurchak, The Politics of Indistinction. Bioaesthetic utopias at the
end of Soviet history, 5 April, (2 June 2006).
Irina Novikova 21
___________________________________________________________
<http://cas.uchicago.edu/workshops/pcs/yurchak-politics-
indistinction.pdf>.
10
A Soviet communal flat was inhabited by several tenant families sharing
a kitchen, toilet and bathroom.
11
R.W Connell, Masculinities. (Berkeley: University of California Press,
1995).
12
The title of the film refers to the second circle of hell depicted in The
Divine Comedy, Volume I: Inferno by Dante Alighieri.
13
Phallogocentrism, by Jacques Derrida, refers to locating the centre of
text/discourse within the logos and the phallus and privileging of the
signified over the signifier.
Irina Novikova is Professor of the Department of Culture and Literature,

Director of the Centre for Gender Studies, at the University of Latvia,
Riga. Her current research is on gender and genre in literature and cinema.
The Living Dead as Cinematic Images of Death
Outi Hakola
Abstract
Death is an open area for beliefs, fears and fictions. The
cinematic living dead, as vampires, mummies and zombies, represent and
visualize death in a corporeal way. These creatures are familiar from the
horror genre where they threat humanity because of physical and mental
transformation through death. The living dead are uncanny other and they
create abjection. They highlight the fear of death and otherness, unknown
existence and marginal phenomena. In the living dead film the undead
characters symbolize contradictions of race, class, sexuality or nationality.
In my presentation I will consider the nature of the living dead
character between life and death and those fears and imaginative
possibilities these creatures open to us. At the same time I will consider
the narrative tradition of these films and how the narration marks these
creatures as monsters. I use as an example Francis Ford Coppola’s film
Bram Stoker’s Dracula. In this film the un-dead character is both evil and
empathetic and victims are both sinful and innocent at the same. In this
film love and sexuality become the driving forces for the unnatural
extension of life beyond death.
Key words: living dead, horror movies, abjection, otherness, narration.
The ‘living dead’ is a term for such fictive creatures as vampires,

mummies and zombies. In this paper I discuss the themes of death and
dying in the living dead films. As an example I use a vampire film - Bram
Stoker’s Dracula (released in 1992) - that was directed by Francis Ford
Coppola nearly 15 years ago.
I start with an image of the love scene between Dracula and
Mina. Dracula, who sees in Mina his former beloved, has taken the form
of a young aristocrat and has seduced Mina. The scene starts when
Dracula enters Mina’s bedroom and Mina demands to know, what he
actually is. Dracula responds: “I am nothing. Lifeless. Soulless. Hated and
feared. I am dead to all the world. I am the monster that breathing men
would kill. I am Dracula.” This is moment when Mina realizes that this
man of her dreams has murdered her best friend, Lucy. Even then Mina
can not deny her love or desire to be what Dracula is. Dracula tells her the
means to become a vampire: “To walk with me, you must die from this
life and be reborn to mine. Then I give you life eternal, everlasting love.
The power of the storm and the beasts of the earth. Walk with me to be my
loving wife forever”.
24 The Living Dead as Cinematic Images of Death
___________________________________________________________
But when Mina is about to drink Dracula’s blood the monster
shows his empathetic side. He stops being seducer and the love towards
Mina forces him to tell the terms of transformation as well. “I cannot let
this be. You will be cursed to walk in the shadow of death for all eternity.
I love you too much to condemn you.” But Mina has already made her
mind. With Dracula she sees her life in a different light. She sees the
obstacles and barriers that limit her decisions. With Dracula she sees the
possibilities to make different choices, to have extreme and denied
experiences. She says: “Take me away from all this death” and starts her
transformation process into a vampire.
This love scene between Dracula and Mina is beautiful and
essential part of the Coppola’s film and in this scene the important themes
of my paper come apparent. This scene reveals the living dead as
immortal, powerful and seductive as well as murderer, nonhuman and
unclean.
In Coppola’s film death is main narrative turning point. On the
one hand, death is feared and avoided because it transforms you to
something creepy. In this case into a monster who has the narrative task to
destroy on physical, moral and / or psychological levels. 1 But on the other
hand death is a doorway to a new life. As for Mina the vampirism reveals
her feeling that she is not always living life to the full. She wants to
bypass the limiting social or moral barriers.
1. The living dead as Otherness

The living dead are undead bodies and death is their main and
unifying feature. They are visualized images of death. As dead and alive at
the same time, they are placed outside the natural order and they represent
otherness and unknown.
The living dead, such as Dracula, visualize death in a very
corporeal way. A living dead is primarily a corpse, a physical and moving
body even though it is pronounced dead. As American horror film
historian Gregory Waller says, the living dead betray their origins. They
stay recognizable human beings, even though their physical appearance
may change or they may achieve supernatural powers or other special
characteristics. 2 The threat caused by the living dead arises from this
transformation and from their unnatural relationship to death. As corpses
these undead bodies start to fall apart and to be able to stop the
decomposing process, the living dead exploit the living. They need blood,
flesh, bodies and even souls of the living to survive. Therefore the
otherness is underlined by physical danger.
Drinking of blood is a key to vampirism and it is a symbol for
extreme egoism that shows no respect to other’s lives. Harto Hänninen
Outi Hakola 25
___________________________________________________________
and Marko Latvanen see the bleeding as the crossing point between life
and death. The vampire does not have its own blood production and
therefore it seeks the blood of others. The vampire’s bite causes
immortality but makes the victims lose both blood/life and their human
identity. 3
Dying separates a person from the society, as well as it separates
him/her from social behaviour. In a moment of death both conscious and
consciousness as a moral figure are lost. The drives and immediate
fulfilment of desires surface instead. The drives, deeply buried into the
subconscious according to Freud’s psychoanalysis, represent the darker
side of humanity. Death brings these suppressed elements of the human
being into the open. The living dead are a nightmare what a mankind
could be and perhaps already are. The monstrousness is in the human
being, it is not something exterior.
2. The living dead as admired creatures

Because we can recognize ourselves in the image of the living
dead, we can identify to the surfaced desires and feelings as well. Vesa
Sisättö considers that even though the vampires stand for death and
darkness, they stand for the ideal of freedom at the same time. For
example, the vampires are powerful creatures, they have conquered death,
they shamelessly fulfil their desires and they express their sexuality
openly. 4 They dare to do what we dare not.
One essential suppressed and desired element is sexuality. Where
as death and immortality stand for the outreaching the natural limits,
sexuality stands for the transgressing the limits of society. As Andrew
Tudor remarks, in horror fiction sexuality is a threat to the social order. 5
Especially in Coppola’s film sexuality and control are important themes.
Dracula is an erotic creature and its victims participate willingly in the
seduction. Andrew Tudor emphasizes that Dracula’s threat arises out of
our own weaknesses. The strongest obstacle for a vampire is a strong will,
not any physical object. The vampire uses our suppressed sexuality and
desire for excitement. 6
In the Bram Stoker’s Dracula the vampires bite one man and two
women. The man is able to resist his own lust and sexual seduction and
escapes. The two women willingly give in for the experience of lust.
However the film does not state that women are easy victims. Instead, as
Bonnie Zimmerman argues, Coppola’s version is a story of attempts to
free oneself from the restrictions that cultural codes have enforced people
to act out. 7 The story is situated to the 19th century and is based on the
sexual restrictions women confronted while men seem to have more space
___________________________________________________________
to express their sexuality. Dracula merely gives to women a chance to
explore their sexual drives openly.
3. Narration of dying
As figures of death the living dead can be feared and admired at
the same time. They image the post-mortem to be both rewarding and
punitive experience. Their unnatural corpses are appalling, but their
freedom from social limitations is envied. However the narration of the
horror films puts these monsters in their places. For horror fiction, as
Yvonne Leffler states, the antagonist is a central narrative and structural
element. 8
The narrative structure with beginning, middle and end brings
forward a narrative progress were a monster is born, then its existence is
accepted and finally the monster is destroyed and the order regained. In
this progress the beginning is the introduction of the main antagonist,
Dracula. Then the threat is materialized with human victims, like Lucy.
The victim is contaminated and he/she returns as a representative of the
undead. The body is alive, but the personality has replaced with
monstrousness. In the end, both main antagonist and other reborn
monsters must be destroyed.
The narration does not only picture a transformation process into
a monster, but also describes beautifully and horrifyingly the processes of
loss, grieve and rejection. One needs to accept the death of a loved one in
order to survive. These films make a viewer to concentrate more on the
cultural and personal meanings of death than on the medical definitions of
it.
4. First death: death of a person

The birth of a monster is important narrative turn. In the living
dead films a death is not the end. Instead it is a new beginning. David Skal
has remarkably interpreted that all monsters can be seen as an expression
of birth, whether it is weird or unnatural. 9
In the living dead films, I call these narrative turning points as
first deaths, deaths of a person, because at the moment of death the
personality of individual victim dies. The essence of person is lost and this
essence appears to be the soul. Soul marks the humanity, the body marks
the animality. Dualistic separation brings the body and bodily instincts,
such as hunger and sexuality, the dominant forces. The loss of soul is
internal transformation, but as Roger Dadoun emphasizes, in the rebirth
process the inner state of monstrousness becomes outer and concrete
reality. 10 In horror fiction the outer appearance reflects otherness and
inner existence.
Outi Hakola 27
___________________________________________________________
In Bram Stoker’s Dracula the fate of Lucy is a good example of
the described process of dying. She is a lively and passionate girl and
easily seduced by Dracula. The first marks for forthcoming transformation
can be seen even before the first death. The external changes work as
warning signs. The bodily marks are bite marks in the neck, paleness and
growing fangs. Personality starts to change as well, and Lucy becomes
openly lustily and aggressive. The first death finishes the transformation
process and makes the changes irreversible.
5. Social death: grieving

Transformation from human into monster is difficult situation to
handle. Norbert Elias has remarked that death is a problem to the living,
not to the dead. The living have to find means to deal with death, loss and
the anxiety they arouse. 11 Those who are left behind have to accept this
change in order to destroy the monster. After being buried Lucy keeps
rising from her grave and eats little children. The normal transition and
grieving rites fail their task and death needs to be faced directly.
Michael Mulkay talks of biological and social deaths. The
biological death is the death of an organism, whereas the social death is
the death of a person’s social influence. 12 The living dead films describe
the same processes. The first death has started a process where a person
has to be declared to be both biologically and socially dead. In the living
dead films, death is a state of emergency and a challenge to the society
and individuals. The exclusion process of death stands as a symbol for
social death.
In the horror narratives the importance of social death is often
described with Julia Kristeva’s concept of abject. Abject has been a part of
a human being, but after separation from the subject it creates a threat to
the identity and therefore it needs to be cut loose. 13 Jonathan Lake Crane
sees a corpse as a typical source of an abject in the horror. The corpse
reminds of life and subject and denies them at the same. The corpse
becomes a source of mayhem and it must be excluded, often with
violence. Before exclusion can take place, the protagonist and other
characters need to accept the transformation of diseased. They must
negotiate between their memories and abject. 14
If characters are unable to deal with loss and grief they become
easy victims for a newborn monster. When men come to destroy Lucy’s
undead body, they do not want to believe that the transformation has
actually taken place. They wish to see Lucy, but in the end they do realize
that the blood-sucking creature is not Lucy, but something else and they
cut her head off.
___________________________________________________________
6. Second death: end of existence
The second death is end of exclusion process and end of
existence. The extermination is a physical act. Because the vampire is not
born naturally, it cannot be killed naturally. For example, ever since the
days of folk tradition the vampire could be pierced with a wooden stick,
burned or the head might be cut off. 15 In the second death the monstrous
body is destroyed. In Coppola’s film Dracula returns to his former, human
body and rests in peace. At the same moment both his and his victims’
souls are set free. Death has been replaced under societal control and
separated from the normal life.
7. Death as a threat to body, identity and society

As a conclusion I claim that the living dead create a threat at least
on three different levels. Firstly, they threaten the body, because they
cause the bodies to transform into something unnatural. Secondly, they
threaten the human identity because they replace sense with drives and
instincts. They make a human to recognize his / hers own monstrousness,
which is the biggest threat to the identity according to Yvonne Leffler. 16
Thirdly they threaten society, because they stand for egoistic desires that
break up the social order.
On the one hand the narratives on these fascinating creatures
criticize the social structure, limitations and humanity; on the other hand
these narratives highlight the importance of status quo and social order. As
Michael Pickering sees, the living dead may serve as ritualistic and
symbolic process of exclusion of otherness. 17 This otherness is marked by
death, and these narratives tell as much about the fear of death than the
process of dying. These films picture death as nightmarish and celebrate
the living.
Notes
1
Yvonne Leffler, Horror as Pleasure (Stockholm: Almqvist & Wiksell
International, 2000), 156.
2
Gregory A. Waller, The Living and the Undead. From Stoker´s Dracula
to Romero’s Dawn of the Dead (Urbana, Chicago: University of Illinois
Press, 1986), 16.
3
Harto Hänninen, and Marko Latvanen, Verikekkerit. Kauhun käsikirja
(Helsinki: Otava, 1992), 58-59.
4
Vesa Sisättö, ’Hirviö on tuhottava! Vampyyrimagian rajoituksista ja
kehityksestä’, in Kirjallisuus, tunteet ja keskipäivän demoni.
Outi Hakola 29
___________________________________________________________
Kirjallisuudentutkijain Seuran vuosikirja 51, osa II, ed. Outi Alanko

(Helsinki: Suomalaisen kirjallisuuden seura, 1998), 76-77.
5
Andrew Tudor, Monsters and Mad Scientist. A Cultural History of the
Horror Movie (Oxford: Basil Blackwell, 1989), 167-172.
6
Ibid, 165.
7
Bonnie Zimmerman, ‘Daughters of Darkness. The Lesbian Vampire on
Film’, in The Dread of Difference. Gender and Horror Film, ed. Barry
Keith Grant (Austin: University of Texas Press, 1996), 397-398.
8
Leffler, 137.
9
David J. Skal, The Monster Show. A Cultural History of Horror
(London: Plexus, 1993), 287.
10
Roger Dadoun, ‘Fetishism in the Horror Film’, in Fantasy and the
Cinema, ed. James Donald (London: British Film Institute, 1989), 49.
11
Norbert Elias, Kuolevien yksinäisyys (Tampere: Gaudeamus, 1993), 3-6.
12
Michael Mulkay, ‘Social Death in Britain’, in The Sociology of Death,
ed. David Clark (Oxford: Blackwell Publishers, 1993), 32-34.
13
Julia Kristeva, Powers of Horror. An Essay on Abjection (New York:
Columbia University Press, 1982), 1-12.
14
Jonathan Lake Crane, Terror and Everyday Life (Thousand Oaks: Sage
Publications, 1994), 30-34.
15
Hänninen, Latvanen, 21.
16
Leffler, 153.
17
Michael Pickering, Stereotyping. The Politics of Representation
(Basingstoke, New York: Palgrave, 2001), 2-5, 47-50.
Outi Hakola is Ph.D. student from the Department of Media Studies,

University of Turku, Finland.
Complicated Grief Faced by the Families of Death Row
Inmates: Obstacles to Effective Grief Therapy
Sandra Jones
Abstract
The families of death row inmates experience unique grief and
loss issues that have largely been neglected by scholars and clinicians
alike. This study uncovers the meaning that lies within the specific forms
of grief and loss experienced by family members who currently have a
loved one on death row or have already lost their loved one to an
execution. The concepts of disenfranchised grief 1 and non-finite loss 2 are
utilized to bring attention to the ways in which the circumstances
surrounding an execution complicate the grieving process for the family
members of those condemned to death. Obstacles to effective grief therapy
for these family members are further examined and addressed within this
study. Qualitative interviews were conducted with 50 family members of
Delaware death row inmates. The reactions of family members to having a
loved one on death row are varied and complex, yet they include the
following common responses: social isolation; loss of the assumptive
world; intensified family conflict; diminished self-esteem; fragmented
sense of security, trust, and meaning; guilt and shame; and a chronic state
of despair. These symptoms create numerous barriers to these family
members receiving effective grief therapy.
Key words: complicated grief, death penalty, disenfranchised grief, non-

finite loss, grief therapy, death row inmates, execution.
1. Introduction
Anyone who has experienced the death of a loved one is likely to
feel that their life has been complicated by their loss. Even under the best
conditions, grieving is a complex and an individual process, yet there are
particular types of deaths that make the grieving process even more
complicated due to the circumstances surrounding the death. 3 Research
aimed at determining the prevalence of complicated grief has led to an
estimation that 14-30% of grieving people develop some form of
complicated grief. 4 Although the mental health profession lacks a formal
diagnostic category for complicated grief, a significant amount of
literature has emerged in recent years aimed at defining and treating those
who suffer from this intensified form of grief. 5
Examples of particular types of deaths that are likely to lead to
complicated grief among the survivors of the deceased include those that
carry a social stigma and those that occur through violent means.6 The
sources of stigmatized deaths are many, yet perhaps no greater stigma
32 Complicated Grief
___________________________________________________________
exists than that which accompanies the death of a loved one due to
execution. While much of society may not see an execution as a violent
death, the family members of death row inmates certainly view it as
violent.7
While much has been written about the effects of incarceration on
family members of the offender8 and there is an important body of
literature on grief and bereavement,9 there has been little research into the
grieving process associated with a death sentence and execution. This
paper explores the effects of a death sentence and execution on family
members of the accused, and their unique bereavement. The obstacles that
interfere with these family members receiving effective grief therapy are
further examined. This article not only provides insight into the
complicated grief experienced by this population, but it also yields
information that should prove crucial to mental health professionals who
strive to address the clinical needs of these families.
2. Overview of the population

In an effort to justify sentencing someone to death row, the
prosecution and media must make the capital defendant appear subhuman
and monstrous. Therefore, it can be difficult for the general public to
realize that there are people who love the accused. To the extent that
attention is even given to the family members of death row inmates, they
are typically criminalized along with their loved one, rather than viewed as
the productive members of society that they tend to be. The pain of having
a loved one on death row, and sometimes having to survive their
execution, is excruciating. Several authors have conducted research with
family members of death row inmates and have found among them high
levels of social isolation, stigmatization, depression, and chronic grief. 10
It is against this backdrop that death row families experience the
grieving process. Moving closer to understanding their bereavement is the
work of John Smykla, Margaret Vandiver, and Susan Sharp. Smykla11
interviewed forty family members of eight death row inmates and found
strong prolonged grief reactions among them that were distorted to the
point that they significantly altered their personalities and lives.
Vandiver12 suggested that the family members experience something that
she called “chronic dread,” which comes from the anticipatory grief
associated with executions. Sharp13 analyzed their grief process using the
approach of stage theory, made famous by Elizabeth Kübler-Ross. Sharp
describes the stages of grief facing the families of the accused as BADD
(bargaining, activity, disillusionment, and desperation). Unlike the stages
of grief described by Kübler-Ross, which eventually reach a point of
resolution, the grieving process brought by the BADD cycle is particularly
Sandra Jones 33
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destructive because it typically contains multiple repetitions of the stages,
pushing eventual resolution farther out of reach.14
3. Methods
The primary source of data collection was qualitative interviews
conducted with the family members of capital offenders. The family
members participated in a 45-minute to several hour interview, which
included questions that explored the nature of their grief as they have
moved from the time of the arrest of their loved one throughout the
various stages of the death penalty process. Topics that were explored
include their relationship with the accused, changes in their family
structure, and their interactions with the criminal justice system, the
media, and their community. Their mental health status was assessed as
they were asked to discuss whether or not they have sought any mental
health services to assist them through the grieving process. When they
indicated that they have received mental heath services were asked to
evaluate the effectiveness of such services. More often than not, the family
members indicated that they have not received such services, thus these
family members were asked a series of questions to assess the obstacles
that prevented them from receiving mental health treatment.
Participation observation served as a secondary source of data
collection, as I visited the prison on numerous occasions to meet with the
men on death row. The time I spent in the prison visiting area provided me
with opportunities to observe the grief of the families. The moments
leading up to, during, and immediately after the time that the families
spend with their loved one on death row allowed me to observe the ways
in which they cope with the realization of their loss and the intensity of
their response
4. Sample
The state of Delaware has a very small death row population, yet
when the small size of the state is taken into account, the rate of
executions is alarming. For nearly a decade following the first execution
in 1992, after the death penalty was re-enacted within this state in 1974,
Delaware held the distinction of executing more people per capita than
any other state in the United States.15 The current Delaware death row
population includes 16 men and 14 others have been executed over the last
14 years since the death penalty was reinstated. My sample includes 37
family members who are related to eleven of the sixteen men currently
sitting on death row and 13 family members who are related to four of the
fourteen men who have been executed since Delaware resumed executions
in 1992.
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5. Non-finite loss
The theory of non-finite loss contributes to our understanding of
the ways in which factors associated with particular types of deaths
complicate the grieving process. Non-finite loss refers to those situations
in which losses are slowly manifested over time, and often do not have an
impending ending. It is loss that is continuous, and exacerbated by such
things as milestones, which are not met by the affected individual. The
continuous nature of the loss eludes the family member’s ability to go
through the stages of grief to a point of recovery.16 Authors Bruce and
Schultz, who coined the term, state that the grieving person is lost between
two worlds, one that is known and one that is dreaded.
There are three conditions for non-finite loss. The first is that the
loss must be continuous and often follows a major event. The second
involves developmental expectations that cannot be met. This is well
illustrated by examining the grief felt by parents of developmentally or
physically disabled individuals. These parents grieve when their children
reach an age that carries significant milestones that cannot be obtained.
The last condition described by Bruce and Shultz is the loss of one’s own
hopes and ideals. Those who experience a non-finite loss question who
they could/should/might have been. An examination of these conditions
that must be met in order for a loss to be considered ‘non-finite’ suggests
that such a loss is very likely to lead to complicated grief on the part of
those who are grief-stricken. Many of the factors associated with the
specific deaths that complicate the grieving process of the mourners can
also be found with non-finite losses. These factors include death from an
overly lengthy illness, the unique nature of the loss, the mourner’s
perception of the deceased’s fulfilment in life, the secondary losses that
come with such loss, and the anticipatory grief that accompanies such a
loss.
6. Disenfranchised grief
The theory of disenfranchised grief contributes to our
understanding of the ways in which particular antecedent and subsequent
variables complicate the grieving process. Disenfranchised grief is a term
that was developed by Kenneth Doka,17 and refers to instances when the
bereaved are denied the ‘right to grieve’ by the larger society.
Disenfranchised grief occurs when a loss cannot be openly acknowledged,
publicly mourned, or socially supported. Doka and others have found that
when disenfranchised grief occurs, the emotions of the bereaved are
intensified and healing becomes more difficult. In addition, the bereaved
often experience high levels of distress, disorganization, and prolonged
grieving. The concept of disenfranchised grief becomes more profound
Sandra Jones 35
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when it is combined with Romanoff’s finding18 that grief is most
effectively addressed when there is community support for the bereaved,
and the relationship between the dead and his or her mourners is
acknowledged.
The mourner who is disenfranchised from his or her grief is
likely to face many of the same antecedent and subsequent variables that
have been noted to occur with complicated grief. These variables include
anger, ambivalence, or marked dependence directed toward the deceased,
‘mourner liabilities’ such as prior or concurrent unaccommodated losses
or mental health problems, and the mourner’s perceived lack of social
support.19 The most obvious variable operating prior to, during, and after
the death of their loved one for those mourners whose grief is both
‘complicated’ and ‘disenfranchised’ is a lack of social support within the
community. As a result of the social isolation that typically ensues from
their loss, it is not uncommon for disenfranchised mourners to feel anger
or ambivalence toward their deceased loved one. Their grief is further
complicated by the assaults waged against their notion of the “assumptive
world,”20 as they are often disillusioned by the lack of social support that
they receive from others during their time of sorrow. Other antecedent and
subsequent variables that complicate grief, including mental health
problems and such social factors as the mourner’s educational, economic,
occupational, or legal status, are frequently found to occur among
disenfranchised grievers.
7. Findings
A. Non-finite loss
When the grief experienced by those families directly affected by
the death penalty is examined, it becomes apparent that many aspects of
their mourning are indicative of a ‘non-finite loss’. In all cases, the pain
started after a specific event, the crime and subsequent arrest. Rebecca’s
description of her family’s reaction to her husband’s arrest was typical
among the families interviewed.
I think it was just shock… I think it hit everyone like a

ton of bricks because it’s unexpected. There was a lot of
grief. I just really can’t put it into words, what you feel.
I guess its anguish, like your world has been snatched
away.
The sudden event then spawns what might be considered the

most overarching experience for family members, which is the continuous
nature of the loss. With each new phase of their loss, including the arrest,
___________________________________________________________
conviction, sentencing, death warrants, numerous failed appeals, and, in
some cases, eventual execution of their loved one, family members feel as
if they are experiencing the loss for the first time. In terms of sheer years,
the time between arrest and execution is often 10 years or more.
Throughout the years, hearings and appeals occur frequently. For
most families, appeals only confirm the death sentence, and most said that
when that occurred, they felt like they were reliving the worst days since
the arrest. However, even a good outcome can bring its own set of fears.
Margaret is the mother of a man who was sentenced to death row over
eight years ago. Her family is one of the ‘lucky’ ones because her son won
an appeal for a new sentencing hearing four years ago. Margaret and her
family have been experiencing ‘anticipatory grief’ as they wait for the new
sentencing hearing to begin, a hearing that has been scheduled and
postponed several times. The various themes that tend to cycle with a non-
finite loss surfaced in Margaret’s comments as she spoke of her fear that a
new sentencing hearing may very well land her son back on death row.
Just when she manages to put aside thoughts of her son’s pending hearing,
a court date is set again and she finds herself isolating from everyone and
entering a state of despair. The constant threat looming over this mother’s
head rings loudly in Margaret’s words when she asks rhetorically,
“Everyday you wonder, is this going to be the day when somebody else
besides God says it’s time to end your child’s life?”
The second condition for non-finite loss is the inability to meet
developmental expectations. The example of having a developmentally or
physically disabled child is aptly compared to the experience of having a
child on death row. Of the family members who were interviewed for my
research, Bonnie’s story provides the clearest understanding of family
members’ experience with developmental expectations. She is the mother
of two sons, one who is developmentally disabled and one on death row.
When Bonnie’s son was sentenced to death row, it suddenly hit her that
both of her two children are likely to die before her. Having already
survived three near death experiences with her disabled son, she had long
ago accepted the possibility that he would die prematurely, but now she
struggles with the realization that her other son’s death sentence may too
lead him to an early grave. The milestones Bonnie will never see, such as
weddings and grandchildren have been exchanged for a different and
devastating event: the death of a child.
In addition to the continuous nature of a non-finite loss, Bruce
and Shultz note that a common characteristic of such mourning is the loss
of one’s own hopes and ideals. This aspect of non-finite loss was readily
apparent in the remarks of the family members interviewed. The most
overarching loss of ideal was the families’ loss of what their government
Sandra Jones 37
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means to them. Prior to their loved one’s conviction, many of these
individuals saw the state as their protector. After their experiences with the
state, they were left feeling quite jaded and betrayed, and were forced to
reconcile this earlier notion with their current view of the state as being no
less than a premeditated murderer. This ambivalent view of the state and,
by extension, the criminal justice system, serves as an example of the
effect of complicated grief upon mourners who have their notion of the
‘assumptive world’ challenged.
B. Disenfranchised grief
The concept of ‘disenfranchised grief’ sheds light on another
dimension of the unique grieving process experienced by the families of
death row inmates. The stigma associated with having a loved one on
death row is so enormous that the families who were interviewed for this
research frequently indicated that they do not feel comfortable
acknowledging their loss with anyone outside of their family. Stated by
one mother of a death row inmate, “I don’t tell anybody. They will never
know it from me.” Of course, it is not so easy to keep this information
from people within the community, due to the high level of publicity that
typically surrounds the case of their loved one. When people within the
community note the associations that family members have with death
row inmates, the reaction is typically negative. As a result, the families of
these men on death row are essentially disenfranchised from their grief.
Elizabeth is the mother of a man who was executed for the
murder of four people, including three children. She recalled the harsh
treatment that she received by strangers in her community during the early
period of her son’s incarceration, when she entered public places like
grocery stores and heard people yell out “There’s the mother of the baby
killer!” The taunting that Elizabeth was exposed to throughout her son’s
death row sentence continued through to his execution. She insisted on
being a witness to her son’s execution, yet was not prepared for the taunts
that she would hear from the victim’s family in the execution chamber as
she watched her son being put to death.
The families of death row inmates are further disenfranchised
from their grief in that their loss is never acknowledged. Even if their
relationship with an inmate were to be recognized as a legitimate and
significant one, many people would not consider the unfortunate
experience of having a loved one on death row to be a real ‘loss.’ To the
extent that the feelings of the family members are even taken into
consideration, it is not usual for outsiders to dismiss any thoughts that
families are suffering a loss because they are considered to be better off
without a murderer in their family.
___________________________________________________________
Perhaps the time when the families of death row inmates are most
often left feeling as though their loss is not recognized occurs soon after
their loved one is arrested and convicted, when the community’s memory
of the horrific murder is still fresh. Several family members who were
interviewed recalled exchanges that they had early on with the family
members of the murder victim or others who were intimately familiar with
the case against their loved one. These exchanges often left the death row
families feeling not only as though their loss had gone unrecognized, but
also that they were being scoffed at for the mere suggestion that they
might be in pain. Particularly when the loss suffered by the family of the
murder victim was contrasted to their loss, the families of death row
inmates were made to feel as though they did not have a right to their
grief. They received remarks like “at least you can still see your son; mine
is dead.”
8. Obstacles to effective grief therapy

The vast majority of the family members in my sample indicated
that they have not sought mental health services to help them deal with the
pain of having a loved one on death row. This was not the case for the
children in my sample. Fourteen of the eighteen children I interviewed
indicated that they have received some form of counselling after their
father was incarcerated. Most of these children currently have a father on
death row, yet three of them have also survived the execution of their
fathers.
Family members provide a variety of reasons for their reluctance
to receive mental health services. Many of them indicated that they were
reluctant to seek therapy even before their loved one was charged with
murder. They reported that they were not inclined to seek counselling
either for cultural reasons or because they viewed such services as
reserved for those who are “crazy” or “weak.” Even those family members
who would ordinarily seek counselling to address problems throughout
their life, however, were unlikely to seek such services to assist them
through their grief. The reason most often given for their reluctance to
seek counselling is that the stigma attached to having a loved one on death
row has left them feeling very mistrustful of strangers. These family
members invest a great deal of energy into shutting themselves down to
outsiders who are not in their immediate support network. They work hard
to protect themselves from the ostracism that they face all too often once
people at their jobs, school, or community find out that their loved one is
on death row for murder. In order to talk to a therapist, therefore, they
must be willing to make themselves vulnerable enough to reopen the
wounds caused by their grief. Many of the family members I interviewed
Sandra Jones 39
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are simply not willing to risk opening these wounds with someone who
they fear may judge them and stigmatize them as so many others within
the community have done. When it comes to the children of the men on
death row, however, family members are much more willing to seek
counselling for them to help them deal with the complications that arise
from having a father on death row. These children typically display
emotional and behavioural problems at home and in school that their
mothers, grandmothers, or other adults in the family worry are
manifestations of the anxiety that comes with their father’s looming
execution. Several of the children in my sample who received counselling
had survived having a father on death row for many years by the time I
met with them. Now young adults, they reflected back on the early years
of their father’s death row sentence and shared how helpful they found
counselling to be for them during that time. Caroline, the 22-year-old
daughter of man who had been incarcerated for nearly ten years at the time
of our interview, stated that she was taken to a couple of different
counsellors as a preadolescent. Her mother sought such services in an
attempt to help her daughter deal with the effects of having a father tried
for capital murder in a highly publicized case. Caroline said that she did
not find counselling at all helpful to her. Her father’s case was in the local
and national news so frequently that she felt suspicious of counsellors who
asked too many questions, wary that they were only interested in hearing
about her father’s famous case.
Even when they were impressed with the demeanour of the
counsellor they visited, the majority of the children of death row inmates I
interviewed indicated that they simply found that they did not want to talk
about their feelings around their father’s death sentence. This was
certainly the case with 21-year-old Bobby. When his father was executed,
Bobby was 14 years old. He was sent to numerous counsellors to address
the “anger problems” he and his paternal grandmother said that he has had
over the years that have transpired from the time that his father killed his
mother, was sentenced to death row, and eventually executed. Many times
such counselling was court-ordered due to numerous assault charges that
he has received since his father’s execution. Bobby said that the
counsellors that he was court-ordered to see were usually very nice to him,
but he just didn’t like to talk about how he felt about having a father on
death row. This was a common sentiment expressed by many of the
children.
In order to assist the families as they deal with the non-finite
nature of their loss of their loved one to death row, it is important for the
grief counsellor to address the loss of ideals and the challenges toward the
mourner’s assumptive world that come with this type of loss. Before it is
___________________________________________________________
possible to do so, however, the loss experienced by the family member of
a death row inmate must be legitimized and the magnitude of the loss must
also be recognized. It is important, therefore, for the grief counsellor to
first enfranchise the grief of the family member in order to address the
non-finite characteristics of the loss. If a grief counsellor hopes to
legitimize the status of death row families as mourners, however, he or she
must first have an awareness of the secondary losses that come with the
disenfranchisement of these families.
9. Discussion
Given the current discussion taking place in the United States
about whether the death penalty should continue to occupy a place within
our criminal justice system, it is crucial to consider the impact of this form
of punishment on the family members of the accused. These family
members have often said they feel like they have been given a death
sentence along with their loved one. The unique experience of having a
loved one sentenced to death row has set them upon a long, complicated
grieving process. Their grief has been made complicated by the interaction
of two circumstances associated with their grief: non-finite loss and
disenfranchised grief. They grieve what may have become of their loved
one before he was accused of murder. They grieve numerous other
secondary losses, including the loss of their assumptive world, the loss of
community support, and for some, and the loss of their own identity.
The mental health needs of this population are great. A majority
of the family members in my sample suffer from some form of a
depressive and/or anxiety disorder. Symptoms of post-traumatic stress in
particular are prevalent among these families at points throughout their
grieving process. This is most often the case among those family members
I interviewed who have survived the execution of their loved one, such as
the mother who witnessed the execution of her son on her birthday.
Unfortunately, the social isolation and stigmatization that is associated
with having a loved one on death row makes it extremely difficult for
these families to feel comfortable enough to reach out for help from a
stranger. They frequently worry that a prospective counsellor may support
the death penalty and, if so; many confided in me that they could not
possibly bear their grief to someone who supports the institution that is
likely to lead to the death of their loved one. Some of them commented
that their loved one had received mental health treatment at numerous
facilities before they committed the crime that landed them on death row.
These family members remarked that they are not inclined to seek
counselling because they are disillusioned by the mental health
community that they see as having failed their loved one.
Sandra Jones 41
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The pain of having a loved one on death row becomes so great,
however, that some family members eventually find their way into a
mental health facility. Their entry into treatment is not typically via the
traditional route of mourners who seek grief counselling. They are more
often compelled to seek treatment by the complications arising from their
grief, such as drug addiction, legal problems, or parenting concerns. When
mental health professionals find an occasion to work with the family
members of death row inmates, there are several implications from my
research that they can use to assist them toward their aim of effective
treatment outcomes for these individuals. They need to have an
understanding of the complexities related to a capital crime. Therapists
also need to be willing to disclose their position toward the death penalty
in order to determine if it is an obstacle for their client. Therapists must
work toward enfranchising the family members by validating their grief.
The secondary losses of the family members must also be identified and
addressed.
Notes
1
Kenneth Doka ed., Disenfranchised Grief: New Directions, Challenges,
and Strategies for Practice. (Illinois: Research Press, 2002).
2
Elizabeth Bruce & Cynthia Schultz, Nonfinite Loss and Grief: A
Psychoeducational Approach. (Baltimore, Md.: Brookes Publishing Co.,
2001).
3
John Bowlby, Attachment and Loss, Vol. III. (New York: Basic Books,
1980); Colin Murray Parkes. Bereavement: Studies of Grief in Adult Life.
(New York: International University Press, 1972); P. Marris, Loss and
Change, 2nd ed. (London: Routledge & Kegan Paul, 1986).
4
Linda Schupp, Grief: Normal, Complicated, Traumatic. (Eau Claire, WI:
PESI Healthcare, 2004).
5
It has been identified with different terms, such as ‘traumatic grief’ by
Selby Jacobs, Traumatic Grief: Diagnosis, Treatment, and Prevention.
(Castleton, N.Y.: Hamilton Printing Co., 1999); ‘pathological grief’ by
John Bowlby ‘Pathological mourning and childhood mourning’, Journal
of the American Psycholoanalytic Association, 11 (1963), 500-541; or
‘unresolved grief’ by A. Lazare, ‘Unresolved Grief’ in Outpatient
Psychiatry: Diagnosis and Treatment, ed. A. Lazare (Baltimore: Williams
& Wilkins, 1979); S. Zisook, & L. Lyons, ‘Bereavement and Unresolved
Grief in Psychiatric Patients’, Omega, 20 (1988-1989), 43-58. Regardless
of the terminology utilized, increasingly more attention has been given to
complicated grief in an effort to equip clinicians with the diagnostic tools
___________________________________________________________
and treatment strategies that will allow them to respond in the most
effective manner possible to those suffering from this form of grief.
6
Edward Rynearson, Retelling Violent Death. (Philadelphia, Pa.: Brunner-
Routledge, 2001); E.K. Rynearson, & J.M. McCreery, ‘Bereavement after
Homicide: A Synergism of Trauma and Loss’, American Journal of
Psychiatry, 150 (1993), 258-261.
7
Susan Sharp, Hidden Victims: The Effects of the Death Penalty on
Families of the Accused. (New Brunswick: Rutgers University Press,
2005); Recent research indicates that the process of lethal injection may be
far more brutal than it appears. Research suggests that some individuals
may feel enormous pain from the lethal injection, yet are unable to express
it, as the protocol requires three injections and the second one is a
paralyzing agent. L. Konaris, T. Zimmers, D. Lubarsky, & J. Sheldon,
‘Inadequate Anaesthesia in Lethal Injection in Lethal Injection for
Execution’, Lancet 365 (2005), 1412-1414. Professional medical groups,
such as the American Medical Association, have deemed it unethical for
their members to participate in executions. As a result, numerous lawsuits
have recently been filed in the U.S., challenging the constitutionality of
lethal injection as a mode of execution, and a recent U.S. Supreme Court
ruling has made it easier for death row inmates to file such a claim. Death
Penalty Information Center (DPIC) <http://www.deathpenaltyinfo.org>
8
Donald Braman, Doing Time on the Outside. (Ann Arbor: University of
Michigan Press, 2004); Katherine Gabel & Denise Johnston, Children of
Incarcerated Parents. (Lanham, Md.: Lexington Books, 1995); Jeremy
Travis & Michelle Waul, eds. Prisoners Once Removed: The Impact of
Incarceration and Re-entry on Children, Families, and Communities.
(Washington, D.C.: The Urban Institute Press, 2003).
9
John Bowlby, 1980; Colin Murray Parkes, Bereavement: Studies of Grief
in Adult Life. (New York: International University Press, 1972); T.A
Rando, Grief, Dying, and Death: Clinical Interventions for Caregivers.
(Champaign, Il.: Research Press, 1984); W. Worden, Grief Counseling
and Grief Therapy, 2nd. ed. (New York: Springer, 1991).
10
E. Beck, S. Britto, and A. Andrews, In the Shadow of Death:
Restorative Justice and Capital Offenders’ Family Members. (New York:
Oxford University Press, forthcoming); E. Beck, B. Sims-Blackwell, P.
Leonard, & M. Mears, ‘Seeking Sanctuary: Interviews with Family
Members of Capital Defendants’, The Cornell Law Review, 88 (2003),
382-418; R. King & K. Norgard, ‘What about our Families? Using Impact
on Death Row Defendants’ Family Members as a Mitigating Factor in
Death Penalty Sentencing Hearings’. Florida State University Law Review,
26 (2003), 119-1174.
Sandra Jones 43
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11
J.O. Smykla, ‘The Human Impact of Capital Punishment: Interviews
with Families of Persons on Death Row’, Journal of Criminal Justice, 15
(1987), 331-347.
12
Margaret Vandiver, ‘The Impact of the Death Penalty on Families of
Homicide Victims and of Condemned Prisoners’, p. 477-505 in America’s
Experiment with Capital Punishment: Reflections on the Past, Present and
Future of the Ultimate Penal Sanction, eds. by James R. Acker, Robert M.
Bohn, and Charles S. Lanier. Durham, (N.C.: Carolina Academic Press,
1998).
13
Susan Sharp, Hidden Victims: The Effects of the Death Penalty on
Families of the Accused. (New Brunswick: Rutgers University Press,
2005).
14
Ibid.
15
Oklahoma recently rose to the position of the state that executes more
people per capita than any other state in the country, bumping Delaware to
second in line for this dubious distinction Death Penalty Information
Center (DPIC) <http://www.deathpenaltyinfo.org>
16
Bruce & Schultz, 2001.
17
Doka, 2002.
18
B.D.Romanoff & M. Terenzio, ‘Rituals and the grieving process’,
Death Studies, 22, 697-711.
19
T.A. Rando, Treatment of Complicated Mourning. (Champaign, Il.:
Research Press, 1993).
20
Colin Murray Parkes, ‘Bereavement as a psychosocial transition:
Processes of adaptation to change’, Journal of Social Issues, 44, 3, 53-65.
Britain’s ‘Punk’ Mourning Culture
Gerri Excell
Abstract
In 1977 the British music industry was rocked when the Sex
Pistols catapulted into the music world with their anti establishment
assault on the industry. Now it’s the turn of the British mourning culture,
out with established rules of mourning and, in with the new anti
establishment mourning culture of the roadside memorial. There are no
prescribed rules of what constitutes a roadside memorial and, this is
exactly the characteristic that appeals to the bereft, the personalisation of a
memorial site. A content analysis of 50 roadside memorials in the UK
reveals that it is the individuality of the symbolism that is important for
those bereft in today’s society. The roadside is a public space and is the
perfect space to incorporate a memorial that can draw attention to the end
of a life; the roadside can be used as a place to celebrate the life whilst at
the same time protest the untimely death. Religious iconography does not
focus heavily in the roadside memorial culture of the UK, is this because
the roadside is not perceived as the place for a religious icon? Could it be
that the death itself has questioned their faith? This paper will chronicle
the development of the roadside memorial in the UK and, discuss how the
proliferation of memorials is challenging established rules of mourning.
The new ‘punk’ movement of mourning will not go away but may
possibly evolve as policy is fashioned and attempts are made at
standardising the memorials. However, more can be learnt from the
individualised memorials; what are societal values today? What makes a
statement about this life, and maybe more importantly what might have
been missed about this life if a memorial had not been placed? The
roadside memorial provides a voice for a life that may only have a brief
eulogy in a crematorium by an officiant who never knew that individual,
this voice encourages freedom of speech.
Key words: mourning, punk music, roadside memorials, spontaneous

memorials.
1. Introduction
In this world nothing can be said to be certain except death and
taxes Benjamin Franklin, 1 death is the greatest leveller for all, besides
being born death is the only other certainty we have. However, how our
deaths are memorialised remains one of the great uncertainties, unless of
course plans have been made in this age of the buy now die later pre-
payment funerals. The mode of your death, however, may have a
qualifying effect on how you are memorialised. Since the 1980s there has
46 Britain’s ‘Punk’ Mourning Culture
___________________________________________________________
been a substantial growth in the number of spontaneous and roadside
memorials in the UK. 2 This paper will examine the phenomenon of the
roadside memorial and compare their emergence on British mourning
culture to that of the onslaught of punk music on the British music scene
of the 1970s. I will argue that Britain’s mourning culture has been subject
to the same processes that the music industry suffered at the hands of the
punk music genre. What was once a bottom up movement moves into the
mainstream. Whilst at first being feared by the established music world
and society, punk music quickly became part of the mainstream and lost
some of its original power. The same argument will be levied at the
roadside memorial phenomenon, what once courted controversy, has once
again joined the mainstream. This paper draws heavily on a previous
research project carried out in 2004 as part of my Masters degree. The
focus was roadside memorials in the UK, in which interviews were
conducted with those who have placed and maintained memorials at the
roadside.
2. Roadside memorials in the UK

Over a period of four years I have photographed roadside and
spontaneous memorials, collecting visual evidence of this form of
memorialisation I decided to research the phenomenon of roadside
memorials for my Masters dissertation; I interviewed individuals who had
been bereaved through road traffic accidents. I wanted to find out why
they chose this form of memorialisation and what meanings they had
attached to the memorial. The findings revealed that the mode of their
loved ones death, sudden, violent often lonely death was the determining
factor in their decision to place a spontaneous memorial.
The British have a stoic reputation when it comes to grief, with
the British stiff upper lip and a lack of demonstrative public acts. Geoffrey
Gorer famously stating in his book on mourning that in the UK death was
“pornographic.” 3 However this historically stoic British reputation was in
jeopardy of being dismissed as a myth when Diana Princess of Wales died
in 1997, the Australian sociologist Peter Griffiths 4 , claiming that in
England there was a new “Mediterreanisation” of emotional expression.
However, public acts of remembrance and memorialisation have
always been a part of the British way of mourning. According to George
Monger 5 there has always been a tradition of placing wayside flowers in
the British Isles.
Yet, it was not until the 1980s that the numbers of spontaneous
memorials grew and became part of the British way of mourning. The
1980s saw a host of tragic events, Hillsborough, Lockerbie and The Kings
Cross Fire for example, each subjected to spontaneous memorialisation-
Gerri Excell 47
___________________________________________________________
both formal and informal. 6 The mass media played an important part in
the dissemination and mass exposure of this organic form of
memorialisation. Today, with the advent of 24-hour news television and
the Internet, news editors depend on the image of the spontaneous
memorial as a poignant backdrop to the news story they are reporting on.
In the course of my earlier research I was helped by the UK
charity RoadPeace, an organisation founded by Brigitte Chaudhry
following the death of her only son in a road traffic accident in 1995.
RoadPeace offer advocacy to the families of those bereft through road
traffic accidents and offer an online memorial site and a permanent plaque
that can be placed at the scene of the fatality. These plastic A4 plaques
feature a bleeding anemone and a space where the bereaved can write the
name of the person who died, to date RoadPeace report that over 3000 of
these plaques are in place. 7 Although RoadPeace claim that over 3000 of
their “Remember Me” plaques are in use, it is the individualised, stylised
roadside memorial that is commonplace in the UK.
3. The study
Having previously established the rationale for the placing of a
spontaneous memorial in an earlier research project 8 , focus was placed on
the material culture of the roadside memorials. Cataloguing over 100
memorials from the UK, 50 random memorials were selected and their
material culture recorded. Cataloguing the unique features of each
memorial in the sample revealed some fascinating insights into our
memorial culture of the UK. Drawing from previous published research
into roadside memorials from the USA and Australia 9 , it was evident that
the UK was unique in its spontaneous memorial culture. Most noticeable
was the dearth of “crosses” in our roadside memorials, In Australia Clark
& Cheshire 10 report that 80% of the memorials in their sample had a small
white cross in the material culture. Similarly in the USA white crosses are
the most common form of memorialisation in the roadside memorial
culture, many states in the US provide formal white crosses to be placed
on the roadside, and only these official white crosses may be placed. 11 The
top ten totems found in British roadside memorials were (1) Flowers; (2)
Names; (3) Footballing items (flags, shirts, tickets); (4) Candles; (5)
Messages; (6) Photographs; (7) Soft toys; (8) Alcohol; (9) Clothing; and
(10) Automobile wreckage. 12
This post-modern mourning culture surrounds itself in personal
representations of the individual, the individual is the focus, what football
team they supported, who they have left behind and what their loss means
to society. The study supported the assumption that roadside/spontaneous
___________________________________________________________
memorialisation is a bottom up movement, where there are no rules of
what makes a good memorial it is entirely personal and organic.
4. The connection with ‘punk’

The early 1970s were dominated by bands that wore more make
up, sequins and glitter than the amassed crowds of female fans. Music
became light, almost comical, the art school college bands and Oxbridge
educated bands like Pink Floyd were edged out by the pop bands such as
Sweet, Glitter Band and T Rex. Throughout the twentieth century music
styles and cultures had clashed, big band sounds versus rock & roll, Mods
Vs Rockers, soon, all music styles encountered their nemesis in the Punk
Rockers. Early punk rock was an underground movement that attracted
those disillusioned by the grandiose ostentation of the glam rock scene.
The Sex Pistols were a band that epitomised the punk movement young
men with little or no futures and marginally less musical ability, but with a
Machiavellian mentor one Malcolm Maclaren. Keen to make as much
money as he could Maclaren was the mastermind behind the Sex Pistols.
The rationale behind the Punk movement was borne from that of the
Situationalists 13 a social movement active in France in the early part of the
nineteenth century. The punk movement was a kick against the established
music, clothing and way of live. The seminal Sex Pistols album ‘Never
Mind the Bollocks’ contained such ground-breaking songs such as
Anarchy in the UK, God Save the Queen and Pretty Vacant. The Sex
Pistols were hailed as the voice of the youth, Johnny Rotten, infamous for
his angry nihilism; was renowned for his bitterly sarcastic attacks on
pretentious affectation and the very foundations of British society. Once
again British society was debating the birth of yet, another subculture.
Sarah Thornton describes a subculture as
Subcultures are groups of people that have something in

common with each other …which distinguished them in
a significant way from the members of other social
groups. 14
This explanation of a subculture exemplifies the punk rock and

spontaneous memorial activists in that they are distinguishable from other
members of society one by their outlandish appearance and the other with
their fervent desire to express their grief so publicly. Thornton goes
further in her dissection of a subculture and reveals that subcultures have
been studied whilst in a state of transience. This is also true of those who
participate in acts of spontaneous memorialisation; they are in a liminal
state, a state transition-the mourning phase. Subcultures are often feared
Gerri Excell 49
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and misunderstood Stanley Cohen’s seminal work on subcultures 15 laid
the foundations for sociological investigations into societal reactions to
deviant behaviour. Punk Rock was feared, the very physical appearance of
the punk rockers with their safety pin piercings, Mohawk hairstyles and
ripped clothing striking fear into the hearts of society. Television
programmes discussed the impending dangers of the punk rockers and
their influence on impressionable teens. Bill Grundy, the late veteran TV
presenter was partly responsible for the Sex Pistols notoriety; the group
disrupted a live television interview with their swearing and apparent
disregard for the presenter. 16 This behaviour had never been seen on
television before in the UK and the nation was in uproar, but the bubble
was soon to burst.
5. The diminishing return

Punk rock was a shock, an underground movement, grass roots
and anti establishment. However this was all soon to change, the music
rapidly became the norm the music charts groaned under the weight of
pseudo punk rock bands. High street fashion shops stocked mass-market
chain street punk fashions; punk was the norm anyone who had the money
could buy into the punk lifestyle. Where once questions were asked in
Parliament, now punk was seen in soap operas, daytime television and
glossy fashion magazines. The power that punk had was diminishing.
The phenomenon of the roadside memorial crept into the British
mourning culture by stealth; nobody was interested in the increasing
numbers of memorials on busy roads or country lanes. Yet, just as punk
burst onto the music scene, now came the dawn of the spontaneous mass
memorial. Throughout the decade of tragedy, the 1980s, nightly images,
via the news channels, were beamed into our homes, haunting images of
the lost lives on the pitch at Hillsborough, or in the sleepy Scottish village
of Lockerbie. Once a mass audience had seen the footage the act was
absorbed by the viewing public and adopted as a format for memorializing
a sudden death, a death that is tragic, and an untimely death. The
fascination with this form of memorialisation is that it is spontaneous,
what is placed is instantaneous and provides a snapshot of that raw grief at
the very moment it was felt. With accidental death agencies of control
taking over - the Ambulance, Police and Coroner - the bereft lose control
of the situation. The mourning period then resembles what Goffman 17
termed front and back stage behaviour, what goes on front stage the
controlled stoical face of ‘bearing up’ has no relation to what is going on
behind the scenes The spontaneous memorial allows an outlet for this
grief, outrage and protest. The scene of the death, where those bereft lives
changed forever can be regained and controlled and personalised within
___________________________________________________________
hours of the death occurring. No waiting for the undertaker to plan the
service and show you the body in its newly purchased coffin, the bereft
can act right away to protest and memorialise the death. This is where the
danger and fear of the memorial began to materialise, the very fact that the
memorials could be used as a protest, a very visual protest. Just as punk
rockers were feared because of the questions they asked of society so do
roadside memorials their existence poses questions of society and this can
be dangerous. Local authorities began to outlaw the practice on the
grounds of road safety; others had their own agenda one local authority
councillor publicly stating “We don’t need this European mumbo jumbo
here in the UK.” 18
As with the punk music phenomenon, there was good and bad
press. The freedom of expression in memorialising was good for all,
especially with the restrictions imposed by cemeteries with regard to
memorial content. However, roadside memorials were considered a
contentious issue and the subject of debate in the press and radio, many
voicing concerns that the memorials were really litter. The spontaneous
memorial made society notice deaths that were sometimes ‘hidden’ for
example the numbers of road deaths, the numbers of deaths due to gun
crimes and fatal stabbings. The media inflamed these debates by using the
memorial sites in their news bulletins and so increasing the numbers of
‘mourning tourists’ those individual’s who choose to visit memorial sites
purely out of curiosity. It is almost de rigueur that a spontaneous memorial
is placed at the site of a fatal accident. Memorials have developed into,
whatever you can do I can do better situation. In economics there is a
theory of diminishing returns, for example when you go to the pub the
first drink you have you savour, it quenches your thirst, you relish the
experience, however, any second or third drinks may be equally enjoyable
but, never the same as the first. The same can be said of the roadside
memorial, whenever you come across your first roadside memorial you
can be saddened, curious angry or disturbed. Yet, it is possible to become
desensitized to the memorials and just drive or walk passed with just a
glance at yet, another memorial.
6. Inclusive mourning
British mourning culture has embraced this new form of
memorialisation and added it to the repertoire and acknowledged that this
form of memorialisation encompasses disenfranchised grievers into the
fold. The sample of fifty UK spontaneous memorials used in this study
revealed that the usually absent group of young individuals 16-25 19 are
heavily involved in this form of memorialisation. Youth culture has
embraced a way in which they can actively participate in the
Gerri Excell 51
___________________________________________________________
memorialisation process and infuse their own values and beliefs into this
practice. Although, this form of memorialisation has allowed a more
inclusive mourning practice here in the UK it is sad to see that what was
once a powerful individualistic way of expressing private grief publicly
has been diluted by its very popularity.
7. Conclusion
The premise for this paper was that Britain’s memorial culture
has been transformed by the same processes and sub cultural
undercurrents that transformed the music world in the late 1970s. In the
USA purpose made memorial crosses and plaques can be purchased from
websites eager entrepreneurs finding a lucrative business. The
spontaneous memorial has become the ‘darling’ of the mass media,
poignant images of a spontaneous memorial site being used as the
backdrop of the new report of the incident. The once spontaneously hastily
placed bunch of flowers in its supermarket cellophane wrapping with
attached price tag, has become a stage-managed prop. Recently on British
television a favourite character was ‘killed off’, the character was stabbed
and died in the street. The next episode began with a panoramic shot of the
gates of the square decked with floral tributes to the dead character 20 .
Most of this episode focused on the memorial and characters central to the
show were seen placing their tributes and talking about who actually had
the right to place tributes there. This can be cited as evidence of how the
spontaneous memorial has become part of the norm when it comes to
memorialising a tragic death. The soap opera in question claims to
represent modern living in London and by using a spontaneous memorial
it is enforcing what would be expected to happen in that locality in real
life .Real life is reflected in the totems found at these post modern
memorial sites . Each memorial is unique, previous research 21 has
highlighted the importance to the bereft of the site of death itself a site that
is made sacred by the bereft and a place in which reflections of a lost
individual can be used in a way to regain control of the tragic
circumstances surrounding the death.
Cemeteries throughout the UK have introduced wide ranging
rules and regulations regarding the decorations and adornments allowed
on the graves. Not surprisingly then that the bereft may attempt to find
another avenue for displaying their grief. The roadside provides this
freedom, the freedom of expression, and the spontaneous memorial is
valuable as it is spontaneous. It provides society with an immediate
response ho the death, whether this response is an angry protest or a
touching human personal response to the death providing a valuable
resource for researchers into death, bereavement and post modern
___________________________________________________________
mourning practices. In the formalized memorial world it may take weeks
often months before a permanent memorial is in place, in the events of
homicide it may be months of bureaucratic demands before the bodies are
released for cremation or burial.
Post war British memorial culture has been dominated by the
denial of death paradigm, Tony Walter 22 has written extensively on the
‘revival of death’ and a Modernist approach to the rationalization of death;
however this rationalization of death only serves to distance death once
again from the bereaved. The spontaneous memorial provides a new fresh
avenue for active involvement in memorial practices, and holistic
approach that was inclusive for all. Lessons can be learnt from the eclectic
array of totems so representative of a post – modern world
I fear that the once innovative spontaneous memorial has lost
some of its initial power and influence on society as a whole. Evidence
has been provided where the cultural image of a spontaneous memorial
has become part of the TV and music video repertoire, this is a double
edges sword it may bring the genre to the masses but, some how reduces
the whole aspect and meaning of a memorial of this type. The law of
diminishing returns, where once a powerful icon of sudden death now the
return has lessened and will we see familiarity breeding contempt?
Notes
1
Benjamin Franklin, Letter to Jean Baptiste Le Roy (1789) US author
diplomat, inventor, physicist, politician & printer (1706-1790).
2
Gerri Excell, Roadside Memorials in the UK: Private Grief made Public.
Unpublished MA thesis, The University of Reading, UK (2004).
3
Geoffrey Gorer, Death, grief and mourning in contemporary Britain
(London: Cresset, 1965), 41.
4
Peter Griffiths, ‘Words cannot say what she is’, in Planet Diana Cultural
studies and Global Mourning, ed. Public (Kingswood: University of
Western Australia, 1997), 47-48.
5
George Monger, ‘Modern Wayside shrines’, Folklore 108 (1997), 113-
114.
6
Anne Eyre, ‘Post-Disaster Rituals’, in Grief, Mourning and Death
Rituals, ed. Jenny Hockey, Jeanne Katz & Neil Small (Buckingham: Open
University Press, 2001), 104-111.
7
RoadPeace actively campaign in the UK for the rights of road crash
victims to ensure the trauma they suffer is acknowledged. Since 31st
August 2003, over 3,000 A4 plaques have been placed nationally,
resulting in over 400 articles in local and national press.
Gerri Excell 53
___________________________________________________________
8
Excell, 2004, 68.
9
Roadside memorials have been subjected to academic debate in the USA
and Australia for some years. The first International symposium on
Roadside Memorials was held in Australia in 2004.
10
Jennifer Clark and Ashley Cheshire. ‘RIP by the roadside: A
comparative Study of roadside memorials in New South Wales, Australia
and Texas, United States’, Omega 48 (2004), 229-248.
11
MADD, Mothers against Drunk Drivers in the USA have campaigned
since the 1980s and are a tour de force in the US. MADD sanctioned the
White Crosses to be placed at the scene of a fatality where alcohol was
involved.
12
Gerri Excell, ‘Contemporary deathscapes’ paper given at 7th Annual
International Conference on Death, Dying & Disposal, The University of
Bath, September 15th-18th (2005).
13
Situationist International (SI) a political movement formed in 1957 in
Italy. It grew out of a number of avant-garde artistic and political
movements. Its main aim was to challenge conformity and overthrow
capitalism.
14
Sarah Thornton, ‘General introduction’, in The Subcultures Reader, ed.
Ken Gelder and Sarah Thornton (London: Routledge, 1997), 1.
15
Stanley Cohen, Folk Devils and Moral Panics: The creation of Mods
and Rockers (London: Mac Gibbon & Kee, 1972), 57.
16
Bill Grundy presented the Thames Television news show ‘Today’ the
show was aired only in the London area. On December 1st 1976 the Sex
Pistols were a last minute stand in the band Queen who cancelled at the
last minute. The band were all intoxicated and were goaded and patronised
by Grundy throughout the interview. Grundy succeeded in getting the
band to swear live on air, the next day the tabloids were outraged, Grundy
was sacked from the show and ‘Today’ was taken off the air for two
months.
17
Erving Goffman, The Presentation of Self in Everyday Life
(Harmondsworth: Penguin, 1971), 70.
18
Sophie Kummer. ‘Road Fatality Signs are Morbid and Un-English’,
Edgware Times, sec3, p.4., 12 July (2003).
19
In my local neighborhood a sixteen year old boy tragically drowned. His
peer group held nightly vigils until his funeral. T-shirts were produced by
the group and worn throughout the period prior to his funeral and at the
funeral. Walls were ‘tagged’ with RIP Tyson and signs defaced with text
speak messages. The group received press coverage throughout the
mourning period those interviewed were in the age range was 14-25.
___________________________________________________________
20
Eastenders is a BBC 1 soap opera shown three times a week in the UK,
first aired in 1985 it portrays the fictional London town of Walford. The
episode in question was shown over the Christmas/New Year period 2005.
21
Excell, 2004, 40.
22
Tony Walter, The Revival of Death (London: Routledge, 1994), 51.
Bibliography
Hartig, Katie & Kevin Dunn. ‘Roadside Memorials: Interpreting New
Deathscapes in Newcastle, New South Wales’. Australian Geographical
Studies 36 (1998), 5-20.
RoadPeace, ‘About RoadPeace’ Available online at
<http://www.roadpeace.org/> [accessed 17 August 2006].
Based at the University of Reading, Gerri Excell has researched the

phenomenon of roadside memorials for the last four years. Her current
research examines the spontaneous memorials following terrorist attacks
in the UK.
The Making of ‘Good’ Memorialisation
Kate Woodthorpe
Abstract
Studying death is by no means a new adventure in sociology.
However, making connections between the different areas of research that
largely follow the chronological pattern of dying, moment of death, and
after death practices, have to date not been systematically made. Thus, this
paper is going to make some preliminary associations between pre-death
and post-death literature, via the concept of the ‘good death’. Specifically,
it will use Bradbury’s 1 conceptualisation of the good death in order to
make sense of how practice in the cemetery is becoming increasingly
subjected to norms of behaviour, and constructions of what conforms to/is
defined as ‘good’ mourning practice. Using this valuable concept I wish to
suggest that, similar to the arguments proposed by Field and James 2 -
whereby the hospice is becoming increasingly institutionalised - that the
contemporary cemetery could now be understood as an institution that
dictates memorialisation behaviour and activity, creating powerful norms
of ‘good’ memorialisation that in turn are utilised to signify how
individuals are ‘coping’ with their bereavement.
Key words: cemeteries, memorialisation, good death, institutions,

bereavement.
1. Introduction
Social research into death and dying is by no means a recent
endeavour. However, the sociality of death and dying remains on the
periphery of sociology, with a lot of the literature being produced in this
area coming from more anthropological perspectives. The origins of these
anthropological perspectives owe much to Hertz, 3 who is commonly
regarded as one of the first, and most significant, anthropologists
exploring the social meaning of death rituals. In terms of Western death
practices, sociological interpretation has tended to reflect the growth of the
death work industry, which recently has been dominated by the
monumental developments in health care.
The 1960s can lay claim to being one of the most progressive
decades in the development of a ‘death movement’, with the establishment
of the Hospice Movement by Dame Cicely Saunders, and the publication
of Jessica Mitford’s ‘American Way of Death.’ 4 Importantly however,
whilst these two isolated occurrences reflect the progress of intellectual
endeavours on death and dying, whereby they did not act to establish a
link between the periods before and after death. This separation between
work on before and after death has prevailed since then, with a huge
56 The Making of ‘Good’ Memorialisation
___________________________________________________________
growth in dying and palliative care study, and less attention paid to issues
surrounding disposal and after-death practices. Evidence for the current
state of affairs in England today includes many academic departments
devoted specifically to researching hospices. Cemeteries, on the other
hand, remain on the periphery of academics’ remits, although there have
been important developments with the establishment of the Cemetery
Research Group at the University of York and the Death Centre at the
University of Bath within the last decade. In addition, whilst there have
been individual academic authors who have attempted to bridge the gap
between dying and death 5, 6 , 7 these works have not fully entered the
contemporary cemetery landscape, tending to focus on exploring wider
ritual activity and frameworks of understanding. This paper therefore
intends to expand on these tentative bridges between disciplines, and
incorporate ‘dying’ literature into an ethnographic study of the
contemporary cemetery and memorialisation practice, underpinned by “a
dawning realisation that contemporary attitudes to death and dying are
unsatisfactory and that society has somehow lost touch with the meaning
of life.” 8
As sites of remembrance, cemeteries have a lot to offer us in
terms of how people understand and remember the dead, both individually
and collectively, locating the activity of bereaved people in the social
world; something which, to date, has been neglected in the positivist
climate of bereavement research. 9 Thus, I wish to create a dialogue
between accounts of those experiences of dying and contemporary
mourning behaviour, using the model of the good death 10 to describe and
suggest there is scope for utilising concepts from the dying experience
when exploring post-death experience, specifically memorialisation. This
will then be extended to suggest that there are similarities between the
institutionalisation of hospice activity 11 and an institutionalisation of
‘good’ memorialisation activity.
The data for this paper comes from an ESRC funded
ethnographic study of the contemporary cemetery landscape, co-funded by
the City of London and Institute of Cemetery and Crematorium
Management. All fieldwork took placed at the City of London Cemetery
and Crematorium in Newham, East London. This 220-acre site is
celebrating its 150 year anniversary this year. It is run by the Corporation
of London, employs approximately 90 staff, and is in the process of
establishing itself as a ‘Centre of Excellence for Best Practice’. In addition
the cemetery prides itself in offering a range of choices for the burial of
dead individuals, including lawn burial, traditional burial and woodland
burial. In this vein, the cemetery attempts to cater for everyone, placing
accessibility and individuality at its core. The purpose of this project has
Kate Woodthorpe 57
___________________________________________________________
been to explore conservation and how different groups of people (visitors,
staff and the local community) perceive this dynamic and complex
landscape. In turn, this has developed into a wider exploration of
meanings and values attributed to the dead and conceptualisations of life,
as “the issue of death throws into relief the most important cultural values
by which people live their lives and evaluate their experiences.” 12
2. The ‘good’ and ‘bad’ death

The beginning of the conceptualisation of the ‘good death’ can be
attributed to Glaser and Strauss’ 13 ideal dying typologies, whereby the
dying person has varying degrees of awareness of their situation. The
notion of an ‘ideal’ way to die was further expanded upon by Ariès 14 who
compared contemporary dying with a romantic model of the ‘tame’ death
from the nineteenth century. Bloch and Parry 15 developed this typology of
death, with several of the papers in their edited collection pointing to a
‘good’ death being closely linked with ideas of rebirth. 16,17
A good death is largely characterised as one where there is an
absence of pain and an awareness of dying, “while a ‘bad death’ may
mean weeks, months, or even years of slow agony.” 18 These conceptual
tools of a ‘good’ and ‘bad’ death can be contested for being overly
romantic 19 and too narrow in their scope 20 , yet the ‘intellectual structure’
that they can provide 21 is nevertheless a useful mechanism through which
to explore experiences of death. In particular, how the good death has been
constructed gives us great insight into how we, individually and
collectively, can understand ‘life’ and ‘death’, as
Sociological contributions to our understandings of the

good death [that] have provided descriptions of the
social management of dying and death, and expositions
of cultural reactions to death and their consequent
shaping of the lives of dying people. 22
Specifically, this paper focuses on Bradbury’s 23 understandings

of the good death to suggest that there are real parallels between activity
within institutions that the dying and dead inhabit. In addition there are
further similarities in tensions that arise between these ‘ideal’ types of
dying/post-death practice and the increasing bureaucratisation and
routinisation of these settings. 24
3. Good death typologies and cemetery memorialisation

A. Sacred good death
___________________________________________________________
For Bradbury a sacred good death involves the notion of
‘moving’ on to a better place and the concept of rebirth. It is therefore
spiritual in that there are larger belief systems about life and death being
incorporated into the death experience, in order to make sense of it. Pain
and agony can be present, but in this death they are acceptable, as they are
part of the process of moving from life into death. In this typology death is
a social event, with death bed farewells commonly occurring. Thus, the
death bed scene is central to this type of death, with the dying surrounding
themselves with things that represent ‘life’. 25
B. Sacred good memorialisation

Using the death bed model, we can understand sacred
memorialisation as activity that takes place beside the (bed) grave, as my
data has suggested: visiting the grave is a social event, where family
members and friends can be reunited with the deceased or other family
members/friends who may visit. It was not uncommon for visitors to
locate their dead in the cemetery, but still as part of their social networks
of friends and family to visit, exemplified by one visitor who told me: “I
always talk to people I come to, tell them different things. I see loved ones
as being here.” Survivors’ new identities also reflect wider beliefs about
their relationship with the dead. As one participant told me: “I think for
some people it’s not just to do this, lay the flowers and that sort of thing.
They find comfort, they do, they talk to them, say things, they ask their
advice.” Thus, for this person the dead continue to have a continuing
social presence in their life, taking on a special - a sacred - capacity in that
they have to be visited specifically in the cemetery.
C. Medical (modern) good death

Control is central to this type of death. The locus of this control is
medical intervention that can be applied and manipulated to orchestrate
the death. Death is the responsibility of experts, whose technical
knowledge means they are the privileged holders of knowledge and their
control over the process can be equivalent to, if not greater than, the dying
person themselves. In this type of death, location and timing are
everything, and is most evident in the hospice or hospital setting, where
symptom control is vital. This can further lead to an increasing
medicalisation of the dying process and a resulting institutionalisation of
practice. 26
D. Modern memorialisation
As in the case of modern dying, this type of memorialisation is
about control and limitations placed upon visitors by ‘the experts’ - who in
Kate Woodthorpe 59
___________________________________________________________
this instance are the cemetery staff. Emphasis is placed on controlling of
expressions of grief through particular forms of memorialisation, and a
practical regulation of any expressions that breach the limits of
acceptability constructed by the cemetery management and enacted
through the cemetery regulations. For example, the City of London
Cemetery and Crematorium Regulation 27 number 86 states that: ‘We do
not allow curbs, posts or vases in the lawn section’. Regulation 94 further
states: ‘We do not allow crosses made of wood, bell glasses, shells, grass
wreaths or other moveable or fragile items in the cemetery.’ Thus
memorialisation activity is perceived as either abiding by or breaking
those rules. The wider meaning or purpose behind it is implied by the
enforcement of memorial directives and the need to maintain a controlled
landscape overall. Much like Lawton’s 28 assertion that patients were
sedated or moved due to the collective nature of wards in the hospice and
the distress dying could cause for others, cemetery staff clear graves of
prohibited memorialisation in order to ensure that the collective space
fulfils their ideal of good memorialisation practice, based on their reading
of the public’s reaction – and then incorporated into the regulations.
E. Natural good death

For Bradbury, the natural good death has a dual meaning: firstly,
a sense of death taking place ‘in’ nature, and secondly of it being
‘natural.’ 29 A death may have only one of these elements or both, but it is
the notion of acceptance of death that permeates both of these meanings.
Primarily, the main focus of this category is the break from, or lack of,
intervention and control in death. Whilst this type of dying may
incorporate elements of the sacred death, in that rituals and concepts of
regeneration may be present, the emphasis is on the individual rather than
wider belief systems.
F. Natural memorialisation
Similar to the ambiguous nature of other items within Bradbury’s
typology, this form of memorialisation can simultaneously be seen as
about being ‘in’ nature and/or being ‘natural’. Burial could take place in a
woodland area or a more conventional municipal lawn section;
importantly, the focus is not where the body is buried, but rather it is this
theme of intervention that is key here. In natural memorialisation there is
an emphasis on the normality of death, an acceptance, and a sentiment
towards the individuality of the person, rather than expert technical
knowledge. Thus, there may be elements of the sacred and modern in this
type of memorialisation, but the focus is on the individual rather than
wider frameworks of shared beliefs and values. In this way, it is the
___________________________________________________________
ultimate late modern act of memorialisation, ‘done my way.’ 30 Inevitably,
in a collective landscape, this individuality can cause conflict, as one staff
member told me:
They still don’t understand that people, you’re not going

to never stop people putting things on the grave, what
they want on the grave. You can give them rules and
regulations, what you can have and what you can’t have,
but people don’t want to listen to that. That’s their little
memory to that person isn’t it? They want to put on it
what they want.
Thus, through all these conceptualisations of memorialisation

practice, visitors and staff members alike are characterising activity,
relating it to their shared and individual understandings of death and
bereavement, and constructing wider notions of what is ‘good’ and ‘bad’
practice. Similar to the hospice and the good death however, this has led to
a routinisation of practice, which has a profound impact upon those
individuals who do not conform to ‘good’ behaviour.
Similar to how the good death has been constructed in a
dichotomous relationship to the aforementioned ‘bad’ death the sacred,
modern and natural types of memorialisation practice can be utilised to
understand perceptions of ‘bad’ activity within the cemetery. Throughout
my data, ‘abandoned’ graves were frequently referred to as ‘being left
behind’ or ‘forgotten’, implying that there is judgement being made about
what is being done by/left on a grave in terms of ‘bad’ behaviour. This
was exemplified by one woman who told me:
I don’t like [it] when I see graves looking… I know it

sounds silly, but I don’t like them when they’re half
falling down and really badly taken care of. I don’t like
that. I wouldn’t like to see my Mother’s grave in a big
mess, I wouldn’t like that. I think it does matter, if it’s
all overgrown. I mean, I know they’re dead already but
to see it look in a big mess like that, it needs to be neater
and tidy, and taken care of. Like someone’s almost
caring for them.
In addition, similar to the ideal good deaths constructed by health

professionals who see dying on a daily basis, 31 staff at the cemetery
construct their own typology of ‘good’ and ‘bad’ memorialisation
(independent of the regulations) based on what they perceive to be either
Kate Woodthorpe 61
___________________________________________________________
valuable or unattractive. One staff member was particularly vocal about
current memorialisation practices:
I can only use one word to describe my feelings

[towards memorialisation], tacky. I think the modern
ones are often tacky. Colours, lack of imagination in the
design of the memorial, strange lines, over polished, the
lettering, machine cut, what more can I say?
As we can see, staff and visitor perceptions of memorialisation

practice around the cemetery are mediated by broad conceptualisations of
good and bad practices, which relate closely to Bradbury’s typologies of
the good death. These in turn are ‘read’ as indicators of the strength of
relationships with the dead, and of how individuals are coping with their
bereavement. Unfortunately there is not the scope of entering into this
final point in greater detail here, suffice to say, one of the principal
suggestions of this paper is that embodied material activity in the cemetery
is being associated closely with ‘clinical lore’ 32 conceptualisations of what
constitutes ‘normal’ and ‘healthy’ grieving behaviour.
4. Conflict in the cemetery

However, tensions arise as these ideal types of memorialisation
sometimes simply do not fit with the actual reality of what happens
(similar to Lawton’s experiences of dying not fitting the ideal type in the
hospice). This tension manifests itself in the clearing of mementoes from
graves if they are deemed inappropriate or dangerous by the cemetery
regulations, causing visitors to complain. This conflict has grown to the
extent that I was told by visitors to the graves that there were ‘mini-
Hitler’s’ in the cemetery office. On another occasion one woman told me:
I don’t know quite how to describe why I think this, but

I do sometimes get the impression that someone in
control, the manager or somebody, would prefer to have
only the people who’ve died and not the people who are
living at all. That they’re a nuisance in some way.
There a distinct parallels here with Lawton’s data that suggests

dying patients feel they are a nuisance or a burden upon their families and
the health authority. This perception, particularly in terms of relationships
between the professionals and the patient/cemetery visitor is troubling, as
it indicates the ideological underpinning of ‘choice’ and ‘individuality’ is
not being successfully negotiated in either the hospice or the cemetery. In
___________________________________________________________
the hospice, this issue is highlighted by the heavy sedation of patients to
fit the ‘good death’ model; in the cemetery this is the removal of items
from the grave to fit a ‘good’ landscape aesthetic. Concurrently,
individuals who do not correspond with the ideal types of dying and
cemetery activity are pathologised: excessive noise/smell/pain are
discouraged in the hospice; excessive memorialisation is also viewed as
disproportionate and actively controlled in the cemetery by removal of
what is deemed ‘inappropriate’. Essentially, it is the controlling function
of the institutional nature of the hospice and cemetery that is key here, as
they impose norms of ‘good’ behaviour and practice upon their residents
and visitors that is further internalised by visitors and adopted as the
‘ideal’ way to ‘do’ memorialisation and bereavement practice. Williams 33
has argued that at an institutional level, all societies need to control death.
However, this abstract statement needs to move beyond the realm of
theory into the lived reality of the two spaces considered in this paper,
where we can see that behaviour is frequently mediated and regulated to
meet institutionalised (collective) standards of practice and behaviour 34 .
McNamara et al 35 believe the institutionalisation of practice in
the hospice is particularly problematic, as it undermines the ideological
foundation of the hospice: that of patient autonomy, holistic practice and
quality of life. 36 To meet the demands of a growing population however,
the hospice has had to become increasingly routinised to ensure that it
functions efficiently and effectively. 37 This in turn has led to a return to
hierarchies of expertise in the hospice 38 and the aforementioned
manipulation of dying experiences to ‘fit’ the ideology. 39 Furthermore,
this institutionalisation of death practice is not limited to the hospice, as
research in other organizations suggests there are similar ideologies being
tested. 40 Through transposing the good death typologies onto
memorialisation activity within the cemetery, we can see comparable
institutionalisation of behaviour in the cemetery landscape, evidenced
particularly by the regulations which state what is allowed. By doing this,
these regulations are constructing ‘appropriate’ collective memorialisation
practices that manipulate behaviour and artefacts left in the cemetery to
‘fit’ the good mourning practice aesthetic.
5. The cemetery in society

Hart et al 41 have expressed a concern over the dominance of the
good death ideology in the hospice; my data suggests that this concern is
applicable also to the contemporary cemetery. Whilst the ideology of the
good death was created in response to the increasing medicalisation of
death, it has now become a possible tool through which control over the
dying experience can be exercised by experts. Similarly, memorialisation
Kate Woodthorpe 63
___________________________________________________________
in the cemetery is now regulated to conform to a collective ideal – which
in reality is problematic and contested. For the dying patient, the
routinisation of the good death experience can be accused of pushing the
patient to the periphery and enabling the ‘experts’ to dominate the dying
experience. Similarly, ideal types of memorialisation behaviour are
creating a routinisation and idealisation of bereavement practices,
enforced by regulations.
So, what does this mean for the contemporary cemetery
landscape? It is the principle argument of this paper that due to the
constructions of ‘appropriate’ memorialisation practice, the cemetery is as
revealing as the hospice in terms of the institutionalisation of death. This
institutionalisation rhetoric does not rest easily with typologies of good
death/memorialisation, and thus, the cemetery needs to be assessed as
under threat from this routinisation of practice as the hospice has been.
Practitioners, policy makers and academics alike need to
recognise the significance of the controlling of memorialisation practice,
and what this actually reflects in terms of wider (late) modernist
understandings of life and death. In addition, we need to expand
perceptions the cemetery landscape in order to understand its
institutionalised role in society and address how this role could change in
the future 42 . By doing this, the cemetery landscape could be much more
closely linked into the process of living and dying, and accordingly attract
more attention from local communities, stakeholders, fundraisers and
policy makers.
6. Conclusion
Through exploring these conceptualisations of good
memorialisation practice, I have shown how the cemetery shapes
mourning behaviour and practice, similar to ways in which activity is
shaped within a hospice. There is much scope for a greater integration of
the cemetery into local communities, in the way that hospices have been,
yet they continue to remain on the periphery of local communities and
policy makers’ agendas. This low status has been reflected in research into
death-related spaces, with only a few notable exceptions in recent years 43,
44
. However, it is my hope that this will begin to change, as
interdisciplinary conferences such as Making Sense of: Dying and Death
promote a dialogue between the different researchers and audiences
working with death and dying. If we - as individuals, academics, policy
markers and practitioners - can begin to develop a constructive across-
discipline conversation about our understandings of how people deal with
dying, death and disposal, there is a greater potential for providing the best
___________________________________________________________
and most appropriate space, landscape and service for the dying, the dead,
and the bereaved, both now and in the future.
Notes
1
Mary Bradbury, Representations of death: a social psychological
perspective (London: Routledge, 1999).
2
David Field, & Neil James, ‘Where and how people die’, in D. Clark,
(ed) The Future for Palliative Care: Issues of Policy and Practice
(Buckingham: Open University Press, 1993), 6-29.
3
Robert Hertz, Death and the Right Hand, Tr. R. and C. Needham
(London: Cohen West, 1960 [1907]).
4
Richard Huntington & Peter Metcalf, Celebrations of Death: the
anthropology of mortuary ritual, 2nd ed. (Cambridge: Cambridge
University Press, 1991).
5
Tony Walter, The Revival of Death (London: Routledge, 1994).
6
Jenny Hockey ‘Encountering the ‘reality of death’ through professional
discourses: the matter of materiality’, Mortality, 1, 1 (1996), 45-60.
7
S.M. O’Gorman ‘Death and Dying in contemporary society: an
evaluation of current attitudes and the rituals associated with death and
dying and their relevance to recent understandings of health and healing’,
Journal of Advanced Nursing, 27 (1998), 1127-1135.
8
Ibid, 1133.
9
Christine Valentine, ‘Academic constructions of bereavement’,
Mortality, 11, 1 (2006), 57-78.
10
Maurice Bloch & Jonathan Parry (ed.s) Death and the Regeneration of
Life (Cambridge: Cambridge University Press, 1982).
11
Field and James.
12
Huntington and Metcalf, 25.
13
Barney Glaser & Anselm Strauss, Awareness of Dying (New York:
Aldine, 1965).
14
Phillipe Ariès, Western Attitudes towards death: from the middle ages to
the present, tr. P.R. Ranum (London: John Hopkins University Press,
1974).
15
Bloch and Parry.
16
Jonathan Parry, ‘Sacrificial death and the necrophagous ascetic’, in
Death and the Regeneration of Life, ed. M. Bloch and J. Parry
(Cambridge: Cambridge University Press, 1982), 74-110.
17
J. Watson, ‘Of flesh and bones: the management of death pollution in
Cantonese Society’, in Death and the Regeneration of Life, ed. M. Bloch
and J. Parry (Cambridge: Cambridge University Press, 1982), 155-186.
Kate Woodthorpe 65
___________________________________________________________
18
Maria Càtedra, ‘Kinds of Death and the House’, in Death, Mourning,
and Burial: a cross-cultural reader, ed A.C.G.M. Robben (Oxford:
Blackwell Publishing, 2004), 77.
19
Norbert Elias, The Loneliness of the Dying, tr. E. Jephcott (Oxford:
Blackwell, 1985).
20
B. Hart, P. Sainsbury. & S. Short ‘Whose dying? A sociological critique
of the ‘good death’’, Mortality, 3, 1 (1998), 65-77.
21
Beverley McNamara, C. Waddell & M. Colvin, ‘Threats to the good
death: the cultural context of stress and coping among hospice workers’,
Sociology of Health and Illness, 17, 2 (1995) 222-244, 237.
22
Hart et al, 65.
23
Bradbury.
24
Beverley McNamara, C. Waddell, & M. Colvin, ‘The
Institutionalization of the Good Death’, Social Science and Medicine, 39,
11 (1994), 1501-1508.
25
Julia Lawton, The Dying Process: patients’ experiences of palliative
care (London: Routledge, 2000).
26
McNamara et al, 1994.
27
City of London Cemetery Regulations, 2000 (30th May 2006)
<http://www.cityoflondon.gov.uk/Corporation/our_services/health_safety/
cemetery_crematorium/>.
28
Lawton.
29
Bradbury, 152.
30
Walter, 1994.
31
Beverley McNamara, Fragile Lives: death, dying and care
(Buckingham: Open University Press, 2001).
32
Tony Walter, On Bereavement: the culture of grief (Buckingham: Open
University Press, 1999).
33
Simon Williams, Medicine and the Body (London: Sage, 2003).
34
see E.K. Abel, ‘The Hospice Movement: institutionalizing innovation’,
International Journal of Health Services, 16, 1 (1986).
35
36
Hart et al.
37
Field and James.
38
39
Lawton.
40
see Carol Komaromy, ‘The performance of the hour of death’, in
Palliative Care for Older People in Care Homes, ed J. Hockley and D.
Clark (Buckingham: Open University Press, 2002), 138-150.
41
Hart et al.
___________________________________________________________
42
Ian Hussein, Paper given at Memorial Awareness Board session, Houses
of Parliament, (3rd May 2006).
43
Phillip Bachelor Sorrow and Solace: the social world of the cemetery
(Amityville, NY: Baywood Publishers, 2004).
44
Doris Francis, Leonie Kellaher, & Georgina Neophytou, The Secret
Cemetery (Oxford: Berg, 2005).
Kate Woodthorpe is completing her Ph.D. thesis on Cemetery

Conservation in the Department of Sociological Studies at the University
of Sheffield, under the principal supervision of Professor Jenny Hockey.
Her other interests include Cultural Sociology and the Sociology of Health
and Illness, particularly chronic illness and embodiment. This project has
been funded by the Economic and Social Research Council, the City of
London, and the Institute of Cemetery and Crematorium Management.
Institutional Loss:
Dialectical Tensions in Coping with Major Loss
Melanie K. Finney
Abstract
Multiple deaths occurring at academic institutions present
interesting challenges for those trying to help others adjust and cope with
such losses. This article addresses the characteristics of higher educational
institutions that make them vulnerable to extreme forms of grieving, and
that may complicate coping with major traumas. In particular, these
factors serve to emphasize the dialectical tensions involved in coping with
major loss that are present when multiple deaths occur in university
communities. Drawing on the dialogism of social theorist Bahktin, five
particular dialectical tensions are outlined: (1) tensions between
individuals’ needs to remember and institutions' need to move on; (2)
tensions regarding the demonstration of private grief and public mourning;
(3) tensions between performance of public and private rituals; (4)
tensions as individuals move between roles as mourners and consolers;
and (5) tensions as individuals struggle to accept pain and move towards
growth. This essay considers how institutions must be aware of, and
address, the frequently competing needs of the various parties as they
encounter these types of losses.
Key words: dialectical tensions, grief, institutional loss, mourning, rituals,

university communities.
As seemingly safe, protected institutions, colleges and

universities face special challenges in helping members of their
communities make sense of, and come to terms with, emotionally
devastating events. This essay first examines the characteristics that
distinguish academic institutions from other types of organizations,
especially in terms of how traumatic events may affect its members.
Additionally, because of these characteristics, administrators may struggle
as they consider the needs of the various groups that are affected by major
losses. In response to these challenges, I outline five dialectical tensions
that may be present as university communities’ grapple with how best to
address institutional tragedies.
1. Universities as distinctive institutions

American academic institutions are generally perceived as safe
havens, where problems are solved through discourse and debate, not
through aggression or violence. Stereotypically, these ‘ivory towers’ are
places where the highly educated have chosen to pursue the life of the
68 Institutional Loss
___________________________________________________________
mind, rather than engage in the vagaries of life. Faculty frequently
function as observers or critics of social practices, rather than actively
‘getting their hands dirty’ with politics, capitalism, or social disputes.
Because university communities are generally perceived as bastions of
liberty, democracy, and locations that promote the free exchange of ideas,
there is a presumption of safety and isolation from the ‘real world’.
Historically, universities have served in some capacity in locus parentis,
as parents entrust their nearly grown children into the care of others.
Generally speaking, bad things are not supposed to happen on college
campuses. Students and faculty should be immune from tragedy or crime.
Additionally, colleges and universities are unique types of
institutions because of their largely transitory population. Typically,
students, who are the largest peer/cohort group in the overall institution,
are enrolled only until they meet their degree requirements, generally in
the range of four to six years. This is the nature of the institution: students
enter, receive training/education, and then leave. While there is less
movement on the part of faculty and administrators, some turnover on the
part of the employees in educational institutions is also expected.
In addition to the transitory nature of colleges, students are a
particularly vulnerable population in terms of their ability to cope with
traumatic or stressful events due in part to the developmental stage of
most students at undergraduate institutions. Young people frequently lack
experience in dealing with loss and haven’t yet adopted behavioural
scripts about how to cope with traumatic events. 1 Specifically, age itself,
especially for those under age 25, is a predictor of complicated or
postponed grief. Additionally, as Janoff-Bulman notes, young people
frequently have a distorted view of their invulnerability. 2 To co-opt the
title of a previously published book, young people generally don’t believe
or understand that “bad things happen to good people.” 3 Most college
undergraduates are not cognitively or emotionally ready to deal with
tragedy, especially when it happens to individuals in their social networks.
Thus, when tragedies occur within an academic institution, those most
affected are unprepared to confront such losses.
A final characteristic of college life concerns the types of bonds
that are formed during the college years. Because most young college
students are living independently for the first time, they seek out and
develop relationships with others. During this developmental stage, many
students become strongly identified with their academic community,
which frequently continues long past graduation. As students are
socialized into their academic institutions, they become loyal fans and
supporters, which is one way that universities keep alumni connected. For
example, supporting varsity athletics is a major contributing factor in
Melanie K. Finney 69
___________________________________________________________
creating a sense of belonging and unity for current and former students.
Alumni come to define themselves in part by their institutions. For
example, students who graduate from Texas A & M University in College
Station, Texas are not simply ‘alums’ of TAMU; they are and forever will
be “Fightin’ Texas Aggies.” This strong identification with an alma mater
explains why, in some cases, people continue to be affected by the events
on a campus even after they have left the university. Thus, the collective
group of people that are affiliated or identified with a particular institution
is very large. University communities are much more than the currently
enrolled student body.
Clearly then, because of their transitory, young adult populations,
coupled with the presumption, or perhaps illusion, that universities are
safe havens and places that are above the fray of violent crime or heinous
behaviour, as well as the fiercely held loyalties to one’s alma mater,
academic institutions consist of multiple audiences and present many
challenges for the study of how individuals and communities cope with
tragedies resulting from multiple or violent deaths.
Addressing those who have suffered a major loss, however, is
complicated since not only the support needs of the bereaved change over
time 4 but frequently, multiple communities or audiences exist. When
dealing with major public tragedies, especially those that involve multiple
loss of life, the needs of many and varied audiences become even more
intricate. For example, in addition to the profound grief experienced by
families and loved ones of the victims, those who may have witnessed the
tragedy and survived may struggle with feelings of helplessness or guilt.
Thus multiple messages, to multiple audiences, whether in the form of
public address, ritual, or memorial construction, require careful attention
and development in order to satisfy individual and social needs
successfully. The next section more fully considers, from a dialectical
perspective, the frequently competing needs of those whose lives have
been touched by tragedy.
2. Dialectical tensions in institutional grief and loss

A dialectical perspective is useful for examining the
complications inherent in coping with major loss. Based originally on the
dialogic work of Mikhail Bakhtin 5 and further developed by Baxter and
Montgomery, 6 dialectics explain the contradictions inherent in the study
of various social relationships. I later expand this approach to apply as
well to issues of grief and loss, and subsequent sense-making, coping, and
moving on. In general, however, the theory of relational dialectics
concerns the ongoing experience and management of tensions in personal
relationships. According to Baxter and Montgomery, there are four
___________________________________________________________
dimensions of dialectics present in relationships: contradiction, change,
praxis, and totality. Contradiction involves the “dynamic interplay of
unified oppositions” in relationships, 7 and describes how simultaneous,
competing needs require careful management. For example, individuals in
personal relationships may have needs for both personal autonomy and
concurrently, emotional connection with a partner. The dimension of
change indicates awareness of these competing tensions as a means for
promoting change and modification to the relationship. Praxis refers to the
idea that individuals are simultaneously subjects and objects, both acting
and being acted upon, so that actions and reactions are perpetually
ongoing. Finally, totality suggests that multiple contradictions or tensions
occur together and are not isolated. It is possible, therefore, for several
different tensions to be present at any one time, further complicating the
desire to respond in a way that helps maintain balance. Overall, this
dialectical perspective recognizes that individuals have competing needs
that require skilful management, at both the personal and the social level.
In a different article, I argue that these same four dimensions of
contradiction, change, praxis, and totality are also evident in how
individuals and institutions adjust to various dialectical tensions
concerning grief and loss. 8
In a grief-related context, Stroebe, Schut, and Stroebe discuss
how bereaved people may oscillate between a loss-orientation and a
restoration-orientation, and emphasize the need for a ‘dual process model’
for coping with loss. They define these two orientations in the following
way:
By loss-orientation we mean that a person is

concentrating on, dealing with, and processing some
aspect of the loss experience. Grief work falls within
this dimension, as do rumination and yearning for the
deceased, just thinking or talking about him or her,
looking at photos, and imagining how he or she would
react. Facing up to the loss or crying over the death
would also be part of this process. 9
By contrast, the process less familiar, and certainly less

explicit, in bereavement research and counselling, is that
of restoration orientation. When a loved one dies, not
only do we grieve for him or her, we also have to adjust
to substantial changes that are secondary consequences
of loss. … It incorporates learning to do things alone -
learning to go places as a single person, not as part of a
___________________________________________________________
couple and this, perhaps more than anything, may force
confrontation again with the fact of loss.) It means
establishing new routines, fulfilling new roles,
developing a new identity, and adjusting to an
environment without the deceased. 10
Thus, when confronted with major loss, bereaved individuals

have both a need to ruminate, remember, and grieve the loss, as well as to
create a new life and identity without the loved one. While not describing
this dual-process model in terms of dialectical theory, clearly this
conflicting pull between these two orientations is a type of dialectical
tension.
Considering the previously outlined complexities within the
university context, I suggest that there are at least five dialectical tensions
concerning grief and loss that must be managed in these types of
institutions: (1) the tension between individuals’ needs to remember and
institutions' needs to move on (similar to Stroebe, et al’s dual process
model); (2) tensions regarding the demonstration (or not) of private grief
and public mourning; (3) the tension between performance of public and
private rituals; (4) the tension as individuals move between being
mourners and consolers; and (5) tensions as people struggle to accept pain
and move towards growth.
The first tension is the most significant and potentially longest
lasting, as individuals and institutions struggle with the desire to hold on
to the past and the memory of the deceased. Socio-cultural assumptions
suggest that the more we love(d) an individual, the more difficult it is to
‘let that person go.’ By staying in a prolonged grieving period, some
individuals may feel they are showing more honour and respect to the
deceased than if they were to begin to ‘move on.’ Frequently heard
expressions relating to this dialectic tension include ‘we will remember’ or
‘we’ll never forget.’ On the other hand, people and institutions cannot
effectively exist in a perpetual state of limbo. Given the cyclical nature of
life in the academy especially, it is imperative that classes continue to
meet, students continue to work on meeting degree requirements, faculty
continue to teach and conduct research, and administrators continue to
oversee both day-to-day and long-term operations. While students
frequently get breaks from classes and faculty members earn sabbaticals, it
is impossible for an academic institution to simply put its obligations on
hold. Life must continue on and institutions must be forward-looking.
Thus, there is a strong dialectical tension between needing to remember
and needing to move on. This tension is probably most strongly evident
___________________________________________________________
when the needs of grieving individuals and the needs of the institution are
in conflict with one another.
Second, especially in western culture, there is a strong dialectical
tension between the demonstrations of emotion in public versus private
settings. Publicly, individuals must grapple with what and how much
emotion to display. In some cases, individuals may feel torn between
needing to be strong or stoic and experiencing and wanting to express
deep pain and loss. In many western cultures, for example, it is generally
considered appropriate for women and children to publicly display intense
grief, especially during the initial stages of loss. For men, however, and
more notably for professional men, emotional displays are considered a
weakness. According to Martin and Doka, gendered stereotypes continue
to exist about the proper ways for men and women to grieve and adapt to
loss. 11 They note that the issue is not so much whether men and women
grieve differently as it is that people have different ways of coping with
grief, and that “different” does not imply inferior. Nonetheless, the
presumptions in many cultures are that weak individuals display emotion
publicly and that strong, professional people should present a stoic front
and grieve in private.
Additionally, there are socially constructed views about the
appropriate ways that the deceased may be remembered publicly, but there
are fewer restrictions about social appropriateness in small, private
settings. For example, privately, it may be appropriate to share personal
and humorous stories of the deceased, but one would never do so in a
formal tribute. There are clear, albeit frequently unspoken, social rules
about how one can celebrate the life of, or eulogize, deceased members of
a community in a public setting. Oftentimes, the tension between
balancing the public and private demonstration of grief and mourning
creates intrapersonal, as well as interpersonal and social conflict.
The third dialectical tension is similar in that it concerns the
performance of public and private rituals. In some communities, there are
precise rituals that must be enacted, regardless of whether the individual
participants wish to do so. For example, when a head of state dies, there
are certain public rituals, i.e., calling for a day of mourning, having an
escorted funeral procession, or a body lying in state, that must be enacted
for the benefit of the larger community, regardless of the wishes of the
immediate family. Conversely, there may be very personal, private rituals
that some may feel need to be performed, yet these rituals may not be
understood by others in the community. For example, one of my family
traditions is that burial clothes for the deceased should be night or bed
clothes, and as such, a family member was buried in a smoking jacket,
rather than a formal suit and tie. This private, personalized tradition may
___________________________________________________________
conflict with norms for appropriate public behaviour. These contradictions
can create difficulties for all parties involved, as an institutional loss is in
some ways private, as well as public.
A fourth dialectical tension exists in the roles individuals must
assume following the death of a community member. While many
individuals may be affected either directly or indirectly, their needs for
offering consolation or requiring comfort may shift back and forth. It is
relatively easy to note those needing assistance or comfort: family
members of the deceased, those who directly worked with or under the
one who has died, those whose lives were personally touched by the
individual. However, grief and loss does not simply affect one individual
at a time, especially in an institution with diverse populations. Put simply:
who comforts the comforters? People may simultaneously be both grievers
and comforters. For example, some hospice workers assume a great deal
of the responsibility for providing assistance and comfort to a terminally
ill patient’s family, yet when the patient dies, they may also experience a
profound sense of loss and require comfort as well. This dialectical
tension concerns how people balance the desire to comfort others and yet
be able to receive or ask for comfort when necessary.
Finally, there is a strong dialectical tension as people struggle to
accept and embrace pain and move towards growth. In John Harvey’s
book, Give Sorrow Words, he approaches dealing with major loss in a way
that “loss becomes gain as we heal and particularly as we use our losses
and what we learn from them to contribute to others who also suffer.” 12
Pain resulting from major loss is not simply something that is experienced
and remains forever so by one person. Pain can bring growth and
development as surely as growth begets additional pain. As prior
bereavement work suggests, acceptance of loss is a necessary precursor
for healing, but individuals may cycle through various phases of pain and
healing throughout one’s life. Thus, moving through pain could be recast
as potential growth. Simultaneously, producing new growth, especially as
the bereaved reach out to others, may necessitate enduring additional pain
as well. For example, life-saving surgeries may be quite painful,
recoveries prolonged and difficult. Similarly, as those who have suffered a
major loss engage with, and help support or care for others, the growth
that results may be inexplicably linked with pain and heartache.
Thus, major tragedies in academic institutions necessitate
balancing many and varied competing needs, notably for many and varied
competing audiences. The five dialectical tensions outlined emphasize the
need for careful and well co-ordinated communication at multiple levels
when tragedy strikes the academy. Pain and suffering resulting from
extensive grief and loss may eventually give way to healing and growth,
___________________________________________________________
but these on-going, intrinsically linked processes require conscientious
forethought and action.
Notes
1
Melanie K. Barnes, et al., ‘The Relativity of Grief: Differential
Adaptation Reactions of Younger and Older Persons’, Journal of Personal
and Interpersonal Loss, 1 (1998), 375-392.
2
Ronnie Janoff-Bulman & Michael Berg, ‘Disillusionment and the
Creation of Values: From Traumatic Losses to Existential Gains’, in
Perspectives on Loss: A Sourcebook, ed. John H. Harvey (Philadelphia:
Brunner Mazel, 1998), 35-47.
3
Harold S. Kushner, When Bad Things Happen to Good People. (New
York: Avon Books, 1981).
4
Melanie K. Barnes, ‘A case study approach to support needs following
the death of a loved one’, Journal of Personal and Interpersonal Loss, 1
(1996), 275-298.
5
Mikhail M. Bakhtin, The Dialogic Imagination: Four Essays by M. M.
Bakhtin, ed. Michael Holquist, trans. Caryl Emerson & Michael Holquist
(Austin: University of Texas Press, 1981).
6
Leslie A. Baxter & Barbara M. Montgomery, Relating: Dialogues and
Dialectics (New York: Guilford, 1996).
7
Ibid, 9.
8
Melanie K. Finney, ‘Accommodating Dialectical Tensions in Academic
Institutions Following Traumatic Events’ (in prep).
9
Margaret Strobes, Hank Schut, & Wolfgang Stroebe, ‘Trauma and Grief:
A Comparative Analysis’, in Perspectives on Loss: A Sourcebook, ed.
John H. Harvey, (Philadelphia: Brunner Mazel, 1998), 91.
10
Ibid, 92.
11
Terry L. Martin & Kenneth J. Doka, Men Don’t Cry… Women Do:
Transcending Gender Stereotypes of Grief (Philadelphia: Brunner Mazel,
1999).
12
John H. Harvey, Give Sorrow Words: Perspectives on Loss and Trauma
(Philadelphia: Brunner Mazel, 2000), 208.
Melanie K. Finney received her Ph.D. from The University of Iowa and is
Associate Professor of Communication and Theatre at DePauw
University, Greencastle, Indiana, United States.
Traumatic Bereavement and Coping:
Implications for a Contextual Approach
Karola Dillenburger, Montse Fargas, Grace Kelly and Rym

Akhonzada
Abstract
Bereavement responses and outcomes depend on multiple factors,
such as circumstances of the death, the relationship with the deceased,
individual characteristics, social context, and cultural factors. Responses
to natural death differ from those following traumatic death. Death of a
child or spouse is most difficult, while age mitigates coping. Social
support is important and cultural differences affect funeral rites and coping
patterns.
Using Northern Ireland as a case in point, this paper explores
implications of violent death over time. Northern Ireland lived in civil
unrest and political violence, commonly known as the Troubles, since
1969. Over 3,600 people have been killed as a result. In 1994/05,
ceasefires were negotiated and since then, violent incidents have decreased
dramatically, although they have not completely stopped.
In the early years of the Troubles, the impact of the violence on
people’s mental health was underestimated and there was a lack of
structured support. Since the ceasefires, more attention has been paid to
those affected and community support groups have grown rapidly.
In this paper, we report data from pre-ceasefire studies and
contrast these with newly emerging post- ceasefire research in regard to
psychological health, depression, and PTSD in individuals who
experienced traumatic bereavement. Quantitative as well as qualitative
data will be reported and implications for a contextual analysis outlined.
Key words: traumatic bereavement, victims’ groups, Northern Ireland,

D.I.S.C analysis, GHQ, BDI, PDS.
1. Introduction
Bereavement is an inevitable and universal experience, although
how each individual reacts to the death of a loved one depends on multiple
factors. Dillenburger and Keenan 1 suggested that bereavement outcomes
and coping are shaped by at least four different yet intertwined contexts:
(1) the Death itself, including the circumstances surrounding the death,
and how the death was communicated; (2) Individual factors, such as age,
gender, relationship with the deceased, and health prior to bereavement;
(3) Social circumstances, such as the extent of social support and quality
of social network; and (4) Cultural context, including cultural norms and
rites, historical circumstances and political situations. In this paper, we use
76 Traumatic Bereavement and Coping
___________________________________________________________
their D.I.S.C model to look at traumatic bereavement and, we compare
data of the PAVE Project (People Affected by Violence) 2 with data of the
first study on violent bereavement in Northern Ireland in the mid-
eighties. 3
Bereavement caused by violence is clearly more traumatic than other types
of bereavement. 4 Since 1969, over 3,600 people were killed as a direct
result of violent conflict in Northern Ireland. This means that thousands
have lost immediate family members, relatives, and close friends in
shootings, beatings and bombings. Mass violence is not unique to
Northern Ireland, and there are many other examples where people have
suffered mass-scale bereavement through war, genocide or natural
disasters. The question is, how do people cope in the long-term?
Ten years after the ceasefires, one could expect that people have
learned to live with their loss, however, recent research shows that many
are still suffering twenty, thirty or even thirty-five years after their loss 5 ,
“for many, the hurt of thirty years ago is just as strong as it was then and
remains undiminished by the passage of time.” 6 In 1985/6, a violently
bereaved widow said:
[my grown up children] say I have to forget him and

they think I should be over it after all these years. But I
will never forget. 7
Twenty years later, these widows cannot stop thinking about their loss:
I know its thirty odd years ago but it seems like

yesterday and I still have not got over it and I will never
get over it. 8
To me, I would say, inside deeply, I still haven’t

snapped out, you know, the death of my husband, I
would say it’s still there but, as I say, it will be there
until the day I die. It does not go away. It won’t go
away. And I have learned to accept that. 9
2. Impact of traumatic bereavement on psychological wellbeing

The impact of conflict in general and violent bereavement in
particular is subject of some controversy in Northern Ireland. In the early
years, psychiatrists 10 and some researchers 11 believed that most people
reacted with astonishing denial or resilience to the continuing violence.
Reports that presented a different picture 12 were all but ignored. Support
was scant. 13 However, with the beginning of the Peace Process in the mid-
Karola Dillenburger et al. 77
___________________________________________________________
1990s, and particularly since the Belfast Agreement in 1998, more
research was carried out that confirmed significant long-term
psychological suffering. 14 The Government paid increasing attention to
victims’ issues, and voluntary support groups experienced a rapid growth.
In this paper, we draw findings from the PAVE project, which explores
the effectiveness of voluntary services offered to people affected by the
Troubles. To-date, 71 individuals, of which 59 were violently bereaved,
completed a set of psychological standardised questionnaires (General
Health Questionnaire, GHQ-30 15 ; the Beck Depression Inventory, BDI-
II 16 ; and the Posttraumatic Stress Diagnostic Scale, PDS 17 ). Findings
show poor psychological health, high levels of depression, and severe
PTSD symptomatology (Table 1).
GHQ mean BDI mean PDS mean

N
(SD) (SD) (SD)
All participants 71 10.46 (9.8) 19.70 (13.9) 25.36 (15.4)
Violently
59 10.05 (9.6) 19.57 (13.7) 24.77 (14.7)
bereaved
Table 1: GHQ, BDI and PDS means of PAVE Project participants
These data are similar to findings from the mid 1980s when the
GHQ-30 mean score for violently bereaved widows was 10.69 (SD 9.4). 18
3. The death
It is widely believed that the circumstances of the death are one
of the crucial factors that affect bereavement outcome. Certain
circumstances, such as sudden death and lack of anticipation, violence, or
multiple deaths, are more likely to lead to more problematic bereavement
or to so-called ‘complicated grief’. 19 For example, Kaltman and
Bonnano 20 found that bereavement following violent death (accidental
death, suicide or homicide) is likely to result in PTSD symptoms and
enduring depression.
In Northern Ireland, a widow in 1985/6 revealed how her
husband was killed and how his violent death affected her:
The gunmen had shot him straight into the face. His face
was so bad that they just put a plastic bag over it. All I
can see when I close my eyes now is that white plastic
bag. I cannot even remember his face. 21
___________________________________________________________
In 2006, a widow explains how seventeen years after the violent death of
her husband, the way he was killed still has an impact on her:
If there was a door here, we were sitting, I would have
to go over and open the door. I can’t bare the door
closed. Probably because of the way they came in
through my back door and murdered my husband. 22
Another important factor is the way in which the death is communicated 23 .

While twenty years ago widows who witnessed the death of their husband
scored significantly lower on the GHQ-30 than those who were told by
somebody else 24 , today those who were present when their loved one was
killed scored higher than those who were told by a third party (Table 2).
N GHQ mean BDI mean (SD) PDS mean

By a 28 8.43 (9.1) 17.39(13.7) 20.39(13.2)
By the 8 8.50 (5.9) 13.13 (8.1) 20.71(10.7)
By a doctor 2 5.50 (6.4) 6.50 (4.9) 10.00(14.1)
Witnessed 23 13.30 (10.8) 25.45(13.6) 32.55(12.8)
Table 2: GHQ, BDI & PDS by how the death was communicated
4. The individual context

Individual factors, such as age and the relationship with the
deceased, have an effect on how the bereaved are coping. 25 Some PAVE
project participants were children when they lost a parent and this
obviously had and still has a huge impact on them:
I suppose for a long time we didn’t even talk about the

death of my mother, how it happened or how it affected
us. I suppose we all just thought you have to get on with
it… it was more really as I got older, got into my teens,
that would affected me more so, ‘cause I had to listen to
my friends saying, ‘oh, I’m off into town with my
mammy’ and I thought I can’t do that… or your first
boyfriend. I had no mother to discuss it with… and
probably to an extent I still resent that. Erm… it’s
something you just can’t let go of, I’d like to, but I can’t,
you know. 26
___________________________________________________________
The loss of a sibling can also have detrimental effects on bereavement
outcomes, particularly if the bond with the deceased had weaken over the
years, as illustrated below:
my other brother… sort of way had drifted from [name

of deceased] and the bond wasn’t quite as strong.… He
said to me, ‘I can’t get him back now. He’s dead. And I
don’t have any chance to get him back’. He thought with
time, things would change… things can improve… But
he was dead and buried. So, I had to carry him for 18
months, as well. 27
Parental and spousal bereavement are particularly difficult. Twenty years

ago, a widow explained how she felt:
I feel most under stress in the morning when I wake. I

cannot help feeling for my husband when I look at his
photo. If he was here I could cope better. My son had an
accident. I felt so useless. When I see other women with
their husbands I feel I have to keep going for my son’s
sake. 28
The bereaved widows in the PAVE Project felt no different:
I thought I can’t live, and then you look at your

daughter… well, what is she going to do? What about
that child? There’s a child here! And I think that is the
only thing that kept me alive… was… had my daughter
there. 29
5. Social context
The social context, in particular the level of social support, is an
important factor in terms of bereavement outcome. Twenty years ago,
bereaved widows relied almost exclusively on support from family and
friends, as very little structured support was available:
Friends of my husband helped me. Two in particular…

They kept encouraging me.
My mother, my sister, my brother and my husband's

niece helped me by looking after the children and by
___________________________________________________________
loving and caring for me and in other ways I cannot find
words to express. 30
Today, the memories are still raw:
There was no help whatsoever, no help for me and my

daughter. And… the last… person we seen coming
down the road, it was my husband in a box and the door
was shut. There’s… nobody ever comes to say… how
are you coping? Can I help? Nothing whatsoever. 31
Most bereaved PAVE project participants (40 out of 59) had received
some support from support groups (n=19), family (n=14), and friends
(n=5). Being able to talk clearly mitigates poor psychological health,
depression, and PTSD (Table 3).
GHQ BDI mean PDS mean

N
mean (SD) (SD) (SD)
Able to talk with 41 8.24 (8.5) 16.75 (12.6) 21.49 (14.9)
Not able to talk with 16 15.69 (10) 28.44 (13.2) 33.44 (10.1)
Table 3: Questionnaires score means by being able to talk with family
Today, voluntary support groups are considered a fundamental

part of the recovery process:
I would have been lost if I hadn’t have had here, when I

had the second daughter… But it’s sort of funny coming
up here like at this time, because you are thinking,
‘Survivors… Oh, my God! What does that mean? And
I’m not one of them’ or whatever. And then, when you
do come in, and you do start talking to people and like…
we are all in the same boat, you know. Maybe some
haven’t had it as bad as others, or maybe they have a
completely different reason why they are here, but
everybody… it’s the same stuff muddle on through
together, you know what I mean. 32
However, some of the services offered by the groups seemed to

be more helpful than others. Those who were availing of indirect services
(such as courses or advocacy), counselling, storytelling, yoga,
aromatherapy, massage and advice and information tended to score lower
___________________________________________________________
in all three psychological measures than those availing of psychotherapy,
reflexology, support groups and respite care, although most of the
differences were not statistically significant.
Participants explained which services found most helpful. Many
highlighted the importance of trust, getting out of the house, and being
amongst people who had similar experiences.
I think that this was great to get away together, talk

about it, and… chatting and doing things like that. So, it
grew from there on, then, the… pantomimes and
shopping trips, weekends away… And everyone in the
group really, really, really enjoyed it. And still does. 33
There’s a girl in here, G, and she does like… reiki, and

aromatherapy and all this stuff, and she does this other
thing, sounds or something… but like I found maybe six
weeks I did it for, the difference was unbelievable. And
I never would have said like, I had a problem or I find it
harder, until I done that with G… And when I came out
of that, I says, ‘G, my face is sore’. And she says,
‘Why?’ and I says, ‘Because I never really must smile’.
All I did was smile the whole day after I came out of
it. 34
The financial situation of the bereaved is another factor that can

affect or complicate their grieving process. In Northern Ireland, a large
proportion of the deaths of the Troubles occurred in socially deprived
areas 35 . This means that many bereaved individuals and families, apart
from having to cope with their loss, had to live in a context of extreme
financial hardship. We found that those participants who had worries
about money (n=32) scored higher in all three psychological measures
than those who did not have such worries (n=25).
6. Cultural context
The effect of cultural and political contexts on the bereavement
process is difficult to assess. Because of dramatic political changes over
recent years, Northern Ireland supplies an intriguing example. During the
early phase of the Troubles, shootings and bombings were nearly daily
occurrences. The effect on people’s coping is reflected in this quote from a
widow:
___________________________________________________________
Whenever I listen to the television and another terrorist
attack happened I feel most under stress. I switch the
television off. I just cannot stand any more murders. 36
In the late-1990s, remarkable political changes occurred and

violent death decreased dramatically, while awareness of victims’ issues
increased. The effect of these contextual changes meant that those still
violently bereaved were more isolated, as a bereaved brother explains:
But this is after the Good Friday Agreement, after the

ceasefires were on, you know, when everybody said
‘The war’s over. We are finished with it’. And
everybody sort of said, ‘We don’t have to look over our
shoulder every five seconds’. And basically people were
walking in the street thinking that this would never
happen. 37
Intriguingly, however, when pre-ceasefire and post-ceasefire data

are compared, psychological health did not improve. Violently bereaved
widows in Dillenburger’s pre-ceasefire study scored well above the
threshold for psychological health with a GHQ-12 mean score of 4.6 (SD
3.9), whereas post-ceasefire bereaved PAVE project participants scored
about the same, 4.61 (SD 4.1). These scores are similar to those of people
affected by Bloody Sunday 38 (GHQ-12 mean score of 4.9 (SD 4.27)),
twenty-five years after the event.
Many are concerned about the changes that the Peace Process has
brought, including early prisoner releases, and feel that justice has still not
been done. These feelings of injustice, frustration, and powerlessness have
obviously an impact on bereavement outcomes, as illustrated below:
I think… the innocent victims should be looked after

better by the Government. So, there’s another hurt there
that you are getting from the Government… and they
were never caught the ones that murdered my
husband… No one was ever brought to justice. 39
There is one thing that… would be a big burden off my

shoulders. It is to see the ones that murdered my
husband in a courthouse, and be punished for what they
did… The Government keeps them people… They
chose to go out and murder my husband, and they
should be made pay for their crime. It’s not fair on me
___________________________________________________________
that they can walk about ten foot high, laughing, and I
have suffered over them. 40
7. Summary
Traumatic bereavement amalgamates the effects of trauma and
grief. 41 Data reported here opens an extensive range of questions for
trauma and bereavement researchers and practitioners. How do those who
have lost a loved one in violent circumstances cope over the years? What
needs to happen for them to move on? Why do some people cope better
than others do? Why do some bereaved individuals still suffer twenty or
thirty years after their loss? In this paper, we argue that a holistic approach
is needed in order to address these questions. Coping with traumatic
bereavement does not happen in isolation and we explored Death-related,
Individual, Social, and Cultural (D.I.S.C.) contexts in order to illustrate
this process.
Notes
1
Karola Dillenburger and Mickey Keenan, ‘Bereavement: A D.I.S.C
Analysis’, Behavior and Social Issues, 14 (2005), 92-112.
2
Karola Dillenburger et al., ‘The PAVE Project’, Victims and Survivors
Newsletter 2nd Edition, (Belfast: Victims Unit, OFMDFM, 2005).
3
Karola Dillenburger, Violent Bereavement: Widows in Northern Ireland
(Aldershot: Avebury, 1992).
4
See: Janice L. Genevro, Report on Bereavement and Grief Research
[report on line] (Washington DC: Center for the Advancement of Health,
2003, accessed 15 July 2005); available from the Center for the
Advancement of Health: http://www.cfah.org/pdfs/griefreport.pdf/; and
Colleen Murray et al, ‘Death, Dying, and Grief in Families’, in Families
and Change. Coping with Stressful Events and Transitions, ed. Patrick C.
McKenry and Sharon J. Price (Thousand Oaks, CA: Sage Publications,
2005, 3rd Ed.), 75-102.
5
see Karola Dillenburger, 1992; Peter S. Curran et al., ‘Psychological
Consequences of the Enniskillen Bombing’, The British Journal of
Psychiatry 156 (1990), 479-482; Patrick Hayes and Jim Campbell,
‘Dealing with Post-Traumatic Stress Disorder: The Psychological Sequel
of Bloody Sunday and the Response of State Services’, Research on
Social Work Practice 10, 6 (2000), 705-721; Dermot O’Reilly and Mike
Stevenson, ‘Mental health in Northern Ireland: have “the Troubles” made
it worse?’, Journal of Epidemiology and Community Health, 57 (2003),
___________________________________________________________
488-492; Ed Cairns and John Mallet, Who are the Victims? Self-assessed
Victimhood and the Northern Irish Conflict; NIO Research and Statistical
Series, Report No.7 (Belfast: NIO Statistics and Research Branch, June
2003); and PAVE Project, 2005/6.
6
Michael Potter, In Their Own Words: A Research Report into the Victims
Sector in Northern Ireland (Belfast: Training for Women Network, April
2004), 4.
7
Widow in Dillenburger, p. 91.
8
A., widow, January 06. PAVE project.
9
M., widow, February 06. PAVE project.
10
Morris Fraser, Children in conflict (Norwich: Norfolk Pelican Book,
1973).
11
Alf McCreary, Survivors (Belfast: Century Books, 1976); and Ed Cairns
and Ronnie Wilson, ‘The impact of political violence on mild psychiatric
morbidity in Northern Ireland’, The British Journal of Psychiatry 145
(1984), 631-635.
12
Curran et al., 479; and Dillenburger, 1992.
13
John Darby and Arthur Williamson, eds, Violence and the Social
Services in Northern Ireland (London: Heinemann, 1978).
14
see Marie Therese Fay et al , The Cost of the Troubles Study. Report on
the Northern Ireland Survey: the experience and impact of the Troubles
(Belfast: INCORE, 1999); Hayes & Campbell, 705; Karola Dillenburger
and Mickey Keenan, ‘Islands of Pain in a Sea of Change: Behavior
Analysis and Bereavement’, European Journal of Behaviour Analysis 2
(2001), 187-207; Cairns and Mallet, Who are the Victims?; O’Reilly and
Stevenson, 488.
15
David Goldberg, Manual of the General Health Questionnaire
(Windsor: NFER-Nelson, 1978).
16
Aaron T. Beck et al., ‘Psychometric properties of the Beck Depression
Inventory: Twenty-five years of evaluation’, Clinical Psychology Review
8, 1 (1988), 77-100.
17
Edna B. Foa et al., ‘The validation of a self-report measure of
posttraumatic stress disorder: The Posttraumatic Diagnostic Scale’,
Psychological Assessment 9, 4 (1997), 445–451.
18
Dillenburger, 1992.
19
Therese A. Rando, The treatment of complicated mourning (Champaign,
IL: Research Press, 1993).
20
Stacey Kaltman and George A. Bonnano, ‘Trauma and bereavement:
Examining the impact of sudden and violent deaths’, Journal of Anxiety
Disorders 17, 2 (2003), 131-147.
21
Widows in Dillenburger, pp.91-92.
___________________________________________________________
22
M., widow, February 06. PAVE Project.
23
E. Kirschner, ‘Data on bereavement and rehabilitation of war widows’,
Series in Clinical & Community Psychology: Stress & Anxiety, 8 (1982),
219-224.
24
Karola Dillenburger and Mickey Keenan, Some suggestions for a
behaviour analysis of bereavement and loss. Behaviour Analysis in
Ireland, 25 years Anniversary Conference, Maynooth, Ireland, 5 May
(2002).
25
Dillenburger and Keenan, 92.
26
C., bereaved daughter, March 06. PAVE Project.
27
D., bereaved brother, March 06. PAVE Project.
28
29
M., widow, February 06. PAVE Project.
30
Widows in Dillenburger, p. 89.
31
M., widow, February 06. PAVE Project..
32
S., bereaved daughter, March 06. PAVE Project.
33
M., widow. February 06. PAVE Project.
34
S., bereaved daughter, March 06. PAVE Project..
35
Paddy Hillyard et al., Bare Necessities: Poverty and Social Exclusion in
Northern Ireland (Belfast, Democratic Dialogue, 2003).
36
37
D., bereaved brother, March 06. PAVE Project.
38
Hayes and Campbell, 705.
39
A., bereaved widow, February 06. PAVE Project.
40
M., bereaved widow, January 06. PAVE Project.
41
Kaltman and Bonnano, 131.
Can the Dying Mourn?
Kate Powis
Abstract
Seale, in identifying the late modern patient-centred ‘scripts’
adopted by the hospice movement, has declared that the dying themselves
can now play the role of chief mourner. For the aware dying, it is
proposed that some of their grief is anticipatory and the manner in which
they mourn their prospective death will offer guidance and even hope to
those who will have to negotiate their own bereavement after the death of
their loved one.
This paper will examine the psychoanalytic roots of mourning
theories to be found in Freud’s ‘Mourning and Melancholia’ in order to
determine how appropriate it might be to apply psychological models of
bereavement to the dying. While there can be no doubt loss is a major
feature in the experiences of the dying, meaning that elements of such
models may have relevance, I will propose that a key feature of Freud’s
foundational theory cannot be available to the aware dying, thereby
rendering the notion that the dying can ‘successfully’ mourn untenable. I
go on to suggest an alternative account of what may be intermingled with
the experiences of loss for the dying: the fear of annihilation.
Key words: mourning, aware dying, psychoanalysis, narcissistic

satisfaction, annihilation, powerlessness, nothingness, meaninglessness.
1. Introduction
Constructivist theorists studying this topic have proposed that the
‘aware dying’ have recourse to social scripts that allow them to negotiate
their way through the dying trajectory. One such script has been
transplanted from psychological theories of bereavement and mourning.
Such accounts have been developed into stage theories, identifying a path
through the mourning process, and in turn allowing those accompanying
the bereaved, and indeed the bereaved themselves, to assess how
successful they are in working through this process. The efficacy of these
theories in the area of bereavement, based as they are on profound
psychoanalytic insights and an understanding of infant experiences of loss
and separation, has meant that attempts have been made to transpose the
model to the dying themselves; the most well-known, indeed some would
say notorious, being that of Kübler Ross.
The purpose of this paper however is not to launch yet another
broadside against Kübler-Ross’s ‘Five Stages’, 1 or propose an alternative
modelling for the dying process. Instead I will examine the psycho-
analytic roots of mourning theories to be found in Freud’s ‘Mourning and
88 Can the Dying Mourn?
___________________________________________________________
Melancholia’ 2 in order to determine how appropriate it might be to apply
psychological models of bereavement to the dying in the first place. While
there can be no doubt loss is a major feature in the experiences of the
dying, meaning that elements of such models may have relevance, I will
propose that a key feature of Freud’s foundational theory cannot be
available to the ‘aware dying’, thereby rendering the notion that the dying
can ‘successfully’ mourn untenable. I go on to suggest an alternative
account of what may be intermingled with the experiences of loss for the
dying drawn from the work of Freud again, and two contemporary
psychoanalysts: Hurvich and Grotstein and their analysis of trauma and
the fear of annihilation and the trinity of powerlessness, meaninglessness
and nothingness.
2. Seale and the dying ‘expert’

Clive Seale identifies late modern ‘scripts’ adopted by the
hospice movement that draw on medical and therapeutic discourses of
‘patient-centred’ treatments. The development of these, he claims, has led
to the construction of “dying and grief as orderly experiences, guided by a
knowing expertise.” 3 The “knowing expert” in this case is the dying
themselves, who are acknowledged within such scripts to be experiencing
an anticipatory grief, that is to say they are grieving their own death in
advance of the actual event. In such a role, Seale claims, they have
become the chief mourner and can offer guidance and even hope for the
grieving processes of those around them. 4
The conceptualising of a ‘journey’ of grieving in the dying, with
the dying person acting as trail blazer for those who will be their bereaved,
draws on psychological literature that describes the unfolding of an inner
process. Drawing on psychological analyses of mourning, such as Freud’s
‘Mourning and Melancholia’, and Bowlby’s attachment theory, 5 psycho-
sociological treatments of mourning present mourning as a process with a
purpose. Versions of these accounts, often over-simplified, have become
central to what Wortman and Silver have termed ‘clinical lore’ in
bereavement counselling. 6 The purpose of mourning, according to Walter,
is presented by such texts to be the reconfiguration of an autonomous
individual, one who has managed to detach themselves from the deceased
and is now able to form new relationships. 7 This end is sought by a
process which involves a ‘working through’ of a gamut of emotions, often
represented as ‘stages’ in order to come to terms with the loss and ‘move
on’.
As already acknowledged, the doyenne of such theorising as it
might be applied to the dying themselves is Kübler-Ross. Although in her
own writing she admits that the reality will be far more complex than a
Kate Powis 89
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matter of simply moving through each stage as though on a step-by-step
programme, her model of five stages: denial and isolation, anger,
bargaining, depression, acceptance, 8 in some cases has been adapted to
clinical practice where the dying may be ‘diagnosed’ as being ‘stuck’ at a
certain stage, say anger or bargaining, and need to be helped to move on
and through the subsequent stages. When examining classic texts on
bereavement such as Freud and Bowlby however, one can discern a richer
depiction of the complexities of mourning, one that might admit to the
need for the bereaved to form a deeper understanding of the deceased in
order to re-negotiate a continuing and meaningful presence of the lost
loved one in their lives. This is a more complex understanding of the
processes of mourning than the idea of simply ‘letting go’ of the dead in
order for the living to go forward in their own lives. Seale acknowledges
this but realises that:
Stage theories have inspired professionals working with

dying and grieving people…because they offer a
classificatory system with which to organise disturbing
experiences… They offer professionals - and sufferers
too - a sense of direction and purpose as well as a job to
do in the face of threats to basic security. 9
I believe that such classificatory systems offer not just a means

for action and purpose in negotiating the mourning processes in dying, but
a distraction from the ultimate source of that ontological threat, both to the
aware dying and indeed those accompanying them. However, before we
examine what this threat might be, the reality of losses that the dying face
should first be acknowledged.
3. Dying and bereaved

Sociological and psychoanalytic literature that broaches the
subject of mourning tends to focus on the normal conception of
bereavement: the permanent separation from oneself of a loved object.
These bereaved, however, will survive the loss and mourning can be the
process that helps them make that survival more than just a survival;
helping them find a new way of living with that loss. The term
‘bereavement’ has however been used by one Jungian psychoanalyst, Joy
Schaverien, in reference to the losses undergone by the dying:
In the psychotherapy literature on bereavement the

focus is usually with the bereaved relatives. Far
less attention has been paid to the bereavement
___________________________________________________________
experienced by those facing death. This is odd
because a person who is dying is on the verge of
losing everything. 10
‘Aware’ dying involves confronting the reality of one’s own

death: the loss of a future, the loss of witnessing the futures of loved ones,
the loss of health, the loss of autonomy, the loss of friends, the loss of
work, the loss of social status. Unlike the bereaved relative, the dying do
not survive the loss because ultimately all these losses amount to the end
of their life. If they were to mourn these losses where would their
mourning be oriented? Can they re-negotiate a continuing and meaningful
presence of these losses in their lives, in the same way that those who have
lost an external presence may be able to use the processes of mourning to
re-formulate that presence into an internal one? How appropriate is it to
transpose concepts derived from those grieving the loss of someone other
than the bereaved person to what might be experienced by the dying
themselves?
To return to Schaverien’s appropriation of the term bereavement
for the experience of loss in the dying themselves, it strikes me that this
highlights a certain dissonance in the comparison between the two forms
of experience here. Although I welcome her acknowledgement of the
paucity of psychotherapeutic literature around the losses experienced by
the dying, using the term ‘bereavement’ and thereby importing the
literature surrounding that topic does not, I feel, seem to answer the
problem at hand for the dying’s experience of loss. In order to explore my
misgivings about the theorising around this topic I will examine the
seminal psychoanalytic text on mourning.
4. The ‘engine’ of mourning

Freud’s paper ‘Mourning and Melancholia’ has formed the most
influential psychoanalytical account of mourning, which he seeks to
differentiate from a condition that he sees has some associations with it,
melancholia. For Freud, mourning can be understood as “the reaction to
the loss of a loved person, or to the loss of some abstraction which has
taken the place of one”. 11 The phenomenon of mourning shares with
melancholia the distinguishing features of “painful dejection…cessation of
interest…loss of capacity to love…inhibition of all activity” but
melancholia has the unique addition of “a lowering of self-regard”. 12 Thus
Freud can distinguish between the two by declaring that for those in
mourning “the world has become poor” by the removal of a cherished
object, whereas for the melancholic “the ego is impoverished” 13 because it
is deemed uncherishable. Another central distinguishing feature of
Kate Powis 91
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mourning is that it is a conscious process – the loss is focused on
consciously, whereas in melancholia the lost object is lost even to
consciousness, but nevertheless this unconscious experiencing of loss
presents somatic as well as psychological features.
The purpose or, as Freud has it, the work of mourning is again to
test reality: to come to an acknowledgement that the loved one no longer
exists, thereby allowing the libido to withdraw its attachment to the lost
object. This work is done in the face of intense opposition from the libido
that seeks to turn away from the reality of the loss of the loved object,
clinging to it through “a hallucinatory wishful psychosis”. 14 Each memory
and association with the lost object has to become the focus of a hyper-
cathexis, an extremely painful and time-consuming process. With each
step of this reality testing the ego is “confronted…with the question [of]
whether it shall share this fate [i.e. the fate of the lost object].” 15 It is only
through this process that the ego can be persuaded via “the sum of
narcissistic satisfactions it derives from being alive” 16 to sever the
attachment to the lost object. It is as though each moment of “narcissistic
satisfaction” provides a little bit more momentum through the process of
mourning, hence the appellation I have given this feature of Freud’s
theory: the engine of mourning. Freud’s recognition of the source of
energy provided for a painful and time consuming process must raise the
question of how can the dying successfully and viably go through such a
process entailing ‘narcissistic satisfactions’ that cannot be open to the
aware dying?
5. An example of narcissistic satisfaction: The Death of Ivan

Ilyich
Leo Tolstoy presented evidence of this mechanism at work even
before Freud himself identified it. In ‘The Death of Ivan Ilyich’ 17 the story
opens with colleagues of Ivan Ilyich discussing the news of the death of
their associate. On hearing this, each one present considers the advantages
that might accrue to them in the form of promotions or transfers. In these
discussions, Tolstoy notes, “the mere fact of the death of an intimate
associate aroused… in all who heard of it a complacent feeling that ‘it is
he who is dead, and not I’.” 18
When they observe custom and visit the grieving family, two of
them exchange glances as though to say “Ivan Ilyich has made a mess of
things – not like you and me.” 19 However for one, Piotr Ivanovich, the
sight of the dead body shakes him: “There was reproach…and a reminder
to the living. This reminder seemed out of place to Piotr Ivanovich, or at
least to have nothing to do with him. It gave him an unpleasant
___________________________________________________________
feeling…” 20 and this unpleasant feeling intensifies when he listens to the
widow’s account of the final days of her husband:
‘Three days and nights of awful suffering and then

death. Why it might happen to me, all of a sudden, at
any moment,’ he thought and for an instant he was
terrified. But immediately he could not have explained
how, there came to his support the old reflection that
this thing had befallen Ivan Ilyich, and not him, and that
it ought not and could not happen to him… 21
Admittedly Tolstoy is interested in exploring the hypocrisy of

complacent Russian bourgeoisies but nevertheless I believe that here he
has exposed the workings of certain defence mechanisms that we are all
prone to when facing a particular death. And what precisely is it that
Ivanovich is terrified of when he hears of the terrible suffering at the end
of his friend’s life? If it was simply the obvious fear of undergoing the
same form of suffering then perhaps empathy and compassion would
figure more here. But what if there is a stronger and more primal source of
that fear that calls forth the defensive manoeuvres in Ilyich’s friends, and
indeed family?
6. Trauma, danger and annihilation

And now we return to Freud, and this time to his analysis of
anxiety. 22, 23 He believed that anxiety could be traced to two sources: the
direct experience of a traumatic situation, and the anticipation of such an
experience. 24, 25 A traumatic situation for Freud consists of overwhelming
stimulation, either internal or external, that cannot be discharged or in any
other way processed. The experience, therefore, is one of absolute
helplessness. Freud postulates that birth is the prototype for the traumatic
situation and therefore it is one of the primary functions of the human
organism to avoid any over-stimulation, as it threatens to overwhelm.
Anxiety therefore recreates the sense of mortal danger that
originates in the associations of extreme and unpleasurable bodily
sensations during birth. The second source of anxiety is the anticipation of
being in a traumatic situation which Freud called a danger situation. He
sees it as a “recognised, remembered, expected situation of
helplessness.” 26 I believe that it is this that terrified Piotr Ivanovich: the
anticipation of such overwhelming suffering in the face of death and the
accompanying helplessness that his friend Ivan Ilyich had undergone.
Kate Powis 93
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For Freud, a danger situation may be triggered, for example, by
fears of loss of a loved object, or the actual loss of love. However, in his
discussion of Freud’s analysis of these phenomena, Hurvich believes that
neither the prospect of the loss of a loved object, nor the loss of love itself
can be constituted as the source of either state of anxiety. Rather it is the
fear of being overwhelmed, annihilated, that is best understood as the
basic danger. The trauma triggered by loss refers back to the prototypical
situation of annihilation anxiety: the overwhelming over-stimulation of
birth. In this model the primary and secondary, anticipatory form of
anxiety constitute two poles of “a series of potential responses”. 27 At one
pole there exists an unprocessed organismic panic, while at the other pole
thought-like processes are possible, reducing the affective element of the
experience. It then becomes obvious that at the primary end of this scale of
anxiety there can be no recourse to a conscious analysis as the experience
harks back to the preverbal condition. Unable to explain the ‘reason’ for
the terror, to ourselves or to others can only increase the panic and the
sense of being utterly overwhelmed. However I would tentatively suggest
that this model of a spectrum of responses between primary and secondary
sources of anxiety offers the hope of a shift from panic to the capacity to
process the trauma induced anxiety. What is necessary though is for others
around the sufferer to at first acknowledge and stay with, or to use Bion’s
term ‘contain’, 28 the panic and the sense of powerlessness - of both the
sufferer and those accompanying them.
7. Power and powerlessness

Thinking again about Clive Seale’s realisation that mourning
scripts offer ways to classify disturbing experiences, I think that the nature
of the ontological threat constituting these experiences has become clearer.
We are driven to find something ‘to do’ to fend off the panic of this primal
anxiety. But, as we have seen they are based on Freud’s concept of the
process of mourning which posits ‘narcissistic satisfaction’ as the source
of power in working through this process. Without access to this the dying
are without the necessary power - indeed are ultimately powerless in the
face of their losses. What role might powerlessness, as the dialectic of
power, play here?
James Grotstein identifies the cultural debt that Freud owed to the
German Romantics’ celebration of the potency of Nature on the one hand
and the power of science and logic on the other, the combination of which
gave birth to psychoanalysis and its emphasis on the power of the
instinctive. 29 However, in a later article, a seminal influence in certain
areas of current psychoanalytic theory, Grotstein goes on to introduce
powerlessness, twinned with meaninglessness, in just such a dialectic role.
___________________________________________________________
30
For him, powerlessness in this case must be understood not as mere
“static emptiness but as an implosive, centripetal pull into the void” 31 ,
analogous to the black hole of astrophysics.
Close kin to powerlessness is meaninglessness; that is content
either without meaning or deprived of meaning. The Kleinian analyst Bion
had identified the “beta prime elements” of the “container” of
meaninglessness: “nameless dread”. 32 Grotstein offers a further distinction
in his conceptualisation of meaninglessness, identifying primary and
secondary forms. The primary form takes place before experience - and
here he refers to the “Darkness of the Deep” in Genesis. It consists of a
‘primal’ void that anticipates content and realisation via experience. The
secondary condition emanates from a turning away from experience and a
return to emptiness, but this time it is not the immaculate void, but rather a
“black hole” that evacuates meaning. 33
Alongside powerlessness and meaninglessness is a third
phenomenon: nothingness. Indeed, for Grotstein psychic trauma
“ultimately consists of meaninglessness… in an atmosphere of
nothingness”. 34 Nothingness here can also be identified as primary and
secondary conditions. The first is the Sartrean notion of an emptiness, a
base condition that must be undergone in order to create meaning, while
the second consists of the negation of being: the no-thing. There is a link
here to the secondary form of meaninglessness, with secondary
nothingness as the “black-hole” breaking down and sucking out meaning,
leaving only the Bionian “beta elements” and the “nameless dread” 35 - a
dread of being stripped of our thingness, of nothingness overwhelming our
existence. At bottom, this is the fear of our annihilation.
8. Conclusion
My starting point in this paper has been a doubt around the
efficacy of a wholesale transposition of mourning theories to the
predicament of the aware dying, albeit that this inevitably involves a range
of losses. With this doubt came a suspicion that what prompted us to rely
on these theories was an unwillingness to examine the ultimate source of
anxiety in dying, the fear of annihilation. This may be seen as
defensiveness on both an individual and a social and cultural scale. Even
psychoanalysts have recognised that their discipline may be prey to this;
Hurvich acknowledges that it is a relatively undeveloped concept in the
literature, with no comprehensive definition. 36 He cites Langs who
suggests “classical psychoanalytic theory and technique has been designed
to some extent as a defence against such primitive anxieties.” 37 I believe
that Grotstein’s discussion of powerlessness as the dialectic of power
offers one answer as to why this might be. In a culture that is driven to
Kate Powis 95
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holding and maintaining power on an individual, social and global scale,
the ultimate relinquishing of it that all humans must face is a terrible threat
indeed.
And finally, to return to Ivan Ilyich: I wish that there had been
time and space to do more justice to this work, but I will end with a brief
glimpse of the predicament of Ivan himself. He faces terrible despair that
racks up the pain and suffering he must endure as he realises that all he
has valued in his life is meaningless. His powerfully connected friends,
status hungry wife and self-regarding doctor can offer him no way out of
his agony. The only person who can bring temporary ease is his serf who
cheerfully stays with him and supports his legs to make him more
comfortable. Finally, an hour before his death, Ilyich is shrieking
desperately. His young son comes to him and kisses his hand and bursts
into tears. It as at this point that Ilyich finds relief, can turn away from
bitterness and looks with compassion on his family, and at last
relinquishes fear. The two least powerful figures in the story are finally the
ones to help.
Notes
1
Elisabeth Kübler-Ross, On Death and Dying (London and New York:
Routledge, 1973).
2
Sigmund Freud, ‘Mourning and Melancholia’ (1917) from On
Metapsychology: The Theory of Psychoanalysis, Volume 11 of The
Penguin Freud Library, Standard Edition edited by James Strachey,
present volume compiled and edited by Angela Richards (London,
Penguin, 1984), 251-268.
3
Clive Seale, Constructing Death (Cambridge: Cambridge University
Press, 1998), 118.
4
Seale, 118 -119.
5
John Bowlby, Attachment and Loss. Vol. III: Loss: Sadness and
Depression (London: Penguin, 1980).
6
C.B. Wortman and R.C. Silver, ‘The myths of coping with loss’, Journal
of Consulting and Clinical Psychology: 57, 3 (1989) 349-57.
7
Tony Walter, ‘A new model of grief: bereavement and biography’,
Mortality 1, 1 (1996), 7-25.
8
Kübler-Ross, 34-121.
9
Seale, 107.
10
Joy Schaverien. The Dying Patient in Psychotherapy: Desire, Dreams
and Individuation (Basingstoke: Palgrave, 2002), 125.
11
Freud, 1917, 252.
___________________________________________________________
12
Ibid.
13
Ibid., 254.
14
Ibid., 253.
15
Ibid., 265.
16
Ibid.
17
Leo Tolstoy, The Death of Ivan Ilyich, tr. Rosemary Edmonds (London:
Penguin [1886]1960).
18
Ibid., 102.
19
Ibid., 103.
20
Ibid., 104.
21
Ibid., 107.
22
Sigmund Freud (1926) ‘Inhibitions, symptoms and anxieties’ from The
Standard Edition 20, edited by James Strachey (London: Hogarth, 1959),
77 -175.
23
Sigmund Freud (1933) ‘Anxiety and instinctual life’ from New
introductory lectures on psychoanalysis (Lecture 32), Standard Edition 22
edited by James Strachey (London: Hogarth, 1933), 81-111.
24
Freud, 1926, 162.
25
Freud, 1933, 94 -95.
26
Freud, 1926, 166.
27
Hurvich, 312.
28
Wilfred Bion Learning form Experience (London: Karnac, 1984).
29
James Grotstein, ‘The psychology of powerlessness: Disorders of self-
regulation and interactional regulation as a newer paradigm for
psychopathology’, Psychoanalytic Inquiry, 6 (1986) 93 -118.
30
James Grotstein, ‘Nothingness, Meaninglessness, Chaos, and the ‘Black
Hole’’, Contemporary Psychoanalysis, 26 (1990), 257- 290.
31
Grotstein, 1990, 257.
32
Bion, 1962b.
33
Grotstein, 1990, 267.
34
Ibid., 264.
35
Bion, 1962b.
36
Hurvich, 1989.
37
Langs, 1981, cited by Hurvich, 1989, 318.
Kate Powis is a Ph.D. student in the Department of Sociology, at the

University of Essex, UK. This paper was presented with the financial
support of the departmental Small Grants Fund. She is also a consultant
lecturer on a part time basis at St Helena Hospice, Myland Hall Education
Centre.
The Death of Innocents:
Noncombatant Immunity vs. the Divine Foetus
Lloyd Steffen
Abstract
This paper argues that one of the reasons the abortion issue is so
intractable is that a metaphysical notion of ‘innocence’ has attached to the
foetus, thus subverting our ordinary, morally framed understanding of how
and why abortion can be justified. Attention is focused on the refusal of
some anti-abortion advocates, including the moral teaching of the Roman
Catholic Church, to accept that a pregnant woman can justifiably abort a
foetus if that foetus poses a threat to her life or health. The just war notion
of ‘non-combatant immunity’ is offered as a non-absolutist point of
contrast with absolutized notions of innocence that would value the foetus
over the pregnant woman.
Key Words: abortion, just abortion, just war theory, religious innocence,
non-combatant immunity, foetal death.
1. Introduction
Why has the abortion debate been so intractable? I suggest in this
paper that the reason may involve people talking past one another over
issues that have not been fully presented for reflection and critique. One
such issue is that of foetal innocence
My argument is that invocations of foetal innocence have
elevated the foetus to a peculiar metaphysical status even beyond the
moral category of person; and to expose this development I shall contrast
this metaphysical claim with more accessible moral notions of innocence
as they arise in non-sectarian moral thinking. The just war idea of ‘non-
combatant’ immunity will serve to expose this moral notion of innocence.
The contrast between metaphysical and moral ideas of innocence will
illumine the meaning of foetal death as it arises in the debate over
abortion.
2. Moral innocence
In our ordinary moral discourse, we make reference to ‘innocent’
persons. We acknowledge in the moral life the threat to innocent lives
posed by a terrorist or armed bank robber who may be panicking; and
what we mean innocence in such situations is that persons so threatened,
all of whom possess a right to life, have been positioned by unwanted life
circumstances, to be in harms way. These persons are agents and capable
of action; their right to life is protected by their inclusion in the moral
category of personhood; and it would be morally wrong to intentionally
98 The Death of Innocents
___________________________________________________________
kill one of these innocent persons. The duty to protect them may lead
others, say, the police, to use deadly force to protect them.
This idea of protecting innocent persons because they are persons
and possessed of a right to life which it is a moral duty to protect has been
enshrined in what we know as just war theory. Just war has always made
appeal to the idea of restraint of force, and underwriting just war as a
policy tool is a moral framework - a structure for moral thinking - that is, I
believe, enormously practical and helpful for thinking through moral
issues and dilemmas. Just war, as a moral perspective, presumes
reasonably that force ordinarily ought not to be used to settle conflicts,
then imposes various tests of justice that must be satisfied if that
presumption against using force is to be lifted so that a use of force then
could make a reasonable claim to being morally justified. The tests of
justice - he jus ad bellum criteria so familiar to us - deal with such matters
as competent authority, just cause, announcement of intention, last resort
and so on; and in the classic jus in bello requirements for the actual use of
force once a use of force has been justified and is underway, two other
constraints, a proportionality requirement that the use of force must be
proportionate to the end of peace (this deals with weapons that are
disproportionate and ought not be used); and a ‘non-combatant immunity’
provision. What this provision says is that the actual use of force requires
that persons not engaged in the conflict must be protected - they are not to
be directly attacked. Non-combatant immunity makes reference to what
we typically call ‘innocent persons.’
What do we mean by this? Combatant and non-combatants are all
persons and all possess a right to life; but non-combatants are immune
from the use of force and it is presumptively wrong to directly use force,
especially lethal force, against them. They are innocent. They are by-
standers in the bank that is being robbed, they are in the line of fire when
warring parties unleash urban mop-up operations; they are in office
buildings and subways when terrorists strike. Directly intending to harm
and kill non-combatants, those not party to a conflict where lethal force is
being used, is, according to just war ethics, morally wrong. Targeting
civilians to achieve some end is wrong; using terrorist tactics, which by
definition are directed at civilian non-combatants, at innocent persons, is
wrong; and every effort must be made, just war wants to say, to prevent
harming these ‘innocent persons.’ The only thing that would make the
killing of an innocent person permissible is if every conceivable effort was
made to prevent such killing and when such killing did take place it
happened as a regrettable and foreseen - but always unintended conse-
quence of a morally legitimized use of force. The doctrine of double-effect
has been devised in the natural law tradition to take note of the messiness
Lloyd Steffen 99
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of moral life and the possibility that even innocent persons may be put in
harm’s way and killed as an unwanted and regretted consequence of a
conflict where force is being used.
I suggest that immunity from harm identifies a reasonable notion
of innocence. The use of force always poses some threat of harm, even
non-violent force. Martin Luther King used to worry enormously about
starting non-violent boycotts, because they would harm innocent persons
not directly involved in the conflict. King, like Gandhi, understood non-
violent force to be a use of force and followed a non-combatant immunity
provision by seeking to avoid inflicting harm on innocent persons in
conflict situations where even the force of non-violent resistance was to be
used.
In summary: In the moral life, we acknowledge that persons not
party to a conflict should be immune from direct action that would cause
them harm. No mantle of absolute protection can be thrown over the
innocent bystander or innocent civilian, however, and in the application of
justified uses of force the death of an ‘innocent’ may be ‘justifiable’ if
every reasonable effort has been made to avoid inflicting such harm. In the
moral life, then, the idea of innocence is attached a duty that falls on the
parties in conflict to respect the lives and well-being of non-combatant,
innocent persons. The innocence is not absolute and can even be rendered
justifiable, even if always regrettably so.
3. Abortion and the innocent foetus

Having examined the idea of non-combatant immunity as a
presumptive protection of person that is not an absolute protection, I want
now to turn to the abortion issue and consider the matter of foetal
innocence.
If we were to use the model of ‘non-combatant immunity’ from
the just war ethic, we could say that a foetus is deserving of protection as a
developing form of human life. But even if one should go so far as to
regard the foetus as a person, that status does not provide an absolute
immunity or prevent the killing of the foetus under any and all
circumstances, if, in fact, a conflict of values leads to the conclusions that
this immunity can be overridden and justifiably so.
In the abortion debate, people who defend abortion rights would
argue that because the foetus is not a person-the argument could be that
the foetus does not possess the attributes of recognized members of the
moral community, self-awareness, ability to use language or whatever
criteria for personhood one would present - the foetus does not enjoy the
protections afforded persons and can be aborted, killed, without that
killing amounting to a moral offence. (This is Mary Ann Warren’s classic
___________________________________________________________
argument 1 ). Pro-life persons, who are not absolutists but who
acknowledge foetal person-hood, would reasonably acknowledge certain
cases where abortion could be justified, those situation typically being
incest, rape, and ‘to save a woman’s life.’ Since rape and incest have been
losing support from pro-life supporters, my focus will be turned to ‘save
the pregnant woman’s life.’ This ‘exception’ arises even for reasonable
pro-life supporters as they acknowledge that pregnancy is a medical
condition that can itself pose dangers to a woman. The foetal ‘person’ can
present itself to a pregnant woman as a material aggressor that cannot
form intentions and is not an agent. In the moral life, a woman facing such
a threat has a right; others would actually claim a duty, to protect herself
from this threat even if it cost the life of the ‘innocent’ foetus.
Whatever ‘innocent’ means for those who ascribe innocence to
the foetus-as-person, reasonable persons would allow innocence is not
absolute, that foetal innocence can be overridden by other values, such as
the life of the pregnant woman; and that a foetus could be aborted and
justifiably so for just cause, say, for reasons of self-defence.
It is beyond this point that things get interesting. What about
those who hold that abortion is never permissible - absolutely
impermissible - and invoke foetal innocence as the reason for this claim?
My case is that in the moral life, this move cannot really be made
rationally and coherently, for conflicts in value, even conflicts involving
the value of life, are possible, and life cannot reasonably be thought of as
an absolute value that will always and in every situation trump other
values when life as a biological reality becomes party to a conflict, else we
would be morally obligated, for example, never to terminate life support
so long as we can keep life going regardless of the patient’s condition.
Reason and morality would assert that foetal life ought to be valued but
not in an absolute sense that it would trump a woman’s life when her
pregnancy was threatening her life; and this would hold I think even for
those committed to the view that the foetus is a person and itself possesses
a right to life.
I make this case even by appealing to a tradition of thought in the
Roman Catholic moral tradition, which has ironically preserved and
developed through the centuries just war theory and non-combatant
immunity provision that is a non-absolutist idea of innocence. Roman
Catholic moral teaching, however, has absolutized the value of the foetus,
even though that same tradition has over the centuries tried to avoid
absolutism and create, if I may as an outsider describe this feature of the
Roman Catholic tradition, loopholes in the interests of justice and in
recognition of the impossibility of acting purely or being god-like in our
Lloyd Steffen 101
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moral knowledge or moral action. Just war theory itself is a model of such
hesitation in the face of absolute certainty.
The Roman Catholic tradition has addressed the idea of foetal
innocence in different ways, and just as there has been change underway
in movement toward absolutizing the foetus in, say, the Republican
Platform of 2004 where ‘rape, incest and to save a mother’s life’ were for
the first time dropped out of the anti-abortion plank, the Roman Catholic
position has similarly changed. Consider how American jurist and moral
philosopher, John Noonan, rehearses the history of the Catholic moral
tradition in its non-absolutism:
In Catholic moral theology, as it developed, life even of

the innocent was not taken as absolute. Judgments on
acts affecting life issued from a process or weighing....
Even with the foetus weighed as human [as ‘person’ in
the moral sense I have been using, LHS], one interest
could be weighed as equal or superior: that of the
mother in her own life. The casuists between 1450 and
1895 were willing to weigh this interest as superior.
Since 1895, that interest was given decisive weight only
in the two special cases of the cancerous uterus and the
ectopic pregnancy. In both of these cases the foetus
itself had little chance of survival even if the abortion
were not performed. 2
This understanding of the moral tradition asserted a strict

protection for the foetus but not an absolute protection. Contrast this with
a statement from Pope John Paul II:
The moral gravity of procured abortion is apparent in all

its truth if we recognize that we are dealing with murder
and, in particular, when we consider the specific
elements involved. The one eliminated is a human being
at the very beginning of life. No one more absolutely
innocent could be imagined. In no way could this human
being ever be considered an aggressor, much less an
unjust aggressor!
Then quoting from ‘Instruction on the Respect for Human Life’,

John Paul continues:
___________________________________________________________
The human being is to be respected and treated as a
person from the moment of conception; and therefore
from that same moment his rights as a person must be
recognized, among which in the first place is the
inviolable right of every innocent human being to
life.... 3
The papal statement regards abortion as murder and the justifying

notion for that characterization of the abortion killing is that the human
being is innocent - absolutely innocent, the Pope emphasizes.
Recognizing the foetus as an absolutely innocent is designed to
remove the foetus from a moral framework where even an innocent foetus
regarded as a person could conceivably be killed in the face of a conflict
where some other value might trump that of the foetus right to life as a
person. Noonan identifies one such situation - only one - in which the
pregnant mother’s right to life supersedes that of the foetus. The Roman
Catholic moral teaching denies that a mother has any right to directly
intend the killing of the foetus; and even to save her own life such a direct
killing cannot be sanctioned. Noonan calls in his article for the Church to
reassert the mother’s right to save her life if threatened by medical
complications in pregnancy, and does so against the papal statement. In
John Paul’s statement, abortion is always murder, and the life of the foetus
always trumps the mother. And that is the normative Roman Catholic
moral teaching.
4. Absolute innocence: the metaphysical trump

I have been contemplating these questions for some time, and the
insight I am going to offer came to me when I was a visitor in Japan.
When I visited the ancient capital of Nara, Japan a couple of years ago, my
guide informed me that deer are sacred in Nara. He then proceeded to tell
me that in recent memory, a driver had accidentally hit a deer and killed it.
The accident was particularly nasty, for the driver was himself killed.
Despite the tragic loss of a human life, the state intervened to sue the
survivors of the now deceased driver. With the law reflecting a Shinto
valuing of sacred being, in this case the kami of sacred deer, the family of
the dead driver confronted both religion and law: killing a sacred deer is a
terrible offence, a religious violation that it carries with it a stiff, legally
imposed fine. Taken to court in metaphysical absentia, the driver was tried
for killing a sacred deer, found guilty, and his survivors were required to
pay the fine. This situation was created by the way the deer was valued,
and be clear: the deer was recognized as spirit-filled, and protected
because it was divine. Any injury to it was a religious offence apart from
Lloyd Steffen 103
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being a legal offence. The dead deer was enshrined with a religiously
conceived, numinous sense of innocence so profound that even if it had
caused the death of a person, any injury to the deer - however that injury
might have actually occurred - always imputed guilt to the one who
caused the injury. Moral meaning folds in the face of religious valuation,
though it is somewhat rare to find in the modern world the law of a nation
bend to religious propriety and the metaphysics of the deer’s status this
way. Japanese law required that the violation of the sacred must be
addressed and requited even when the deer was responsible for creating
harm to a human being, even when that harm was so serious as to be the
loss of a human life. Clearly the religious point of view trumped the moral
point of view: the deer was worth more than the human being, and its loss
imposed a debt beyond rational moral proprieties
Here’s the connection. What the pope has done in absolutizing
the foetus is not at all unlike what the Shinto inspired legal proceeding did
to the family of the deer-killer: it has identified an offence wherein the
object of the offence is sacralized, regarded as sacred or holy - even
divinized. I use the Shinto example because it is easier for those not
Shinto to see this kind of elevated sacralizing divinizing valuation in
another culture than in one’s own. Were we able to step outside our
Western framework and see what is happening with the ascribing of
absolute innocence to the foetus, we would, I suggest, draw a similar
conclusion about the papal view of what cannot be anything but a divine
foetus.
Lest this conclusion seem outrageous or implausible, let me ask a
question about absolute innocence as part of the Christian, and especially
the Roman Catholic, faith tradition: where do we find absolute innocence?
Who is to be regarded as absolutely innocent?
The answer: for Christians it is God the Father, Jesus Christ, and
the Holy Spirit, and for many Christians, Mary, Mother of God. These are
all absolutely innocent, and in the religious context, metaphysical
innocence when absolutized identifies sinlessness. To assure Jesus of such
metaphysical innocence, a Roman Catholic doctrine pronounced ex
cathedra regarding Mary’s own Immaculate Conception guaranteed that
Jesus would not contract the condition of original sin not only in utero but
also post utero. Whatever the specifics of theological understanding, it is
clear that the foetus not only cannot act but cannot sin, so that its status is
metaphysically pure. The foetus trumps the pregnant woman when the
medical condition of pregnancy is posing a threat to the mother’s life
either because the mother is not a person and the foetus is; or because the
pregnant woman is a person, and the foetus is something higher - god-like,
God. That is what absolute innocence means - that the foetus is God. No
___________________________________________________________
wonder the foetus cannot be a material aggressor: it is innocent – it is
divine. It is akin to the deer in Nara - a religious, sectarian valuation has
removed it from the rational constraints of the moral life and reframed the
meaning of its status outside the rational framework of moderate moral
thinking and evaluation.
The abortion debate becomes divisively intractable at the point
where moral argumentation is engaged with a sectarian religious position,
where moral issues are simply superseded. The divine foetus trumps even
the life of the pregnant woman, a position that poses enormous difficulties
for practical reason and the moral point of view. The moral point of view
does of course allow that the foetus should be valued, but not so much as
the mother who is a fully endowed member of the moral community; and
even if regarded as a person that foetus cannot be protected absolutely
against every and all possible challenges, not from the moral point of
view. Religion deals with ultimate power and absolutes, and ‘pro-life’
religion that deems the foetus inviolate confers absolute value on the
foetus, rendering it sacred, holy, and numinous - outside the categories of
moral thought and discrimination. This is a suppressed dimension of the
abortion debate, but identifies the source of the passion some people have
that seeks to protect the foetus even at the expense of the pregnant
woman’s life. Granting the foetus power to trump a fully endowed
member of the moral community in every situation for the sectarian reason
that its metaphysical status is superior to the woman’s moral status as
person renders the foetus divine - at least that is how the moral point of
view would interpret this shift from moral to some kind of extra or supra-
moral valuation. Killing the foetus is abhorrent because it is akin to killing
God. If absolutely innocent, a foetal death killing can never be justified.
At this point, the debate about abortion is not a moral debate, but a
religious proclamation about the foetus against which the moral point of
view can exercise little if any influence.
5. Conclusion
Invoking a sectarian notion of foetal innocence is socially
dangerous especially in a pluralistic society where different religious
views are held about such matters as abortion rights and no one religious
view should receive official sanction as privileged and commanding and
authoritative over all. Furthermore, to hold that the foetus is absolutely
innocent is to create a divine foetus that is also, for purposes of religious
valuation, also interpretable as an idol, and idol making for some religious
people violates clear prohibitions on such activity. The injection of a
sectarian metaphysics has the effect of devaluing the pregnant woman as
agent and decision–maker because the god within her subverts her
Lloyd Steffen 105
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autonomy as person, as agent, as decider. She is the Nara family member
who must pay a terrible fine for killing a divine deer. The meaning of that
killing reaches beyond moral meaning and is superseded by religion.
The abortion debate is intractable because the terms of the debate
are not commensurate - it is a debate over moral apples and theological
oranges. . The debate over abortion ought to be a moral debate conducted
by reasonable people respectful of women as persons, as fully endowed
members of the moral community. The problem is that a sectarian
viewpoint, represented by the idea of ‘absolute innocence’ has skewed the
terms of the debate and made rational conversation difficult and in some
contexts impossible. Those who want to affirm an absolutely innocent
foetus should be free to do so. The moral community situated in a
pluralistic society condones this absolutizing tendency to its peril. The
moral point of view centres on the imperfections of existence and the
conflicts that arise over goods and values. It advances the view that even
life itself ought not be considered ‘an absolute good’ that trumps every
other value. Such a viewpoint reflects a commitment to a religious purity
the moral life cannot sustain and ought not to accept as normative; for the
religious viewpoint is powerful and dangerous enough to create moral
chaos.
Notes
1
Mary Anne Warren, ‘On the Moral and Legal Status of Abortion’, The
Monist, 57, 1 (1973).
2
John T. Noonan, Jr., ‘An Almost Absolute Value in History’, reprinted in
Christina Sommers & Fred Sommers, eds., Vice and Virtue in Everyday
Life, 7th edition, (Belmont, CA: Wadsworth, 2006), 391.
3
John Paul II, ‘The Unspeakable Crime of Abortion’, from Evangelium
Vitae, March 25, 1995; reprinted in Thomas Mappes and David DeGrazia,
Biomedical Ethics, 6th Edition (New York: McGraw-Hill, 2006), 458.
Lloyd Steffen is Professor and Chair of Religion Studies, and University

Chaplain, at Lehigh University in Bethlehem, PA. Among his books is
Abortion: A Reader and Life/Choice: The Theory of Just Abortion.
Do We Have Moral Obligations to the Dead?
Liz McKinnell
Abstract
Much has been written about moral obligations to future people. 1
In this piece I look at the related area of our obligations to past people (the
dead). Past people have some morally relevant similarities to future
people. Neither group of people exists at the present time. There are also
some interesting differences: We can do things that affect the identities of
future people, not with dead people; and we can do things which affect the
experiences of future people; but again this is not the case with the dead. I
address the question of whether there can be a wrong done against
someone when we cannot affect his experiences. I conclude that this does
not present us with a major obstacle to having obligations to the dead, and
identify the biggest problem as lying in the fact (if it is a fact) that the
dead do not presently exist, and therefore do not meet the ‘existence
condition’ for harm. 2 After exploring a number of responses to this, I
conclude that we can wrong the dead, but by a process of ‘backward
signification’ (distinct from backward causation) we wrong them while
they are alive.
Key words: death, ethics, existence, identity.
1. Introduction
The intuition that we have obligations to the dead is at once a
very strong one and a very old one. There have always been moral beliefs
about what we owe to our ancestors, just as there always have been about
what we owe to our descendents. Our culture’s respect for these traditions
is no exception. For example, institutions such as wills are held as very
important, and on a more personal level, we often feel we owe something
to those who are no longer around. However, as we shall see, the notion of
having an obligation to someone who has died can be metaphysically
puzzling.
2. Are past people like future people?

For me, the question of what we owe to people who no longer
exist arose out of research that I have done on future people. Discussions
of intergenerational justice inevitably encompass past people as well as
future people. It might be appealing to think that there is symmetry
between our moral relationship with the dead and our moral relationship
with the not-yet-living. In both cases there is no presently existing person
who we can affect or have obligations to. This is the main root of the
108 Do We Have Moral Obligations To The Dead?
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problems concerning the moral status of future people and indeed of the
dead.
However, when we compare past people with future people the
asymmetries are more interesting than the symmetries. One of these
asymmetries is that we can affect the conscious experiences of future
people, but we cannot affect the experiences of the dead. When I talk
about my obligations to my great great grandchildren, I am probably
talking about things that I can do that will affect their lives, such as
preserving the environment or refusing to sell the family silver. When I
talk about my obligations to my great great grandparents I cannot mean
the same kind of thing, since their experience of life has already been
played out and determined before I even appear on the scene.
This is a difficulty with obligations to the dead that does not arise
with future people, whereas the other major asymmetry between past and
future people poses a problem for obligations to future people, but not to
the dead. This relates to Derek Parfit’s ‘Non-identity problem’. 3 The crux
of the non-identity problem is that by making decisions about the future,
we affect which individuals will come to exist. This, Parfit suggests,
means that making a choice in order to benefit future people is essentially
self-defeating, because we cannot identify anyone who has been benefited
or harmed. This problem does not apply to the dead. Winston Churchill,
although dead, was a specific person. We can refer to him and be referring
to a particular individual, and (unless we believe in bizarre science fiction
scenarios) we cannot do something that prevents him from having existed.
So the idea that past people have moral status has one advantage
and one disadvantage over the view that future people are morally
significant. The ‘advantage’ that the dead have over the not-yet-living
stems from the fact that their identities have been determined and cannot
be affected by what we do now. Their ‘disadvantage’ is that their
conscious experiences, likewise, have been determined and cannot be
affected by what we do now.
3. Conscious experiences and harms

You may now (quite rightly) accuse me of neglecting the idea of
an afterlife. If conscious experience continues beyond life on earth, then it
is at least theoretically possible to affect the conscious experiences of ‘the
dead’, but by at least some views that accept the idea of an afterlife the
difficulty might remain. It could be theologically difficult to claim that the
torment of hell can be assuaged or the joys of heaven diminished by what
a mortal does on earth, since it would give us the ability to moderate
divine justice. It might also be claimed that any afterlife is simply ‘beyond
this world’ and that events that happen here and now are simply
Liz McKinnell 109
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insignificant to it. So the argument that we cannot have obligations to the
dead because we cannot affect their experiences is by no means confined
to the realms of the atheist.
If the main problem with obligations to the dead is that we cannot
affect their conscious experiences, this means that there must be a problem
with labelling anything wrong if it does not affect the conscious
experiences of the person who is said to be wronged. This view would not
just pose a problem for wronging the dead, this is the notion of wrong
which in many people’s understanding underpins the badness of sexual
infidelity, lying and cheating.
Of course, we have all heard the adage ‘the crime is getting found
out’ and we might argue that it is the possibility of discovery that makes
unexperienced wrongs wrong nonetheless. Perhaps it is wrong for us to
commit an act of deception because there is always at least a remote
chance that the deceived individual will discover the deception and be
distressed. Of course, if this is what is wrong with deception, then we can
argue that the dead cannot be harmed in the same way. Not only do dead
people not know what we do or say about them, it is in fact impossible for
them to know about it. This would mean that, while we can accept that
there are some wrong actions that do not affect the conscious experience
of the one who is wronged, there can be no wrong without some risk of
discovery.
However, there are a couple of reasons why I think this isn’t the
case. Firstly, if it is a risk of being caught that makes a deception bad, then
presumably the smaller the risk, the less serious the wrong. It would be
strange to have a moral theory that relied on risk in this way without
taking account of the fact that some risks are greater than others. This
would make the coldly skilful adulterer’s actions less bad than those of the
honest husband who cannot hide his terrible lapse from his wife. If the
possibility of getting found out is what makes the action bad, then we
seemingly lessen our crimes by becoming adept at disguising them.
A second point arises when we examine why the wronged
person’s feelings are hurt if they discover the wrong. When someone
discovers that they have been deceived, ridiculed or lied to, they are not
upset because they have discovered that this has happened, they are upset
because it has happened. The adulterer’s wife does not cry because she has
found out about her husband’s adultery, she cries because he committed
adultery.
Given these points, we should not reject the notion of obligations
to the dead on the grounds that we cannot affect their conscious
experiences. Whether their experiences have already been played out from
___________________________________________________________
start to finish, or whether they dwell in an afterlife beyond the reach of our
actions, we cannot use this as a reason to deny our obligations to them.
4. Is there a problem of non-existence?

Any problem that uniquely affects obligations to the dead must
relate to the fact that their lives are confined to the past. A simple, but
perhaps very serious point that can be made is that if dead people no
longer exist, then there is nobody to whom we have an obligation. At the
heart of this problem is something that Fred Feldman terms the “Existence
Condition.” 4 This condition states that something can only be good or bad
for a subject s at time t if s exists at t.
This condition would only pose a problem for those who do not
believe in an afterlife. If a person’s consciousness continues after death, he
continues to exist, and there remains an individual who can be the subject
of good and bad events, and to whom we can owe an obligation. This is
the case even if a person in the afterlife cannot be consciously affected by
what goes on in the world. What is important is that they meet Feldman’s
existence condition. If a subject s has eternal life, then for any time t after
his birth s exists at t.
Those who do not believe in an afterlife must have a response to
this argument if they wish to defend the intuition that we have obligations
to the dead. How can we have obligations toward them when they do not
exist? This relates to a wider metaphysical worry which David-Hillel
Ruben terms a “puzzle about posthumous predication”:
In order for something to happen to an object it must

acquire or lose a property; and to do that it must exist…
A suitable slogan might be: No properties can be had or
acquired by things at times at which the thing in
question is not there to have or acquire a property. That
is,
5
(4) If, at t, x has the property P, then x exists at t.
It is clear how this problem relates to the ‘existence condition’

which states that something can only be good or bad for a subject s at time
t if s exists at t. Ruben’s ‘puzzle’, similarly, states that something can only
be a property of a subject s at time t if s exists at t. In fact, if ‘being
wronged’ is a property, then the existence condition is arguably very
similar to the puzzle of posthumous predication. I will assume here that
‘being wronged’ is a property, although there probably are good grounds
to question this.
Liz McKinnell 111
___________________________________________________________
There are several ways that we can attempt to avoid this problem.
We can try to show that the dead do, in some sense exist to be wronged at
the time that they are wronged, and that therefore there is no puzzle in the
first place. Alternatively we can challenge the assertion “(4) If, at t, x has
the property P, then x exists at t”. A final answer might be to argue that
the property in question (being wronged) is one that is instantiated by the
person before they died, and that time t when the property P was
instantiated was in fact a time when s existed.
5. Do dead people exist?

It is important to note that the believers in an afterlife who want
to believe in obligations to the dead have already got their way. The
problem of affecting conscious experiences, in as much as it faces those
who believe in an afterlife, has been dealt with. The problem that we now
face (that dead people do not exist to be wronged) is not one that concerns
the believer, since he believes that the dead do exist. But what if the non-
believer can employ a similar line of defence? Can a person who does not
believe in the conventional concept of life after death still argue that the
dead do exist in the present?
There are various linguistic devices, which seem to imply that a
person does not cease to exist at the moment of death. We talk about a
person being ‘immortalised’ through his work. It can be responded that
these turns of phrase are just that. It seems reasonable to say that a human
life ends at the point of death, and that the language of ‘immortality
through our work’ is employed metaphorically. The sense that
‘immortality’ in this context is not real immortality is nicely summed up
by Woody Allen, who said, “I don’t want to achieve immortality through
my work… I want to achieve it through not dying”. 6
But does this mean that we need to dismiss the idea of ‘living on’
through one’s work, projects or relationships as insignificant to our topic?
Not necessarily. It is true to a greater or lesser extent that a person is
defined in terms of their most closely held projects, relationships, goals
and beliefs. These things are not simply external factors, they are
intimately entangled with who and what we are. Since we are so entangled
in these projects, and they are so involved in our personal identity, then it
might be arguable that, even after our biological life has come to an end,
some of the constituents of our identity carry on in the form of our
projects and relationships. If this is true, then perhaps there is no puzzle of
posthumous predication when we talk about the property of ‘being
wronged’ in one who has died.
I am going to leave this idea as a mere suggestion, since it would
require an entire theory of personal identity. So for now we should simply
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note that, as with the idea of a conventional afterlife, if we can hold a
theory of personal identity that allows people (in an unconventional, non-
conscious sense) to exist after their deaths, then we can escape the puzzle.
6. Must someone exist to be wronged?

Let us recap. Faced with the thought that dead people no longer
exist, we encounter a difficulty in accounting for how they can be
wronged. Dead people being wronged (if being wronged is a property) is a
specific example of Ruben’s ‘puzzle of posthumous predication’:
But do we have to accept this ‘puzzle’? It is true that, in the case

of most properties that we ascribe, it is nonsense to speak of something
having that property if that something does not exist. This is what is
wrong with sentences like ‘The current King of France is bald’. There is
no current King of France, so we cannot say that it is true that he is bald.
So in terms of ‘normal’ properties like being bald it is true that a non-
existent person cannot instantiate them.
However, it can be argued that being wronged is not like ‘being
bald’. Ruben suggests that, while we cannot ascribe properties in the
everyday sense to things that no longer exist, we can say that they are the
subject of ‘Cambridge changes’. Cambridge changes are relational
changes that, while they may be a real change in the one of the relata, are
not a real change in another one of the relata. To put this a little more
clearly, when my first nephew was born in 1998, I underwent a
Cambridge change. No real change occurred in me, and yet I became an
aunt. Ruben argues that this kind of change can occur in the dead. I am
inclined to agree. Joe’s grandmother Ethel died before he was born, even
though, while she was alive, Ethel was not his grandmother. If this
perfectly sensible assertion is true, then there must have been a point
(Joe’s birth) when Ethel underwent the change of becoming Joe’s
grandmother, even though at that point Ethel no longer existed. Ruben
also points out that:
To predicate a Cambridge change of an object may be to

predicate of it a phoney change, but notice that it is to
predicate of the object a perfectly good property. To say
of some person that he has acquired a new cousin upon
the birth of a child to his aunt or uncle, is to ascribe a
perfectly genuine property to that person, but it is not to
ascribe to him a perfectly genuine change. 7
Liz McKinnell 113
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This would also seem to apply to Ethel, who becomes a
grandmother posthumously. However, the problem here would be to see
why a ‘phoney change’ like this can have any real moral significance for
the person who ‘is wronged’. If they no longer exist to be the subject of a
real change, it seems that they no longer exist when they come to
instantiate the property ‘is wronged’. After all, we might accept that a
fictional character can have certain properties, but their non-existence
would make it difficult to claim that we can have obligations toward them.
Cambridge changes seem to lack the moral force that obligations to the
dead would require.
7. When is a dead person wronged?

Until now we have assumed that the time at which the dead
person instantiates the property ‘is wronged’ is after his death. It is
certainly true that if I defame Winston Churchill in July 2006, I am
wronging Churchill after Churchill has died and (we shall assume) no
longer exists. However, it may be the case that my act of wronging
Winston Churchill is not identical with his instantiation of the property ‘is
wronged’. If this can be possible, then perhaps the time t at which x
instantiates the property of ‘is wronged’ is in fact during x’s lifetime, and
so it is undeniable that x exists at this point.
I do not think that there is any particular problem with someone’s
wronging of x and x instantiating the property of ‘is wronged’ occurring at
different times. We might compare this with me shooting at someone and
that someone being shot. I shoot at them the moment I pull the trigger, but
they do not instantiate the property ‘being shot’ until the bullet hits them.
This analogy makes it clear how, by separating the wronging
from the property ‘is wronged’, we can make sense of the two events
happening at different times. This certainly makes sense of how we can
wrong future generations. Remember that (as with the dead) they do not
exist at the present time, so they would also be subject to something rather
like the puzzle of posthumous predication (a puzzle of prenatal
predication?). If I wrong someone at a particular time, and then at some
other time they are wronged, this might make sense of how I can wrong
future generations before they come into existence, and when my life does
not overlap with theirs. I can exist to wrong them, and they can exist to be
wronged at a different time. This is entirely consistent with Ruben’s
formulation of the ‘puzzle’:

___________________________________________________________
However, this solution is rather more counterintuitive when it
comes to the notion of wronging the dead. This is because, if the dead
person is wronged during his lifetime, I actually wrong him after he is
wronged. This starts to look rather worryingly like backward causation, a
concept that all but the bravest philosophers are keen to avoid. However,
the relationship between wronging someone and their being wronged is
not necessarily causal. It has been suggested that what goes on when the
dead are wronged is not backward causation, but rather backward
signification. Geoffrey Scarre writes “While a person cannot be pleased or
pained by what he never knows, occurrences after his death can cast a
backward light or shadow over his life”. 8 It is this notion of ‘casting a
shadow’, not an instance of efficient causation that is meant by backward
signification. Pitcher has a beautiful example:
If the world should be blasted to smithereens during the

next presidency after Ronald Reagan’s, this would make
it true (be responsible for the fact) that even now, during
Reagan’s term, he is the penultimate president of the
United States. 9
If signification, not causation is what connects the act of

wronging with the instantiation of the property ‘is wronged’ then it
becomes possible for it to be made true, after a person’s death, that they
instantiate that property during their lifetime. This means that they do
exist at the time that they are wronged, giving the act of signification
(wronging them) genuine moral importance. This notion needs more work,
but if it can be supported, backward signification may well open the door
to obligations to the dead.
Notes
1
The prime example being Derek Parfit, Reasons and Persons (Oxford:
Clarendon, 1984).
2
Fred Feldman. ‘Some Puzzles about the Evil of Death’, The
Philosophical Review (1991), 205-227.
3
Parfit 351-381.
4
Feldman, 205.
5
Ruben, David-Hillel. ‘A Puzzle about Posthumous Predication’, The
Philosophical Review (1988), 213.
6
Oxford Dictionary of Quotations 4th ed., (1996).
7
Ruben, 224.
Liz McKinnell 115
___________________________________________________________
8
Geoffrey Scarre. ‘On Caring about One’s Posthumous Reputation’,
American Philosophical Quarterly (2001).
9
George Pitcher. ‘The Misfortunes of the Dead’, American Philosophical
Quarterly (1984), 188.
Liz McKinnell is studying for a philosophy Ph.D. at Durham University.

Don’t Fear the Reaper:
An Epicurean Answer to Puzzles about Death and
Injustice
Simon Cushing
Abstract
I begin by sketching the Epicurean position on death - that it
cannot be bad for the one who dies because she no longer exists - which
has struck many people as specious. However, alternative views must
specify who is wronged by death (the dead person?), what is the harm
(suffering?), and when does the harm take place (before death, when
you’re not dead yet, or after death, when you’re not around any more?). In
the second section I outline the most sophisticated anti-Epicurean view,
the deprivation account, according to which someone who dies is harmed
to the extent that the death has deprived her of goods she would otherwise
have had. In the third section I argue that deprivation accounts that use the
philosophical tool of possible worlds have the counterintuitive implication
that we are harmed in the actual world because counterfactual versions of
us lead fantastic lives in other possible worlds. In the final section I
outline a neo-Epicurean position that explains how one can be wronged by
being killed without being harmed by death and how it is possible to
defend intuitions about injustice without problematic appeal to possible
worlds.
Key words: death, deprivation, possible worlds, Epicurus, Nagel,

Silverstein, Feldman, McMahan.
1. Introduction
First, let me clarify that when I talk about death in this paper, I
mean the state of being dead. None of what I say should be taken to apply
to dying (which Epicureans can certainly concede to be harmful) or death
as a moment, whereby one can debate whose death is better, Joan of Arc’s
or Elvis’s (Joan of Arc’s was painful but heroic, while Elvis’s was quick,
but, all things being equal, one wants to avoid any chance of the phrase
“straining at stool” appearing on one’s death certificate).
Next, a disclaimer: I am not an Epicurus scholar. When I talk
about the Epicurean position, I will not attempt to argue that this is
precisely what Epicurus said or even what he meant. With that in mind, as
I take it, the Epicurean position on death is essentially as follows:
1. The only way one can be harmed is if one experiences suffering.

2. It is impossible to experience suffering when one does not exist.
3. When one becomes dead, one ceases to exist.
118 Don’t Fear the Reaper
___________________________________________________________
4. Therefore, one is not harmed by being dead.
To put it succinctly: death won’t be bad for me because I won’t

be around. As Epicurus’s follower Lucretius pointed out, we don’t lament
the time of our non-existence before our births, so we should no more fear
the time of our non-existence after our deaths. That is not, of course, to
say that Epicureans deny that my death will be bad for other people. It is
my fervent hope that upon my death the wailing and gnashing of teeth of
my surviving great great great grandchildren will be heard across the land.
(Of course, this hope in itself is probably as irrational as a fear of death,
but even philosophers should be allowed occasional lapses.)
I find this Epicurean reasoning about death very compelling, but I
must concede that it has counterintuitive implications, not least of which is
that it appears to suggest that attempted murder is worse for the victim
than successful murder. If only Caesar hadn’t had time to say “et tu,
Brute” he would’ve been fine.
However, even if the Epicurean view has these implications, they
are not sufficient to constitute a reductio of the position if the argument for
it cannot be faulted. And, as we shall see, it is not clear that alternative
views fare any better in the strange consequences department.
The Epicurean position has been met with much snorting and
sputtering. As Steven Luper-Foy writes:
Epicurus’s famous argument…is about as absurd as any

I have seen…The self-deception of people like Epicurus
is not conscious; we cannot relieve our anxiety by
swallowing beliefs of whose inanity we are aware. But
deception is nonetheless at work. 1
One is reminded of David Lewis’s comment about criticisms of

his views, that it is hard to argue with an incredulous stare. Of course, the
critics offer alternatives, most of which fall under what Harry Silverstein
has called ‘the standard argument’ 2 or what Fred Feldman calls ‘the
deprivation approach.’ 3 In what follows I will consider some of the better-
known versions of this approach and explain why I think each is
unsatisfactory. I shall conclude by attempting to explain away the more
counterintuitive implications of the Epicurean position.
2. The deprivation approach

Let us make clear the common ground between the Epicureans
and the anti-Epicureans. First, we will assume, as writers on this subject
typically do, that death marks the end of all experience. That is not to rule
Simon Cushing 119
___________________________________________________________
out by fiat the possibility of a so-called afterlife, just to deny that it
happens during death. Better to say that those who believe in an afterlife
in fact believe in immortality and deny that death happens. (They needn’t
deny the death of the body, just that the person dies along with it). With
that understanding of death, very few people deny the third Epicurean
premise, which Fred Feldman dubs the termination thesis, that we cease to
exist at death. Feldman himself is one who does deny it, but not in a way
that gives much solace to those approaching death. Although he calls
himself a “survivalist” to distinguish himself from so-called “terminators”
who accept the claim, Feldman’s position is a mixed bag. I quote:
The good news is that most of us will survive death.

Most of us will continue to exist after we die. The bad
news is that though we will survive death, and will
continue to exist after we die, each of us will then be
dead… We will just be corpses. 4
In something of an understatement he concedes, “such survival

may be of very little value.” Feldman’s position follows from his view that
we are our bodies, and while that view has some advantages (for example,
it makes sense of statements like “we’re burying Aunt Ethel today”), it
does not really capture what we care about. So I will assume the
termination thesis in what follows. Even if one did not, however, one
would still be forced to accept premise 2, which is as uncontroversial as
any claim in philosophy can be.
That leaves premise 1 as the only weak spot in the Epicurean
argument, and it is indeed on this that the critics focus. Of Epicurus’s
contemporary critics, undoubtedly the most well known is Thomas Nagel,
who points out its implications:
It means that even if a man is betrayed by his friends,

ridiculed behind his back, and despised by people who
treat him politely to his face, none of it can be counted
as a misfortune for him so long as he does not suffer as a
result. 5
Nagel implies the plausible claim that being ridiculed against

one’s knowledge is an example of harm without suffering. Although I will
not challenge this claim here I am not sure I find it fully convincing. I am
inclined to say that those who ridicule or betray their friends wrong them
even if they do not harm them. I shall return to this below, but notice that
Nagel’s examples of harm are all inflicted by other persons – that is,
___________________________________________________________
exactly the kind of beings that can inflict wrongs. But death itself (that is,
the state of being dead, not the titular Grim Reaper) cannot betray or
ridicule one, 6 so Nagel’s analogy is flawed. It remains to specify exactly
what the harm of being dead consists in.
Nagel’s answer is what gives the deprivation approach its name:
one can be harmed by being deprived of something, even if this does not
cause suffering. In the case of death, what one is being deprived of is
everything. Nagel offers the following as an example of harm (without
suffering) by deprivation:
Suppose an intelligent person receives a brain injury that

reduces him to the mental condition of a contented
infant, and that such desires as remain to him can be
satisfied by a custodian, so that he is free from care.
Such a development would be widely regarded as a
severe misfortune, not only for his friends and relations,
or for society, but also, and primarily, for the person
himself. 7
3. The Epicurean strikes back

Nagel’s case reinforces what we already knew: the idea of death
being a loss seems perfectly intuitive. However, the Epicurean is used to
fighting uphill against received wisdom, and has hard questions to ask.
These centrally include: Who is harmed? When is this person harmed?
And what exactly is the harm?
The candidates for the subject of harm are suggested by Nagel’s
parallel case of deprivation. In that case, we can say either that the pre-
injury, intelligent person, or the post-injury person is harmed by his
current brain-damaged state. George Pitcher dubs the parallel “before and
after” persons in the case of death the ante-mortem person and the post-
mortem person. 8 As noted, in Nagel’s brain-injury case we are inclined to
say that the before-and-after are the same person, but in the case of death,
since we have accepted the termination thesis, not only can they not be the
same, there is no post-mortem person. How can a non-existent individual
be harmed, and why should one care? So that leaves the ante-mortem
person as the only remotely plausible subject of the harm of death. But in
what way has the living Aunt Ethel been harmed by her death? 9 She isn’t
dead yet, and so has not been deprived. Hence the second Epicurean
challenge, specifying when one is harmed by death. Again, if the ante-
mortem person is harmed after her death, then why should she care? And
is it even possible for there to be a connection between a person and a
harm committed after she has ceased to be?
Simon Cushing 121
___________________________________________________________
Harry Silverstein argues that it is, and responds to this second
Epicurean challenge by denying the “temporality assumption” which
requires that a harm to a person “must have a temporal location or extent
at least part of which” is prior to her death. 10 Expanding on a remark by
Nagel that “for certain purposes it is possible to regard time as just another
type of distance,” 11 Silverstein argues that events in the future exist just as
much as events far away exist, and that thus
A’s death coexists with A (“in an eternal or timeless

sense of the word” [Quine]), and is therefore a possible
object of A’s suffering, and is therefore an intelligible A-
relative evil. 12
What is interesting about Silverstein’s approach is that he, unlike

Nagel, accepts a variant of the first Epicurean premise that harm must in
some sense be connectable with suffering, or, more generally, what he
calls the “Values Connect with Feelings” view. 13 His variant, however,
allows that a particular event x can be viewed as a harm for person A even
if it does not actually cause suffering for her:
x can intelligibly be said to have a certain A-relative

value provided merely that it be possible, or possible
under certain conditions, for A to have the appropriate
feelings as a result of x. 14
Thus, on this view, the ante-mortem Aunt Ethel can be harmed

by post-mortem event x because they coexist with each other in a timeless
sense and x is therefore a possible object of suffering for Aunt Ethel. But
it still remains for this view to explain the harm of death itself, rather than
particular events after Aunt Ethel’s death. Besides the problems of such a
strange entity as one’s state of being dead being an object of suffering, 15
we need to know what about it would cause suffering. Silverstein’s
response is as follows:
[T]he reason one fears death, of course, is that it

shortens the duration of one’s life; if A contracts
terminal cancer…his approaching death would typically
be the object of negative feelings precisely because of
his awareness of the brevity of his life as a whole, and
the consequent sparsity of its content, in comparison
with alternative imaginable lives. In short, it is the
“four-dimensional” ability to understand life in
___________________________________________________________
durational terms, to view one’s life as a temporal whole
and to make evaluative comparisons between it and
alternative possible life-wholes which ultimately
accounts for the fact that statements of the form “A’s
death is an evil for A” are commonly regarded as not
merely intelligible, but true. 16
That is, Aunt Ethel’s being dead is a harm to her while alive
because she is potentially aware of the comparative brevity of her life in
comparison to “alternative possible life-wholes” in which she lives longer.
It seems we are to picture Aunt Ethel as a disembodied self in something
like Rawls’s Original Position (minus the veil of ignorance) asked to
choose which among the various possible lives she would prefer. If there
is one that is better (which, for now, simply means longer) than the actual
one, then her death is a misfortune for her.
However, what exactly are we to understand by alternative
‘possible life-wholes’ (henceforth PLWs)? The most philosophically
familiar way to spell out this idea is using possible worlds, as Fred
Feldman (among others) makes explicit.
Assuming, purely for the sake of engaging Epicurus on common
ground, a crude form of hedonic calculus, Feldman suggests the following
analysis to explain the harm of dying in a ‘plane crash:
Suppose I am thinking of taking an airplane trip to

Europe.… consider the nearest possible word in which
I… die en route to Europe on this trip… Let us suppose
that that world is worth +500 to me… Next…consider
the nearest world in which I do not die en route to
Europe on this trip… Let us suppose my welfare level at
that world is +1,100. [This account] implies that my
death on this trip would have a value of -600 for me. It
would be a terrible misfortune. 17
There are all sorts of potential pitfalls with possible worlds,

though. For one thing, there is the problem of establishing transworld
identity: in what sense are all these people, some who die, some who live,
Fred Feldman? This question is contentious, and the subject of high-level
metaphysical debate. It seems odd that the harm of death, supposedly so
intuitively obvious as to make the Epicurean position absurd, should hang
on such abstract philosophizing. According to the view popularized by
Saul Kripke, Fred Feldman could possibly be just about any being in any
circumstances at any time. There is a possible world in which I, sitting
Simon Cushing 123
___________________________________________________________
here named Simon Cushing, am in fact Fred Feldman. If there are such a
wide range of possible lives for me, then it seems that the actual me,
sitting here alive, is harmed by more than my actual death. If the harm of
being dead is that I am thusly deprived things of value I have in some
other possible world, then presumably I am currently being harmed
because in some alternative possible world I live the life of an immortal
philosopher-king. What is more, this is exactly the same kind of harm that
constitutes the harm of being dead, and, on Feldman’s calculus, potentially
far greater. This seems to me either a reductio of the possible-worlds
deprivation account, or the biggest excuse for whining ever.
Can the anti-Epicurean avoid these unpalatable implications by
restricting the range of possible mess? Feldman has this in mind when he
refers specifically to the nearest possible worlds. Jeff McMahan spells out
this idea in more detail:
Let t be the time at which some person died. Our

overall, objective evaluation of how bad or good his
death was for him will be based on a counterfactual
claim about what would have happened to him if he had
not died at t. Let the antecedent of the relevant
counterfactual be “if the entire transitive cause of his
death had not occurred….” To complete the
counterfactual, we consult the possible world in which
the antecedent is realized which is closest to the actual
world up to t. 18
McMahan thinks that this view both encapsulates and develops

the intuitive idea that “death is bad for a person…at any point in his life,
provided that the life that is thereby lost would on balance have been
worth living,” 19 where the “life lost” is the life that is had by the person on
the possible world that is identical to the actual world except for the key
causal factor that brought about the death of the actual person. Does
McMahan’s account remove the counterintuitive implications of PLW
views?
I do not think so. McMahan’s focus is on establishing the harm of
a person’s actual death. This is how he can justify comparing the actual
world to just one closest possible world, where the closeness includes as
much as possible an identical life up to the point of death. However, my
complaint against the PLW school is that if you are going to allow that a
person is harmed because of the existence of an alternative, better life on
another possible world, then there are a lot more harms than just death,
and again, these can be much more extensive. McMahan thinks focusing
___________________________________________________________
on someone’s actual death removes the relevance of other possible worlds.
But why not focus on someone’s actual non-buying-of-a-winning lottery
ticket? Or even one’s actual absence of genius because the potential
genius combination of sperm-and-egg got pipped to the post by faster-
swimming but duller sperm. All of these are harms as real as the harm of
death on accounts like these. 20
In sum, McMahan has not successfully delimited the number of
PLWs that one should compare oneself with to find out how much one is
being harmed, and thus his view, as much as any of the PLW views
subjects actual people to potentially infinite harms in its attempt to make
being dead a harm to the living.
4. Accounting for injustice

That’s all very well, the anti-Epicurean can respond, but the
Epicurean position has far worse implications, most notably that you do
not harm a person by killing her. Not only that, but eschewing possible-
worlds talk deprives the Epicurean of the apparatus to explain all kinds of
harms, including, in particular, injustice. Earlier I compared Silverstein’s
PLWs to the possible worlds a party in Rawls’s Original Position
contemplates, and it certainly seems that views like his make use of
counterfactuals to explain the injustice of actual institutional arrangements
or distributions. If I am disallowing comparisons across possible worlds,
can I no longer account for actual people suffering injustice?
Here is my suggestion: one does not suffer injustice because there
is a possible world in which one is better off (in justice-relevant ways).
One suffers injustice because one is not better off in this one. This is an
incredibly crude characterization, and I cannot hope to do justice to the
topic of justice in such a short space, but let me explain what I mean.
There are two ways in which injustice might be taken to be
comparative. One way is that I suffer injustice if things could have gone
better (in the relevant justice-relative ways) for me in another possible
world. Here the possible world would have to be relatively near: if it is
one where I am some amalgam of FDR, John Lennon and Pele, the
injustice seems trivial. But that leaves the possibility that, in fact, although
I suffer in the actual world, there is no near-enough possible world that
both preserves my identity sufficiently and in which I am better off. On
this account of injustice, I do not suffer it. Positively Panglossian. The
alternative suggestion for the relevant comparison is to some ideal of
justice that perhaps is impossible to attain amongst humans. This would
allow that the best of all actually possible human worlds would still
exhibit injustice. I am inclined to think this is the correct view.
Simon Cushing 125
___________________________________________________________
In these foregoing remarks I have been discussing justice in a
purely distributive sense. There is also another, more personal, sense of
injustice, the kind that more closely fits a Nozickian model than a
Rawlsian one. Here I am done an injustice if somebody deprives me of
something (however abstract) that is rightfully mine. But this kind of
injustice concerns wrongs, not harms, and, moreover, does not require
possible worlds to account for it. In fact, possible worlds talk might have
counter-intuitive results. Consider the argument against restitution to the
descendents of slaves, that in fact they are better off than they would have
been had they stayed in Africa. That, even if true (and of course it does not
apply to the non-descendents of the people who died childless in the
crossing) is surely beside the point: it was wrong to enslave people, even
if they fared better than their possible non-enslaved counterparts.
That one can be wronged even if one is not harmed by death: if I
murder someone, I wrong him because he has the right of self-
determination that my action robs of its essential basis. I have no right to
embark on the course of action that causes that right to be annulled. That
is the sense in which I wrong the living person before he dies. There is no
mystery as to when this wrong occurs – it occurs as I act intentionally, and
thus the victim of the wrong is the ante-mortem person, wronged
simultaneous to my act. As I mentioned earlier, I take this to be parallel to
the case of a person being wronged by a betrayal of which he is oblivious.
I am fairly certain Epicurus would not be happy with my
suggestion that there are some wrongs that can be done with no
accompanying harm. And he is probably not alone. Am I just turning this
into a squabble over words? Well, not really. I deny that one is wronged or
harmed by being dead, but further deny that this undercuts the wrongness
of killing. More broadly, I deny that one is harmed by being deprived of
something, while allowing that the person who deprives me of it may
thereby wrong me.
In sum: I do not believe that the Epicurean challenge has been
met by the various writers who have attempted it. In particular, possible-
world deprivation accounts are in the unenviable position of claiming that
the living suffer the deprivation of being dead, and the use of possible
worlds to characterize actual harms opens the door to horrendously
implausible claims about the harms we suffer because of our myriad
possible selves. 21
___________________________________________________________
Notes
1
Steven Luper-Foy, ‘Annihilation’, in The Metaphysics of Death, ed. J.
M. Fischer, (Stanford: Stanford University Press, 1993), 270.
Interestingly, it is the now simply Steven Luper who writes the entry in
the Stanford Encyclopedia on Death (see note 20). For somebody so
scornful of the Epicurean argument, he has certainly devoted enough time
to it.
2
Harry Silverstein, ‘The Evil of Death’, in ed. Fischer, 98.
3
Fred Feldman, Confrontations with the Reaper (New York: Oxford
University Press, 1992), 236.
4
Ibid., 105.
5
Thomas Nagel, Death, in ed. Fischer, 64.
6
Of course, the dead being betrayed by the living is a common fictional
theme (at least, in the films I like to watch), but the stories inevitably have
to resort to the device of the betrayed party either returning from the grave
or at least reaching across to the land of the living to exact revenge. That
is, the stories cheat by allowing an existing party to experience the
betrayal.
7
Nagel, 64.
8
George Pitcher ‘The Misfortunes of the Dead’, in ed. Fischer, 161.
9
Presumably this is different from jumping up and down on a long-buried
person’s grave: supposing, contrary to what I believe, a harm is committed
to a person by this disrespectful act, it surely must be (contrary to the
termination thesis) to the post-mortem person. Disrespect to the dead is
not disrespect to the living.
10
Silverstein, 106.
11
Nagel, 66.
12
Silverstein, 112.
13
Silverstein, 107.
14
Silverstein, 107.
15
While one might view the moment of death as an event, it seems odd to
view the potential infinity of time one spends being dead as a single
discrete event. Moreover, even if it were legitimately seen as such, is it
possible for one to have an infinitely long event as the subject of feelings?
16
Silverstein, 116. While I have lumped Silverstein in with proponents of
the so-called standard argument, Silverstein is adamant in distancing his
position from the standard anti-Epicurean view, because that approach
makes the fatal mistake of suggesting that death is a loss to the non-
existent dead person. His view, he insists, entails a coherent ‘life-life’
comparison instead of an incoherent ‘life-death’ comparison. However, in
Simon Cushing 127
___________________________________________________________
my opinion his view is just a more respectable fleshing out of the

deprivation idea.
17
Feldman, ‘Puzzles about the Evil of Death’, in ed. Fischer, 316-317.
18
Jeff McMahan, ‘Death and the Value of Life’, Ethics, 99 (October
1988), 48.
19
McMahan, 58.
20
Steven Luper suggests a terminological loophole for PLW views as
follows: “An explanation of why it is awkward to speak of harm when
certain good possibilities, such as enjoying God-like powers, are not
actualized, is that we tend to use the term ‘harm’ to refer to misfortune,
and often it is not a misfortune for us when good possibilities fail to be
actualized (since the failure does not bear on our having essential goods),”
“Death”, The Stanford Encyclopedia of Philosophy,
<http://plato.stanford.edu/archives/spr2006/entries/death/> (Spring 2006).
The suggestion is that we are only harmed by not having ‘essential goods,’
but if not having something can constitute a harm, then I think most
people would feel it a harm if they missed out on $1M (say, because they
lost a lottery ticket) even if they were otherwise comfortable.
21
Harry Silverstein insists that his account is different from the “standard”
deprivation accounts, specifically because future events (on his view) can
be the objects of the feelings that constitute a harm to the living (and,
recall, this is so even if in fact one experiences no actual adverse feelings).
He attempts to support this case in “The Evil of Death Revisited,”
Midwest Studies in Philosophy, XXIV (2000), with a case where a
husband finds out the truth, that his wife is having an affair with his best
friend, by a report from another friend who mistakenly thought he
overheard something to that effect (123-4). This is a case where, claims
Silverstein, the affair is the object of the husband’s misery without
actually being the cause of it. That is, he holds a de re view of the objects
of feelings. I find this simply implausible; while I might allow that my
statement “the alien with thirty arms somewhere in the universe” might
have as its object that actual being, my feelings cannot be “about” that
being without some causal connection. My feelings are about my
conception of that being. And so with my death: I cannot have feelings
about my actual death (or state of being dead), just my imagination of it,
and thus on his VCF view, I cannot be harmed by it.
Tele-visions of the Dying: Ghost-Seeing in the Society for
Psychical Research in the 1880s 1
Shane McCorristine
Abstract
The spread of spiritualism in the second half of the nineteenth
century led to the establishment of the Society for Psychical Research
(SPR) in London in 1882 as a scientific society dedicated to investigating
the phenomena emanating from the spiritualist séances. In the landmark
quasi-sociological study, ‘Phantasms of the Living’ (1886), the SPR
published some 700 cases which pointed away from the traditional
concept of the ghost as a disembodied spirit, in favour of a new theory
based upon the telepathic awareness of (living) loved ones in a state of
crisis, or in a dying situation – in essence a percipience of an embodied
ghost, a ‘phantasm of the living’.
The SPR reformatted the popular ghost story through the
language of psychical research by positing a modernist death-ritual that
invested the bodies of both the agent and percipient in the ghost story with
a telepathic apparatus that extensively mirrored the developments in
contemporary tele-technologies. With the telepathic hypothesis entrenched
in interpretations of ghost-seeing, psychical research suggested a salient
feature of modernity – the idea that the spectres of the self expressed a
disturbing psychical reality more marvellous by far than the sensational
accounts of ghosts so prevalent in Victorian and Edwardian fiction.
Key words: ghost-seeing, spiritualism, telepathy, hallucination, death,

psychical research, mourning, technology.
In the dumb agony which seizes the soul when some

loved one is taken from us, in the awful sense of
separation which paralyses us as we gaze upon the
lifeless form, there comes the unutterable yearning for
some voice, some sign from beyond; and if in answer to
our imploring cry for an assurance that our faith is not in
vain, that our dear one is living still, a smile were to
overspread the features of the dead, or its lips to move,
or even its fingers to be lifted, should we deem any
action a paltry thing that assures us death has not yet
ended life, and still more that death will not end all? 2
This was written by Sir William F. Barrett, Professor of Physics at the

Royal College of Science, Dublin, and founding member of the Society
for Psychical Research, a scientific group set up to investigate claims of
130 Tele-visions of the Dying: Ghost-Seeing in the Society for
Psychical Research in the 1880s
___________________________________________________________
paranormal phenomena which had emerged toward the end of the
nineteenth century. This quote serves to encapsulate the sheer utopian
yearnings that were invested in the figure of the post-mortem body during
this period.
Following the rapid spread of the modern spiritualist faith in
America and Britain in the 1850s and 1860s, rationalist groups and circles
of friends with an investigative urge and pretensions to the ‘scientific
method’ had sprung up chiefly interested in exploring the validity of the
unexplained phenomena emanating from the new spiritualist séances.
Spiritualism was an anti-materialist faith with a varied set of beliefs
centred upon the tenet that the spiritual world could and does manifest
itself through so-called ‘supernatural’ occurrences in the physical world
such as ghosts, materialisations, and extra-terrestrial communications via
mediums. The establishment of the Society for Psychical Research (SPR)
in London in 1882 was the consequence of the efforts of a number of
spiritualists and Cambridge scholars to place their beliefs upon a sounder,
unprejudiced, and more scientific footing. This would lead to the
establishment of ‘psychical research’ and the examination of ghost-seeing,
as profoundly influential cultural constants in late-Victorian and
Edwardian society.
Ghost-seeing is as old as the human nervous system, yet for the
agnostic generation of the 1860s there was the feeling that the issue of
apparitions had reached a crisis-point, with the validity of spiritualistic
phenomena being fiercely debated in the public sphere, and blended into
religious discourses on one hand and psychiatric discourses on the other.
Seeking to find a way out of this extremism, the members of the SPR
sought to usurp and replace what William James called the ‘will to
believe’, with the “will to investigate” - an avowedly scientific approach
which sought to finally solve paranormal issues through the setting up of
objective fact-finding committees, with a sceptical bias it must be said.
The most productive of these committees was lead by Professor William
Barrett who, after conducting experiments into ‘thought-reading’ in Co.
Westmeath and London in the late 1870s and early 1880s, believed that
the SPR would profit most by investigating the area of supernormal
communications, where it seemed there was a huge amount of evidence
above the rate of chance which could be gathered within an objective and
scientific environment.
The theory of thought-reading, or ‘thought-transference’ - that A
could consciously know what B was thinking of – allowed for new ways
of approaching the ultimate questions of psychical research, ways which
could be packaged as both experimentally valid and scientifically
Shane McCorristine 131
___________________________________________________________
pioneering. Yet the thought-transference hypothesis was most fully and
fruitfully integrated into theories regarding hallucinations, apparitions,
‘phantasms’, and the alleged hauntings of the dead, for the role of thought-
transference was seen as crucial in determining the difference between
delusive and veridical hallucinations, and this differentiation opened up
the genre of supernatural hallucinations to scientific explanation and
exposition. The increased speculations about thought-transference, and its
wider implications for theories of hallucinations and apparitions led to its
second name-change in the space of a year with Frederic W.H. Myers
coining the word ‘telepathy’ from the Greek ‘tele’ (distant) and ‘patheia’
(feeling).
Despite the seeming prevalence of ghosts, wraiths, and spirits in
everyday life, the SPR Committee on Haunted Houses and Apparitions
seemed to encounter a reluctance on the part of their prey, for as it
remarked upon the activity of ghost-hunting, ghosts “like aerolites, seem
to be no respecters of persons; and no amount of scientific watchfulness
will make them come to order”. 3 It was undoubtedly the acute lack of
sensational eyewitness experience on the part of SPR investigators which
led to them toward a more sociological approach, toward the more
pedestrian methods of collecting and collating masses of material, and
issuing circular requests for data to friends of the Society and the major
newspapers and journals. It prioritised a personal interview with the
percipient - as they called the ghost-seer - and expressed the wish to “hear
his story told in a manner which pledges his honour to its truth”. 4 It was at
this point that testimony from people the SPR considered hysterical,
hypochondriacal, or uneducated would be discounted, for it is evident that
notions of tellability and its hierarchical requirements played a key role in
the scientific discourse on ghosts and apparitions at the time. This is
further demonstrated by a footnote to the above quote which notes that if
the case concerns the testimony of an illiterate person, the narrative is
accepted as authentic only on the authority of the local clergyman. 5
Clearly, then the SPR developed an a priori notion of an accredited ghost
story which relied upon the non-sensational account of a literate and
respectable member of the public willing to communicate with, and be
interviewed by, the SPR. However, if the primary requirement of personal
acquaintance with the person who experienced the occurrence were not
possible, then cross-examination by letter would be a necessary procedure,
an avenue which proved to be the primary method of verification for the
SPR in the 1880s; some 10,000 letters were sent to correspondents by the
SPR Literary Committee in 1883 alone. 6
In this heavily regulated sociology of the ghost story,
exaggerated, embellished, and ‘readerly’ accounts of the supernatural were
___________________________________________________________
to be mistrusted, and the Society was proud of the fact that the ghost
stories they reported were “far more likely to provoke sleep in the course
of perusal than to banish it afterwards.” 7 This quantitative, rather than
qualitative methodology of reducing ghosts to statistics was certainly a
novel approach to the area, an approach that was in tune with the new
sociological trends of the period, and which aimed to develop a critical
mass of evidence from witnesses whom they considered of a high
character. In short the SPR developed a montage-approach to ghost-
hunting with a view to synthesising recurring themes within an
experimentally valid framework. They sought to counter beliefs that they
were only engaged in cold theorisation and snobbishly experimenting
within their chosen circle, and assured percipients that statistics in this
matter were everything: “The achievement which we claim for our Society
is not a theory of cases but a colligation of facts.” 8 They went even further
and outlined the direct role that the public could play in supporting and
constructing the work of the SPR:
The public are for the first time being made

participators in scientific work: for the first time they
appear as the sources of evidence, as the actual material
(so to speak) of the experiments, which the novel nature
of recent inquiries demands. 9
While this does point to a conscious development in the

democratisation of scientific work, it may be more accurate to conceive of
a chosen ‘community of sensation’ within the SPR’s ghost-seeing
investigations. Thus from the outset, the success or failure of the SPR
theory of apparitions depended to a large extent upon public participation
in their investigative enterprise, upon offering up cases of ghost-seeing for
the project, based as it was upon a liberal epistemology and middle-brow
marketing. 10
By far the most common type of ghost being described by the
correspondents of the SPR in the 1880s was the ‘crisis apparition’: this
involved cases where A, or the agent, entered a critical or traumatic state,
usually a dying situation, and supernaturally appeared to B, or the
percipient, in the form of a hallucination of the senses, possibly due to a
pre-existing personal rapport with the percipient or a strong psychical
connection with the locality of the occurrence. This type of ghost-seeing
experience was usually a decidedly family affair, with, for example dying
husbands appearing to their wives, or was an acute awareness of the loss
___________________________________________________________
of a close relation, and thus could be verified in death records as to the
factual reality of the claims made.
Building upon this veridical nature of apparitions, the SPR began
to use the term ‘phantasm’ to refer to the paranormal apprehension of a
crisis apparition. Thus, by describing them as mental phenomena with no
physical reality, by dealing with a person who was dying, i.e. still
technically alive, and by linking the topic to what they believed was
scientifically proven - telepathy - the SPR sought to modernise the ghost
story as an empirical narrative within the precepts of scientific naturalism.
The classic representation of this exploration remains ‘Phantasms of the
Living’. 11 This two-volume work is a huge compendium of some 700 tales
of ghosts from Britain and Ireland of many different hues with speculative
comments interspersed by the SPR psychologists Edmund Gurney, and
Frederic W.H. Myers, who were aided by Frank Podmore, a postal official
and co-founder of the Fabian Society.
‘Phantasms of the Living’ included many stories which
resembled cases of experimental thought-transference in the extreme
banality of the impression received. Non-lethal telepathic hallucinations
included the case of a woman who felt she was struck on the lip at the
very moment her husband was elsewhere, a clergyman who intuitively
‘knew’ when his daughter had arrived safely in India, and a father who
had a feeling that his child had fallen out of bed many miles away. 12
However the themes in ‘Phantasms of the Living’ quickly took on a darker
tone, for it is primarily a book drenched in death and dying: about half the
cases included deal with an attested occasion when a percipient’s ghost-
seeing experience either coincided with, or shortly followed, the death of a
loved one. The problem that the SPR now faced was how to distinguish
between the ghost of a dying person and the ghost of a dead person, how
to distinguish between the cessation of life and the cessation of its
psychical affects. The creation of this distinction was crucial in proposing
theories of ghost-seeing which could be propounded as naturalistic and
scientific, without the taints of theology, spiritualism, or the occult. As a
result the SPR implemented a temporal limit of 12 hours from the moment
of the agent’s death during which the ghost-seeing experience of the
percipient, the appearance of the phantasm, would remain within the
boundaries of scientific naturalism and remain a phantasm of the living
and not a phantom of the dead. By compartmentalising and allotting
arbitrary time-frames to the moment of death and the moment of ghost-
seeing based upon neo-Schopenhauerian theories of vitality and the
latency of psychical forces, the SPR sought to break up the
supernaturalism of the traditional ghost story and reformat it as a
phenomenological event within a temporal culture. The intervention of the
___________________________________________________________
SPR into theories of ghost-seeing, and its influence in paranormally
translating late-Victorian attitudes on death and dying would link its
interest in the cultures of intimacy surrounding telepathy with the more
precarious and quasi-spiritual theories clustered around the moment of
death and the possibility of survival. 13 Thus, after a few years of research
the SPR had forcefully begun to advance the rather surprising thesis that it
was ‘phantasms of the living’ and not the ghosts of the dead which held
the most evidential, experimental, and ultimately speculative value for
society.
The arena for this modern prophesising, or pre-emptive grief, was
firmly within the normality of everyday life, and the manifestation
situation of ghost-seeing reflected a passive state of mind on the part of
the percipient – about as far away from the agent’s crisis as was possible.
Indeed, most ghosts, like accidents, happened within the security of the
home, and many of the cases recorded in ‘Phantasms’ were reported to
have taken place in the bedroom where such an encounter with the
unheimlich would resonate most fully. An example of this would be the
case of a woman waking up after dreaming of her own death to find her
husband sobbing beside her, saying that he had dreamt the exact same
thing. 14
When the case relied upon visual sightings, the apparition was
usually distinctly recognised by the ghost-seer. The apparition was
described most commonly as being anthropomorphic, pale, misty, and of a
melancholy demeanour. Notably the figure of the hallucination rarely
induced horror or fear in the percipient. Rather, profoundly existentialist
themes of dread, anxiety, and Weltschmerz feature prominently in many of
the cases recorded in ‘Phantasms’, and indeed premonitions and the
physical reactions to such forebodings were a common trope of popular
ghost stories. However, in the 1880s these premonitions of the death of the
other appear to resemble the simulated death of the self. One example
serves to illustrate the type of language (and rationalisations) used in these
cases:
Case No. 68:

Mrs Powys reports: About 3 months ago as I was sitting,
quietly thinking, between 5 and 7 p.m., I experienced a
very curious sensation. I can only describe it as like a
cloud of calamity gradually wrapping me round. It was
almost a physical feeling, so strong was it; and I seemed
to be certain, in some inexplicable way, of disaster to
some one of my relations or friends, though I could not
___________________________________________________________
in the least fix upon anybody in particular, and there was
no one about whom I was anxious at the time…on
Monday I got a letter from my sister…in which she told
me she had received a telegram…informing her of the
dangerous illness of her brother-in-law, at which she
was greatly upset. This appeared to be a very probable
explanation of my extraordinary presentiment, and I
wrote and told her all about it at once. 15
The psychoanalyst Nicolas Abraham has theorised the phantom

as representing a gap within the mind of the percipient, as a secret hidden
and buried in a crypt constructed by the psyche. 16 In the cases recorded by
the SPR, the phantasm of the dying person can be interpreted as using the
emotional apparatus of the percipient to express the secret of the death of
the other/self, to fill the gap left by the pre-empted loss of a loved one.
That this gap is usually confirmed by the swift arrival of a black-bordered
telegram, which confirms the death of the other and affirms the ghost-
seeing of the self, suggests how bodies in crisis can act as both the
medium and the message. It can be seen quite clearly how the essentially
nunciative function of the telepathic apparition can be linked to
contemporary innovations in tele-technologies such as telephones,
telegraphs, phonographs, x-rays, spectroscopes, and photographs. 17 With
many cases involving the phantasmic appearance of loved one’s residing
throughout the British Empire, it can be seen that ghost-seeing functioned
as a form of magical thinking and magic linking which to some extent
reflects developments in instant communication in late-Victorian science
and culture. Furthermore, the psychological impact of the new magical
technologies can be traced in the large amount of cases involving auditory
hallucinations, or the hearing of the voices of loved one’s in one’s own
head. For this forms a direct link both with the experience of receiving a
telephone call from the other side of the world, and with the appearance of
new dissociative mental disorders at the end of the nineteenth century,
such as Multiple Personality Disorder. Through its committed
investigation of ghost-seeing and the phantasmic death of loved ones, the
SPR inspired experimental psychologists such as Charles Richet, Pierre
Janet, Frederic Myers, Theodor Flournoy, Carl Jung, and Sigmund Freud
to deal with the dark phenomena of unconscious desires, fears, and
projections that came to characterise the birth of modernity.
To conclude, in the 1880s we have the concerted attempt to
normalise, scientise, and collectivise ghostly experiences by withdrawing
investigations from religious and psychiatric discourses of faith and
diagnosis and attempting to place them within a ‘psychical’ context which
___________________________________________________________
utilised and influenced the emerging disciplines experimental psychology,
sociology, and probability theory. 18 With the telepathic hypothesis
entrenched in interpretations of ghost-seeing, psychical research suggested
a salient feature of modernity - the idea that the spectres of the self
expressed a rich and disturbing psychical reality more marvellous by far
than the sensational accounts of ghosts and ghouls so prevalent in
Victorian and Edwardian fiction. Ghosts, spirits, and ‘phantasms of the
dead’ as phenomena embedded within popular literary-oral and spiritualist
culture were to be either pushed aside as unsubstantiated superstitions or
else examined through the medium of the scientific and experimental
standards which the SPR championed, standards which held an
increasingly ambiguous status in the mainstream spiritualist movement.
As a Society which was at the crossroads between a spiritualist group
based upon belief and a scientific society based upon fact, the SPR
provided a unique arena of ‘as-if-ness’ 19 where ghost-seeing and its
implications could be expressed with the tools of empiricism, sociology,
and abnormal psychology. With ghosts, phantasms, and spirits trapped
between traditional modes of religious belief or supernatural
expressionism on one hand, and modern scientific trends of public
demonstration, explication and cultural investigation on the other, the
huge level of ghost-seeing in the 1880s is not surprising at all.
Notes
1
The author wishes to acknowledge the funding and support provided to
him by the Humanities Institute of Ireland.
2
William F. Barrett, On the Threshold of the Unseen: An Examination of
the Phenomena of Spiritualism and the Evidence for Survival after Death
(London and New York: Kegan Paul, Trench, Trübner &Co, 1917), 197-
198.
3
William F. Barrett, A.P. Percival Keep, Charles C. Massey, Hensleigh
Wedgwood, Frank Podmore, and E.R. Pease, ‘First Report of the
Committee on Haunted Houses’, PSPR, Vol. I (1882-1883), 101-115.
4
Barrett et al, ‘Literary Committee’, 117.
5
Ibid, ff.
6
William F. Barrett, Charles C. Massey, Stainton Moses, Frank Podmore,
Edmund Gurney, and Frederic W. H. Myers, ‘Second Report of the
Literary Committee’, PSPR, Vol. II (1884), 43-55.
7
Barrett et al, ‘Haunted Houses’, 117-118.
___________________________________________________________
8
William F. Barrett, Charles C. Massey, Stainton Moses, Frank Podmore,
Edmund Gurney, and Frederic W. H. Myers, ‘Third Report of the Literary
Committee’, PSPR, Vol. II (1884), 109-136.
9
Ibid, 112.
10
See John Peregrine Williams, The Making of Victorian Psychical
Research: an Intellectual Elite’s Approach to the Spiritual World,
unpublished Ph.D. Thesis, (University of Cambridge, 1984).
11
Edmund Gurney et al, Phantasms of the Living, 2 vols. (Gainesville,
Florida: Scholars’ Facsims & Reprints, 1970).
12
Ibid, 188, 192, 196-198.
13
See Frederic W.H. Myers, Human Personality and Its Survival of Bodily
Death (New York: Longmans Green, 1909).
14
Gurney et al, 316.
15
Ibid, 271.
16
Nicolas Abraham, ‘Notes on the Phantom: A Complement to Freud’s
Metapsychology’, Critical Inquiry, vol.13, no.2, (Winter, 1987), 287-292.
17
See for instance Steven Connor, “Voice, Technology and the Victorian
Ear”, Roger Luckhurst and Josephine MacDonagh eds, Transactions and
Encounters: Science and Culture in the Nineteenth Century (Manchester:
Manchester University Press, 2002), 16-29.
18
On the influence that psychical research had upon probability theory see
Ian Hacking, ‘Telepathy: Origins of Randomization in Experimental
Design’, Isis, Vol.79, no.3, (September, 1988), 427-451.
1919
See Hans Vaihinger, The Philosophy of ‘As If’: A System of the
Theoretical, Practical and Religious Fictions of Mankind. tr. C.K. Ogden
(London: Routledge & Kegan Paul, 1965).
Bibliography
Brandon, Ruth. The Spiritualists: the Passion for the Occult in the
Nineteenth and Twentieth Centuries. (London: Weidenfeld and Nicolson,
1983).
Cerullo, John J. The Secularization of the Soul: Psychical Research in
Modern Britain. (Philadelphia: Institute for the Study of Human Issues,
1982).
Gauld, Alan. The Founders of Psychical Research. (London: Routledge &
Kegan Paul, 1968).
Haynes, Renée. The Society for Psychical Research 1882-1982: A History.
(London and Sydney: MacDonald & Co, 1982).
___________________________________________________________
James, William. The Will to Believe: and Other Essays in Popular

Psychology. (New York: Longmans Green & Co, 1898).
Luckhurst, Roger. The Invention of Telepathy: 1870-1901. (Oxford:
Oxford University Press, 2002).
Oppenheim, Janet. The Other World: Spiritualism and Psychical Research
in England, 1850-1914. (Cambridge: Cambridge University Press, 1985).
Ronell, Avital. The Telephone Book: Technology, Schizophrenia, Electric
Speech. (Lincoln, Nebraska: University of Nebraska Press, 1989).
Thurschwell, Pamela. Literature, Technology and Magical Thinking,
1880-1920. (Cambridge: Cambridge University Press, 2001).
Shane McCorristine received his BA in History and MA in Cultural

History from University College Dublin. He is currently a Doctoral
Scholar in the Humanities Institute of Ireland.
“Of Death I Try to Think like This”: Emily Dickinson’s
‘Play’ with Death 1
Lucia Aiello
Abstract
This paper explains Emily Dickinson’s use of the concept of
‘Death’. The paper argues that in her poetry Dickinson divests death of
traditional metaphysical connotations and turns it into a signifier shedding
light on the composite nature of human experience. Within her poetry the
concept of death is divested of its intimidating power, without falling into
the cliché of becoming replete with ‘positive’ meaning. ‘Death’ in
Dickinson is a figure of the poetic form that, together with other figures
such as ‘Life’, ‘Poet’, ‘I’, ‘Immortality’, ‘Grief’, etc., assumes a
conceptual dignity beyond the role allocated to it by traditional semantic
definitions. New combinations become workable, innovative associations
emerge as a result of the expansion of perception and prefigure
possibilities of new meanings. The paper explores some of these
possibilities using Dickinson’s poems as examples.
The paper concludes by advancing the hypothesis that
Dickinson’s playful engagement with death at the level of the conceptual
covers in fact a deeper ontological need, namely the need to make sense,
not of death, but of human experience as a whole. The paper argues that a
fear of a loss of sense is an anxiety concerned with the ineffable, the
unspeakable, and therefore the meaningless.
Key words: Dickinson, death in poetry, Heidegger, Adorno, poetry of

experience.
1. Kenosis
In poem 1052, Emily Dickinson writes:
I never saw a Moor -

I never saw the Sea -
Yet know I how the Heather looks
And what a Billow be -
I never spoke with God
Nor visited in Heaven -
Yet certain am I of the spot
As if the Checks were given -
For Dickinson, experience does not define existence. A Moor, the

Sea, God and Heaven, are all available concepts, the existential reality of
which is not legitimated by direct experience. This dispels possible doubts
140 Emily Dickinson’s “Play” with Death
___________________________________________________________
about Dickinson misunderstanding the nature of the poetic as the
unmediated expression of experienced reality. Dickinson’s poetry is
consciously not poetry of experience. It is a universe made of words
arranged through the poetic form into a different order of experience - one
perhaps could call it aesthetic, but this might be reductive - an order,
however, not less significant in existential terms. In this universe, words
such as God, Life, Immortality, I, Love, etc., assume a conceptual dignity
which is augmented, not diminished, by the fact that they are not tied to
the experiential moment. Value hierarchies and traditional roles are
revised and an expanded concept of existence emerges from Dickinson’s
poetry.
‘Death’ in Dickinson is not exempt from such treatment. In fact,
the impossibility for the living to experience the facticity of their own
death is reworked in her poetry as the trace of an experience, a test, an
experiment, which the poetic word bears witness of, thus preserving the
memory of a desire for fullness of experience. In the well known poems I
felt a funeral in my brain and I heard a fly buzz - when I died, 2 death is
represented as the recollection of a series of sensory perceptions that, once
organised in the artistic form, give a sense of what experience might be.
These poems reveal as illusory the image that the poetry of experience
pretends to convey, that is of a time when the word might have expressed
with confidence the fullness of experience. In Dickinson’s poetry there is
always an obstacle to absolute unity and immediate expression: in poem
465, such obstacle is ironically represented by a fly, interposed between
“the light and me” and “I could not see to see”; in poem 280, “a plank in
Reason broke”, and “I finished knowing then.” The moment of self-
consciousness, however, does not precede the poetic composition in order
to be subsequently transferred onto its content. It is accomplished in and
through the poem itself. The only possibility of a return to experience,
however differently it might be conceived, is given only if the poet
renounces the idea that the word carries the essence of that which it
represents, while retaining the trace of a desire to transcend its semantic
boundaries. I will return to this point later.
Briefly, Dickinson’s treatment of death can be said to consist of
three main strands. One such strand concerns the recorded experience of
the death of others; another one assumes the death of the poet herself,
who, imagining being a corpse, comments at her curious new condition.
The third larger component takes the form of a complex elaboration on the
conception of death. This paper will deal mainly with the latter, although
the implications stemming from it inevitably affect the other two. In
dealing with death, Dickinson makes a double effort in order first to divest
the concept of death of its traditional metaphysical connotations and
Lucia Aiello 141
___________________________________________________________
second to let this concept interact with other concepts and thus create new
combinations. Such double movement is not sequential but occurs
simultaneously, thus increasing the gap between the initial effect of
disorientation that her poetry engenders and the playful composure of her
poetic lines.
“Of Death I try to think like this,” states the first line of poem
1558, meaning that death is intelligible to us. In Dickinson’s poetry, death,
far from representing the mysterious beyond of life, carries as a concept an
existential weight that goes beyond the experiential moment traditionally
associated with the end of life. This, however, does not imply a
transposition into a transcendental sphere, as critics have often inferred. In
metaphysical terms, death can say very little to the living. As the final
stanza of poem 432 clearly states:
I need no further Argue -

That statement of the Lord
Is not a controvertible -
He told me, Death was dead -
Death, “the Old Imperator,” 3 is dead, or, to put it in other terms,

it is not, or not any longer, the unintelligibility of death that constitutes a
problem for the living, as the fact that death is now intelligible to us and is
an available tool for the poetic form. To think of death through the poetic
form means to mediate the facticity of death and to explore the prismatic
nature of a word through which the living try to “distil sense”
(Dickinson’s expression) of what is lacking to them. For Dickinson, death
is “but our rapt attention to Immortality,” 4 or “an ecstasy of parting
denominated ‘Death’.” 5 “Life is but Life! And Death but Death!” 6 Death
is indifferent (“the quiet nonchalance of death” 7 ), but for “Us” (capital
letter often used by Dickinson) is the “most profound
experiment/Appointed unto Men-.” 8
Although death is still a fact of existence, “potential to that Man
who dies,” 9 little can be known about it. As the first two stanzas of poem
153 state:
Dust is the only Secret -

Death, the only One
You cannot find out all about
In his “native town.”
Nobody knew “his Father” -
Never was a Boy -
Hadn’t any playmates,
___________________________________________________________
Or “Early history” -
If death’s history cannot be known, certainly the significance of

the word “death” unfolds itself in history and not outside history. This
historical “presence” constitutes and legitimizes the existential conception
of Death. The most well known exponent of the existential encounter with
death is of course Martin Heidegger. In ‘Being and Time’, Heidegger is at
pains to explain how one does not “experience” death, in any other way as
“Dasein’s potentiality-for-Being,” as an anxiety, not “in the face of one’s
demise,” but as an impending possibility of Being. 10 However to give a
“full existential-ontological conception of death,” in Heidegger’s terms, 11
is not the main aim of Dickinson’s poetry. Unlike Heidegger’s disregard
for the historicity of Being, Dickinson confronts History by addressing the
constitutive historicity of the word as the mark of the detachment from the
essence it purports to represent.
2. The experiment
Interestingly, when Heidegger seeks to give an ontological
definition of Dasein, it is to the German lyric poet Friedrich Hölderlin that
he turns. Heidegger’s interest in Hollering has been commented upon both
by Theodor Adorno and by Paul de Man.
In ‘Parataxis’, one of the most remarkable essays of his ‘Notes to
Literature’, Adorno thus comments on Hölderlin’s use of ‘abstractions’ in
his late hymns: “In his poetic usage they [the abstractions] acknowledge
themselves as something historical rather than pictorial representations of
something beyond history.” 12 One could hardly find a better and more
appropriate definition of the non-metaphysical use of names in
Dickinson’s poetry. Dickinson’s poetic universe is made of a
‘constellation of abstractions’, stemming from a self-reflective
consciousness, aware of the illusory character of the correspondence
between name and meaning. Perhaps the fact that originally Adorno refers
this comment to Hölderlin gives us an insight into unexplored affiliations
of Dickinson with the poetic continental tradition including poets such as
Hölderlin, Rainer Maria Rilke, and Paul Celan, the translator of Dickinson
into German. All these poets’ works, and Dickinson’s with them, address
the question of the impossibility of the subject to speak for itself. In this
sense their poetry stands in contrast with the poetry of experience. As
Adorno writes: “Only by virtue of the fact that the abstractions put an end
to the illusion that they can be reconciled with the pure concrete entity are
they granted this second life.” 13 This ‘second life’, in which the concept is
abstracted into and mediated via the poetic form, does not turn words into
“living organisms,” as some critics have inferred in regard to Dickinson, 14
Lucia Aiello 143
___________________________________________________________
but into simulacra through which the whole of human experience is
rethought in completely different terms.
Heidegger’s rhetoric of the presence of Being, which he sees
enacted in Hölderlin’s poetic language, neglects what Adorno calls “the
agency of form” and turns concrete experience into an ultimately inward
circuit of Being. 15 Heidegger places Being-towards-death right at the core
of Dasein’s Being and accredits Hölderlin’s poetic language with a
foundational quality that, as Paul De Man demonstrates, language simply
does not have. In a crucial passage of his essay called ‘Heidegger’s
Exegeses of Hölderlin’, Paul De Man writes:
In its moment of highest achievement, language

manages to mediate between the two dimensions we
distinguish in Being. It does it by attempting to name
them and by seeking to grasp and arbitrate their
difference and their opposition. But it cannot reunite
them. Their unity is ineffable and cannot be said,
because it is language itself that introduces the
distinction. Propelled by the appeal of parousia, it seeks
to establish the absolute presence of immediate Being
but can do no more than struggle, never found. 16
If poetic language undertakes the task to reflect critically on the

nature of such distinction, then it becomes decisive to point out that in
Dickinson such reflection does not lead to nostalgia. Although loss has
penetrated the concept to its core, the ‘second life’, which Adorno makes
reference to, should not be mistaken for a possible transformation of the
impossibility of the poetry of experience into the possibility of the poetry
of consolation. “Death sets a Thing significant,” states the first line of
poem 360. One might ask: significant to what? Does this mean that
Dickinson invests death with a ‘positive’ meaning? A further analysis into
the context in which she uses the word death seems to disprove this
suggestion. If on the one hand the human condition of ‘finiteness’ is a
‘privilege’ 17 and death a ‘need’, 18 on the other hand, the possible outcome
of a close encounter with death is manifold and unpredictable. Dickinson’s
use of death is certainly not designed to reconcile us with the anxiety we
experience in the face of our own demise. In her constellation of
abstractions, a demythologised version of death is granted a ‘second life’
and connected to other apparently remote abstractions. Thus, in poem 234,
death is characterised in commercial terms: “'Tis just the price of Breath -
/With but the ‘Discount’ of the Grave -/Termed by the Brokers -‘Death!’”
In poem 614, Death is associated with Grace: “Many Things - are fruitless
___________________________________________________________
-/'Tis a Baffling Earth -/But there is no Gratitude/Like the Grace - of
Death-.” Death and Life are juxtaposed in many of Dickinson’s poems.
For example, the short poem 816 states: “A Death blow is a Life blow, to
Some/Who till they died, did not alive become/Who had they lived had
died, but when/They died, Vitality begun.”
Dickinson is at ease in the territory of literary language. Amongst
all abstractions, death allows for a more sophisticated play with
equivocations and ironic language games. The ambiguity lies at the core
of a word that designates that which by definition cannot be concretely
experienced but it is constitutive of Dasein as an impending possibility.
Heidegger, by placing the ontological characterization of ending and
totality at the centre of Being, resolves this ambiguity by making
Hölderlin’s poetic word coincide with essence, absolute presence of
Being. Instead, in Dickinson’s play with death such ambivalence is
wilfully maintained; the essence of poetry is to mediate for the living the
impossibility of an authentic unmediated Being. Not only death is
demythologised in her poetry, but even the semantic coordinates within
which the word “death” occurs are destabilised and destabilising. Thanks
to the use of the “syntactic doubling” - namely, as Cristanne Miller
explains, “the use of a single word or phrase to cover two nonparallel
syntactic contexts” 19 - the destabilising effect permeates the structure of
the poems even down to its minimal components. In poem 539, the play is
between the words Death, Defeat, and Despair:
The Province of the Saved

Should be the Art - To Save -
Through Skill obtained in Themselves -
The Science of the Grave
No Man can understand
But He that hath endured
The Dissolution - in Himself -
That Man - be qualified
To qualify Despair
To Those who failing new -
Mistake Defeat for Death - Each time -
Till acclimated - to -
Again, the question one might ask is: “acclimated” to what? To

death? To defeat? Or despair? And in any case, “that man” that is qualified
“to qualify despair”, what kind of dissolution has he endured? The
dissolution of death or of defeat?
Lucia Aiello 145
___________________________________________________________
In poem 510, the ambiguity is played both at the level of content
and form: “It was not Death, for I stood up, / And all the Dead, lie down-”
Thus the poem begins. It is and it is not death. Another line states: “The
Figures I have seen/Set orderly, for Burial, /Reminded me, of mine-.” In
this poem, the “experience” of death is nothing other than a trace in our
memory, stimulated by sensory perceptions - sight, sound, smell, taste,
and touch are all involved. A feeble ‘as’ separates the remembrance of a
semblance of death - what would be a paradox in a non poetic context -
from a ‘shaven life’, ‘fitted to a frame’: ‘as if my life were shaven/And
fitted to a frame,/And could not breathe without a key […].’ Such
reference to ‘life’, however, is not reassuring. The poetic form does not
romantically authenticate experience, nor does it impart a coherent
meaning to fragments of existence. Dickinson’s poetry reflects
thematically the impossibility of fulfilling its original promise to achieve
and elaborate meaning on the sole basis of its own strength, and ultimately
it therefore prompts the question as to whether or not there is concrete
meaning.
In existential terms, Dickinson’s ironic and playful engagement
with death at the level of the conceptual administers to a much deeper
ontological need, namely the need to “distil sense,” making sense, not of
death, but of experience as a whole, in its contradictory forms. In poem
883, Dickinson reflects on the limits inherent in the position of the poet
vis-à-vis the production of meaning:
The Poets light but Lamps -

Themselves - go out -
The Wicks they stimulate -
If vital Light
Inhere as do the Suns -

Each Age a Lens
Disseminating their
Circumference -
Poets go out, “disseminating their circumference”. It is not a fall

into meaninglessness or, worse, a renunciation of the stimulating light of
poetry, and neither, however, is it mystical transcendentalism, as it has
often been imputed to Dickinson, but poetry as the refracting lens through
which new understandings of experience, death included, are historically
unfolded. The poet is not the dispenser of pre-established meanings but
the distiller of sense. As the first stanza of poem 448 states:
___________________________________________________________
This was a Poet -
It is That
Distils amazing sense
From Ordinary Meanings -
Sense is the word that here identifies the beyond which

Dickinson’s abstractions point at, in a dialectical movement that distils
meaning from the multiplicity of a fragmented experience and returns it to
us as poetry.
Notes
1
The poems are numbered according Thomas Johnson’s arrangement in
The Complete Poems of Emily Dickinson, ed. Thomas Johnson (Little,
Brown and Company, 1957), which reproduces the 1955 Harvard edition
but gives only one version of each poem. “Of Death I try to think like
this” is the first line of poem J 1558.
2
Respectively poem J280 and J465.
3
Poem J 455.
4
Poem J 7.
5
Poem J 71.
6
Poem J 172.
7
Poem J 194.
8
Poem J 822.
9
Poem J 548.
10
Martin Heidegger, Being and Time, trans. John Macquarrie and Edward
Robinson (Oxford: Blackwell Publishing, 1962), 295.
11
Heidegger, 303.
12
Theodor W. Adorno, ‘Parataxis’, in Notes to Literature Volume Two,
trans. Shierry Weber Nicholsen (New York: Columbia University Press,
1974), 124.
13
Adorno, 125.
14
See Joseph Raab, ‘The Metapoetic Element in Dickinson’, in The Emily
Dickinson Handbook, ed. Gudrun Grabher, Roland Hegenbüchle and
Cristanne Miller (Amherst and Boston: University of Massachusetts Press,
1998), 273-295.
15
Adorno, 114.
16
Paul de Man, ‘Heidegger’s Exegeses of Hölderlin’, in Blindness and
Insight: Essays in the Rhetoric of Contemporary Criticism, 2nd ed.
(London: Routledge, 1989), 259.
17
Poem J907.
Lucia Aiello 147
___________________________________________________________
18
Poem J1112.
19
Cristanne Miller, ‘Dickinson’s Experiments in Language’, in The Emily
Dickinson Handbook, 249.
Lucia Aiello is a Lecturer in Literature and Philosophy at John Cabot

University, Rome, Italy. Currently she is working on a monograph on
Emily Dickinson’s poetry and the idea of a feminist poetics.
Coming to Grips with Death: Explained and Explored in a
Children’s Picture Book
Phil Fitzsimmons
Abstract
This paper details how Jenny Wagner’s best selling children’s
picture book ‘John Brown, Rose and the Midnight Cat’, explores the
onset of death and coping with death. Although this text was the
Australian picture book of the year in 1978 and has continued to be a
children’s favourite for almost three decades, the description of the book
on the Healthy Books website as “a strange little fable, but quite
beautiful in both words and pictures” 1 reveals just how widely
misinterpreted and misunderstood this text continues to be. An overlay
of archetypal analysis discloses a deeper subtext where the concept of
death becomes a para-textual sliding signifier revealing the current First
World’s fear of death.
Key words: children’s’ literature, death, fear of dying.
1. Introduction: from the personal to the public

Overall this paper represents a thirty-year reflective culmination
of trying to understand how one of Australia’s best selling children’s
picture books could have been bypassed by academics and to some
degree educators for over a generation. How could a text such as ‘John
Brown, Rose and the Midnight Cat’ reach classic status amongst parents
and children and been research dormant for this period of time?
Conversely, why do parents still by this book for their children?
In regard to the first question, the answer could simply be that
this book has slipped through the methodological cracks of academe
because the overwhelming debate amongst educational researchers
during this period has been on how children learn to read and not on
what they are reading. However, as I see it this period of debate, a
euphemism for what has been termed the ‘literacy wars’, is also
symptomatic of an even longer socio-cultural disavowal, a period and
perspective that Rose has termed “the difficulties and contradictions of
childhood.” 2 In the field of children’s literature these contradictions
include the continuing impact of Rousseauian philosophy on publishers
of children’s books, the sexuality of the child and the concept of death.
This cultural denial has in turn lead to the almost exclusive use of
‘puritan’ images and imagery of children and childhood in First World
publishing houses that attempts to completely deny or completely ignore
the existence of these facets.
150 Coming to Grips with Death
___________________________________________________________
This leads to the second question, why do parents still by this
book for their children? It has been my experience that parents have no
idea about the true nature of this text. It would appear that they have
become so imbued with the typical feel good sentimentalism of
children’s texts they have, in the Antipodes at least, fallen into a form of
Freudian deception. That is children’s literature just like the fictional
nature of language itself has built up a façade, in this case one of
denying reality.
In general, the background condition of an interpretative

community in the reading process can be so pervasive
that it can be hard to see that it is there. 3
On the surface this text is a typical, albeit quirky, children’s

picture book. Its drawings are rounded and soft. The text, although a
little bizarre, involves a grandmother figure and animals, forms and
figures that children are supposedly attracted to because of their
“psychological and cognitive appropriateness, and their ability to
stimulate youthful imaginations.” 4 I want to argue that the visual
appearance and simple story line in this narrative is a complete
smokescreen and a form of literary epithelization, a fictional veneer that
overlays an ongoing context of culture in denial.
2. Children, death and the context of culture

‘John Brown, Rose and the Midnight Cat’ arose out of the
cultural milieux of the late 1970’s that in some degree gave it literary
birth, a time characterised by “a lack of mythology in our society.” 5 Of
course, this context of situation was the product of a much larger chain
of historical events.
In the area of child growth and development, it is generally
accepted that there are three historical periods of death as it relates to the
more industrial societies. From 1600 to 1830, children lived in an
overwhelmingly agrarian culture and within an extended family.
Because of its proximity and constant exposure death in the family and
death of the livestock that supported the family was a natural part of life.
The second period extending from 1830 to 1945 is viewed as the
‘dying of death’. With increased urbanisation and the Victorian tendency
to pigeon hole its worldview; death and life became separated as
constructs. As well, the extended family began to disintegrate and death
was gradually relegated to the retirement home. Death also became
professionalised with the mortician now undertaking the formalities that
Phil Fitzsimmons 151
___________________________________________________________
the family used to perform. The rituals of death and its preparations
became an ‘out of sight out of mind’ concept.
The first explosions of the atomic bomb in 1945 ushered in the
third phase of death and dying. With the possibility of universal
annihilation at the push of an anonymous button, mortality became more
focussed in the collective psyche of ‘first world’ peoples. There was a
supposed reawakening of death. However, with this resurrection of
death, there was a corresponding universal movement to protect and
shield children from it. Thus a social phenomenon commenced in the
1830’s that sought to “restrict children from accessing taboo topics.” 6
Children’s literature became the bastion of all pure thoughts and reality
was kept at arms length.
However, I believe that this last period has evolved into another
phase. The overwhelming cultural belief of the Allies following the end
of the Second World War was one of trust in science, economics and the
existential view that “God is on our side.” 7 To a large degree these
world-views came to a crashing halt with the end of the Vietnam War
and the ensuing ‘blood guilt’ of those countries that participated in this
war. With the failure of the American intervention in Vietnam, I would
argue that this personal “repression of death” 8 was further hardened into
a period of increased collective repression and a period of nihilism and
further denial was ushered in.
In the world of children’s literature, the effect on publishers was
to further enforce the collective shield that grew out of the post 1945
period. While death in the early 1970’s had been a clearly manifested in
the daily news reports on the body bags gathering in Vietnam, with only
a few exceptions children’s books in Australia generally reflected and
reinforced wholesome images. John Brown, Rose and the Midnight Cat
was one of these exceptions, and while it gained critical acclaim its
content has never received critical scrutiny.
3. Peeling back the pages and scrutinising the layers

A. A summary of the narrative
This twenty-five paged book opens with a single frame that
depicts an old woman patting a large dog, underpinned by the sentences;
Rose’s husband died a long time ago. Now she lived

with her dog. His name was John Brown.
With the notion of death at the fore, this text then moves into a
continuing pattern of illustrations above the text. However, despite the
simple and often single sentence descriptions, the notion of death is
___________________________________________________________
subtly carried forward in nearly every illustration or linked illustrations.
However, one has to look beyond the text, as this text is deceptive
because of its elegance. As copyright and limited editorial space does
not allow me to reproduce the book in tact, the following summary is
provided so that you the reader can begin to understand the paratextual
interplay in this narrative.
Rose and John Brown live alone in a small farmhouse. The are
seemingly comfortable in their existence, feeding the animals and sitting
reading under a tree until Rose, looks out the window one night and
thinks she sees a cat. Refusing to accept she sees a cat, John Brown in
subsequent frames refuses to even look in the direction that Rose is
gazing, stating that he doesn’t see any cat. It is in the next frame that a
pivotal confrontation occurs. In one of the two most focussed pages in
the entire book, John Brown is seen aggressively facing the cat as it
quietly sits:
But that night when Rose was safe in bed, John Brown
went outside. He drew a line around the house… and
told the midnight cat to stay away. “We don’t need you,
cat,” he said. “We are alright, Rose and I.” 9
In the following pages Rose is seen again peering out the window
and winding back her clock as she debates with John Brown about being
able to see the cat. John Brown moves into total denial, finally closing
his eyes. In the next six pages there is an ebb and flow of denial and
acceptance of the cat. Rose puts out milk for the cat, John Brown tips it
out and is shown facing in the opposite direction to Rose. The last page
of this section, the two are facing each other and John Brown exclaims,
You don’t need a cat. You’ve got me. 10
It is at this point that the midnight cat appears at the window, and
Rose wants to let him in but John Brown again refuses. Rose then goes
to bed. John Brown waits for his breakfast but nothing happens. When
he visits Rose in her room she states that she is staying in bed;
All day, and for ever. 11
In one the last of the two largest and most focussed frames, John
Brown thinks things through, and after waking Rose asks if letting the
cat in would make her better. “Yes”, she replies. “That’s just what I
___________________________________________________________
want.” The cat is let in and Rose gets out of bed to join her animals
companions, and the book ends with the cat purring.
B. Understanding the subtext

The text that I have highlighted gives insight into Booth’s notion
that even the simplest of narratives “can only be spoken of in figures and
metaphors.” 12 The critical metaphorical point of course is where John
Brown draws a circle around the house and attempts to stare down the
midnight cat. It is this double paged instance a critical mythical symbol
surfaces, and creates the chiastic hinge which allows the reader to see
the more clearly the metaphoric symbols before and after this sequence.
The circle in mythic terms represents the dividing line that
“illuminates the balance between life and death.” 13 The circle is actually
a simpler form of the labyrinth, an outline that represents the alignment
between life and death, a path that “… joins the visible to the invisible,
just as the axis joins and separates two inverse and symmetrical parts of
a single pattern.” 14
The encounter between John Brown and the midnight cat with the
circle acting as the dividing line is also a long held mythic tool of
analysis. Two contrasting animals typically represent the ultimate
asymmetrical psychical tension common to all human kind that is the
contrast and lack of understanding between the two interconnected
worlds of human kind’s faulty appreciation and the realities existing in
the larger cosmos. In this instance, this tension is further highlighted by
the dog being personified and the cat being named but not with capital
letters. Thus, the now generalised midnight cat, often seen as being
representative of death, darkness and whose name has connotation of the
darkest hour, is in this context a typical inversion metaphor that often
occurs in tropological literature. Lying as it does at the heart of the
metaphoric labyrinth, a point in which both sides of the one element of
theme confront each other, and by a subtle shift of perception and
transformation reveal their interconnectedness. Hence in this text the dog
represents those who resist “the fact that death is the destiny of life” 15 ,
and the cat the actual destiny:
Awareness of mortality is the alpha and omega of all

that we do. 16
While cast as being happy in these opening two pages, Rose does
not smile again in this text until the final frame. This is a carefully
constructed signal because despite the appearance of contentment, Rose
does not look directly John Brown again until he allows the midnight cat
___________________________________________________________
into the house. While the text tends to indicate otherwise, the pictures
reveal that Rose is living an inauthentic life. With the written narrative
purporting an apparently comfortable existence within the four walls of
her house with her pet as her only companion her downcast face gives
off the sense that she is otherwise absorbed. Her house is in fact her
prison. Typically, the house is emblematic of the universe and its
inhabitants with the points of architecture representing the intervention
of light into darkness. However, in this case instead of a microcosm of
transcendence, Rose’s immediate world is the opposite in focus and
direction. With her eyes down cast or peering outside, she is both
physically and symbolically unable to see the truth that is all around her.
The initial symbolism of the brevity of summer quickly passing into
winter in conjunction with her gaze gives metaphoric voice to her
ignoring of the passing of time. In tandem with this the blazing fire in
the opening scenes is seen to die down in subsequent frames. With the
chimney presenting the universal passageway from this world to another,
in the very opening scenes the text may frame a life of ease, the visual
elements reveal a life in denial.
In harmony with the symbols of transformation and change, Rose
is also framed by archetypal elements representing a further series of
polarities. The wallpaper in her house is a patterned with roses. In
mythic terms, and a corresponding “life as art view” 17 this flower is a
more modern version of the lotus, representing both spiritual direction
and universality. In this text the central character’s name and immediate
surroundings reveal her need but her actions, reveal that Rose’s
existential view was becoming “…hardened,… fixed,… and
irreparable.” 18
That is until she sees the midnight cat and realises that the life
she has been living in denial. Life without death is role-playing one’s
entire existence, and having accepted this she is then seen at doors and
windows, the universal symbols of the gateway to the genuine soul.
4. The ultimate narrative: A question of life and death

‘John Brown, Rose and the Midnight Cat’ is a metaphorical
microcosm revealing that the first world has not only “lost the symbol
system of death” 19 but that by and large is in a state of “denying their
final destiny.” 20 This book offers no answers to what happens after
death, but seeks to highlight the greatest dilemma that lies at the deepest
stratum of psyche; “… our fear of death. That which we carry secure in
our heart, but this is our authentic heart, our authentic self.” 21
___________________________________________________________
Just as Rose faced the existential choice of whether to let the cat
in and accept death or remain suspended in ‘inauthenticity’, so too we
too do not have to be “boxed in by a fiction of permanence.” 22
To let the cat in is to live.
Notes
1
Healthy Books, ‘On-line sales’ 3 June 2005, (14 February 2006).
<http://www.healthybooks.org.uk/cgibin/get.pl?name=bookInfo&se=03.3
>.
2
Jacqueline Rose, The Case of Peter Pan or the Impossibility of
Children’s Fiction. (Philadelphia: University of Philadelphia Press, 1984),
15.
3
Carol F. Feldman, ‘The Construction of Mind in an Interpretive
Community’. In Literacy, Narrative and Culture, edited by Jens
Brockmeier, Min Wing and David R Olson, 52-66. (Surrey: Curzen Press,
2002), 58.
4
Michael Hilton, Potent Fictions. Children’s literature and the challenge
of popular culture. (London: Routledge, 1996), 25.
5
Steven .A. Galipeau, The Journey of Luke Skywalker: An analysis of
modern myth and symbol. (Chicago: Open Court, 2001), 3.
6
Maire Messenger-Davies, ‘The Child Audience - Pre-School
Programming’. In The Television Genre Book, edited by Glen Creeber, 97-
102 (London: British Film Institute, 2002), 99.
7
Susan Wallis, Portents of the Real: A primer for post 9/11 America.
(New York: Verso, 2006), xiv.
8
James Park, Our Existential Predicament: Loneliness, Depression,
Anxiety and Death, 5th Edition. (New York: Existential Books, 2000), 183
9
Jenny Wagner and Ron Brooks. John Brown, Rose and the Midnight Cat.
(Camberwell: Puffin), 1.
10
Wagner and Brooks, 5.
11
12
13
Wayne C. Booth, The Rhetoric of Fiction. (Chicago: University of
Chicago Press, 1961), 24.
14
Patrick Conty, The Genesis and Geometry of the Labyrinth:
Architecture, Hidden Language, Myths and Rituals. (Rochester, Vermont:
Inner Traditions, 2002), 53.
15
Conty, 53.
16
Alfred Adler, Problems of Neurosis. (New York: Harper), 145.
___________________________________________________________
17
Jeffrey Kaufman, ‘Disassociative Functions in the Normal Mourning
Process’. Omega, 28, (1994), 31-38, 38.
18
Richard Rorty, Contingency, Irony and Solidarity. (Cambridge:
Cambridge University Press, 1989), 45.
19
Charles Pierce, ‘The Fixation of Belief’, in Buchler, J. (ed.),
Philosophical Writings of Charles Sanders Pierce. (New York: Dover
Press, 1955), 12.
20
Ernest Becker, The Denial of Death. (New York: Free Press, 1997), xiii
21
Becker, viii.
22
Fritz Perls, Gestalt Theory Verbatim. (Lafeytette, Cal.: Real People
Press, 1969), 260.
Phil Fitzsimmons currently lectures in language education at the

University of Wollongong, Australia. His research interests focus on
critical literacy, visual literacy and children’s literature.
Older People’s Preferences at the End-of-Life: a Review
of the Literature
Eileen Sutton and Joanna Coast
Abstract
This paper presents evidence from a review of 60 studies looking
at older people’s preferences at the end of life published between 1995 and
2005, and highlights the potential for future research in this area. The
review revealed three main areas of focus: treatment decisions, place of
care/death and good death. However, there is some evidence of a cultural
variation in research focus. Whilst much of the research on treatment
preferences originates from the US, where advanced care statements are
more popular, research on place of care mostly originates from the UK.
Studies present conflicting evidence on the impact of socio-demographic
variables such as age, gender, religiosity and ethnicity on treatment
preferences and preferred place of care/death, and there are indications
that patient choice may be service-led and tempered by personal
circumstances such as the availability of informal care, the existence of
local service provision, and awareness of this provision. Although it is
difficult to disentangle the relationship between age, health status and the
dying experience, it would appear that there may be certain features of a
good death that remain constant.
Key words: older people, death and dying, end-of-life, end of life,
preferences.
1. Introduction
The proportion of older people in the United Kingdom population
is growing. In 1961, just 0.7% of the population were aged 85 and over,
but by 2002 this rose to 1.9%. Projections for 2031 indicate that this will
rise to 3.8%. 1 This growing ageing population has implications for health
and social care service provision. The UK National Health Service already
spends around 40% of its total budget on people over the age of 65, and
approximately 50% of Social Services expenditure is also allocated to this
age group. The Government has declared its commitment to providing
high quality person-centred care for older people, as well as dignity in care
at the end-of-life 2 and it is important that resources are carefully targeted
to meet older people’s needs. Death is now most likely to occur at the end
of a long life 3 and the recent growth in hospice and palliative care services
has drawn attention to the importance of quality of death and dying, in
addition to quality of life, in old age. However, research has found that the
modern way of death does not always meet people’s hopes and desires. 4
Questions around how to separate, or measure quality of death, rather than
158 Older People’s Preferences at the End-of-Life:
A Review of the Literature
___________________________________________________________
quality of life, have been raised. Is there a particular point in time when
people can be regarded as being “actively dying”, 5 and is this dependent
upon the “dying trajectory” 6 or perceived course of a particular disease or
condition? Organizations such as the Help the Aged and Age Concern
have produced guidelines or definitions and principles of a good death, 7, 8
but we do not know if goals to improve the dying experience of older
people are being achieved in practice. Some evidence exists that their
choices concerning place of death are not being met, with the majority still
dying in hospital, despite saying they would prefer to die at home. 9, 10
However, whilst statistics are available on life expectancy, mortality and
cause and place of death, we still know relatively little about older
people’s personal experience of the dying process.9 This review, therefore,
aims to examine the existing literature on older people’s preferences for
care at the end-of-life and indicate areas for future research.
2. Main findings of the literature review

The majority of studies included in this review originated from
the United States (64%), with literature from the UK providing 19% (11
papers), and Israel 9%. There were also three papers from Canada, one
from the Netherlands, and one joint paper from the US and Japan. The
main focus of studies was treatment decisions – including advance care
directives/planning, living wills, and life sustaining treatments. The next
most popular theme was a good death (quality of care/dying). These
papers tended to focus on older people’s perspectives of what constitutes
good quality care at the end-of-life and during the dying process. The
remaining papers were specifically concerned with place of care at the
end-of-life or place of death. Studies employed a range of methodologies
from reviews of literature to surveys and qualitative interviewing.
3. Treatment decisions
These studies focus on advanced care statements/planning, living
wills, health care power of attorney and medical decision-making (issues
around life-sustaining or prolonging treatments/technologies and their
continuation or withdrawal). Several papers seek respondent’s preferences
for life-sustaining treatments (LST’s) in various illness/disability scenarios
presented. Studies looking at the stability of people’s preferences and
gender and cultural variations in end-of-life decision-making are also
included. Eight studies present data on the number of respondents with
some type of advanced care directive, or living will, although it should be
noted that the terminology is used somewhat interchangeably. Four of the
papers originate from the US, but interestingly, the study from the
Eileen Sutton & Joanna Coast 159
___________________________________________________________
Netherlands, where euthanasia was legalised in 2001, revealed the lowest
numbers of written advance directives. 11 Figures range widely from 9% 12
to 64%. 13 Schiff et al’s 14 UK study found that 82% of participants hadn’t
heard of a living will, advance directives or advanced care statements, and
of those who had, only four could describe them correctly, most believing
they were concerned with financial arrangements. Some studies also
present figures for those who have a designated power of attorney or
surrogate decision-maker, ranging from 27% 15 to 49%. 16 Three studies
report that the majority of respondents had discussed end-of-life
treatments with either doctors or relatives, 17, 18 but conversely Matsumura
et al 19 found that few had discussed these issues with a doctor, but many
would like to do so. Gender differences may be apparent, with more
women than men in one study possessing a living will (28% compared to
19%). 20 Hawkins et al 21 report that 55% of older people in their study felt
that it is “definitely necessary” to record patients’ wishes in an advance
directive, although the study does not give figures for the number of
people who had executed such a document. Qualitative research from the
UK emphasises the interdependency between dying people and their
families and concludes that advanced care statements can be helpful with
the burden of decision-making at the end-of-life, but that this process
should involve ongoing discussion and review, to take account of
changing preferences. 22, 23 , 24
A substantial number of papers are concerned with the expressed
preferences of older people for treatment, or its withdrawal, in various
illness/disability scenarios. There is some evidence that people value
cognitive ability more than physical functioning 25,26 with advanced
dementia the most feared condition in one study, becoming even more
unacceptable when combined with other disabilities. 27 Some studies 28, 29
look at the effect of treatment outcomes on people’s preferences, with
varying conclusions. In a study by Fried et al 30 almost all participants
preferred a low-burden therapy that would restore their current health
status, if the alternative without treatment was death, but if the low-burden
therapy resulted in an outcome of severe cognitive impairment almost
90% would not choose to receive the therapy. In contrast, other studies
found that in illness scenarios presented there were many instances when
participants rated the outcomes of treatments as a heath state worse than
death, but still wanted treatment 31 or rejected a recommendation for
palliative care, requesting active treatments. 32 A study of bereaved
relatives has shown that patients’ preferences are often ignored, revealing
that 56% of patients had received at least one LST in the last three days of
life, despite requesting “comfort only” care. 33 Other studies, however,
show that doctors and caregivers have varying perceptions of the patient’s
___________________________________________________________
preferred type of treatment 34, 35 , 36 , 37 with one revealing that 50% of
patient-caregiver pairings disagreed concerning mechanical ventilation. 38
A further study reporting on patient’s chosen surrogate decision-maker’s
lack of knowledge of end-of-life treatment preferences found that 91% of
patients were, nevertheless, willing to let these surrogates have some
leeway to override their written decisions. 39
Results from studies are, in some cases, further analysed for the
impact of personal and socio-demographic characteristics, including
religiosity, gender, and ethnicity. Five papers look specifically at the
attitudes and preferences of different ethnic groups to end-of-life care
40, 41 , 42 , 43 , 44
and ethnicity is one of the variables noted in many of the other
papers reviewed, although much of the research reported here involves
white respondents. African-Americans were found more likely than
European-Americans, Korean-Americans and Mexican-Americans to want
to be kept alive on life support in one study 45 and similarly African-
American patients with terminal cancer desired the use of LSTs more than
their white counterparts in both their current health state, and in a near-
death condition. 46 African-Americans were found to be less likely than
whites to have executed advanced care statements, 47 but there is some
evidence that attitudes towards end-of-life care change with acculturation,
with increasingly positive attitudes towards foregoing care and advance
care statements. 48
Significant gender differences in treatment preferences are
reported in some studies 49,50 with men reporting a stronger preference
overall for LSTs. 51 However, the significance of gender on treatment
preferences is disputed by other authors. 52, 53 The impact of marital status
appears to be less contested, with unmarried individuals more likely to
have discussed their preferences with others 54 or present an “activist”
position towards end-of-life decision-making. 55 In this study “activists”
were seen to prefer a voice in the decision-making process, in contrast to
“delegators” who prefer to delegate decision-making to their doctors, to
God or to fate. “Activists” were more likely to be better educated, held
more professional and managerial jobs and tended to be middle class. 56
Age may also be a relevant consideration, with some participants in a
study by Rosenfeld et al believing that at an advanced age they had lived a
natural life span placing more importance on maintaining function, rather
than living on, and being less willing to tolerate the risks of pain and
uncertain outcomes of some treatment options. 57 The impact of age on
preferences, however, is disputed in another study. 58
The literature presents conflicting information on the impact of
religiosity on older people’s treatment preferences, with Cicirelli et al 59
___________________________________________________________
reporting that respondents with a greater preference for refusing treatment
and in favour of assisted suicide were less religious, this conclusion is
supported by Klinkenberg et al 60 who found that more religious people
were less likely to have expressed preferences in advance. However, other
studies found no significant association between religiosity and treatment
preferences 61 and only small differences in position on control of dying. 62
A study of male veterans found that, for treatment preferences, only tube
feeding showed a significant relationship with religious affiliation, with
Catholics less willing to undergo this type of treatment than other
Christians. 63
Two studies, one from the US and the other from Israel, report
specifically on the stability of older people’s treatment preferences over
time. In one US study, preferences were reported as moderately stable
over a two-year period, with those concerning the most invasive
treatments showing the greatest stability. 64 The second study found that
preferences were relatively alike and quite stable over a similar time
period, with around 70% of respondents showing no change in
preferences, but with a slightly stronger trend towards wanting less
treatment. 65 Declining health status could also impact on preferences over
time. A study examining the relationship between worsening physical
function and depression and preferences for LST in older doctors found
that those who experienced clinically significant physical functioning
decline were more likely to prefer high-burden treatment options rather
than no treatment, thus posing a challenge to written advance care
statements which do not take account of declining health status. 66
4. Good death (quality of care/dying)

Authors recognise the difficulties in distinguishing between the
quality of the dying experience and quality of life. Differentiation between
some of the main components of a good death can also be problematic,
because of the co-dependence between these components. For example,
psychological well-being is closely connected to spiritual/whole person
concerns. Nevertheless the most frequently cited features of a good death
are detailed below. It should be noted that much of the research in this
section involves data from both older and younger participants, and those
with, or without, terminal illness. Consequently, it is more difficult to
determine the impact of age and health status upon preferences in this area
than in previous sections, although results will be differentiated where
possible.
___________________________________________________________
A. Family/carers
The most common theme, which occurs in the majority of papers,
is the significance of family and caregivers to the quality of the experience
of the dying person, regardless of their age and socio-economic status.
This theme has two main strands, firstly social, and secondly caring
perspectives. The importance of spending time with friends and family 67
68
is emphasised, as is valuing friends and family 69 and feeling loved and
cared for. 70 Social relations and support, 71 and social functioning and
well-being 72 are also highlighted. Dying may also facilitate reunion with
relatives 73 and a strengthening of relationships with loved ones, 74 with the
majority of older people preferring family and friends to be present at
some stage during the dying experience. 75 Williams highlights the
importance of being cared for by the right people 76 and family members
are often vital to the care of older people, 77 thus enabling their preferences
to be met. Family members are frequently involved in the decision-making
process regarding treatment options 78 and place of care. There is evidence,
however, that older people’s preferences in this area are tempered by
concerns around the potential caring burden on family or other caregivers
and the availability of informal care. 79, 80 , 81 , 82 , 83 , 84
B. Symptoms/physical care
Many of the papers mention the physical symptoms of terminal
illness and their treatment, and in particular pain control,
85, 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95
with broad agreement that patients should have
access to appropriate medication and therapies. Nevertheless, research by
Steinhauser et al with terminally ill patients, bereaved family members,
doctors and other care providers, found that the most highly ranked
attribute by all groups was being kept clean. 96 Interestingly, although
freedom from pain was universally highly rated in this study, patients
themselves judged this attribute to be slightly less important than did the
three other groups. Being able to participate in activities of daily living
such as eating, sleeping, and walking was also rated as significant by
respondents in some studies, 97, 98 , 99 and this is closely connected to the
theme of independence and control (discussed below).
C. Spiritual/whole person concerns

This theme was quite complex, with threads relating to religious
faith 100, 101 , 102 and being at peace with God, 103,104 spiritual and existential
beliefs, 105, 106 , 107 as well as feelings of worth. 108 Care at the-end-of-life
should be culturally sensitive 109 and take the whole person into
consideration, with the dying person able to access desired spiritual and
___________________________________________________________
emotional support, 110 which might include visits from a religious leader or
clergy member. 111 Older people participating in an Israeli study felt that a
good and meaningful life was a prerequisite for a good death 112 and
similarly in a UK study 74% of patients felt that it was important to
remember personal accomplishments, although this attribute of a good
death was ranked more highly by care providers, relatives and doctors than
patients themselves. 113
D. Psychological well-being
Closely linked to the above are issues surrounding the
psychological well-being of older people. Authors report the need to be
treated with dignity and respect 114,115 and to receive emotional support
from both professional and family caregivers 116 to help alleviate feelings
of fear, anxiety and depression, which are often experienced at the end-of-
life. 117 Older people’s fears included being a burden, loss of dignity or
“being a vegetable” 118 and having a doctor with whom one could discuss
fears was regarded as significant by 90% of patients in Steinhauser’s 119
study. Similarly, discussing fears was integral to affective communication
in Gautier’s model of end-of-life care. 120
E. Time/place of death
Uncertainty around the dying trajectory of individual diseases
and conditions means that it is difficult to establish at what point people
can be defined as “actively dying.” 121 Some authors viewed death as a
sequential process occurring over a prolonged period of time and
extending beyond the moment of death, to take account of the impact of
death on loved ones. 122 Contradictions existed between some study
respondents’ descriptions of a good death, which envisaged dying quickly,
quietly, unconsciously, in a desired location and free of pain, avoiding
inappropriately prolonged dying, 123, 124 , 125 , 126 with a desire to complete
preparations and having time to say goodbye, possibly surrounded by
family and friends. 127, 128 Age of death was noted as having an impact in
one UK study, which found that in practice older people experienced
better deaths than their younger counterparts. This may have been partly
due to older people feeling that they had lived a full life, that some of their
closest companions had already died and that they might possibly be
reunited with them, if they believed in an afterlife. 129
F. Preparation
Being prepared for death was recorded as an important attribute
of a good death by several authors, this theme covering personal, medical,
practical and financial preparations. As previously mentioned, having the
___________________________________________________________
opportunity to say goodbye to loved ones, and resolving unfinished
business or achieving a sense of closure 130, 131 were all viewed as
significant. Other concerns such as having funeral arrangements in
place 132 and making appropriate financial preparations, including those
concerning care costs, were also regarded as important. 133 Appointing
surrogate decision-makers and deciding on treatment preferences, or
writing advanced care directives, were other aspects of
preparation. 134, 135 , 136 Much of the motivation for making preparations in
these areas was to remove burden from loved ones. 137
G. Independence/control
Several authors mentioned the significance of allowing dying
people to retain some control over their care. 138, 139 , 140 , 141 This might
involve participating in everyday activities for as long as possible, or
permitting them to feel that, even at this time, they had something to
contribute to others. 142 Young and Cullen described the way some study
participants with terminal illness attempted to exercise control by taking
less than their prescribed dose of pain medication, perhaps to reassure
themselves that death was not imminent, as pain and death were closely
associated for some respondents, so managing without pain relief
signalled progress. 143
H. Policy/service provision
The need for co-ordinated health care and related services which
are focused on the requirements and values of the dying, including
specific provision for those suffering from dementia, is highlighted
throughout the studies. 144, 145 , 146 A lack of hospice care provision within
some areas in the UK has resulted in unmet need. 147 The UK Debate of
the Age Heath and Care Study Group recommend that palliative and
terminal care services should be based on the principles of a good death
presented within their report, in order to ensure that older people can
achieve maximum individual autonomy and control over their deaths. 148
5. Place of care/death
Preferences for place of death vary across studies, with figures
for home as preferred place of death ranging from 43% 149 to 94%. 150
There is conflicting evidence on the impact of health status upon
preference, as in one study recently hospitalized patients were more likely
to opt for hospital care, 151 whereas in other studies, respondents with life
limiting or terminal illness preferred either home or hospice care. 152,153
___________________________________________________________
Age and gender may both impact upon choice, with preference
for home care falling, and hospice care rising, with advancing age. More
women than men opt for hospice care 154 and also express more practical
concerns over care in the home. 155 However, other authors dispute the
impact of gender. 156, 157 There is some evidence that unmarried people are
less likely to opt for home care, 158 this being related to the availability of
informal carers potentially restricting their choice. Dependency when
dying 159 and fears of being a burden to relatives 160 are also important
factors which need to be understood when analysing patient preferences.
Only one of the studies considers the impact of ethnicity upon
preferences and this revealed that a higher number of deceased black
Caribbean than native-born white patients living in the UK had expressed
a preference for location of death, and that, of those patients that had,
slightly more of the former group wanted to die at home. 161 However, the
study also shows that only just over half had this preference met, with
similar figures for both groups. Similarly, only one study published results
by employment status, revealing that those from a professional and
management background were more likely to opt for hospice care and
those from semi-skilled backgrounds had the highest preference for care at
home. 162 One study conducted in a deprived area of London comments on
the potential impact of social disadvantage in shaping patient choice. 163
Two studies mention the impact of religion, with contradictory results,
being either influential 164 or insignificant. 165
6. Conclusions
A review of the literature on older people’s preferences for care
at the end-of-life has revealed three main areas of focus: treatment
decisions, place of care/death and good death (quality of care/dying). The
majority of studies originate from the US and there is some evidence of a
cultural variation in focus. Whilst much of the research on treatment
preferences originates from the US, where advanced care statements are
more popular, research on place of care tends to have been carried out in
the UK, so further research in other geographical areas would be useful to
help to establish the existence of cultural differences in these preferences.
Although many of the studies in this review involve research with white
respondents, there is some evidence that ethnicity has an impact on
preferences for care at end-of-life. Studies present conflicting evidence on
the impact of socio-demographic variables such as age, gender and
religiosity on treatment preferences, but there are indications that patient
choice may be service-led, with older people’s preferences tempered by
personal circumstances such as the availability of informal care, the
existence of local service provision, and awareness of this provision.
___________________________________________________________
Although some evidence exists on the impact of health status,
further research involving direct comparisons between healthy older
people’s preferences with those of older people with terminal illness,
would be helpful to inform health care commissioners targeting end-of-life
service provision and to improve patient choice.
The second section of the review attempted to elaborate on the
many and complex components of a good death. Although it is difficult to
disentangle the relationship between age, health status and the dying
experience, it would appear that there might be certain features that are
constant, such as the importance of family and friends, and the adequacy
of symptom relief and physical care. Other important issues noted
included those surrounding holistic, culturally sensitive care;
psychological well-being; preparation; and retention of
independence/control. As previously observed, much of the research in
this section originated in the US. Further research investigating the
relationship between health status and preferences, which takes account of
different cultural perspectives, would be helpful to inform future policy
provision within the UK.
Studies on preferred place of death/care reveal that older people
have a range of preferences for care at the end-of-life, but, in general there
is a strong preference for home death/care, and that this preference
remains fairly constant across national boundaries, although it should be
noted that the majority of studies in this section of the review originated
from the UK. There is also some evidence of the impact of socio-
economic factors, personal circumstances, health status, age, gender,
religiosity and ethnicity upon choice, although the extent or importance of
such factors remains a matter for debate and requires further clarification.
However, there is evidence to suggest that preference for place of death is
influenced by patients’ knowledge of available services and variances of
service provision, such as hospice care, in different geographical areas.
Further qualitative work investigating older peoples’ preferences at
different stages on the dying trajectory, possibly comparing the
preferences of healthy older people, those living in residential care and
those receiving palliative care in a contemporary UK setting, would also
be useful to establish the relative importance of different attributes of care
at the end-of-life and aid the targeting of resources.
___________________________________________________________
Notes
1
National Statistics, Focus on Older People, (19 July 2005).
<http://www.statistics.gov.uk/cci/nugget.asp?id=874>
2
Department of Health, National Service Framework for Older People.
(London: The Stationery Office, 2001).
3
Clive Seale, ‘Demographic change and the experience of dying’, in
Death, Dying and Bereavement, ed. D Dickenson, M Johnson, and J
Samson Katz (London: Sage, 2000), 35-43.
4
Liz Lloyd, ‘Dying in old age: promoting well-being at the end of life’,
Mortality 5, 2 (2000), 171-188.
5
Anita L Stewart, Joan Teno, Donald L Patrick and Joanne Lynn, ‘The
Concept of Quality of Life of Dying Persons in the Context of Health
Care’, Journal of Pain and Symptom Management, 17, 2 (1999), 93-108.
6
Anselm L Strauss and Barney G Glaser, Anguish: the case history of a
dying trajectory (San Francisco: Sociology Press, 1977).
7
Help the Aged, End-of-Life: making decisions around the end-of-life, (20
July 2005).
<http://www.helptheaged.org.uk/NR/rdonlyres/evmneb3k63ooalcmc3lcy2
xrkqdzjpr2r5xk3w75xxcc2vnrnusw6odxkblwnxdpcpbm7gpk7udat4vicljdi
wg2j6f/endoflife.pdf>
8
Melanie Henwood and Debate of the Age Health and Care Study Group,
The future of health and care of older people: the best is yet to come.
(London, Age Concern. The Millennium Papers, 1999).
9
Richard Smith, ‘A good death’. British Medical Journal, 320, 129
(2000), 130.
10
Irene J. Higginson, Priorities and Preferences for end of life care in
England, Wales and Scotland. (London, National Council for Hospice
and Specialist Palliative Care Services, 2003).
11
Marianne Klinkenberg, Dick L. Willems, Bregje D. Onwuteaka-
Philipsen, Dorly J.H. Deeg and Gerrit van der Wal, ‘Preferences in End-
of-Life Care of Older Persons: After-Death Interviews With Proxy
Respondents’, Social Science & Medicine 59, 12 (2004), 2467-2477.
12
Klinkenberg et al.
13
Joseph J. Gallo, Joseph B. Stratton, Michael J. Klag, Lucy A. Meoni,
Daniel P. Sulmasy, Nae-yuh Y. Wang and Daniel E. Ford., ‘Life-
Sustaining Treatments: What Do Physicians Want and Do They Express
Their Wishes to Others?’, Journal of the American Geriatrics Society 51,
7 (2003), 961-969.
___________________________________________________________
14
Rebekah Schiff, Chakravarthi Rajkumar, and Christopher Bulpitt,
‘Views of Elderly People on Living Wills: Interview Study’, BMJ, 320,
7250, (2000), 1640-1641.
15
Klinkenberg et al.
16
Kathryn L. Braun, Alvin T. Onaka, and Brian Y. Horiuchi, ‘Advance
Directive Completion Rates and End-of-Life Preferences in Hawaii’,
Journal of the American Geriatrics Society, 49, 12 (2001), 1708-1713.
17
Etienne Phipps, Gala True, Diana Harris, Umi Chong, William Tester,
Stephen I. Chavin, and Leonard E. Braitman, ‘Approaching the End of
Life: Attitudes, Preferences, and Behaviors of African-American and
White Patients and Their Family Caregivers’, Journal of Clinical
Oncology 21, 3 (2003), 549-554.
18
Boaz Kahana, Amy Dan, Eva Kahana, and Kyle Kercher, ‘The Personal
and Social Context of Planning for End-of-Life Care’, Journal of the
American Geriatrics Society 52, 7 (2004), 1163-1167.
19
Shinji Matsumura, Seiji Bito, Honghu Lui, Katherine Kahn, Shunichi
Fukuhara, Marjorie Kagawa-Singer and Neil Wenger, ‘Acculturation of
Attitudes Toward End-of-Life Care: a Cross-Cultural Survey of Japanese
Americans and Japanese’, Journal of General Internal Medicine 17, 7
(2002), 531-539.
20
Phipps et al.
21
Nikki A. Hawkins, Peter H. Ditto, Joseph H. Danks and William D.
Smucker, ‘Micromanaging Death: Process Preferences, Values, and Goals
in End-of-Life Medical Decision Making’, Gerontologist, 45, 1 (2005),
107-117.
22
Jane Seymour, Gary Bellamy, Merryn Gott, Sam H. Ahmedzai and
David Clark, ‘Good Deaths, Bad Deaths: Older People's Assessments of
the Risks and Benefits of Morphine and Terminal Sedation in End-of- Life
Care’, Health Risk & Society, 4, 3 (2002), 287-303.
23
Jane Seymour, ‘Technology and Natural Death: A Study of Older
People’, Z Gerontol Geriat, 36, 5 (2003), 339-346.
24
Jane Seymour, Merryn Gott, Gary Bellamy, Sam H. Ahmedzai and
David Clark, ‘Planning for the End of Life: the Views of Older People
about Advance Care Statements’, Social Science & Medicine 59, 1 (2004),
57-68.
25
Kenneth E. Rosenfeld, Neil S. Wenger, and Marjorie Kagawa-Singer,
‘End-of-Life Decision Making - A Qualitative Study of Elderly
Individuals’, Journal of General Internal Medicine 15, 9 (2000), 620-625.
26
Terri R. Fried, Elizabeth H. Bradley, Virginia R. Towle and Heather
Allore, ‘Understanding the Treatment Preferences of Seriously Ill
___________________________________________________________
Patients’, The New England Journal of Medicine, 346, 14 (2002), 1061-

1066.
27
Schiff et al.
28
Rosenfeld et al.
29
Terri R. Fried and Elizabeth H. Bradley, ‘What Matters to Seriously Ill
Older Persons Making End-of-Life Treatment Decisions?: A Qualitative
Study’, Journal of Palliative Medicine 6, 2 (2003), 237-244.
30
Terri R. Fried et al, 2002.
31
Donald L. Patrick, Robert A. Pearlman, Helene E. Starks, Kevin C.
Cain, William G. Cole and Richard F. Ulman, ‘Validation of Preferences
for Life-Sustaining Treatment: Implications for Advance Care Planning’,
Annals of Internal Medicine 127, 7 (1997), 509-517.
32
Rudoph M. Navari, Carol B. Stocking, and Mark Siegler, ‘Preferences
of Patients with Advanced Cancer for Hospice Care’, JAMA: The Journal
of the American Medical Association, 284, 19 (2000), 2449.
33
Joanne Lynn, Joan M. Teno, Russell S. Phillips, Albert W. Wu, Norman
Desbiens, Joan Harrold, Michael T. Classens, Neil Wenger, Barbara
Kreling and Alfred F Connors Jr., ‘Perceptions by Family Members of the
Dying Experience of Older and Seriously Ill Patients. SUPPORT
Investigators. Study to Understand Prognoses and Preferences for
Outcomes and Risks of Treatments’, Annals of Internal Medicine 126, 2
(1997), 97-106.
34
Phipps et al.
35
Hawkins et al.
36
Gregory P. Gramelspacher, Xiao-Hua Zhou, Mark P. Hanna and
William M. Tierney ‘Preferences of Physicians and Their Patients for
End-of-Life Care’, Journal of General Internal Medicine, 12, 6 (1997),
346-351.
37
Sara Carmel, ‘Life-Sustaining Treatments: What Doctors Do, What
They Want for Themselves and What Elderly Persons Want’, Social
Science and Medicine 49, 10 (1999), 1401-1408.
38
Phipps et al.
39
Hawkins et al.
40
Phipps et al.
41
Kahana et al.
42
Matsumura et al.
43
Leslie J. Blackhall, Gelya Frank, Sheila T. Murphy, Vicki Michel,
Joycelynne M. Palmer and Stanley P. Azen, ‘Ethnicity and Attitudes
Towards Life Sustaining Technology’, Social Science & Medicine 48, 12
(1999), 1779-1789.
___________________________________________________________
44
A.M. Fairrow, T.J. McCallum and B.J. Messinger-Rapport, ‘Preferences
of Older African-Americans for Long-Term Tube Feeding at the End of
Life’, Aging & Mental Health 8, 6 (2004), 530-534.
45
Blackhall et al.
46
Phipps et al.
47
Kahana et al.
48
Matsumura et al.
49
Blackhall et al.
50
Jamila Bookwala, Kirsten M. Coppola, Angela Fagerlin, Peter H. Ditto,
Joseph H. Danks and William D. Smucker, ‘Gender Differences in Older
Adults' Preferences for Life-Sustaining Medical Treatments and End-of-
Life Values’, Death Studies . 25, 2 (2001), 127-149.
51
Bookwala et al.
52
Gramelspacher et al.
53
Merrijoy Kelner, ‘Activists and Delegators: Elderly Patients'
Preferences about Control at the End of Life’, Social Science & Medicine
41, 4 (1995), 537-545.
54
Kahana et al.
55
Kelner et al.
56
Kelner, 1995.
57
Rosenfeld et al.
58
Kelner, 1995.
59
Victor G. Cicirelli, Peter MacLean, and Lisa S. Cox, ‘Hastening Death:
A Comparison of Two End-of-Life Decisions’, Death Studies 24, 5
(2000), 401-419.
60
Klinkenberg et al.
61
Gramelspacher et al.
62
Kelner et al, 1995.
63
Oscar Heeren, A. Srikumar Menon, Allen Raskin and Paul Ruskin,
‘Religion and End of Life Treatment Preferences among Geriatric
Patients’, International Journal of Geriatric Psychiatry 16, 2 (2001), 203-
208.
64
Peter H. Ditto, Joseph H. Danks, Renate M. Houts, Kristen M. Coppola,
William D. Smucker, Jill A. Jacobson, Angela Fagerlin and R. Mitchell
Gready, ‘Stability of Older Adults' Preferences for Life-Sustaining
Medical Treatment’, Health Psychology 22, 6 (2003), 605-615.
65
Sara Carmel and Elizabeth J. Mutran, ‘Stability of Elderly Persons’
Expressed Preferences Regarding the Use of Life-Sustaining Treatments’,
Social Science & Medicine 49, 3 (1999), 303-311.
___________________________________________________________
66
Joseph B. Straton, Nae-Yuh Wang, Lucy A. Meoni, Daniel E. Ford,
Michael J. Klag, David Casarett and Joseph J. Gallo, ‘Physical
Functioning, Depression, and Preferences for Treatment at the End of
Life: the Johns Hopkins Precursors Study’, Journal of the American
Geriatrics Society 52, 4 (2004), 577-582.
67
Donald L. Patrick, Ruth A. Engelberg, and J. Randall Curtis,
‘Evaluating the Quality of Dying and Death’, Journal of Pain and
Symptom Management 22, 3 (2001), 717-726.
68
Karen E. Steinhauser, Nicholas A. Christakis, Elizabeth C. Clipp, Maya
McNeilly, Lauren McIntyre and James A. Tulsky, ‘Factors Considered
Important at the End of Life by Patients, Family, Physicians, and Other
Care Providers’, JAMA 284, 19 (2000), 2476-2482.
69
Elizabeth K. Vig and Robert A. Pearlman, ‘Quality of Life While
Dying: a Qualitative Study of Terminally Ill Older Men’, Journal of the
American Geriatrics Society, 51 (2003), 1595-1601.
70
Elizabeth K. Vig and Robert A. Pearlman, ‘Good Deaths, Bad Deaths,
and Preferences for the End of Life: A Qualitative Study of Geriatric
Outpatients’, Journal of the American Geriatrics Society 50, 9 (2002),
1541-1548.
71
Ezekiel J. Emanuel and Linda L. Emanuel, ‘The Promise of a Good
Death’, The Lancet, 351, 1002 (1998), SII21-SII29.
72
Stewart et al.
73
Rory Williams, A Protestant Legacy: attitudes to death and illness
among older Aberdonians (Oxford: Clarendon Press, 1990).
74
Singer et al.
75
Vig and Pearlman.
76
Williams.
77
Emanuel and Emanuel.
78
Donna M Gauthier and Robin D. Froman, ‘Preferences for Care near the
End of Life: Scale Development and Validation’, Research in Nursing &
Health 24, 4 (2001), 298-306.
79
Patrick et al.
80
Vig and Pearlman.
81
Williams.
82
Singer et al.
83
Michael Young and Lesley Cullen, A Good Death: conversations with
East Londoners (London: Routledge, 1996).
84
Ronald D. Leichtentritt and Kathryn D. Rettig, ‘Meanings and Attitudes
toward End-of-Life Preferences in Israel’, Death Studies 23, 4 (1999),
323-358.
___________________________________________________________
85
86
Vig and Pearlman.
87
Elizabeth K. Vig and Robert A. Pearlman, ‘Good Deaths, Bad Deaths,
and Preferences for the End of Life: A Qualitative Study of Geriatric
Outpatients’, Journal of the American Geriatrics Society 50, 9 (2002),
1541-1548.
88
Williams.
89
Singer et al.
90
Young and Cullen.
91
Steinhauser et al, 2001.
92
Patrick et al.
93
Robin Yurk, David Morgan, Steve Franey, Jennifer Burk Stebner and
David Lansky. Understanding the Continuum of Palliative Care for
Patients and Their Caregivers
94
J. Randall Curtis, Donald L. Patrick, Ruth A. Engelberg, Kaye Norris,
Charles Asp and Ira Byock, ‘A Measure of the Quality of Dying and
Death. Initial Validation Using After-Death Interviews With Family
Members’, Journal of Pain & Symptom Management 24, 1 (2002), 17-31.
95
Joan M. Teno, ‘Patient-Focused, Family-Centered End-of-Life Medical
Care: Views of the Guidelines and Bereaved Family Members’, Journal of
Pain and Symptom Management 22, 3 (2001), 738-751.
96
97
Vig and Pearlman.
98
Patrick et al.
99
Yurk et al.
100
Patrick et al.
101
102
Leichtentritt and Rettig.
103
Stewart et al.
104
105
Emanuel and Emanuel.
106
Gauthier and Froman.
107
Yurk et al.
108
___________________________________________________________
109
Ann C. Hurley, Ladislav Volicer, and Zuzka V. Blasi, ‘End-of-Life
Care for Patients with Advanced Dementia’, JAMA: The Journal of the
American Medical Association 284, 19 (2000), 2449-244a.
110
Melanie Henwood and Debate of the Age Health and Care Study
Group, The future of health and care of older people: the best is yet to
come. (London, Age Concern. The Millennium Papers, 1999).
111
Patrick et al.
112
113
114
Stewart et al.
115
Teno et al.
116
Henwood.
117
Stewart et al.
118
Williams.
119
120
Gauthier and Froman.
121
Matsumura et al.
122
123
Henwood.
124
Patrick et al.
125
Singer et al.
126
Curtis et al.
127
Patrick et al.
128
129
Young and Cullen.
130
Patrick et al.
131
132
133
Yurk et al.
134
Henwood.
135
Williams.
136
Yurk et al.
137
138
Stewart et al.
139
Henwood.
140
Singer et al.
141
Young and Cullen.
142
143
Young and Cullen.
144
Henwood.
145
Yurk et al.
___________________________________________________________
146
Hurley et al.
147
Williams.
148
Henwood.
149
Terri R. Fried, John R O'Leary and Margaret A. Drickamer ‘Older
Persons' Preferences for Site of Terminal Care’, Annals of Internal
Medicine 131, 2 (1999), 109-112.
150
Donna M. Wilson, ‘End-of-Life Care Preferences of Canadian Senior
Citizens With Caregiving Experience’, Journal of Advanced Nursing 31, 6
(2000), 1416-1421.
151
Fried et al, 1999.
152
C. Thomas, S.M. Morris and D. Clark, ‘Place of Death: Preferences
Among Cancer Patients and Their Carers’, Social Science & Medicine 58,
12 (2004), 2431-2444.
153
Edward Ratner, Linda Norlander, and Kerstin McSteen, ‘Death at
Home Following a Targeted Advance-Care Planning Process at Home: the
Kitchen Table Discussion’, Journal of the American Geriatrics Society 49,
6 (2001), 778-781.
154
Irene J. Higginson, Priorities and Preferences for end of life care in
England, Wales and Scotland. (London, National Council for Hospice
and Specialist Palliative Care Services, 2003).
155
Merryn Gott, Jane Seymour, Gary Bellamy, David Clark and Sam
Ahmedzai. ‘Older People's Views about Home as a Place of Care at the
End of Life’, Palliative Medicine 18 (2004), 460-467.
156
Fried et al, 1999.
157
Judith C. Hays, Anthony N. Galanos, Tahira A. Palmer, Douglas R.
McQuoid and Elisabeth P. Flint, ‘Preference for Place of Death in a
Continuing Care Retirement Community’, Gerontologist 41, 1 (2001),
123-128.
158
Wilson.
159
Wilson.
160
Thomas et al.
161
Jonathan Koffman and Irene J. Higginson, ‘Dying to Be Home?
Preferred Location of Death of First-Generation Black Caribbean and
Native-Born White Patients in the United Kingdom’, Journal of Palliative
Medicine 7, 5 (2004), 628-636.
162
Higginson.
163
Koffman and Higginson.
164
Thomas et al.
165
Hays et al.
___________________________________________________________
Eileen Sutton is a Research Associate at the Medical Research Council,

Health Services Research Collaboration. Joanna Coast is Professor of
Health Economics at the University of Birmingham.
The Wholeness of a Broken Heart
Leeat Granek
Abstract
Contemporary western psychology teaches that an ‘autonomous’
ontology is the only healthy kind. This view holds that ‘normal’, ‘healthy’
development is towards separation, most especially from the mother in
childhood and adolescence, growing towards individuation, or the total
separation of one’s being from others in adulthood. This ontological view
of humanity, with it’s assumptions of essential separate selves leads quite
naturally into the Western understanding of mourning when there is a loss.
The idea is that when someone you love dies, you grieve for them for a
prescribed period and then you ‘move on’ with your life, perhaps a little
sadder then you were before, but mostly intact. Mourning my mother has
taught me otherwise; this has not been my experience.
Whereas Holub writes of mourning as the process in which we
‘heal and repair the bond between our bodies and souls’, I contend that
grieving is not about mending or repairing, but about learning how to live
with the painful split. Whereas western psychology and the culture in
which its housed insists on putting the pieces together’ in order ‘move on’
and ‘move forward’ as quickly as possible, I believe that mourning is a
process in which we must stand still in the chaos of our shattered pieces
and feel the pain of our brokenness in order to truly heal.
Key words: mourning, mothers and daughters.
1. Introduction
To create is to reveal the parts from the whole.
To repair takes a greater wisdom. It is to discover the

whole from the shattered parts. 1
My mother’s death was not a surprise. Despite 17 years of her

relative psychological and physical health while she lived with metastatic
breast cancer, the last year of her life was a violent struggle against the
disease that aggressively invaded her body. I am by training a
Psychologist. I know all about the stages of grief. My mother fought her
death until the last moment. One day we were shopping, eating lunch, we
were united, arm in arm, solid and content in our togetherness, and the
next day she was in the hospital, attached to tubes, to wires and to pain
pumps. Suddenly her face was swollen, suddenly she was confused,
suddenly she was no longer my mother, but a body withering in pain,
uncomprehending in her terrible, terrible suffering. Within three days of
178 The Wholeness of a Broken Heart
___________________________________________________________
being admitted, she died. I thought I would be prepared for her death. I
wasn’t. I agree with Didion 2 who has written recently, “Grief, when it
comes, is nothing we expect it to be.” Holub writes:
How can we tell where one person ends and another

begins? The material finitude of our bodies is evident,
but the borders of the soul are less definite…Love blurs
the boundaries between one soul and another… When
the tenuous coupling of a person’s body and soul is
undone by death, the bond of body and soul within each
person who has been close to the met/metah [dead
person] is also weakened... And so it is that a survivor
must mourn, to heal and repair the bond between his or
her own body and soul - literally, in some measure, to
stay alive. 3
In Jewish theory, there is a concept called Tikkun Olam, which

roughly translated, means ‘mending of the world’. It is taught that G-d
created the world by forming vessels to hold the Divine Light. But as G-d
poured the Light into the vessels, they shattered, tumbling toward the
realm of matter. Thus, our world consists of countless shards of the
original vessels entrapping sparks of the Divine Light. Humanity’s task
involves helping G-d by reuniting and mending together the scattered
Light that is found in the shards, raising the sparks back to Divinity and
restoring the broken world.
Mourning my mother has taught me that people are reflections of
the cosmic broken vessel and that I am a broken vessel too. People who
are grieving often say that they feel like they are shattered into a million
pieces. Mourning is the slow, painful process of stitching together the
pieces of ourselves including the body and the soul that was split with the
death of our loves, to become a new kind of scarred and sacred vessel that
holds a different light than before.
This is not a traditionally academic paper. What I mean by that is
my ‘data’, which in this case are my observations about mourning do not
come out of books or out of analysis of interviews or from statistics, they
come out of me, out of my own pain and my suffering and my own
struggle to accept an unacceptable loss. I intend to stay true to this
process. I have thus decided to draw on excerpts of writing I did before
my mother died and shortly after she died as an introduction to my thesis
on the phenomenology of mourning. The first except was written three
months before my mother died when she began to get sick to the degree
that for the first time in her life, she was physically impaired.
Leeat Granek 179
___________________________________________________________
2. July 2005
My mother has been a cancer patient for as long as I can
remember. I was nine when she was first diagnosed. I don’t remember
much before that. I remember the matching dresses we used to wear, a
visible sign of our unity; I remember the comfortable weight of being
embraced, nestled contentedly in the concave of her curled body. I
remember the weight of her scent that used to envelope me when I came
back from school each day, familiar and intoxicating. I remember that this
weight used to feel different than it does now. Sometimes it thrilled when
it took the shape of her proud gaze and sometimes it burdened when it
chained me with guilt and kept me from straying too far.
Today the weight is not comfortable, it is heavy. It fills my nights
pressing hard on my chest making it impossible to breathe. It is in my
head during the day- heaviness that hurts- a vice squeezing from the inside
out. It is in my legs- this weight. Walking is slow, painful; it is dragging
stones through wet sand, stiff and effortful and tiring. It is in my hands
making them feel thick and calloused and clumsy as they brush over the
dishes, my lover’s face, the keyboard, the pages in a book.
But for the most part this weight hovers around my heart. It
seems a cliché to talk about a broken heart, a painful heart, a bleeding
heart. But here it is again, another metaphor that persists even though my
critically trained mind recognizes its kitsch, balks at its obviousness, its
mundaneness. The intellect is nothing in matters of the heart. It is the heart
that bears this burden. In my writings I have often reflected on the
meaning of embodiment. Never did I imagine that grief and fear and pain
could be so tangibly located in the body- could be the body. There is a
constant, chronic dull pain that begins around my left shoulder blade and
branches out up my neck and down my left arm. My shiatsu therapist says
it’s the heart meridian that is overworked and out of balance. I look at him
suspiciously trying to remember if I told him about my mother. My yoga
teacher says my heart chakra is ‘working overtime’ and I need to breathe
through this, let it go. Am I this transparent? I wonder, feeling shell-
shocked and dazed.
I stop going to shiatsu and stop going to yoga and sit instead in
the steam room wrapped in white towels at the Jewish Community Center
near my house. I am comforted by the sounds of old Jewish women
talking. Their Yiddish intonation, their loudness makes me feel safe, like
those brief and rare occasions that I would sit at my grandmothers table in
Israel and listen to her laughing with her own daughters. Those moments
felt like eternity, like they could go on forever. That was pre-cancer.
Those moments no longer exist. I wonder if my mother will live to be an
old woman. Having lived so far from my grandmother, I always imagined
___________________________________________________________
that when I would have my own children, we would live close to my
mother so that I could be whole and they could have the grandmother that
I have been missing all of my life.
I have spent sixteen of my twenty six years on this earth in the
shadow of a disease. Cancer. A dirty word - the dirtiest I can think of - has
held me captive to its insatiable grip on my mother’s life. No matter how
many times her tired body has been blasted with poison, no matter how
many times her flesh has been brutally cut, forced to heal and heal again,
this angry, persistent disease comes back to mock her. I am so angry I can
barely breathe. I want so badly to be free - to be released from these chains
of anxiety, terror, rage. I am twenty five, I think, feeling the lingering
hysteria, the panic that always resides just beneath (what I imagine to be)
my calm exterior threatening the surface. I am twenty five. I should be
travelling the world; I should be wandering through shoe stores instead of
doctor’s offices, choosing a husband instead of choosing a palliative care
specialist. I feel so old. There is a haunted quality in my reflection that I
do not recognize. Pounds that I have struggled with for years shed
themselves without effort. And laughter - my oxygen - has evaporated
leaving me constantly heaving for breath.
What is it like to be a daughter of cancer? It is odd to phrase it
this way, but it is true. Cancer demands more then its immediate victim, it
is not satisfied until it has swallowed the spirit of all that surround the
‘patient’ struggling for their lives. I feel guilty for indulging in my own
struggle to come to terms with my mother’s ill health. The West demands
autonomy, demands individuals define themselves sharply, demands
isolation and clear boundaries between people. I cannot carve this clean,
bloodless line. For me it is still like when I was four in our matching
dresses, when it was still ok to be an extension of my mother or at the very
least to indulge in the illusion that we defined each other by our very
presence, by the very act of witnessing the existence of the other. We are
blurred, my mother and I. The psychologist in me jumps out, protective;
Winnicott would say that I have never fully individuated from my mother
and that this is a pathology. The academic voice is stern and unfeeling and
it is asking me, demanding from me to retract my conclusion, to show
myself in a better, more psychologically healthy light. But I am too tired
to heed this voice which has lorded over me for the last eight years of my
academic life and which will be certain to follow me into the next thirty as
I become a professor myself. I am too tired not to tell the truth. And the
truth is that my mother and I are connected by the invisible umbilical cord
that was never really fully cut. And that with each day of her dying,
Which is torturously slow and tortuously painful, I am dying too.
Leeat Granek 181
___________________________________________________________
3. October 2005
My mother is dead. It’s been less than a month since she died. I
sit and sit and sit and sit, pondering these words. It is raining outside as it
has been for the last three days. I haven’t left my apartment in what feels
like weeks. I sit all day, I stare out the window, grateful for the rain,
grateful for the permission it affords me to hibernate indoors. There is
nothing to say, but I think I might die in this silence, so I make the attempt
to think through this unforgiving fog, to produce something, anything that
will crack the vice around my head. Mourning is nothing like people
describe. There are no cycles, there are no ‘phases’, there are no rituals
that help. It is a bloody war, it’s painful. And not painful like ‘emotionally
painful’, or ‘mentally painful’, not painful like the clean, neat category of
what pain is described as in my solid compendium of mental disorders that
sits on my bookshelf. I mean painful. Gut wrenching - physically
excruciating - ‘wish you could crawl into a hole and die’- painful. My
breath stops a hundred times a day. I fall to the floor and curl into a ball
trying to ease the crushing weight pressing into my stomach. This grief
has literally brought me to my knees; I attempt with caution to stretch out
one limb and then the other to see if the pain has passed. My mother’s
death is breaking me. And it comes at the most unexpected times. There is
no ‘bereavement phase’ when all you do is think about the deceased. What
a lie! Death is trauma. And trauma is devious. It will follow no order,
there are no rules, it comes and goes and I flail in its grip. A broken,
vulnerable, weakened woman unhinged.
4. August 2006
That’s how I felt just after she died, since then, ten months have
passed. The physical pain I describe in this last excerpt is no longer a daily
occurrence but still grips me often and always at unexpected times. While
I was writing this paper, I experienced a wave of such grief that I decided I
needed help. I sent the abstract for this paper to a colleague asking for
some direction with readings on the subject. She sent me back a short note
with a question instead of an answer. She asked, “Do you really want to
theorize your own grief?” This is a good question. After much reflection
on it, I realized that yes, indeed I did want to theorize, or at the very least
think about my grief. I have learned more about life from this year of
mourning than I have from all of my other life experiences combined. And
if I am able to learn, then maybe I am also able to say something
meaningful about death, about dying and about mourning that other people
might be able to relate too.
Out of all these lessons, the one alluded to in the introduction
about brokenness and mending is the one I’m most interested in. I quoted
___________________________________________________________
Holub who said that when a person dies, their body and soul separate and
that each person who has been close to that person also experiences a
break or a weakening of the bond between their own body and soul.
Mourning and grieving, according to Holub, is what happens when we try
to mend that split. The interesting part of this idea for me is not that we
break, but why we break when another dies?
Contemporary western psychology teaches that an ‘autonomous’
ontology is the only healthy kind. This view holds that ‘normal’, ‘healthy’
development is towards separation, most especially from the mother in
childhood and adolescence, growing towards individuation, or the total
separation of one’s being from others in adulthood. This ontological view
of humanity, with it’s assumptions of essential separate selves leads quite
naturally into the Western understanding of mourning when there is a loss.
The idea is that when someone you love dies, you grieve for them for a
prescribed period - no longer than three months according to the DSM or
it becomes pathological! - and then you ‘move on’ with your life, perhaps
a little sadder then you were before, but mostly intact. Mourning my
mother has taught me otherwise; this has not been my experience.
Adrienne Rich has written, “The loss of the daughter to the
mother, the mother to the daughter, is the essential female tragedy.” 4 And
it’s true. Losing my mother was a tragedy of epic proportions. More
painful, more shattering, more devastating than I could have ever
imagined. Losing her is about more than love; it’s about more than
missing the familiarity and comfort that only a mother can bring; it is
about more than mourning these terrible incomprehensible losses, it is
about mourning my own death with her passing. It is about mourning the
person that I used to be that died when she died. It is about recognizing
that contrary to the Western insistence on individuation, I was indeed,
undoubtedly part of her and she of me. Our boundaries were blurred, fluid,
osmotic. We are all closer to each other than we think, fluidly connected,
dependant on one another to exist.
I recognize that my mother and I were unusual in our closeness.
She was my best friend, we could intuit each others’ thoughts, we spoke
several times a day and could always make each other laugh. Because I
recognized the finitude of this relationship in my life from a very young
age, I also knew it had to be an accelerated one. There was a time urgency,
we had to live out what should have been a life long mother-daughter
trajectory in just two and a half decades. This awareness of her mortality
intensified our bond to a degree of closeness in my youth that many
people never experience in their entire lifetimes. It is from this place that I
present these observations on mourning and it is ALSO from this place
that I recognize their limitations; they cannot be generalized to everyone.
Leeat Granek 183
___________________________________________________________
While recognizing that the intensity of mourning my mother
comes out of the symbiotic relationship I had with her, I also assert that
the deaths of those we love change us irreparably. Whereas Holub writes
of mourning as the process in which we ‘heal and repair the bond between
our bodies and souls’, I contend that grieving is not about mending or
repairing, but about learning how to live with the painful split. Whereas
western psychology and the culture in which its housed insists on ‘putting
the pieces together’ in order ‘move on’ and ‘move forward’ as quickly as
possible, I believe that mourning is a process in which we must stand still
in the chaos of our shattered pieces and feel the pain of our brokenness in
order to truly heal. In a culture that insists on the total separation of human
beings, this is a radical prescription for mourning. It acknowledges that in
addition to grieving for the person who has died, we are also mourning the
loss of our selves that will never be entirely whole or unscarred again.
In Judaism there are two kinds of prayers for health; the first is a
prayer for ‘re’fuat haguf’, translated to mean the ‘healing of the body’.
The second kind is called ‘re’fuat h’nepshesh’, which calls for the healing
of the whole human being - this includes the body, the mind, psyche, the
soul and every other aspect that makes up each individual person. Healing
in turn comes form the word ‘wholeness’ and has been associated with
‘holiness’. I believe that healing from grief comes when we sit with our
brokenness and acknowledge the fissures as part of ourselves. It is as the
Rabbi I quoted in the introduction says, to heal is to ‘discover the whole
from the shattered parts’.
Notes
1
Org Chabad. A Daily Dose of Wisdom from the Rebbe. (words and
condensation by Tzvi Freeman). Retrieved in an email, April 10, 2006.
2
Joan Didion. The year of magical thinking. (New York: Knof, 2005), 26.
3
Margaret Holub. ‘A cosmology of mourning’, in, Lifecycles: Jewish
women on life passages and personal milestones, ed. Deborah Orenstein
(Woodstock, Vermont: Jewish Lights Publishing, 1994), 341-351.
4
Adrienne Rich. Of woman born: Motherhood as experience and
institution. (New York: Norton, 1986), 237.
Leeat Granek is a doctoral student in the History and Theory of

Psychology Program at York University in Toronto, Canada. Her research
interests are in feminist, critical psychology and take an interdisciplinary
approach drawing from psychology, anthropology, sociology, women’s
studies and neuroscience. This is her first article on grieving.
Religion and Medicine in the Process of Managing Death
and Dying: The Case of Hospice Circle in Poland
Malgorzata Zawila
Abstract
Religion and medicine are both very meaningful phenomena
when considering death and dying. They can be understood as important
elements constructing social attitudes toward death and dying as well as
factors helpful in the process of managing the individual with death and
dying. The question of place and role of religion and medicine in the
context of attitudes toward death and dying is important especially in the
conditions of medicalization and secularization on one hand and the New
Age movement and growth of spirituality on the other. In the context of
the processes mentioned above (medicalization, secularization) religion
and medicine are often understood as opposite to each other. According to
some sociologists and historians in the twentieth century the place and role
of religion in handling the death and dying takes medicine. In my opinion
it is worth to raise the question of this process once more nowadays, in the
twenty first century. The paper focuses mainly on the results of the
research conducted, in three Polish hospices, on the patients, their relatives
and the staff. The main research goal was to study attitudes toward death
and dying among the hospice circle. The method chosen for analysis was
Grounded Theory. Initial analysis of the empirical material gathered
during the research allows treating medicine and religion as
complementary and not opposite to each other, when attitudes toward
death and dying are considered.
Key words: death, dying, religion, medicine, hospice, trajectory, coping,

Grounded Theory, secularization, medicalization.
1. Introduction
Over the centuries many social institutions were involved in
peoples’ managing with death and dying on an individual and a social
level as well. Magic, religion, medicine and family all are the phenomena,
to some extent, concerning the problem of death and the process of dying.
They all influence social attitudes toward death and dying and help people
to cope with death of their own and grief. There are many different views
on the changes in using those factors like religion, medicine and family in
handling with death and dying on macro and micro level as well. In this
paper I am looking at some ways of understanding of the changes in the
culture of death, as we may call all the human acts, attitudes, and works
concerning the subject of death. I’m focusing especially on the changing
role of religion and medicine in the historical context of death and dying.
186 Religion and Medicine in the Process of Managing
Death and Dying: The Case of Hospice Circle in Poland
___________________________________________________________
In the first part of the paper there are some theoretical
considerations on changes, which took place on a macro scale. In the
second part, there is a presentation of a research project that was run in
three Polish hospices, which shows using religion and medicine in coping
with death and dying on a micro level.
2. Medicalization and secularisation processes: history, presence

or future?
In the literature on death and dying for last few decades there has
been a wide discussion on such processes as medicalization of death and
dying and secularisation of death rituals and attitudes. We will discuss
these both processes in one part of the article because they seem related to
each other; what’s more they are inseparable.
Secularisation - a term considered mostly by sociologists of
religion, defining: “the process by which sectors of society and culture are
removed from the domination of religious institutions and symbols.” 1
According to Peter Berger secularisation is a process that can be observed
on two levels: social-structural level and a subjective one as a
secularisation of consciousness. 2 There are many various origins of
secularisation found, but two of them are especially interesting when
speaking about medicalization of death and dying, these are the processes
of fragmentation of society and specialization. The process of
modernization of society was accompanied by formation of more and
more specialized spheres of social life. From one total universe embracing
existence of each individual creating community social reality has
changed into many, different, fragmented realities. This process can be
easily observed in the case of religion, which used to be inseparable and
non-questionable part of everyone’s life and with the process of
modernization it no longer played such an important role. Religion was
separated from such social spheres as: education, politics, economy, law
and also from medicine and morality. The place of religion in these
spheres took science, state and other secular phenomena. Even if there are
religious schools, hospitals and laws they are not obligatory to everyone,
they are a matter of every person’s choice but not fate anymore.
When people’s health, illness, death and dying are considered,
magic and religion became replaced by medicine. This process is called
medicalization. The role of shaman and then the priest taking care of the
seriously ill and the dying is taken over by nurses and physicians. The
responsibility for and control over the dying lies in hands of professionals,
who are usually secular ones, using their education and scientific
knowledge to do their job. In this case, the scientific experiences and
Malgorzata Zawila 187
___________________________________________________________
knowledge is the source of healing power and the control over the patient
and not the supernatural power or God, like it is with religion. The place,
when the medical care and also the dying process takes place, is usually
not home anymore, but the hospital, hospice or other highly specialized
institution. Philippe Aries in his ‘Western Attitudes toward Death’ writes:
Death in the hospital is no longer the occasion of a ritual

ceremony, over which the dying person presides amidst
his assembled relatives and friends. Death is a technical
phenomenon obtained by cessation of care, a cessation
determined in a more or less avowed way by a decision
of the doctor and the hospital team. 3
When speaking about medicalization we need to remember that

Aries wrote these words in the 1970s and at that time this process was
especially apparent. The discussion on medicalization was raised in the
1970s and continued for next decades but not without any critics.
Particularly in the 1990s, there started to be noticed opposite processes to
the mentioned above; they are de-secularisation and de-medicalization of
death and dying.
There are many examples of de-secularisation and de-
medicalization processes in western societies, which I just want to
mention: like the growing role of physicians and other medical staff in
their professional settings, what was described by Steven S. Miles in his
article on ‘The Role of the Physician in Sacred End-of-life Rituals in the
ICU’, the whole idea of hospice care in which religion and spirituality
plays quite important role. 4 Those are only the most discussed ones, not to
mention all the New Age ideas and spirituality that are used in our popular
culture very often.
3. The research project

In the research presented here forty eight people closely
connected to three Polish hospices took part. It was a group of patients,
relatives and/or friends of patients and stuff which were volunteers and
medical staffs like: physicians, nurses and physiotherapists. The reason for
choosing a hospice circle as I called the research group was the fact of its
closeness to the phenomena of death and experience of dying. For those
people death and dying are not a hypothetical experience but real and a
tangible one.
The research project was based on a combination of elements of
visual sociology and Grounded Theory. Visual sociology was used on the
level of the research technique and Grounded Theory on the level of
___________________________________________________________
analysis of the data. All interviewees were given the same set of twelve
illustrations and were asked a set of questions to each. Firstly they were
asked to describe the illustration, next to describe the feelings of people in
the illustration and then to describe their own feelings. Later on they were
asked to say what are the needs of people in the illustrations and
eventually to say what may happen after the situation illustrated. At the
end of each interview interviewees were asked how he did/she thinks,
what happens with human after death. Only this question was not
accompanied by an illustration so not to suggest in any way the answer. In
the research I treated illustrations (photographs and pictures) as an
interview device making speaking about such an intimate problem as
death, as natural and open as possible. In visual sociology such a
technique, as used in presented research is called ‘photo-elicitation’ and is
more and more commonly used for exploring people’s values, beliefs,
attitudes and meanings. 5
A method chosen for analysis of empirical material gained from
interviews is Grounded Theory, which gives an opportunity to build a
theory on the basis of the gathered data. Grounded Theory method gives
clear set of procedures, techniques (tools) for analyzing data, which were
used for analyzing interviews about death and dying. As a result of the
process of open coding, which is a part of GT method of analysis, a set of
categories were defined and developed out of the data. During the process
of axial coding, categories were related to their subcategories on the basis
of their properties and dimensions. In the process of selective coding a
core or central category has been chosen and a coding for process helped
to achieve continuous, changeable and moving picture of the data.
4. Research results
This diagram shows a part of the result of first three mentioned
processes of coding.
Central category: Death & Dying COPING
Subcategories: RELIGION MEDICINE RELATIVES

Dimensions: - ritual - treatment - psych. help
- priest/nun - medicines - physical help
- God/higher power - medic. equipment - being/assisting
- Faith - staff - family
- Afterlife - medical org. - friends
Diagram 1: Coding process results
___________________________________________________________
To avoid reducing this presentation to a research report I will
focus now on the most important categories which have influenced the
most the process of building the grounded theory in this case. These are
two categories: religion and medicine. They are both in some way social
institutions, helping the individual to cope (each one in other ways) with
the phenomena of death and the process of dying. But before that I’d like
to show some sample ways of understanding death among group
researched.
Death:
• “Then, the new life starts, about which we don’t know much.”
(P5)
• “I don’t know, for me person comes into another stage of life and
that is normal, that someday body will be dust.” (S2)
• “After the death? Soul will go somewhere and body will stay in a
grave.” (P4)
• “According to what everybody says, what I read in this book
about life after death, that’s exactly what I imagine. Meeting a
lightning creature, first there is a tunnel and then the light and
you go into a different life.” (S5)
• “I think, well I don’t know how to call it; spirit or human
conscious or some kind of energy. I think it comes back to the
source, which is God’s energy, God’s mind, some kind of
wisdom, something like this. It unites. Body is physically
changed.” (S9)
• “I don’t know, I don’t know. If I had known, I’d have easier in
my life. That is a puzzle.” (F1)
As we see the category of death is closely related to the category

of religion, understood in a quite wide way. In some cases it’s hard to say
about religion, sometimes more convenient term than religion would be
spirituality. Those examples do not show the wide range of possibilities,
but they are the most frequent. Let’s see now some sample answers
categorized in the category of religion/ritual:
Prayer:
• “It can be that grandma suffers a lot, he will thank God that He
took her with Him. Because it will relieve her pain.” (P4)
• “A prayer for peace and averting wars and conflicts.” (F1)
• “He will pray a lot and through it, he will join her.” (S8)
___________________________________________________________
In the category of religion another very meaningful subcategory
is God or higher power. And as the analysis showed it’s also very
important and connected with death, and here are examples of
understanding God and its role in death and dying:
God:
• “Grief he may feel or that they didn’t care for him and hence
their child is dying, or that God punished him.” (P5)
• “Blaming God for taking his child.” (S5)
• "He has already agreed with God’s will.” (F1)
As it is shown in these examples God/supernatural power is

usually understood in the context of death as its source, Master who
punishes people with death, and who can be blamed of someone’s death.
By showing examples in these two categories death and religion I wanted
to indicate close connection between them. Nevertheless, religion is not
the only one factor helping people to handle the death and dying process.
The other one, equally important is medicine.
The analysis showed that both religion and medicine are
complementary factors in coping process. However, they are used together
at the same time in the dying trajectory very rarely. Institution used for all
the time of dying process is a family (relatives/friends). When
understanding the process of dying as a trajectory, started at the point of
having an awareness of being seriously ill (diagnosis) and finished with
death, then we may notice a turning point in defining ones own situation
(role) by the patient.
MED.DIAGNOSIS REDEFINING OF SITUATION DEATH
patient dying person
MEDICINE RELIGION
RELATIVES /FAMILY /FRIENDS
Diagram 2: Dying trajectory and coping factors used in Polish hospices.
In the first stage of the process of dying; started with the diagnosis,
patients’ major role in coping with the disease is a medicine accompanied
by family, then in the second stage (after the redefining the situation) in
___________________________________________________________
the place of medicine – religion is being used. Here are some sample
citations taken from interviews:
• “I don’t know, maybe its grandma and grandson, that’s what I

thought, didn’t I? She’s praying there, maybe she has the last
stadium of disease, or they are aware that there’s not much time
left.” (S1)
• “Here you can’t help, here only a prayer will help, nothing
more.” (P11)
• “If they’re dressed, standing over the grave only a prayer will
help.” (P5)
• “Here nothing can help. Nothing. Even a prayer won’t.” (P13)
• “Only this Holy Communion can…improve her health…well and
can, can…a miracle may happen.” (P6)
• “Surely they’re taking care of her, well spiritual sphere, she’s
getting Communion. Obviously, they’re praying. They feel that
she is ill, probably she’ll die, so to help her in a spiritual way
rather. And she’s thinking more about these matters related with
God, more than about herself in a physical way. “ (S15)
The turning point in the trajectory of dying is the redefinition of

the individual’s situation and the role, which is based on the effectiveness
of the factor used in coping process. The patient understands that medicine
with its prescriptions, equipment and highly specialized staff is no longer
effective in his or her case and turns to other institution which is religion
and which is estimated as more helpful in his/her present situation. This
point in the dying trajectory Anselm Strauss and Barney Glaser called
“nothing more to do” situation 6 . It is the situation when there is nothing
more to do for the medical professionals, there is no hope for the healing
and for good diagnosis for the patient or rather we would say for the
dying.
5. Conclusion
On the basis of the analysis of the data some general conclusions
may have been drawn. First of all, religion and medicine are
complementary factors in the individual process of coping death and dying
- that is on a micro level. Then - medicine and religion are equally
important in the process of coping with death and dying for the researched
hospice circle. Another conclusion is that individuals use
medicine/religion according to their subjective estimation of the situation
and the estimation of the effectiveness of used factor. And the last is that
using the specific factor is related with the redefining of the person's role
___________________________________________________________
(from the patient to the dying), that includes the expectations, the plans,
the goals and the estimated perspective, relations and ways of
communicating with others.
Notes
1
Peter Berger, The Sacred Canopy, (Anchor Books, New York, 1967),
107.
2
Ibid, 108.
3
Philippe Aries, Western Attitudes toward Death. From the Middle Ages
to the Present, (London: The John's Hopkins University Press, 1975), 88.
4
Steven Miles, ‘The Role of the Physician in Sacred End-of-life Rituals in
the ICU’, in Managing Death in the ICU, ed. J. Randall Curtis, Gordon D.
Rubenfeld (Oxford: Oxford University Press, 2001), 207-211.
5
Jon Prosser and Donna Schwartz, ‘Photographs within the sociological
research process’, in Image Based Research: a Sourcebook for Qualitative
Researchers, ed. Jon Posser (Falmer Press, 1998), 123.
6
Barney G. Glaser and Anselm L. Strauss, Awareness of Dying, (London:
Aldine Transaction, 1965), 204.
Bibliography
Posser, J. Image Based Research: a Sourcebook for Qualitative
Researchers, (Falmer Press, 1998).
Randall, J.C. and Rubenfeld G. D, Managing Death in the ICU (Oxford
University Press: Oxford, 2001).
Malgorzata Zawila is a Ph.D. student at the Institute for Scientific Studies

of Religions, Jagiellonian University in Krakow, Poland, and is interested
in sociological aspects of death, especially in social attitudes toward death
and dying and its religious elements. Her other subject of interest is
sociology of religion and contemporary religious changes including
privatization of religion and secularization.
Convenient Arrangements with Death
Florence Ollivier
Abstract
How does (or does not) a doctor accept to bring death to a
patient? How is the medical staff confronted with this moral problem? We
have studied these questions from the angle of deviance, in order to
understand how a doctor could practice ‘euthanasia’ even if there is an
absence of law, traditional medical ethics, or a request from a patient.
This paper is the result of a sociological study based on
interviews with twenty French doctors. Our study has focused on the
attitudes of doctors confronted with difficult decisions in the context of the
end-of-life. In our choice, we have tried to vary doctor’s specialities in
order to obtain a multiple context of the end-of-life situation (urban
environment, rural environment, hospital/ home). We have examined how
the question of ‘euthanasia’ is understood in accordance with the
speciality of doctors.
We have defined three stereotypes of doctor’s attitudes towards
the end-of-life situation, which are more or less well appreciated. A
distinction is obvious by the use of the drug treatment. Our results
demonstrate that euthanasia is practiced as much in hospital as at home,
but with different drugs and in different situations. These practices are
revealed to young doctors during their hospital training. However it is
quite perceived as a negative point for both doctors and the medical
profession, or it is tolerated as an extreme response to a limit of life.
To minimize deviance, doctors are brought to produce an
arrangement with this ‘secret’ practice within the medical staff. This
practice is tolerated in silence, by all in the profession. Furthermore,
doctors are led to a second arrangement that is a linguistic strategy.
Doctors rename deviant practices under a neutral label. The last
arrangement is the request of a consensus between all actors. Families
rarely denounce euthanasia, because it is often a result of consensus. A
denunciation of euthanasia is more likely to arise from a conflictual
situation within the medical staff.
Key words: medicine, decision making, deviance, practice of euthanasia,

France, consensus.
1. Introduction
In 2003, we were witnesses to the prosecution of a nurse who
was found guilty of killing six patients, and on the opposite side, Vincent
Humbert, 1 a 21-year-old man, was announcing his death to the Public. A
few months later, a couple of caregivers were arrested for having stopped
194 Convenient Arrangements with Death
___________________________________________________________
a patient’s life in a hospice. Death was coming into the open through the
media. A public sphere was created to speak about death in our society:
movies, prosecution and debates in media 2 were promoting these
questions of end-of-life 3 acts. For this reason, my present request to speak
about euthanasia with the doctors I had solicited was less of a surprise. 4
On the contrary, some of them were very talkative on this question of
legalisation. They were less forthcoming in revealing their practice in the
end-of-life. Our questions were how a doctor accepts (or does not) to put a
patient to death and how the medical staff is confronted with this moral
problem.
We have studied these questions from the angle of deviance, in
order to understand how a doctor could practice ‘euthanasia’ even if there
is an absence of law, traditional medical ethics, or a request from a patient.
As society knows deviance and tends to stigmatize this kind of
attitude to reaffirm the order of society. 5 Deviance is related to an
interactive relation. According to Becker’s approach, “We must see
deviance as a consequence of a process of interaction between people,
some of whom in the service of their own interests make and enforce rules
which catch others who, in the service of their own interests, have
committed acts which are labelled deviant.” 6
This paper is the result of a sociological study based on
interviews with twenty French doctors. Our study has focused on the
attitudes of doctors confronted with difficult decisions in the end-of-life
context. In our choice, we have tried to vary doctor’s specialities 7 in order
to obtain a multiple context of the end-of-life situation (urban
environment, rural environment, hospital/ home). We have examined how
the question of ‘euthanasia’ is understood in accordance with the
speciality of doctors.
This study presents a double interest. Firstly, there is still a lack
of knowledge on the medical practice of euthanasia and its conditions in
France. Secondly, studies on deviance in sociology are often about
minorities 8 . It is rare to have qualitative surveys on deviants’ attitudes in
entire professions (and in the dominant class). Therefore, our starting
question is about how a doctor is brought to put a patient to death in spite
of the law and official medical ethics?
2. Practice of euthanasia: a deviant practice or deviant doctors?

A. Forms of ‘euthanasia’
In the 1980s death was redefined by prioritizing brain activity
over cardiac activity. This new definition of death was legitimised in order
to remove organs. In this way, stopping machines of resuscitation for a
person with deficient brain activity is no longer described as a murder.
Florence Ollivier 195
___________________________________________________________
This form of ‘euthanasia’ is especially done in intensive care units when
doctors are confronted with the limit of life. The Law has recently allowed
this practice after consulting each member of the medical staff 9 .
This change has contributed to legitimise this practice and to
create a new label ‘stopping care’, but also goes on denigrating other
practices, which put an end to a patient’s life. Doctors tend to rename their
own practice to avoid being labelled as a deviant. For those ‘falsely
accused’, the distinction of label between ‘stopping care’ and ‘euthanasia’
is crucial. It especially concerns hospital practitioners. Their strategy is to
demonstrate that their decision is tolerated by all of the medical staff and
that it conforms to ethical positions.
Euthanasia is a brutal act... It is for this reason that is

experienced as a poisoning, a murder... but a decision
made with the staff... because we have some patients
with no solution to save them. It is not euthanasia... we
have done our best but as for this patient, we are not
able to save him. [Dr. A., women, in emergency room]
The more euthanasia is practiced in the quiet, with a distant

reflection and with ‘soft’ drugs, the more the practice is marked as
‘worthy’. The more a doctor is experienced in end-of-life decisions, the
more he will use a ‘soft’ method to practice euthanasia, or the more he
will feel he is acting in a ‘good’ way.
Doctors make distinctions between the dirty practice and the
clean practice in end-of-life, according to their own representations: a
dirty practice is close to ‘providing deliberate death’, and a clean practice
is closer to ‘stopping care’, or ‘to relieve a suffering patient’. However as
Mary Douglas has shown, the perception of what is dirty is correlated to
the position of observer.
This distinction pure/impure is also found through a classification
of drugs used for euthanasia. Drugs are more or less labelled as dangerous
for the patient (even if all drugs lead to death). The first group of drugs
labelled as ‘soft’ drugs are hypnotics, Valium. They bring patients into a
deep sleep, and so patients do not feel themselves dying.
The second group is an analgesic group, they ‘released patient
suffering’. The use of morphine for an act of euthanasia is more tolerated,
because the effect is slow and less brutal for survivors. The third labelled
negatively label is Chl. Its action is ‘brutal’ and ‘too speedy’. This last
drug is perceived as ‘impure’ for those initiated in the practice, because it
is also used for criminal execution in capital punishment. We have noticed
that the more a drug used in ‘euthanasia’ is tolerated, the more the act is
___________________________________________________________
labelled under another name more neutral than ‘euthanasia’:
‘accompaniment’, ‘stopping care’, ‘care in end-of-life’, ‘helping to die’,
‘sedation’, or ‘IVV’. 10
B. A Deviant’s Career
Becker‘s analysis helps us to understand social conditions for
pursuing a deviant activity. Becker demonstrates that a deviant practice is
not the result of a deviant actor, but an actor who is brought to practice a
deviant act. During his ‘career’, the deviant will develop a ‘culture’
coherent to his attitude.
According to this theory, a doctor will continue to practice
euthanasia on the condition that he has translated his attitude into a belief,
which brings coherence to his attitude. However, the system of
justification, or the ideology could be different to other deviant doctors.
Thus, deviant actors do not share the same value, or the same beliefs.
To neutralize the bad label (i.e. to consider euthanasia as a
murder), the doctor will use an ideology, or a system of auto-justification
and pass out his deviant position to qualify others as deviant. He stops
feeling guilty after having constructed a meaning of his activity. His
ideology gives him a ‘good’ reason to pursue. Some of deviants keep their
beliefs and no longer trust the official conventions. Good reasons are
supported by the feeling of satisfaction. It could come from the family. 11
Often, this group of doctors is far from the official organization called
Conseil de l’Ordre des médecins.
3. Doctor’s socialisation to death

A. It is known but it is not revealed
Euthanasia does exist in the hospital, 12 but it is never denounced
outside of the institution. The secret is shared by professional caregivers.
To terminate a patient’s life is ‘bad work’ for a senior doctor. This ‘bad’
task is generally delegated to the technician who could be the most
experienced nurse, a voluntary nurse, or also a doctor demonstrating for a
young graduate student. This act is a severe test for caregivers, 13 until they
give a reason to themselves.
These practices are often revealed to young doctors during their
hospital training. Usually, the senior doctor prescribes or has his staff
understand that a patient should die, because he can no longer be saved.
This kind of decision, made after a ‘consensus’ decision has been reached,
is followed by an implicit message, which any care-givers who are in on
the secret know the meaning. It could be written with an acronym, or it
could be suggested by some looks or words. A nurse explained that:
___________________________________________________________
Doctors speak to nurses, or caregivers, he knows well.
Everyone knows, but no one speaks honestly. He looks
at you, starts to say: ‘Well, he is not well. We should
start a drip.’ And you reply ‘ok’. Then we do it, and
that’s enough.
Doctors do not say more, nurses seem to understand the implicit

message. They have also learned to locate and translate ‘the death
cocktail’, or ‘D.L.P.’ prescription.
All share in this experience, but rarely do people speak about it.
This practice is tolerated: known and shared by all in the profession. As
the anthropologist, Jean Jamin, said: “the knowledge of secrets supposes
or implies knowing how to keep quiet which defines a power-to-say.” 14
Doctors and nurses internalize this norm of secrecy for their socialization.
Revealing the secret is to break the frontier between being initiated and
non-initiated. 15
B. Role of hospital
Death is not taught at school, or even officially at the university.
More than death, it is the dying process which is taboo in our society. I
mean that death is less hidden than the process of dying. The moment of
death is hidden as an impure moment or as a ‘private’ moment for the
individual.
Scientists know the birth process, and even teenagers learn this in
detail at school. They even learn how humans reproduce. It is not the same
for the dying process. That means that dying is still a mysterious event for
people and they more lack knowledge about it, especially since death is
professionalized. 16 Further, our contemporaries have lost their popular
knowledge of the signs of death. They no longer know how to detect signs
of approaching death, as they did when people died at home. They have
become dependant on professional’s experience and expertise. It is quite
the last “knowledge” resistant to the disillusion of the world 17 , and so, it
leaves a place for other interpretations and beliefs around this ‘natural’
event. In this way, even some GPs don’t know how people die, or how to
practice euthanasia. This group of GPs comes more from urban areas.
Anaesthetists are known to be experts in the dosage of
neuroleptics. This medical figure controls techniques in order to put
patients to sleep, to resuscitate and also has the power to save or kill them
with their chemical drugs. In addition, this speciality dominates others
specialities in the medical hierarchy. They should be well placed to give
an advice on the procedures to perform euthanasia. For instance, Dr. M., a
___________________________________________________________
GP in Belgium, had never been socialized to euthanasia in hospital, and
she had never been involved in it before the law allowed it.
I had to ask about the meaning of a death cocktail... in

general, it is asked to anaesthetists. [Dr. M., women, GP
in town]
C. Strategy for providing the necessary drugs

We could think that the status of being a doctor is enough to
obtain the drugs in order to perform euthanasia, but it is not so easy.
Paradoxically, these drugs are frequently used in intensive care units in
order to resuscitate patients. Therefore, hospital chemists can only provide
them. This implies that doctors, who conduct euthanasia with ‘soft’ drugs,
should be in contact with the hospital, or else they have to use so-called
‘bad’ drugs. In fact, the GP’s means are reduced to basic analgesic drugs.
As we have said, this group of drugs is less effective for practicing ‘soft’
euthanasia. Therefore, either the GP sends the patient to a hospital, he uses
‘bad’ drugs, or he is included in the hospital networks and obtains drugs
from an accommodating colleague.
To perform euthanasia or to give death to a patient, especially for
a GP, is not easy. As one doctor says:
As doctors, we learn to save lives, but not to give

death... I once used Valium, and as I was a novice, I
thought everything would well... and then I realized it
was taking too long. I thought she was weaker. I put
myself in an awkward situation. I thought it will go on
fast with Valium. I used that because I had nothing
handy. It would work because it did not take time, it
wasn’t painful for her. She was sleeping deeply. But if I
had to do it again, I wouldn’t do it like that. [Dr. M.,
man, country GP]
One GP takes advice from another GP who is said in the professional

circles to practice euthanasia:
I receive regularly a ring from doctors who ask me what

I do, what kind of drugs I use. [Dr. H., man, country GP]
___________________________________________________________
4. Consensus is required
A. The lack of social control
Stories of doctor’s prosecution for euthanasia in newspapers
contribute to social control. Doctors increase their vigilance; those who
are occasional deviants, and those who experiment with euthanasia know
that the social control is weak.
While euthanasia is forbidden in France, there should be more
controls on death in hospitals, or more autopsies. But an investigation has
shown that the number of autopsies has decreased. 18 Moreover, chemists
should control the reason for prescriptions, but there seems to be
connivance between professionals. 19
Moreover, we may see a compassionate view from judges in
most cases of the murders of disabled persons, or of the sick. They are
rarely convicted or if convicted, they are released due to the benefit of
tolerance. The murder is considered to be committed in a moment of
distress. 20 Either a parent could not take sole responsibility for a disabled
child or a spouse who is extremely ill. This brings to mind Memmi’s
analysis on the evolution of the decline of penal control on the regulation
of the body. Individuals seem to be free to consume their own
reproductive or disease-bodies without strong outward control.
B. A triangle of dependence around death

Despite a lack of penal control, doctors tend to convince all care-
givers, and also family members that their act is ‘good’, with regard to the
situation. For a decision concerning end-of-life, the favourable opinion of
all persons involved (family, nurse) is necessary, because there is a risk of
denunciation. Doctors are constrained to listen and take into account all
opinions, and try to reach a ‘consensus’.
But when everyone agrees, there are no more problems!

[Dr. A., women, in emergency room]
In a recent case, a doctor and a nurse were accused of killing a

patient, but the reasons were that they had done it alone, without asking
the medical staff. Beyond the form of euthanasia, deviance concerns the
way of doing it. Furthermore, in this case, the denunciation arose from
colleagues and not from the family.
A denunciation of euthanasia is more likely to arise from a
conflictual situation within the medical staff, under a conflict of value.
The patient’s death is the source of a power conflict where the survivors
try to bring forth their values and their needs.
___________________________________________________________
Even if last wishes are pronounced, they could be changed in
regards to a family agreement. That means families take a part in decision-
making. An end-of-life negotiated by the patient could only take place in
the case where all the family and doctor agree with his or her decision. In
this way, the patient is dependant on survivors.
5. Conclusion
So what are convenient arrangements with death in an end-of-life
situation? Firstly, doctors make an arrangement “between themselves” and
with nurses to keep this practice secret. This practice is tolerated in silence
by all in the profession. Secondly, there is a convenient arrangement
around a linguistic strategy. Doctors tend to avoid a practice being
labelled as a deviant one by renaming it with a neutral label. Thirdly,
consensus seems to be required as a magic solution to a deviant practice in
medicine.
Further studies can explain more fully how consensus comes up
in the triangle of dependence around the dying patient. ‘Consensus’ is
beginning to be a new obligation for professional caregivers, even if they
had already been constrained to have it before the law was passed.
However, by consulting families and patient’s wishes, it remains to be
seen what doctors will hear, or what families and patients could say.
Notes
1
After a car injury, Vincent Humbert became quadriplegic, blind and
dumb for four years in a hospital. He was the co-author of Je demande le
droit de mourir, (Paris: Michel Lafon, 2004).
2
Between the end of 2003 and 2004, there was a surge of debates on
euthanasia and palliative care which opposed Marie Humbert and Dr.
Chaussoy to medical ethics, added to journalistic comments, a series of
movies (C’est la vie, J-P. Ameris, 2002; The Barbarian invasions, D.
Arcand, 2003 ; Mar adentro, A. Amenabar, 2004; Million dollars baby, C.
Eastwood, 2005) came out the same year. It was public incitement to a
‘reflection’ on end-of-life with a normative background.
3
In this article, we will use the concept of end-of-life in a large meaning.
This concept will include all situations in that patients are, conscious or
not, suffering from a chronic disease or suddenly dying. For instance, few
patients are rapidly confronted with death in case of bleeding.(throat
cancer, patient with an insufficient heart condition.) or in instability
cardiac condition.
___________________________________________________________
4
This paper is the result of an investigation led between 2003 and 2004 in
France.
5
Marc Augé, Le sens des Autres. Actualité de l’anthropologie. (Paris:
Fayard, 1994), 95.
6
Howard Saul Becker, Outsiders: Studies in the Sociology of Deviance.
(New York: The Free Press, 1973), 163.
7
Our sample is composed of eight country GPs, five anaesthetists in
intensive care units, three doctors in emergency rooms, two doctors in
palliative care, one cardiologist, and one doctor in geriatrics.
8
H.S. Becker’s studies were focused on marijuana smokers, and the
community of jazz musicians.
9
See Law 22 April 2005 ‘Loi relative aux droits des malades et à la fin de
vie’.
10
Interruption volontaire de la vie (termination of life). This acronym is
deliberately close to IVG (abortion, termination of pregnancy).
11
Care-giver could be thanked, or receive flowers.
12
See E. Ferrand. ‘Withholding and withdrawal of life support in
intensive-care units in France: a prospective survey’, Lancet, 357, (2001)
9249. According to this study, 88% of ‘stopping care’ results from a
unique medical decision.
13
See A. Paillet, ‘Consciences professionnelles, approches sociologiques
de la morale au travail à partir des cas des décisions d’arrêt ou de
poursuite en réanimation néo-natale’, thèse de doctorat de sociologie à
l’EHESS ss dir. Cl. Herzlich, 2003.
14
Jean Jamin, Les lois du silence, essai sur la fonction sociale du secret.
(Paris: Maspéro, Dossiers africains, 1977), 43.
15
Although the interviews were anonymous, only a half of sample
declared to me that they have been personally confronted to euthanasia by
having performed it. That characterizes the importance of secret around
this practice in end-of-life.
16
Annick Barrau, Humaniser la mort: est-ce ainsi que les hommes
meurent? (Paris: L’Harmattan, logiques sociales, 1993), 9.
17
Max Weber, Le savant et le politique. (Paris: 10/18), 63.
18
Claude Got, Les autopsies remis au secrétaire d’Etat à la santé et à la
sécurité sociale, (Sicom, 1997), 68.
19
Laure Patrick, Caroline Binsinger, Les médicaments détournés. (Paris:
Masson, 2003), 111.
20
1996: accused J-M. Préfaut to have poisoned her autistic-girl, a two-
year suspended sentence.
1998: Dr. Duffault is released
___________________________________________________________
1998: A. Pasquiou on her boy, a three-year suspended sentence

2004: E. Bendayan on his Alzheimer-wife, a two-year suspended sentence
2006: M. Humbert and Dr. Chaussoy, discharged from lack of evidence
Bibliography
Arborio, Anny-Marie, Un personnel invisible : les aides-soignantes à
l’hôpital. (Paris: Anthropos, 2001).
Baudry, Patrick, ‘De la mort à la disparition’, in Savoir mourir , ed.
Christiane Montandon-Binet (Paris: L’Harmattan, Nouvelles études
anthropologiques, 1993), 211- 217.
Douglas, Mary, De la souillure. Essai sur les notions de pollution et de
tabou. (Paris: La découverte et Syros, 2001).
Memmi, Dominique, Faire vivre et laisser mourir. Gouvernement
contemporain de la naissance et de la mort. (Paris: La découverte, Textes
à l’appui, Politique et sociétés, 2003).
Florence Ollivier is a Ph.D. student in Sociology at Ecole des Hautes

Etudes en Sciences Sociales in Paris. She receives a grant from Institut
National du Cancer in order to achieve her study on thanato-politics in
Europe.
Death and Funerals in Sunni Communities of Turkey
Reyhan Varli Görk
Abstract
This study discusses the perception of death and funerals in Sunni
Moslem communities of Turkey whilst evaluating Islamic culture and
urbanised society. The main theme is to understand the attitudes of the
urbanised Islamic Sunni society toward the death phenomenon in
metropolitan cities provincial towns particularly in Ankara and Marmaris.
Emphasis is placed on changes in attitudes over time, in the light of
comparisons between Ottoman and modern Turkish culture. Graves,
tombs, tombstones, epitaphs and cemeteries are also discussed from the
viewpoint of Islamic culture. With these objectives, the study begins with
the analysis of the concept of death. In order to carry out the study, a
method approaching the subject from four disparate points has been
employed. First, literature was surveyed to gain an understanding of the
meaning of death in present-day society. Second, the Islamic canon was
reviewed with regard to the death phenomenon. Third, reflexive narratives
originating from personal observations as a participant in the funerals of
my family members’ were employed in this study. The fourth and last
field of research includes field observations and photographs from
Karşıyaka Cemetery in Ankara, and copies of photographs from several
other sources in order to identify the divergence of the modern from
traditional. The major verdict of this study is that in modern Islamic
culture, in contrast to its earlier traditional evaluation, death is
sequestrated from social communal life and assigned to the status of an
institutional event.
Key words: death, funerals, cemetery, tombstone, Islam, modernism,

urbanised society.
1. Introduction
The aim of this study is to analyse the perception of death, and
the actions performed for the deceased in urban communities considering
themselves Sunni Moslems living in Ankara and Marmaris.
Through visits to the Karşıyaka Cemetery, affiliated with the
Ankara Metropolitan Municipality, I have attempted to observe attitudes
of members of the present-day Turkish urban community regarding death,
the procedures followed death, burial procedures, graves and gravestones.
As interview with the relatives of the deceased might be deemed
offensive, frequent use of participant observation has made use of. In a
manner not common in academic literature, my personal experiences of
the decease and funerals of parents and brother are inevitably reflected in
204 Death and Funerals in Sunni Communities of Turkey
___________________________________________________________
this study. In addition, perception of death in hospitals and death at home
will be included in this study.
2. The Perception of Death

Death ends human life, and no one can experience death without
his/her own death. This may account for why death is frequently perceived
as a phenomenon befalling others. Death is the only ‘absolute
nothingness’ defiance and revolt against life, therefore all living people
endeavour to find immortality in modern medical sciences.
If death comes to an old aged person because of an illness, people
are somewhat able to console themselves. Visitors to the patient do not
refrain from saying ‘may God give one of two goods” to the relatives of
the patient or even to the patient. This phrase means; if there is no way of
recovering from an illness, death is a salvation from continual suffering.
Here, there is a reference to divine might. In traditional and Islamic
discourses, death and life are not opposites but complements of one
another. In an article of Department of Religious Affairs, 1 death is
described as:
… the most effective advice and the biggest warning. It

is impossible to escape death ... People who are in bond
with the Great Creator, see death as an instance of
reunite. Death turns to be ‘şeb-i arus/ night of wedding
as Mevlana 2 proposes.
As it evokes death, the thought of being a tiny spot in the

universe is unbearable to man. 3 At this moment, the meaning of the world
constructed within daily life is abolished. The orderly relationship with
things and people is disintegrated. 4 I remember my grandmother at the end
of her life at eighty-one she reflected the disintegration between her self
and material objects in sentences such as:
I want to buy a new cardigan but I lived enough, I don’t

want to cause needless expense. But I don’t die either!
3. Death at home and death in hospital

When death takes place at home, it is almost exhibited; separated
in small parts and stages. It is not possible to know exactly when - with
the loss of consciousness or with the last breath - death occurs. 5 Five
hours before the decease of my mother, just after her loss of
consciousness, my grandmother visited us. During this visit, my
grandmother stood behind the head of my mother, whose bed has been
Reyhan Varlı Görk 205
___________________________________________________________
positioned facing Kıble (the direction of Mecca) ten days ago, and read
passages from Qur’an and dampened lips of my mother with Zemzem -
holy water from Mecca. I emphasize the position of my grandmother as it
relates to her religious and traditional beliefs. Accordingly, a mother does
not stand in front of her child who is about to die; this is to defy God and
equivalent with demanding a return of the ‘helal’ - canonically lawful-
milk she has provided to her child.
As the illness of my mother become more serious, there was an
increase in the number of people who visited us to express their wish “get
well soon”, but actually, they were all there for ‘helalleşmek’; to forgive
and be forgiven by the soon to be deceased.. Even rarely met people
visited us to express their best wishes for health and good appetite.
In urban part of Turkey, although the occurrence of death in
hospital is getting more common, hospital authorities inform the relatives
about the impending death of patients. Doctors of the state university
hospital in İzmir told us that my mother’s life expectancy was around
fifteen days and we, her family, were allowed to take her back home if we
deemed it appropriate for her to die at home. In such circumstances,
families face a dilemma: taking the patient to the home to let all the
relatives say their farewell but at the same time impeding her stay in the
hospital and annulling the chance of living for a longer period of time. My
entire wish during the journey back to Marmaris was to get her home
while she was still alive.
Similar to my mother’s death, in spite of his exhausted body
following a one and half year cancer cure program, my father was released
from a state hospital in Ankara. Since I was working and it was not
possible to take care of him properly at home, I decided to take him to a
private hospital. It was interesting that despite his diagnosis, operations
and all the cure programs, the authorities of this private hospital claimed
“the patient’s health is in very good condition, but feels ill psychologically
and is well enough to self-sustain him and even go shopping”, and
released my father. Despite these claims, one day later my father passed
away in sleep at night. Some time afterwards I was informed by a health-
care authority that both state and private hospitals are very careful about
not to accept critically ill patients and this was mainly because of their
motivation to reduce the rate of ‘ex’ or ‘dead’. According to this view,
“the reason of decease is the unsuccessful cure program of the hospitals.” 6
After a death at home, one of the elderly members of the
household ties the chin and toes before the body cools. The necessity of
this act is explained by keeping the joints together and prevention of
drooping of the chin. The corpse is laid down facing upward; the arms are
joined on the belly and covered with a sheet in a way such that all the
___________________________________________________________
body including the face is under the cover. A steel knife is laid lengthwise
on the corpse and metal coins are put on the eye lids as it is traditionally
done in many places across Anatolia. This knife is believed to prevent the
body from swelling up and the coins keep the eyes shut. If the burial is to
take place in the day following the decease, relatives and friends do not
leave the corpse alone, but stay with the corpse and keep the lights open. 7
If the decease takes place at home, washing of the dead body, the
first step of the funeral may also be done at home. For this purpose, a
wooden couch is placed either in the garden or balcony and the sides of
this couch is covered with sheets or curtains to limit visual access.
Nowadays, there are ready packages sold by funeral companies, which
include the necessary materials for funeral procedures. In these packages,
there are soap, washcloth, two towels for body and head, a bowl, a piece
of cotton and shroud for winding. After the water is heated, the corpse is
laid down on this couch with the sheet on it. The procedure continues as
follows:
The corpse is washed by someone who is a relative or is

experienced about washing. The washer expresses the
statement of intention (niyet) and begins washing.
However, there is no need to wash children who are not
adolescent according to Islamic definitions. Men wash
men and women wash women. A woman may wash her
husband, but according to Hanifi doctrine a man shall
not wash his wife. 8
During the washing of my mother, the washerwomen did not take

the cover off throughout performing the washing with their hands under
the cover. Thus, they prevented corpse to be seen by both themselves and
the others and ensured that they were in line with the principle of Islam,
which states that the corpse should be secluded during the wash. After the
washing, the dried and covered corpse is laid out over shroud cloth. The
washers invite the same-gender friends or relatives of the deceased to join
in the shrouding procedure. I, as the only daughter, was persuaded to
participate in this procedure. The only thing I remember is that the
participants lined on both sides of my mother holding one piece of the
shroud with both hands also before covering with the shroud, participants
holding a piece of shroud in their hands pretending to cover three times,
before finally covering the body. The essential thing was that I should not
cry, since it was said that even one drop of tear on the shroud would
torment the soul of my mother. Mourning has become something to be
___________________________________________________________
ashamed not because it means to resist the fate in Sunni communities but
also means madness in modern societies.
After washing and shrouding, the burial process is started with
the application to the municipality with the “death certificate.” The
municipality funeral vehicle or ambulances from private funeral
companies carry the corpse to the mosque for the funeral praying in a
coffin. When my mother was taken from home to vehicle, I was told to be
silent. Why? Because her soul would feel hurt! In those years, in towns,
women did not generally go to the mosque or attend the burial. After a few
hours, I felt a pain in my chest. The reason for this pain was a cord tied
very tightly just below the chest called “nerving belt.” This was supposed
to help me to preserve my fortitude.
I did not mourn loudly in response to this experience at twenty-
three, either because of the shock or because I was so persuaded.
However, four years later at the funeral of my elder brother who passed
away due to a heart attack fifteen days after the decease of my father, I lost
all fortitude. I was told later that everybody thought I had gone mad.
Shouting and braying in the middle of cemetery, “There is no God! If
there were, all this could not happen!” could not be attributed to anything
but madness.
After death started to occur in hospitals, it ceased to be something
of spectacle. In fact, to die in a hospital setting has also become an
indicator of status and level of consumption. In a recent funeral I attended,
a relative of my friend who had lost his father, was remarking: “Thanks to
the money his son provided, he lived up to now, otherwise he would have
died a long time ago.” On the other hand, the son of the deceased, my
friend was remarking: “I am at peace with my self. Everything that could
be done was done until the last moment. This is my only consolation.”
4. The funeral and the funeral prayer

As is known, in Islam every prayer is performed upon a call for
particular azan (Moslem call to prayer). A funeral prayer performed in
accordance with this purpose is described below:
A Muslim child, when born, is taken in to arms of a man

with ablution, who turns towards the direction of Mecca
with the baby’s head to his right, and whilst standing
calls the azan of this new Moslem life. Taking the head
of the child to his left, calls Kamet (an azan peculiar to
funerals), and names the child... When this child dies,
only Moslem men perform the funeral prayer of this
call, standing and as a group. 9
___________________________________________________________
For the last five years, in Turkey women attending funerals may
also be observed performing the funeral prayer. There is no criticism or
aggression about the participation of women to funeral prayer, neither at
individual nor institutional level. The matter of debate is essentially about
the place occupied by women relative to men in the funeral prayers.
Indeed, a woman performing the funeral prayer in front of a man is held
responsible for undoing the prayer of that man. 10
According to Islam, some preconditions exist for the dead person
to be eligible to a funeral prayer. The most important precondition is that
the dead person be a Moslem. To perform a funeral prayer for people who
are non-Moslem, is deemed as disrespect to their memory.
After the funeral pray, accompanied by the relatives and friends
of the deceased, the coffin is taken to the cemetery for burial by the
funeral vehicle or ambulance. Generally, silence prevails among this
group, but if the deceased is someone with a political persona or the cause
of death is murder committed under suspicious circumstances, the
participants chant slogans from time to time. Even though these kinds of
rituals are not found strange by urban society, religious authorities
emphasize that these rituals are not in harmony with Islamic practices.
In urban societies where people are increasingly alienated to each
other, funerals are announced to relatives and friends by obituaries
published in newspapers rather than the ‘Sela’ - an announcement made
by the masque about the death of the deceased. It’s not surprised to see
‘lively’ relatives acting as the host of the funeral going around the
courtyard of mosque introducing people to each other, then moving on to
the next group of people after a chit chat of a few sentences to host the
others.
A. The burial of the corpse

The corpse, which is carried to cemetery after the funeral
ceremony and prayer in the mosque, “is carried to the place of burial in the
coffin which is a wooden chest with four handles on the shoulders of those
close to the deceased,” 11 then the corpse is taken out of the coffin to be
placed in the hole dug in the ground. In these burial ceremonies, laying the
corpse inside or outside of the coffin in a position of sleep has become a
tradition. According to Islamic practices, the corpse is laid down on
his/her right side facing the direction of Mecca/Kıble. It’s an old tradition
for those participating in the burial to shovel at least one spade of soil on
the gravel, to give money to the poor nearby and to cook halva (either by
flour or semolina) in the evening for distribution in the neighbourhood.
Traditionally, a religious relative of the deceased or an imam
reads passages from Qur’an. After the burial, the participants express their
___________________________________________________________
condolences to and wish fortitude for the relatives of the deceased. They
express wishes such as “May your life be spared” or “God give long lives
to the remaining”. After the burial, no further time is spent in the
cemetery, those close to the deceased mostly go leave for the home of the
deceased.
B. Rituals after the burial of the corpse

Either after having the burial of the corpse, halva made with flour
or semolina is prepared for those who come back to home of the deceased.
People other than the first-degree relatives assume this responsibility to
spare them the commotion. It is generally the bride who cooks and serves
the halva. Grooms go after any necessary shopping errands. Nowadays,
major restaurants prepare special menus for funerals. The family of the
deceased eats and drinks together with those who came for condolences.
During the meal, some proclaim “may it touch the soul of the
deceased/rahmetlinin ruhuna değsin.”
Afterwards, a religious attendant reads passages from the Qur’an.
As most of the women are unprepared they hurriedly cover their heads.
One of the women of the home of the deceased distributes headscarves.
After reading passages from Qur’an, people start to pray, pronouncing the
deceased’s name and pleading for forgiveness for his/her sin. The name of
the deceased’s mother is pronounced with emphasis as only the mother
can be known with certainty in early ages.
On the evening of the burial, and the seven days following, the
deceased is commemorated with similar rituals. People pray and
especially read passages from Qur’an; sometimes ‘mevlit’ is also read.
Lemonade which is a sugary drink and Turkish delight and sugar candies
in the packaging of well-known patisseries - in past times wrapped in
paper cones - are served. The aim is the symbolic exorcising of the
bitterness of death through their sweetness. ‘Mevlit’ 12 is generally read on
the fifty-second day of the decease is read on the fortieth and fifty-second
days after the burial. In Western Anatolia, especially in Marmaris, on the
fortieth day a dessert with honey or sherbet (lokma tatlısı) is served. In
Mevlit ceremonies, women and men sit in different places- if it takes place
in the home of the deceased, in different rooms. Mevlit ceremonies which
may be organized at any time of the year and especially after burials are
read by an imam or by a religious volunteer. 13
The home of the deceased continues to be visited in the days
following the burial. Neighbours and relatives bring meals for the family
of the deceased for ten to fifteen days. During these visits of consolation,
especially in western Anatolia, the guests bring granulated or lump sugar
to symbolically help to family disperse their bitter sorrow. In rural areas, if
___________________________________________________________
the guest owning cattle will also bring fresh milk. In my opinion, the
“clean-whiteness” of the milk and its being the first foodstuff of life is a
symbolical invitation to a life after darkness of death.
5. Cemeteries as a space
In Ottoman cemeteries, until the nineteenth century, practices
similar to western practices of graves and cemeteries may be observed.
The shift in the cemetery culture of Ottoman Empire took place after the
nineteenth century. In the present day, cemeteries are situated far from
cities either because of economical necessities or ‘city planning’
principles. But in big cities like Ankara, or even in small towns like
Marmaris, cemeteries, which were initially intended to be far outside the
city are again becoming situated inside cities because of the haphazard and
rapid growth of these cities.
As is the case with almost all municipally-owned cemeteries, in
Ankara Karşıyaka Cemetery there are wash rooms, mosques or ‘mescit’s,
a large area for funeral praying, and ‘musalla taşı' - a stone used as a table
on which the coffin is temporarily placed - kept ready for the funeral
prayer.
A. Graves and Gravestones

Even before Islam, in Turkish culture corpses were buried in
‘taşhöyük’ graves which are round hillocks of six to seven meter diameter
with holes opened up at the ground level. 14 Unlike Islamic practice, in
these graves, “corpses were positioned in east-to-west direction, not facing
the Kıble, direction of Mecca” 15 , instead the “head is positioned either to
the east or to the north.” 16 The first Moslems and religious men “strictly
opposed to the building of gravestones to prevent idolatry, but tolerated
stones to be put on graves to protect the corpses from wild animals. More
moderate ones, allowed within limits the use of simple gravestones made
with non kiln-dried bricks.” 17
Later on, especially after tenth century, “along with the building
of mausoleums of important by people for themselves, graves which are
not in line with Islamic tradition re-appeared.” 18 Because of this change in
grave culture in Moslem societies, it is not possible to talk about a single-
type Islamic grave culture. Instead, “there arises the necessity of
introducing distinctive Egyptian, Persian or Turkish grave cultures
resulting from interaction between Islamic practices and local
traditions.” 19
Accepting the interpretation of Ottoman gravestones as abstract
symbols of man, it may be asserted that this tradition stems from Central
Asian Turkish Shaman practices. 20 In Ottoman grave culture male grave
___________________________________________________________
stones are more dominant. It is also possible to identify gravestones as
belonging to men or women from the stonework. 21 On present day
gravestones such a distinction is not easily made without reading the
names on the gravestones. It may be observed in Karşıyaka Cemetery that
all the graves are similar to each other. Most of the graves seem like to
have been made by the same worker or as copies of each other. The
primary work of marble workers situated on the ways both inside and
outside the cemeteries is to make graves and gravestones. For urgent
orders, they have pre-made stones of standard dimensions, everything
including the writing of “Ruhuna Fatiha/Pray for the Soul” is ready except
for the name and the birth and death date of the deceased.
‘Head and foot stones’, the basic constituents of Ottoman graves,
are sometimes not erected separately on the cover stone but, “like a
sarcophagus placed on the stones covering the grave so as to form a
unity.” 22 Modern graves as seen in Turkey have solely a ‘headstone’. The
rest of the grave has evolved in to rectangular boxes, usually made out of
marble, with centres filled with soil, serving as flowerpots. These
rectangular boxes remind us the traditional garden of the Persians which
was a sacred space that was supposed to unite four separate parts within its
rectangle, representing the four parts of the world. 23 The garden is the
smallest fragment of the world and, at the same time represents its totality.
This fragment, eventually to be owned by each person, also has an
economical value. The price of a plot, according to the January 2006
tariffs of Ankara Metropolitan Municipality is 275YTL/137€/£93.
However, the purchase price of plots bought in advance by people with the
apprehension of having no one to bury them after their death and to be
buried in a ‘cemetery for people with no one’ or as a family burial place is
6600YTL/3300€/£2237 .
As a tradition, still, only one person is buried per grave. Von den
Driesh, ambassador of Vermondt to the Ottoman Empire during 1719-20,
expressed his surprise that “there are extraordinary number graves in the
courtyards of the mosques, because of their tradition of separate graves per
one dead.” 24 As an exception, a women and her child may be buried into
the same grave according to Islamic traditions. Laquer 25 points out a
gravestone which belongs to a women who died during giving birth, and
thus deemed a martyr is buried in the same grave as her child who died
with her. Even for couples who have deeply loved each other and whish to
be buried in the same grave; it is against Islam. According to Islam, the
reason for this prohibition is that the religious wedlock between spouses
ceases with death.
Thus, couples may not be buried together as they become
‘namahrem’ (i.e. a woman and man not of first degree relationship or
___________________________________________________________
married to each other and therefore not allowed to share the private sphere
of life).
B. Cemetery visits
Before visiting the cemeteries Sunni Moslems still have a wash
‘boy abdesti/ablution’ according to Islamic practices and women cover
their heads with headscarves. Cemeteries may be visited on any day of the
year, but in Islam, it is especially day before the religious bairams. People
take flowers, or as in Marmaris branches of myrtle, believed to be holy, to
put in the vases at the foot of graves. It is also common to take flowers to
funerals. Wreaths prepared for this purpose are readily available in flower
shops, or indeed may be ordered online. The aim of cemetery visits before
bairams is to symbolically celebrate the bairam with those who have
passed away to the ‘other world’. Due to the sacredness of the day, people
read either the prayer of their ‘hatim’- a previous complete read of Qur’an-
or the Sura of Yasin from the Qur’an. Also in compliance with the request
written on the gravestones ‘RUHUNA FATİHA/FATIHA FOR THE
SOUL’, they read the Sura of Fatiha. Writings on gravestones requesting
for a prayer reflect a tradition extending back to Ottoman grave culture. 26
Traditionally, it is suggested that one should not walk or stand on
the graves and complete the visit standing-up. Nowadays, children are not
seen in burial rituals and even at cemetery visits. In 1970s, during my
childhood, children were taken on cemetery visits at least on the day
before bairams. Particularly my grandmother used to take all her
grandchildren to the cemetery to help her in cleaning and watering of the
graves. In complete silence, somewhat bored, but excited by doing
something different and happy that, according to my grandmother, we had
gained some ‘sevap’—credit awarded by God for good deeds—we would
complete the visit.
6. Conclusion
To make an interpretation on how Sunni Moslem society
especially those who live in cities view death and the subsequent funeral
arrangements in today’s Turkey; it may be stated that there change has
occurred since Ottoman Times. Some people, despite their lessening faith
ensure a religious funeral for their relatives and friends. Perhaps the
refrain from funeral rites outside those sanctioned by the Islamic tradition
to preserve the esteem their nearest are held in, on their final journey.
Even people without faith, are left in a position of being the organizer of
an ‘Islamic Funeral Ritual’ as their deceased relative is a Moslem and
would want to be buried in accordance with the Islamic tradition.
___________________________________________________________
To conclude; it seems true to say that these changes point to an
accelerating trend in the social institutionalization of death. Through this
transformation, both death itself and funeral rituals are producing a
services sector within organizations and establishments. In view of all this,
it may be observed that funerals, the last social rituals in which people
participate, will evolve into mechanistic, ever-rationalized and
commercialized procedures participating in the societal division of labour.
Notes
1
‘Cenaze İle İlgili Bazı Uygulamalar’ (Some Practices about Funerals),
22 September 2000, (03 June 2002).
<http:// www.diyanet.gov.tr/makaleler/cenaze.html >
2
(06.06.2006), <http://www.mevlana.net/>
“Mevlana who is also known as Rumi, was a philosopher and mystic of
Islam, but not a Muslim of the orthodox type. His doctrine advocates
unlimited tolerance, positive reasoning, goodness, charity and awareness
through love. To him and to his disciples all religions are more or less
truth. Looking with the same eye on Muslim, Jew and Christian alike, his
peaceful and tolerant teaching has appealed to men of all sects and
creeds.”
3
Yaşar Çubuklu, ‘Ölüm Üzerine Spekülatif Düşünceler’, Defter, 1, 2
(1987), 72-77, 75.
4
Çubuklu, 76.
5
Phlippe Ariés, ‘Yasak Ölüm’, Defter, 1,2 (1987), 78-94. p. 80. [‘Yasak
Ölüm’ The last chapter of ‘Batı'nın Ölüm Karşısındaki Tutumları’ by
Philippe Ariés, Western Attitudes Toward Death (London, Baltimore: The
John Hopkins University Press, 1974)].
6
Ariés, 80.
7
According to traditions burial should not be left after mid afternoon time.
8
Ana Britannica, Volume 7, s.v. ‘cenaze yıkama’ (İstanbul: Ana
Yayıncılık A.Ş., 1994) p. 377.
9
Münif Çelebi, Kuran Dili ve Alfabesi ve Okuma Kaideleri, Tecvit ve
Namaz, (Ankara: Balkanoğlu Matbaacılık Ltd. 1974), 57.
10
Diyanet İşleri Başkanlığı, (Religous Affairs) 03 June 2002,
<http://www.diyanet.gov.tr/dinibilgiler/nampage.html> "... Be it Friday,
Religious Festival or funeral prayer, if women are going to participate in
the group of prayers, they should be situated in a suitable place separated
from that of men. Indeed, Prophet Mohammed organized the prayer group
as the men standing in the front part followed my boys and then women.
___________________________________________________________
Otherwise for Hanefi (a Moslem sect), if men is situated behind women

during a prayer, the prayer of the man is undone and the women
responsible for that is deemed to commit a sin.”
11
Ana Britannica, Volume 24, s.v. ‘cenaze töreni’ (İstanbul: Ana
Yayıncılık A.Ş. 1994) p. 303.
12
“… a work in Turkish and Arabic Literature composed of 730 verses in
‘mesnevi’ style narrating the birth and life of the Prophet Mohammed with
praise and written by Süleyman Çelebi in the years between 1409 and
1410 with title Vesid. letü’n Necat” Ana Britannica, 22nd volume
(İstanbul: Ana Yayıncılık A.Ş., 1994) s. 341.
13
Nancy Tapper, Richard Tapper, ‘The Birth of the Prophet: Ritual and
Gender in Turkish Islam’, Man (N.S), 22 (1987), 69-92.
14
Necibe Saracoğlu, ‘Türk Mezarlarına Dair Araştırma’ II. Bina Bilgisi
Kürsüsü, 3.1.1947 tarihli Yeterlik Çalışması, İ.T.Ü. (İstanbul: İstanbul
Matbaacılık, 1950) p. 8. (Ph.D. Thesis, University Publishing)
15
Saracoğlu, 28.
16
Saracoğlu, 8.
17
Hans-Peter Laqueur, Hüve'l-Baki: İstanbul’da Osmanlı Mezarlıkları ve
Mezar Taşları, çev. Selahattin Dilidüzgün, (İstanbul: Tarih Vakfı Yurt
Yayınları 46, 1993), 1.
18
Mez, Adam., Die Renaissance des Islams, (Heidelberg, 1922), 371,
quoted in Hans-Peter Laqueur, Hüve'l-Baki: İstanbul’da Osmanlı
Mezarlıkları ve Mezar Taşları, çev. Selahattin Dilidüzgün, (İstanbul: Tarih
Vakfı Yurt Yayınları 46, 1993), 2.
19
Adam, 2.
20
Laqueur.
21
Laqueur.
22
Laqueur, 131.
23
Michel Foucault, ‘Of Other Spaces: Utopias and Heterotopias’ in
Rethinking Architecture ed. Neil Leach, (London and New York:
Routledge, 1997), 350-356.
24
Gerardo Cornelio Drischio, Historia magnae legationis caesaaarae..., I,
(Viennae, Austriae, 1721), s. 246. German translation: Historische
Nachricht von der Röm. Kayserl.Gross-Botschaft nach Constantinopel...
(Nürnberg: 1723), 113. quoted in Hans-Peter Laqueur, Hüve'l-Baki:
İstanbul’da Osmanlı Mezarlıkları ve Mezar Taşları, çev. Selahattin
Dilidüzgün, (İstanbul: Tarih Vakfı Yurt Yayınları 46, 1993), 107.
25
Laqueur, 108.
26
Laqueur, 92. "This part of the gravestone consists of the request of
praying for the deceased. … Although Fatiha is read for someone
particular, reading Fatiha means the requesting God to forgive all the evil
___________________________________________________________
deeds of the all living and deceased. This is why a religious Moslem,
when enters a cemetery, reads Fatiha not for someone particular, but for
all deceased to be forgiven by God.”
Reyhan Varli Görk is a Research Assistant in the Faculty of Fine Arts,

Akdeniz University, Antalya and a Ph.D. Candidate in the Department of
Sociology, Middle East Technical University, Ankara, Turkey.
The Body of Necessities in Finnish Discourse on
Euthanasia
Leila Jylhänkangas
Abstract
The purpose of this study is to examine the different ways in
which people discuss euthanasia in contemporary Finnish society. The
data in this study consist of letters in which ordinary Finns discuss
euthanasia. Arguments today often focus on the question of whether a
terminally ill individual should be allowed to die with active death
assistance. Although active euthanasia has not been legalised in Finland,
the issue occasionally arises in the Finnish media. Unsurprisingly, the data
reflect people’s interest in discussing euthanasia. Representations of
suffering, pain and despair often arise in arguments supporting euthanasia.
Considering this, it is interesting to note that psychological distress
(especially depression) is one of the main factors behind requests for
euthanasia. In Finnish euthanasia discourse, however, the fear of pain, and
the possibility of falling into the care of other people in particular, are the
principal motivators. The data compel one to pose the following questions:
What kinds of cultural representations do people construct concerning
dying and suffering in end-of-life situations? How are representations of
euthanasia related to them?
Key words: euthanasia, death and dying, cultural categories, human body.
1. Introduction
The purpose of this study is to examine some of the different
ways in which people discuss euthanasia 1 in contemporary Finnish society
as well as to shed light on representations of a dying human body in
euthanasia discourse. The data in this paper consist of letters 2 in which
ordinary Finns discuss euthanasia. Arguments today often focus on the
question of whether a terminally ill individual should be allowed to die
with active death assistance. In euthanasia letters, images of the last stages
of one’s life are often associated with despair and worry about pain.
Cultural constructions of the body serve to sustain views of social
relations. Human beings relate to each other through their visible body, a
body that sees and can be seen. Euthanasia discourse represents different
kinds of bodies. One of them is the body of necessities, a human body
dependent on the help of other people to maintain basic, necessary vital
functions and everyday hygiene 3 . I define the body of necessities as
something that is crucially related to dying, the last stages of human life.
The body of necessities is a construct closely and concretely related to
data, in this case Finnish euthanasia discourse, on pain and suffering
218 The Body of Necessities in Finnish Discourse on Euthanasia
___________________________________________________________
related to dying. In euthanasia discourse, dying is considered an
unwelcome intrusion into the midst of a happy life. Representations of
suffering, pain and despair often arise in arguments supporting euthanasia.
Considering this, it is interesting to note that psychological distress
(especially depression) is one of the main factors behind requests for
euthanasia 4 . In this paper I’ll also examine hopelessness and rejection.
Hopelessness at the end of life is not simply ‘the absence of hope’, but
attachment to a kind of hope that is lost 5 . Rejections, on the other hand,
are consequences of hopelessness. Rejection of medical technology
toward the end of life is one example of this.
In this study, the analysis of the data will include category-
theoretical orientations which presume that cultural categories play a
significant role in euthanasia discourse. Following Mark Johnson, I
consider reasoning and experience to be closely linked to one’s
understanding of the human body. 6 Also, the ideas of Mary Douglas are
useful in the analysis of euthanasia discourse, for according to Douglas,
the body is a model standing for any bounded system 7 . We can see in the
body a symbol of society, for the powers and dangers credited to social
structure are manifested on a smaller scale to the human body 8 .
Consequently, the social and cultural categories of the human body are
considered strong influencers of euthanasia discourse. The body is also
central to the construction of metaphors 9 concerning the body of
necessities.
2. When life holds no greater worth than death

The issue of competence frequently arises in the treatment of the
elderly and dying 10 . In treatment situations, the fear of losing individual
autonomy and control seems to worry patients when they contemplate the
end of life. The following writer ‘would not want to live with a respirator’
because it would not be a ‘natural’ way to live:
My opinion is based on the fact that modern medicine

can artificially support human life so well that in this
matter we are already playing God... Birth, life and
death are part of being a human. I would not want to live
with a respirator. If I cannot live ‘naturally’, I want to
die. (KE 42)
What happens at death is, of course, understood differently across

various cultural and religious groups. Death and euthanasia are also
related to how life is conceived and illness is treated. As a kind of mental
or ‘imagined ritual’, 11 euthanasia has a certain effect on social continuity:
Leila Jylhänkangas 219
___________________________________________________________
it can be seen as a threat or as a relief. The following writer talks about ‘a
living corpse who is kept alive with the assistance of machines’. The
writer defines such life-sustaining treatment as ‘ill-treatment of the worst
kind’.
Even if a person is already a living corpse, he is kept

alive with the assistance of machines, poisonous
medicines are fed to him and injections are given in
order to keep this person alive. It is harsh – and ill-
treatment of the worst kind. (KE 109)
Perhaps more than ever before, modern dying is prolonged and

shaped by human choice. According to Mark D. Sullivan, this is the
reason for the current situation in which hope and hopelessness play an
active role in the dying process 12 . Sullivan also points out that
hopelessness and depression share much common ground, both considered
classic symptoms of melancholia 13 . In euthanasia discourse, images of
uncleanliness and the unpleasant sights surrounding death are often
categorised as intolerable. Hence, images of the last stages of one’s life are
often associated with fear and despair. The following writer fears the
possibility of ‘falling into the care of other people’:
I’m not so much afraid of death. What scares me is the

possibility of falling into the care of other people. It
would be so safe to look at my life one day at a time and
to know that I could leave when I don’t enjoy my life
anymore, don’t have the energy to live. Physicians
should have the right to help people to obtain a beautiful
and dignified death. (KE 61)
A dying person may consider death the only way to escape from
dying and the concrete physical pain and emotional distress. For example,
the following writers are worried about the pain and suffering various
incurable illnesses cause. The latter person writes about such suffering
‘that only death can end’.
Nowadays people live long and experience all kinds of

illnesses. When there’s pain and suffering, it comes to
one’s mind that a person should be helped to escape
from the pain. (KE 128)
___________________________________________________________
In the last stages of lung cancer, a person experiences
terrible pain. There is a lot of suffering that only death
can end. (KE 65)
The previous writer is worried about the pain in cancer and notes
that ‘in the last stages of lung cancer, a person experiences terrible pain’.
People want to escape the pain cancer causes, and very often death is
considered the only way to end the pain. Considering this, it is worth
noting that cancer is a risk factor for suicide, and the risk increases with
disease severity 14 . According to Émile Durkheim, melancholia and
depression have ‘a long history’ in the individual who commits suicide.
Although an individual may be driven to suicide by what appears to be an
immediate cause, no such sudden stimulus alone would result in such self-
murder 15 . This notion is analogous to the notion according to which
cancer is a risk factor for suicide (or any other life-threatening illness).
There is a sufficient ‘time to be anxious and depressed’ before death
comes. The following excerpt comes from a letter belonging to a 40-year-
old woman who describes the serious illness and suffering of her own
husband. Her husband had attempted suicide twice:
My husband has an incurable muscle illness called

dystrophia myotonica... He has said that he is not afraid
of death. In his illness, the body and muscles decay but
the mind is left untouched... My husband has been
depressed for a long time... My husband tried to commit
suicide twice. (KE 65)
In Finnish discourse on euthanasia, people seem to have a

tendency to fear situations in which scientific medicine eventually fails to
ease the patient’s pain and physical discomfort. In such circumstances,
(active) euthanasia is considered a welcome option. However, these
circumstances vary. Hence the body of necessities has different kinds of
dimensions. One is a human body in terrible pain. Another important
dimension concerns a situation in which a dying person is losing her or his
personality. For example, a hospitalised person may not always be called
by her or his name, but by her or his illness, as in ‘that lymph follicle
cancer in compartment six’. 16 In such a situation the patient becomes
depersonalised. He or she is no longer referred to as a person.
People may also associate the weakness of the human body with
mental incapacitation. Such a state illustrates the idea that one’s inability
to control oneself in one area causes the inability to control one’s
behaviour in other areas. 17 In the following excerpts, the body of
___________________________________________________________
necessities appears as ‘an idiot who has lost his personality’ and as ‘a half-
dead person’. The writers feel that to deny euthanasia to the physically
weak is unfair (‘an additional punishment’ and ‘torture of a human
being’). They demand and stress the right to assisted death, especially for
situations in which a dying person is brain-dead and dependant upon
machines, or is already ‘half-dead’.
If a healthy person has the right and the ability to kill

himself, why is this right robbed from those in such bad
condition that they cannot kill themselves anymore?
Why such an additional punishment? This is simply
cruel and unfair. Euthanasia is justified in a situation in
which a mentally healthy person expresses his will for
not wishing to live brain-dead and dependant upon
machines…I have already told my friends for many
years that I do not wish to live brain-dead, dependant
upon machines, or as ‘an idiot’ who has lost his
personality. (KE 36)
It is the torture of a human being, a waste of drugs, I’d

like to say it is hate, envy, cruelty to try to keep a half-
dead person alive on this earth. There are drugs for
mercy killing. (KE 63)
3. Rejecting medical technology
I have told my spouse that I’m never going to be

connected to any life support machine. If I would be
injured, for instance in an accident, and there would be a
choice between dying and living connected to life
support machines then I would definitely choose death.
(KE 41)
Technological advances over the past decades are vast, and they
have enabled us to overcome many diseases and have extended life. At
times, however, the result has been an unfortunate prolongation of the
dying process. 18 Due to technological advances made during the past
decades, death has changed radically, having passed largely from the
home to the hospital. According to Ariès, “the hospital is the only place
where death is sure of escaping a visibility - or what remains of it - that is
hereafter regarded as suitable and morbid”. 19 When death has been
___________________________________________________________
removed from the home and taken to the hospital, it has been rendered
invisible.
David W. Meyers writes that “the natural tendency of many
doctors has been to use any available technology, in the hope it may
improve the patient’s condition or extend his life, even if the patient is
suffering from a terminal and incurable malady.” 20 The following writers
are worried about a situation in which an unconscious person is
‘connected to machines’:
A person is connected to machines and is unconscious.

At some point, the relatives are asked if the machines
could be turned off because the person cannot breathe.
This is euthanasia, right? It just happens with another
label. I think this is the case. We all have the right to die
with dignity. That’s why euthanasia should be accepted
and the word euthanasia in particular should be used,
without any pretexts. (KE 81)
When a person is already outside all consciousness, it

should be obvious that he should be released from the
machines. This idea should also be applied to children
and youngsters, not just to the elderly. (KE 120)
Euthanasia discourse is constructed with body-based metaphors.

A good example of this is the vegetable metaphor, which describes a
human body that has lost all capacity to live independently and is totally
dependent upon machines and the care of other people. The vegetable
metaphor appears in arguments that accept euthanasia, as the following
example illustrates:
Euthanasia should be used when a brain injury makes a

child or a young person ‘a vegetable’…when a patient is
incurable, you hope the law would permit an end to the
suffering. (KE 120)
Mark Johnson has argued that metaphors are more than just
‘isolated beliefs’. For example, for a physician whose understanding of a
human body is structured by the ‘body as machine’ metaphor,
representations such as ‘breakdowns occur at specific point of injuries in
the mechanism’, influence his or her perception, diagnosis, treatment,
theorising and other practices. Such representations constitute the
physician’s grasp of medical situations. 21 In the same way, the ‘body as a
___________________________________________________________
vegetable’ metaphor is a kind of ‘chief metaphor’ that systematically
structures the dying process in a very definite manner. It seems easier to
give up and let a person die when he or she is no longer considered a
human, but rather a vegetable.
In this study, not all of the writers supporting euthanasia use
strong metaphors such as ‘a vegetable’ or ‘a living corpse’. As already
mentioned, some writers worry about ‘the intense physical pain’ and life
being ‘all but distress’. In such a worry, euthanasia can be represented as
‘a salvation’, and as a means ‘to end the suffering’ justifiably, ‘especially
when the physical pain is intense’:
I think that every human being deserves the right to

make the decision of his own life and death, especially
when the physical pain is intense. When a person sees
that his life is all but distress and can no longer be
healed, the physician should have the right to help him
to end the suffering, meaning to help him to have a
quick and painless death. It’s not killing; it’s a salvation.
(KE 54)
The following writer stresses the value of human life. This excerpt
compels us to remember that death can also be ‘dignified’:
Life is always dignified; one cannot deny that. However,

we should also remember that death can be dignified
too, even more dignified than life. (KE 42)
It is not the concern here how fortunate or unfortunate the entire

life of a dying person has been, but more importantly, the concrete
suffering that the human body (of necessities) experiences towards the end
of life. Euthanasia is accepted on the basis of the possibility that a dying
person will live ‘outside all consciousness’, and that continued life will
involve the endurance of great suffering. At the same time, the ideas of
autonomy, self-determination and control are actively defended in
arguments supporting euthanasia, as the following example illustrates:
I have thought about it [the possibility of falling

seriously ill] and have also told my children that I
wouldn’t want to live as ‘a vegetable’, dependant upon
machines. And if I could think and understand
everything, but couldn’t ever move by myself or take
care of myself, I guess I’d like to end such a life; it
___________________________________________________________
wouldn’t be worth living. In addition, in such a
condition, I’d cause trouble for and distress to my
friends. (KE 38)
An interesting point concerning the body of necessities stems

from the idea that every human being has the right to determine what shall
be done to his own body. As in the previous examples, the following
writer is also concerned about falling into ‘unconsciousness’ and
‘helplessness’, and worries about being dependant upon machines:
I definitely support euthanasia. I’d like to be euthanised

when I’m already helpless and connected to a
machine…it is not worth nursing brain-dead and
unconscious living corpses. (KE 89)
According to Hazel Biggs, medically assisted suicide is usually

contemplated because life and medicine have nothing left to offer but a
prolongation of the dying process 22 . Such circumstances are inevitably
characterized by dependence and loss.
4. Rejecting the prolonged torture
I definitely support active euthanasia. I’ve heard from

many sources that cancer is very painful and distressing
in its late stages; it is all but prolonged torture for the
dying person. I don’t store a broken radio forever;
useless and old property is thrown away. Why would I
keep my useless mortal clay when I don’t have a use for
it anymore! (KE 35)
Sometimes the body of necessities is defined as someone easily

forgotten by the social environment. The following voice belongs to a
concerned nurse who has observed in her work that the longer the patients
remain hospitalised, the more forgotten they become:
During the years I nursed ill people, I noticed that the

longer the patients remained in hospital, the more
forgotten they became…On the basis of these
experiences, I’ve become a supporter of euthanasia. (KE
132)
___________________________________________________________
The following excerpt comes from a letter belonging to a nurse
who has worked in a hospital for chronic patients. According to the nurse,
many patients were ‘skeletons’ fed with a pap made of chocolate and
banana in order to make them gain weight. On the basis of her
experiences, the nurse thinks that people who reject euthanasia must be
‘sadists’ who enjoy the suffering of other people.
When I was young, I worked in a hospital for chronic

patients... There were many skeletons who were fed
with a pap made of chocolate and banana in order to
make them gain weight. They lay in a foetal position
and unable to talk, being nothing more than skin and
bone... People who do not accept euthanasia must be
sadists who enjoy the suffering of other people. (KE 65)
Besides being a collection of anatomical structures and

physiological processes, a person is also ‘a socio-emotional being that
elicits moral, compassionate responses from others.’ 23 In addition, those
individuals who have been seriously ill and begin to recover often feel
they must prove to themselves and to others that they are capable of
surviving on their own and are not so dependant on the help of other
people 24 . The body of necessities (in the case of a very seriously ill and
dying person), however, doesn’t encourage such hope for recovery and
survival. According to discourse accepting of euthanasia, all one can do in
the face of death is to minimise the suffering of a dying person.
5. Conclusion
The theoretical orientation of this paper combines ideas of Mary
Douglas, George Lakoff and Mark Johnson. Structures of human
understanding have their origin in the body, and human life has always
been a concept confined to the body. 25 George Lakoff and Mark Johnson
have argued that our conceptions of reality should not be separated from
what we experience in our embodied interactions. The movements of our
bodies and their placement in space generate knowledge structures and
modes of reasoning evident in linguistic usage. 26
The socially constructed world of euthanasia discourse sees the
crossing of the line between life and death as a matter of individual
autonomy and as a matter for the whole community. More than death,
which itself is an experience not easily shared with others, dying is an
observable and sometimes lengthy process whose contemplation shapes
peoples’ perceptions of their own lives and forthcoming modes of dying.
___________________________________________________________
In Finnish discourse on euthanasia, people talk about hopelessness and
rejection in end-of-life circumstances.
Hopelessness arises from situations in which life is considered to
hold no greater value than death. Rejections, on the other hand, are
consequences of hopelessness. These rejections are directed at life-
sustaining treatment (especially machine-based) and a life of all but pain,
distress and ‘torture’. The body of necessities appears differently in these
situations. In this paper, I have offered examples in which the body of
necessities is viewed as a suffering person totally dependant upon
machines and the care of others. Finnish discourse on euthanasia
represents the culturally constructed dying human body and its treatment
in the community. The body is also central to the construction of
metaphors concerning the body of necessities.
Notes
1
Definitions of euthanasia are, of course, cultural constructions.
Originally, the Greek word euthanasia meant ‘easy death’, but the
definition of the word has evolved throughout the years depending on the
cultural environment in which it has been defined. In the data of this
study, the concept ‘euthanasia’ usually refers to its active form: a doctor
intentionally ends the life of a terminally ill patient who is in intense pain
and who voluntarily chooses to end his or her own life to stop the
prolonged suffering. Hence, in this article, ‘euthanasia’ refers to its active
form even though the word ‘active’ does not appear in every context.
Passive euthanasia is to allow the patient to die by succumbing to his or
her illness.
2
I obtained the 132 letters (coded KE 2-133) by publishing in several
Finnish newspapers a request in which I invited people to discuss
euthanasia. This article contains excerpts from the data translated from
Finnish into English.
3
Silva Tedre, Välttämättömyyksien ruumis vanhusten hoivassa, (The
Body of Necessities in Old People’s Care), Naistutkimus 9, 4 (1996), 2-14.
4
Ezekiel J. Emanuel, ‘Depression, Euthanasia, and Improving End-of-Life
Care’, Journal of Clinical Oncology, 23, 27 (2005), 6456-6458.
5
Mark D. Sullivan, ‘Hope and Hopelessness at the End of Life’, American
Journal of Geriatric Psychiatry, 11 (2003), 393-405.
6
Mark Johnson, The Body in the Mind. The Bodily Basis of Meaning,
Imagination, and Reason (Chicago: University of Chicago Press, 1987).
7
Mary Douglas, Purity and Danger. An Analysis of the Concepts of
Pollution and Taboo (London and New York: Routledge, [1966] 1996).
___________________________________________________________
8
Ibid.
9
According to George Lakoff and Mark Johnson, human thought
processes are metaphorical, and metaphors are part of our everyday
language. George Lakoff and Mark Johnson, Metaphors We Live By
(Chicago and London: The University of Chicago Press, 1981); Mark
Johnson, 1987.
10
David W. Meyers, Human Body and the Law (Edinburgh: Edinburgh
University Press, 1990); Hazel Biggs, Euthanasia. Death with Dignity and
the Law (Oxford: Hart, 2001).
11
Presently, no specific law on euthanasia exists in Finland, and no
legislative enactment mentions the concept of euthanasia. Elise Kosunen
et al., ‘Finland’, in Euthanasia in Europe. National Laws, Medical
Guidelines, Ethical Aspects, eds. Wolfgang Sohn & Michael Zenz
(Stuttgart: Schattauer, 2001), 43-57. Consequently, I define euthanasia as
an ‘imagined ritual’.
12
Sullivan.
13
Ibid.
14
Erlend Hem et al., ‘Suicide Risk in Cancer Patients from 1960 to 1999’,
Journal of Clinical Oncology, 22, 20 (2004): 4209-4216.
15
Émile Durkheim, Suicide. A Study in Sociology (New York: The Free
Press, 1966).
16
Terhi Utriainen, Läsnä, riisuttu, puhdas. Uskontoantropologinen
tutkimus naisista kuolevan vierellä (“Present, Naked, Pure: Study in the
Anthropology of Religion on Women by the Side of the Dying”)
(Helsinki: SKS, 1999), 61-63.
17
Tedre, 2-7.
18
David W. Meyers, Human Body and the Law (Edinburgh: Edinburgh
University Press, 1990); Philippe Ariès, The Hour of Our Death (New
York: Alfred A. Knopf, 1991).
19
Ariès, 571.
20
Meyers, 277.
21
Johnson, 129-130. Susan Greenhalgh has analysed the various ways in
which “the ritualised practices of the initial consultation works to turn
doctor and patient into subject and object, knower and known, mind and
body of medical science”. This is not to suggest, however, that doctors are
cynically manipulative or deliberately exploit the patient’s emotional
vulnerability. Susan Greenhalgh, Under the Medical Gaze. Facts and
Fictions of Chronic Pain (Berkeley: University of California Press, 2001),
77-81.
22
Hazel Biggs, Euthanasia. Death with Dignity and the Law (Oxford:
Hart, 2001).
___________________________________________________________
23
Julia Lawton, ‘Contemporary Hospice Care: the Sequestration of the
Unbounded Body and ‘dirty dying’’, Sociology of Health & Illness 20, 2
(1998), 121-143.
24
Janice M. Morse and Joy L. Johnson. ‘Understanding the Illness
Experience’, in The Illness Experience. Dimensions of Suffering, eds. J. M
Morse and J. L. Johnson, (Newbury Park: Sage, 1991), 1-12
25
Douglas.
26
Lakoff and Johnson.
Leila Jylhänkangas is a Ph.D. candidate in Comparative Religion at the

Faculty of Arts, University of Helsinki, Finland. She is currently working
on her dissertation, which explores cultural representations of euthanasia
in contemporary Finnish society.
Images Of Death, Images Of Society: The Case Of Poland
and Polish Community
Emilie Jaworski
Abstract
The globalization may be described as the expansion of the
capitalist system and its ideals. This phenomenon implies deep structural
transformations inside societies and reorganization of worldwide
population, because of the intensification of the migratory movements. It
is then obvious that each society must redefine all their social and cultural
practices, in order to give sense to the new social reality.
The mechanism of those reshapenings obviously appears in
funeral rituals. Those events, which combine economical, social and
cultural dimensions of a society, are interesting to get a better
understanding of a population. The part of participators for funeral is to
establish the dead among the ancestors - references for the identity of a
group - and fix his memory. Then, during this action, they solicit all the
values and ideals of the society. So funerals are a total social fact, 1 which
can be considered as a mirror of the society.
This problematic which involves social change and funerary
rituals, can be applied to the case of Poland and polish community in the
North of France. Since the fall of communism in 1989, the social and
cultural environment of Poland had deeply changed and the population
must adapt itself to a new reality. The polish community also had to
reconfigure its practices but in a foreign environment. A comparative
study of those two common original populations, facing the social change,
can help to understand the mechanisms which drive the social and cultural
reshapenings. According to this aim, I especially focus on a practice which
was common to both of the concerned populations: the post-mortem
pictures, consisting in taking pictures of dead relatives in the coffin before
the funerary mess. By working on social uses and functions of those
pictures and by re-establishing them in the whole of funerary practices, it
is possible to understand how works a society and how a population adapt
itself to changes.
Key words: globalization, cultural re-shaping, funerary rituals, post-

mortem pictures, Polish community, Poland, Catholicism.
1. The uses and functions of post-mortem pictures

A. The post-mortem portraits in the past and in the world
The practice of post-mortem pictures seems to be the product of
an old tradition of representations of the deceased. Portraits and sculptures
were adorning the sepulchres in Egypt between the 2nd and 3rd century and
230 Images of Death, Images of Society
___________________________________________________________
in ancient Greece. In Europe, during the Renaissance, the great aristocratic
families have built chapels with representations of their dead. During this
period also existed a great fashion of recumbent statues on the graves,
especially intended to the royal families. In the 16th century, in the
Flemish bourgeoisie, painters were requested in order to paint the
deceased during his exhibition. Between the 18th and 19th have occurred
the tradition of mortuary masks in France, in England, Germany, United
States, Italy and Russia. When the photography appeared it permitted the
democratization of funeral portraits. Then, the practice of post-mortem
pictures was affordable by many people and became famous in all Europe,
in United States, and in South America. Briefly, those portraits
encountered a great success mainly in Christian countries, including
Poland and Polish community.
B. Conception and uses of post-mortem pictures

The way of making post-mortem pictures in Poland and in Polish
community was not determined by strict rules and depended on the wishes
of the families. Some of them preferred not to take such pictures at all,
some other only take pictures of the mess and the burial or eventually of
the grave, some other of the corpse in the coffin and finally some other
take pictures of all the funeral. Nevertheless, we can notice that each
practice is based on values and needs which correspond to the social and
cultural configuration of the society.
Mainly, the pictures of a corpse work as pair: there are pictures of
the dead surrounded by the closest family and other of the dead alone 2 .
The other common point between those pictures concerns the decorum.
Generally we can find a lot of flowers and plants not only all around the
coffin but also on the feet of the dead. It is usual to see a crucifix and
candles on the top or on one side of the coffin. The dead wear in general
the most elegant clothes and shoes. It is also usual to see a corpse adorned
of catholic icons, with a rosary and sometimes with a prayer book in the
hands.
The treatment of children is different compared to the adults, and
we can distinguish here two kinds of post-mortem portraits: one that
shows them in the coffin and surrounded by all the signs of death as the
crucifix, the white flowers and clothes, the icons, except the rosary and
payer’s book when the child is really young; the other one where the
children look sleepy. In general the family does not appear on those
pictures.
By looking to those pictures, to the way people are dressed, to the
decorations, to the colours used we can easily notice that they are an
Emilie Jaworski 231
___________________________________________________________
expression of the social level, of the degree of integration of the deceased
in the community or in the group, of the cultural and social values.
Those pictures can be made by a member of the family, or by a
photographer. This depended on the wealth of the family. When
developed those pictures could be shared between the closest members of
the family. If somebody else wanted to have such pictures he could ask the
family. In general, this kind of wish is appreciated by the family, because
it means that other people miss the dead showing his qualities.
In polish families, those pictures are in family albums among
pictures of baptisms, communions, weddings and other events which
constitute the different steps of life. Then, such albums can be considered
as house archives where is written the story of the family in a non-verbal
language. In the Polish community the use seems to have been different. I
can not know exactly how those pictures have been used by the members
of the first generation of immigrants - who arrived in France about 1920 -
because almost all of them are not alive. Nevertheless, by consulting
archives we can realize that many mortuary pictures have been taken. The
following generation kept or hided those pictures received or transmitted
by the first generation in shoes box or in the very end of a forgotten
drawer or something similar.
When facing emigration or family separation, those pictures had a
precise role. When a member of a family died in France or in Poland the
other part of the family could not participate to the funeral. Then, sending
such pictures was a way to share this event with the members of the
family who lived abroad.
Picture 1: Deceased surrounded Picture 2: Same deceased alone

(Source: personal) (Source: personal)
C. The functions
The first function we can attribute to those pictures concerns the
required process of creating ancestors. This concept of ancestor refers to
all the dead who stay alive in the memory of the family. This means a
___________________________________________________________
descent is necessary to reach this status. Children, as they are pure
according to Catholicism and do not have descent, become angels, if they
are baptized of course. So the pictures of adults and children belong to
different processes, but actually the most interesting for us is the case of
adults. The first element which drives us to this conclusion appears when
we consider the post-mortem pictures as a part of a more general practice,
which consists in taking pictures of all the great events of a the social life
as for example baptisms, weddings and funerals. All those events are
finally some rites de passage, which confirm a change of status and of
identity. Then post-mortem pictures are an expression of a specific
moment of the life’s cycle: the death. For Catholics, this event is not the
End, but the beginning of a new way of life. The funeral, according to this
point of view, is the first step consisting in raising the soul of the dead and
establishing him among the other ancestors. Here the fact that the post-
mortem pictures work as a pair, which shows the dead alone and with the
family, makes sense. This can be interpreted as an expression of the
individuality of the dead on one hand, and as the expression of his position
in a social network on another hand. In fact, this way of taking pictures
would illustrate the rupture between the dead and his relatives, as
Sakalavas in Madagascar expresses this rupture by the symbolic cut of a
string which fastens the dead husband to his live wife for example. In
general, the funeral is the occasion to create a legend about the dead, to
create a hagiographic speech which consists in deleting his bad sides and
insisting on his good sides and his good actions corresponding to the
values of the society. In fact the aim of this process is to create a local
hero, which will allow the group and the family to recognize themselves in
him and use him as a social and cultural reference.
The ultimate step which ends the process of making an ancestor
occurs the first birthday of the death. Usually the family celebrates this
birthday by cleaning and then adorning the grave of flowers and candles.
This birthday is also connected with the setting up of the real grave. In
Poland a family can choose between a gróbowiec and a nagróbek. This
choice is determined in general by the standard of living of the family. A
gróbowiec is made of a vault, when a nagróbek just includes the funeral
monument. In this last configuration the dead and its coffin are buried
directly in the ground. For this kind of grave the monumental mason must
wait one year before installing the definitive grave. According to them one
year corresponds to the time necessary to get the ground stable. By setting
up this definitive grave starts the ancestor’s cult.
The post-mortem pictures, which illustrate parts of the process of
making ancestors, can be considered as the support of the memory; so do
the graves. They show the last moments of the dead on earth and his
Emilie Jaworski 233
___________________________________________________________
transformation in ancestor with all its implications. Those pictures will fix
this process in the memories and also the values of the society represented
by the ancestor. The post-mortem pictures here work as a metonymy of the
entire life, and do not only refer to the values implied in a particular
moment of the life as weddings for example which are especially focused
on fecundity.
In Poland in general, and probably in the first generation of
Polish immigrants, the family pictures, including post-mortem portraits,
are or have been watched during family meetings. Relatives, by watching
them together, refresh and strengthen the family history, identity and links.
The members of a family recognize themselves in a common ancestor and
in the values funding their culture and which belong to different levels of
the society - it can be national values like the respect of catholic tradition
or patriotism, regional, local, familial and individual values which refer to
the specific history and traditions of the region, the village, the family and
the individual. Those pictures refer also to the social status of the ancestor.
The way the dead is dressed, the quality of the coffin and grave, the kind
of flowers exhibited are all signs revealing and fixing it. So by taking such
pictures, and watching them in special circumstances, a family reactivates
what is meaningful for itself and reaffirms its social position among a
group. Globally those pictures can be considered as non-verbal texts,
which help a family to perpetuate its indoor cohesion, its outdoor position
within a larger group. The comparison between post-mortem pictures and
graves can be made. The grave is a monument which is connected to the
values, to the identity and the social level of a family thanks to its
architecture, its symbols and its quality, but the main difference is that a
grave is fixed when a picture can be given or sent and infinitely
reproduced. This point is really important in a context of immigration. The
families which had been separated can symbolically gather by sending
post-mortem pictures to the part who could not attend the ceremony. So
the entire family is aware with the family history. But the interest of those
pictures is lost without the speech. As they are metonymies of the family
history, they have to be supplemented by the oral evocation of the
ancestors. So their memory is continuously updated, insuring the
perpetuation and cohesion of family identity.
Here the post-mortem pictures and the graves have the same
purpose: to let a track of the stay of somebody on earth. This track works
as a transitional object 3 , which support the psychological process of
mourning. It is a kind of compromise which enable the transition between
the presence and absence of the deceased and which is a proof of the
reality of death. So, post-mortem pictures are also very interesting to help
people who could not participate to funeral by showing them the
___________________________________________________________
indisputable reality of death and allowing them to launch the process of
mourning.
2. Disappearing of post-mortem pictures and social changes

A. The circumstances of disappearing
The disappearing of post-mortem pictures started first in Polish
community immediately after the second generation of immigrants. This
seems to be a consequence of integration of Polish community in French
society where using such pictures did not make sense anymore. Nowadays
in Poland we assist to the same phenomenon especially in big cities. As
post-mortem pictures worked before as a part of life’s cycle, we can
conclude to a disconnection between death and life for those two
populations. The progression of the jobs linked with the death sounds like
the confirmation of this hypothesis. Before the family and the closest
relatives used to care about the corpse whereas today the family let the
professionals - in hospitals and funeral firms - assume this responsibility.
So the common knowledge concerning the funeral practices have been
transferred from ordinary people to specialists and become a sector more
and more autonomous. This results in weaker and weaker links between a
family and it’s deceased. As death disappeared from the everyday life, the
approach of the dead causes more and more troubles and disgusts.
The new conception of cemeteries seems to confirm this fact
since they are managed by architects or engineers. The cemeteries are no
longer areas where ordinary people act directly and where the ordination
of graves depends on the free room and the wishes of people. Nowadays
they are the product of a professional knowledge and new space
management linked with the process of urbanization, which implies that
the space is more and more precious.
B. The cremation as a new alternative

The beginning of cremation in Poland, and its popularity in
France and in the Polish community can be interpreted as another
consequence of the disconnection between death and everyday life. It
seems to be a response to the new rationalization of the societies.
Cremation can be considered as a way to save time and space more and
more precious in western societies, and to destroy a corpse which disgusts
and is cumbersome. But the meanings of cremation are deeper and it
responds also to a reconfiguration of social network. The family structure
is changing and is more and more centralized around parents and children.
In this case, the family graves correspond less and less to the new
expectations of the society. People have to leave more and more often the
place they born to a city or abroad in order to get a job. So the families are
Emilie Jaworski 235
___________________________________________________________
spread which makes the common ancestors' cult more and more
complicate. The cremation permit not to spend so much money in a grave
which is losing its strength and offers a freedom in rituals which
corresponds to the actual ways of life and the diversity of situations.
3. Conclusion
Post-mortem pictures were involved in practices which were
corresponding to the expectations and the needs of a society and a group.
In such case it’s analyze is really interesting to understand the functioning
of a population. The disappearing of this element is a witness of deep
transformations of a society, which is, in the case of Poland and Polish
community, linked with the phenomenon of globalization. The new
economical configuration requires a population to change its behaviors
and its system of perception of the reality. Here we see clearly how the
capitalist rationality works in the two populations studied. The traditional
knowledge is transferred to specialists who create a funeral market, and
the family is not anymore really concerned by the care of the deceased. So
taking a picture of them does not make sense anymore if they belong in
another dimension of the society more and more autonomous from its
origin, and do not belong anymore in the family surroundings. The same
logical is observable in cemeteries, which are areas submitted to the
knowledge of urbanists and architects. In this new social configuration the
practice of cremation become an alternative which corresponds to the new
rationality and social structure of the society. It implies a gain of space
and time, and then of money, but also a reinventing of funerary rituals
correlatively to the new plurality of lives trajectories and to the
individualism.
The specialization of the funeral knowledge and the diversity of
funeral rituals generally drive people to think the death became a taboo
and the funerals are debased. This conclusion is maybe not totally false,
but could not we appreciate those evolutions of funerals practices as
adaptations which correspond to the new social structures and needs? Are
the funerals debased or do we assist to everyday micro-reinventing
connected with the new realities, more and more diverse, and the personal
needs?
Notes
1. Marcel Mauss, Sociologie et anthropologie (Paris: PUF, 1950).
2. Picture 1 and Picture 2, p.3.
___________________________________________________________
4. Donald Woods Winnicott, Jeu et réalité: L’espace potentiel (Paris:

Gallimard, 1971).
Bibliography
Berger, Laurent. Les Nouvelles Ethnologies: Enjeux et Perspectives.

(Paris: Nathan, 2004).
Goedefroit, Sophie, and Lombard, Jacques. Andolo: L’Art Funéraire
Sakalava au Menabe. (Paris: A. Birot, 2004).
Jaworski, Emilie. Usages et Fonctions de la Photographie Post-Mortem
dans la Communauté Polonaise du Nord-Pas-de-Calais. (Mémoire de
Maîtrise en Anthropologie, USTL, Sous la Direction de Sophie
Goedefroit, 2003).
Jaworski, Emilie. La Pratique de la Photographie Post-Mortem chez les
Catholiques Polonais en Pologne: Vers une Occidentalisation des
Pratiques Funéraires? (Mémoire de DEA en Anthropologie, USTL, sous
la Direction de Sophie Goedefroit, 2004).
Thomas, Louis-Vincent. Anthropologie de la mort (Paris: Payot, 1975).
Urbain, Jean-Didier. L’Archipel des Mort: LeSsentiment de la Mort et les
Dérives de la Mémoire dans les Cimetières d’Occident. (Paris: Payot,
1989), 65.
Emilie Jaworski is a Ph.D. student in social anthropology, at the

University of Paris V.
Attachment Trauma, Sudden Death and Anticipatory
Grief: the Chamorro Sample
Stephen W. Kane and Vera de Oro

Abstract
Fifty nine female Chamorro subjects in a sample size of sixty six
responded to the Family Crisis Scale to determine their emotional and
psychological reactions to threatened loss, anticipation of loss and sudden
death of a family member. A corollary interest was an inquiry into culture
specific mental health interventions which could be recommended for this
population. Subject’s responses to the instrument resulted in the
development of the Chamorro Family Crisis Scale with two variables
ranked more stressful when compared to the western Family Crisis Scale.
Further results revealed that twenty five per cent stated there was no
emotional difference between situations of threatened loss, anticipated loss
and sudden death. Of the twelve subjects who listed a sudden death in the
family in the last year, seven likewise reported the occurrence of a
divorce. The most frequent attachment traumas in the past year included
threat of dissolution of the family, loss of a job and a family member
leaves temporarily. And finally, sixty two percent of respondents ranked
most stressful more than once to FCS items. These results are discussed
within a context of an examination of the Chamorro culture and an
application of attachment concepts.
Key words: Chamorro, attachment theory, anticipatory grief, sudden

death, attachment trauma, family crisis, family therapy, family
counselling.
1. Background of the study

An understanding of Pacific Islanders mental health concerns and
effective psychotherapy strategies for this population have been dimly
studied with little or no island specific recommendations.
Monica McGoldrick’s 1 prodigious work focusing on the
interactions of ethnic status, cultural peculiarities and cultural specific
interventions follows a global application of matching therapy with ethnic
status. Her direction of identifying mental health concerns with cultural
uniqueness to arrive at the best therapeutic applications comes from a
substantial amount of historical, cultural and psychological information as
well as, in many cases, psychological studies designed to reveal best fit
models of therapy.
McGoldrick’s 2 work covers an examination of the following
broad groups of peoples: American Indian families, families of African
origin, Latino families, Asian families, Asian Indian and Pakistani
238 Attachment Trauma, Sudden Death and Anticipatory Grief:
the Chamorro Sample
___________________________________________________________
families, Middle Eastern families, families of European origin, Jewish
families and Slavic families. Her third edition of Ethnicity and Family
Therapy, however addresses Pacific Islanders as only limited to Hawaii, a
group comprised mostly of Polynesian heritage.
The aim of this paper has been to explore the psychological
demography of the Chamorro people who are likewise considered Pacific
Islanders, and who populate the Northern Marianas islands. Of particular
interest is the Chamorro’s culture and their psychological responses to
sudden death, anticipatory grief and attachment traumas.
An understanding of attachment traumas, or, losses experienced
in the context of the family are advanced by the application of the author’s
Family Crisis Scale. The Chamorro Family Crisis Scale will be presented
and compared to the western Family Crisis Scale, and a variety of
questions designed to explore the Chamorro’s psychological reactions to
losses in the family are advanced. An understanding of these variables is
broadly hypothesized as the recommended starting point for the derivation
of psychological mental health interventions for the Chamorro people and
Pacific Island inhabitants of the Marianas Islands.
2. A brief history of Guam and the Chamorro people

Guam lies at the southernmost tip of the Marianas Islands. These
islands include Farallon De Pajaros, Asuncion, and Pagan to the north,
with Tinian, Saipan, Rota and Guam to the south, and make up an area of
the western pacific known as Micronesia. Forty two million years ago
volcanic activity, the result of the collision of the Pacific and Philippine
plates, resulted in the development of these islands which aligned
themselves in an arc according to eruptions at locations at the bottom of
the earth’s crust beneath the Marianas Trench. 3
Anthropologic estimates of the beginnings of the Chamorro
people who eventually settled on Guam and islands to the north place a
diaspora of peoples from Southeast Asia at or around 3,500 B.C. across
Indonesia and the Philippines to the Marianas. These peoples who spoke
an Austronesian language modified it further upon discovery of the
Marianas islands in response to their survival and reactions to a
challenging environment. The men were described as tall, muscular, and
their families were matrilineal, where women held highest ranks and
controlled property. They developed their own religion and believed in the
spirits of dead ancestry who inhabited the jungle. These spirits, called tao
tao mo’na, were in a position to critically involve themselves for good or
ill in the lives of the living if they were pleased or offended. 4
Stephen W. Kane and Vera de Oro 239
___________________________________________________________
This early existence of the Chamorros up to the birth of Christ
and for another 1500 years thereafter was, according to record, an
unremarkable period. While Europeans establishing trade routes first made
their appearance to the Chamorros in the 1400s, it was not until the arrival
of Magellan, on behalf of the Spanish monarchy in 1521 which initiated
an intrusive domination and conflicted presence on the islands of Guam,
Rota, Saipan and Tinian for the following 300 years. 5
The Chamorros fought the presence of Spain for two hundred
years until the end of the 18th century when it was estimated that there
were only 1300 natives remaining, most of whom were women and
children. It was at this point that the Spanish were able to take
considerable control of the culture and religion, converting the Chamorros
to Christianity and marrying into what was left of the matrilineal order.
After this longstanding Spanish intrusion the eventual ethnic makeup was
characterized as ‘mestizos’, or, a blend of Chamorro, Hispanic, Mexican
and Philippino as well as the Carolinian races, as it today. 6
3. Chamorro spirituality and responses to death

The Chamorros have two distinct influences on the development
of their spiritual values. One is from their psychological reaction to the
island jungles of the Marianas islands circa 3500 B.C. with their
reinforcing sense of deceased relatives ‘staying on’ in the form of spirits
to inform, instruct and affect the lives of their progeny. The other is
Catholicism introduced by the Spaniards. The mediating fulcrum between
pre-Christ islanders attempt to attribute sense to death and dying and
Catholicism’s ordered arrangement of morality and steps to achieve
everlasting salvation appear to be connected by a matrilineal elevation of
the spiritual persona of Mary, mother of God. Focus and devotion to the
liturgy of the rosary, particularly as it relates to forgiveness, not only to
the dying but to the dying member’s kin, is seen in the phrase of the
Catholic Hail Mary prayer: “holy Mary, mother of god, pray for us sinners
now and at the hour of our death”. These words likewise inspire thoughts
of a wish for un-conflicted acceptance and union with mother.
This spiritual bond with Mary, mother, is incorporated in the
Chamorro ritual of the nine nights of rosary prior to the internment of a
family member and the nine nights of rosary after internment. The rosary
ritual prior to internment is open for everyone on the island and the nine
nights after internment is closed to family members. While practical
explanations of the nine nights prior to internment revolve around the
temporal contingencies of family members in other parts of the world
attempting to return home to a small island in the pacific to pay respects,
the spiritual intuitive sense may point to a profound need and respect for
the Chamorro Sample
___________________________________________________________
maternal forgiveness and reconciliation in life and after death. The
maternal matrix, for example, represented by the circular band of beads
and the group recitation of prayers in the form of the rosary bridges
spiritual, matrilineal forgiveness and unconditional acceptance passions
within the Catholic context.
4. The psychological impact of family loss

The aim of this paper has been to explore the psychological
demography of the Charmorro people in an attempt to gauge their
sensitivities and peculiar/unique attributes regarding (1) sudden death and
anticipatory grief, and (2) to derive an ethnic sensitive mental health
approach to direct counselling and psychotherapeutic interventions for this
population.
George Vaillant 7 assumed direction of a longitudinal study at
Harvard University which was initiated in the nineteen forties. The study
focused on the personal development and careers of Harvard graduates
over time. It was a sample of males who were followed throughout their
lives by the collection of pertinent data about themselves every few years.
One important variable was longevity. Age at death was recorded.
Circumstances of death were recorded such as types of illnesses and
injuries. One further notation was made if the death was ‘sudden’.
In those cases of sudden death a further investigation was made
in the form of a psychological autopsy. Valliant’s research team was able
to discover that a significant proportion of those individuals who died
suddenly had experienced a ‘loss’ in the six months prior to death.
Furthermore, the loss in question included either an estrangement, divorce,
separation or death of an immediate family member. 8
These results reaffirmed the emerging research of the day which
focused on stress, change and loss, and their effects on physical and
psychological health. The study was also the impetus for the development
of the Homes-Rahe Social Readjustment Scale 9 and the author’s Family
Crisis Scale 10 . The Holmes-Rahe scale was the pioneering study which
linked stressful events to psychological and physical health. The Family
Crisis Scale, modelled after the Holmes-Rahe scale lists 9 attachment
traumas, or, unavoidable losses occurring in the family and extended
family. The Family Crisis Scale was developed to demonstrate the kinds
of losses that effect calibrated grief reactions for individuals in their
families.
___________________________________________________________
5. A closer look at the Family Crisis Scale
The following is the Family Crisis Scale. It has face validity from
a western perspective. The nine attachment traumas, or, losses which
occur within the perspective of the family are listed in order from (1) least
severe to (9) most severe. The list in its entirety is shown below.
(1) A geographical move but all family members are included. This is a
loss of the familiar. The loss of the familiar can be a profoundly disturbing
experience. Object constancy is a clinical term that refers to the healthy
individual’s ability to keep an intact identity and secure sense of self
despite being geographically and socially uprooted. For some people the
fear of losing the familiar and the routine can be so reinforcing as to
prevent them from leaving a hurtful or punishing relationship. This loss of
the familiar in this case describes the loss of geographical and social
familiarity, but not family familiarity, which operates to reduce the stress,
because all family members are included.
(2) A developmental conflict of a family member. Loss of psychological
well being because of a developmental conflict of a family member
presents a problem to the entire family as well as to the one suffering.
Examples include the parent who acknowledges a developmental delay in
a child, or a spouse who has seen the onset of depression in her mate.
Problems that one member experiences are usually met with compensation
by others in the secure family. Insecure families are burdened by the guilt
of the deficiency.
(3) A move has occurred but not all family members are included. This
category includes losses revolving around agreed upon separations of a
family member, for example a spouse who travels to support his family, a
child’s stay at a summer camp, or the developmental milestone of an
eighteen year old leaving for college or military service. In the latter case
when the offspring leaves the stability of the family requires compensation
by the others to adjust.
(4) Family member experiences a loss of status. Stress is generated at
multiple levels when the loss of a job, demotion or financial complications
jeopardize the well being and material security of all family members.
Depression and further complications from financial setbacks may
highlight the guilt generated by the family member’s conflicted confusion
of his inability to provide love and protection in a material way.
(5) A threatening illness or injury. In this category physical trauma of a
family member alters the terrain of the familiar and routine and forces the
victim and family members to evaluate the impact of a potential loss of
life. While the physical trauma in this category is recoverable the threat of
potential loss of a loved one can be as emotionally painful as a loss of
loved one over the short term until the loved one is out of danger.
the Chamorro Sample
___________________________________________________________
(6) A terminal illness or injury of a family member. The anticipation of
the death of a family member is included in this category where remaining
family members are given a period of time to react with grief in advance
of the loved one’s passing. Advances in medicine to extend the lives of the
terminally ill in many cases from six months to two years has allowed
family members to express their feelings and activate closure with loved
ones in their final stages of their lives. Typically the first experience of a
member dying from a terminal illness is a grand parent.
(7) A threatened dissolution of the family. Chronic episodes of tension and
chaos characterizes this family’s attempts to remain together with
intimidation, threats of violence, ridicule and threats to abandon as the
instruments of maintaining an intact unit. Ever present warring factions
and literal threats of abandonment, separation and divorce are constantly
experienced as a possibility.
(8) The loss of the family. The abdication of parental responsibilities by
one or both parents because of conflict or incompatibility has a profound
psychological impact on the remaining family members. The loss of the
unit by divorce or separation is accompanied by shame, psychological and
geographical distancing or abandonment, in some cases without any future
contact with the divorcing parents. Many family members suffer guilt and
depression revolving around feelings of being rejected or not being loved
by the perpetrators.
(9) Sudden death of a family member. The sudden loss of a loved one is
more stressful than a loss preceded by anticipatory grief. A conflicted
relationship with the suddenly deceased family member also increases the
possibility of conflicted bereavement in the aftermath and depression over
the long term.
This western version of the Family Crisis Scale, see Appendix A,
was administered randomly ordered to a sample of Chamorro subjects to
explore their reactions to sudden death, anticipatory grief and related
family attachment traumas. Questions for study, procedures and results are
considered in next sections.
6. A look at the subjects and procedures in this study

The subjects were adults with ages ranging from 19 to 60. Ninety
eight percent of the subjects were Chamorro and two percent represented
Philippino, Caucasian and other. There were 59 females and 11 males.
These subjects were enrolled at Guam Community College in adult basic
education courses. In a regularly scheduled classroom arrangement
subjects were presented the Family Crisis Scale randomly-ordered and
asked to rank each attachment trauma on a Likert Scale in terms of least
___________________________________________________________
severe to most severe. They were then instructed to circle all attachment
traumas they had experienced in the previous year and to respond to two
open ended questions. The questions concerned emotional reactions to
three situations: threat of loss, anticipation of loss and sudden loss of a
family member. After responding, subjects were encouraged to discuss
their personal feelings and reactions to the exercise.
7. A look at the questions that were asked of respondents in this

study
The following questions were raised with the help of the Family
Crisis Scale to investigate the Chamorro psychological reactions to
attachment traumas. The questions are listed below.
Question 1: Is there a difference between Chamorro subject’s ranking and
western ranking of attachment traumas, or, the experience of loss(es) in
the family?
Question 2: Is there a difference between a threatening potential loss of a
family member and the anticipation of loss of a family member?
Question 3: Is there a difference between the anticipation of loss of a
family member and the sudden death of a family member?
Question 4: Is the occurrence of sudden death related to any of the listed
attachment traumas?
Question 5: What are the 3 highest ranked frequencies of attachment
traumas in the past year?
8. Results
Question 1: Rank of attachment traumas. Chamorro responses to
two attachment traumas resulted in their being ranked as more stressful
when compared to western perspectives. These included (6), a terminal
illness and (2) a developmental conflict in a family member. Further
comparisons revealed the ranking of divorce, threat of dissolution of the
family, job loss and a move, not all family, as less stressful. Chamorros
ranked sudden death, threatening illness and a move, all family, equally
with western perspectives. The Chamorro Family Crisis Scale, to be found
in appendix B, is portrayed and compared with the western Family Crisis
Scale.
Questions 2 and 3: What are the differences between threatening,
anticipatory and sudden death of a family member? Twenty five percent of
respondents indicated there was no emotional difference between the
situations of threatening, anticipatory and sudden loss of a family member.
Question 4: The occurrence of sudden death. While analysis
revealed 12 subjects had experienced a sudden death in the family in the
previous year, 7 of the 12 likewise indicated the occurrence of a divorce.
the Chamorro Sample
___________________________________________________________
Question 5: Frequencies of stressors. The three most frequent
attachment traumas included threat of dissolution of the family tied with
loss of job by a family member. A family member leaves temporarily
ranked second in terms of frequency and a move, all family included, was
third most frequent.
A corollary observation was made to discover that sixty two
percent of respondents ranked most stressful more than once to FCS items.
An understanding of these results are addressed in the next section of this
study.
Attachment traumas affect all human beings throughout their life-
spans. The ability to cope and handle the stress within a family varies
from person to person and family to family. Results from the Family
Crisis Scale reveal several thoughts that allow an understanding of the
psychological demography of the Chamorro people. An analysis of their
responses to the questions generated in this study is presented below.
9. Value placed on families

Families are a traditional core value in Chamorro lives. Actions,
decisions and behaviours often affect other family members, and most
often stay within the family. In this study Chamorros ranked terminal
illness of a family member more seriously when compared to western
perspectives. An understanding of the rank for terminal illness for
Chamorros lends support to the notion that they may tend to rate/rank all
potential threats of loss of life and sudden death equally. A more practical
explanation is advanced given the composition of females, fifty nine, in
this study. On the island of Guam there is a paucity of services aimed at
care-giving for the elderly ill and disabled. Care-giving for an ill, dying
family member is typically reserved for and expected of a female
offspring or relative of the ailing family member. Ranked number six on
the western FCS, for female Chamorros this variable jumped two levels
ahead in terms of stress and fell immediately behind the most stressful,
sudden death.
Likewise, a developmental conflict, for example, an emotional or
psychological difficulty experienced by a family member, is seen as more
serious for Chamorros. It appears that a developmental conflict might
hinder or prevent an individual from supporting the overall family or
extended family, which is seen as critical for family well being. Again, the
predominantly female sample may be reacting to their sense of their
husband’s loss of status, which on Guam, conforms to traditional male,
female roles.
___________________________________________________________
10. Calibration of emotions
A corollary observation indicated that sixty two percent of
respondents ranked most stressful to more than one FCS item.
Respondents selectively weighted several family losses as all equally
stressful. This may demonstrate an instrumental way of cognitive
processing in terms of perceiving and coping with stressful situations. An
instrumental approach addresses conflicts parsimoniously by reducing
reflection to good or bad, or right or wrong, and is indicative of a less
cognitively complex process. A complicating variable to add to this
understanding is the occurrence of the Iraq war which was in progress
during the collection of data. Guam has been historically, since world war
two, overrepresented in the successful recruitment and enlistment of
substantial numbers of individuals into the armed services. In this study it
is quite possible that females, having deployed husbands or other family
members in the armed services, are placed in a position to experience a
significant increase in the probability of threat of loss, anticipation of loss
and sudden loss because of the war. Unavoidable losses occurring within
the perspective of the family are stressful by their nature, but raising the
expectation of the various threats and exposure to loss may have provoked
an overlapping stressful blur of bleak possibilities for these Chamorro
females, leading to the sixty two percent response rate.
Regarding questions 2 and 3, the question of instrumental ways
of thinking is again evident in the Chamorro’s understanding of family
losses as represented in the qualitative/open ended questions section. For
example, ‘Is there a difference between a threatening potential loss and the
anticipation of loss?’ and ‘Is there a difference between anticipation of
loss and sudden loss?’
Twenty-five percent of respondents stated that there is no
emotional difference to the three situational loss experiences. This raises
the question, instrumentally speaking, do some Chamorro’s belief systems
contain the internalization that any threat of experience of loss in the
family is consequently regarded as equally emotionally devastating and
damaging? And indeed, if the Iraq war phenomenon can be applied,
perhaps the twenty five percent of subjects were likewise stressfully
overlapping and blurring the potential for negative expectations.
Regarding question 4, responses to sudden death and its
correlation to other attachment traumas reveals a frequency in this study
that is in keeping with the results by George Vaillant’s longitudinal study
of a cohort of Harvard graduates. He found significant correlations
between sudden death of a subject and the occurrence of a break up in the
family or an estrangement with a loved one. In this study seven of twelve
the Chamorro Sample
___________________________________________________________
subjects, or over fifty percent, indicated sudden death and a divorce in the
family in the same year.
Regarding question 5, “What are the most occurring attachment
traumas” found in this study within the past year? The three most frequent
attachment traumas included threat of dissolution of the family and loss of
job, tied, and a family member has to leave temporarily. All of these
stressors affect the core value of the family and represent movement away,
geographically, emotionally and financially from the strengths contained
in the foundation of the family, the extended family and the clan.
The notion of movement away is suggested as a threat to the
psychological well being generated by living on an island where
containment and multi-generational family lines indigenously reinforce
well being and contentment.
11. Conclusion
The stress generated losses examined in this study, experienced
by subjects within their families/extended family/clan occur in many cases
without a calibrated, differentiated pattern of emotional response(s)
deemed necessary for coping. It is broadly hypothesized that
psychotherapeutic interventions for Chamorros contain emotion based
models to process the varying types of unavoidable losses, and supportive
cognitive models to enhance cognitive complexity, vis-à-vis, the
coordinated calibrated appraisal of conflict management at home, work
and at school.
Appendix A
The Family Crisis Scale
1. A geographical move. All primary kin, however move together.
Any move, relocation where family remains intact.
2. A family member experiences a developmental obstacle; anxiety,
depression, identity conflict; developmental issues, psychological
distress.
3. A move has occurred but not all primary kin members are
included. Some temporary form of agreed upon separation.
Extended periods of time spent away from family due to work,
travel obligations; a college student.
4. A family member experiences some form of loss of status. A
change in socio-economic standing; loss of job, demotion, a
threat to family well being due to loss of financial stability.
___________________________________________________________
5. A threatening illness, accident or harmful physical threat to life
of family member. A loss of anatomical or physiological
functioning; a recoverable form of trauma.
6. A terminal illness or accident/injury of primary kin member.
Eventual loss is perceived; a state of preparedness for loss,
anticipatory grief. Typically the first experience of dying family
member dying from terminal illness is grandparent.
7. A threatened dissolution of the family. Individuals perceive a
break due to separation or divorce. Also indicates warring
factions amongst family members. Inharmonious atmosphere,
chronic conflict, aggression, violence.
8. A separation, divorce, abandonment; a break occurs. Separation
of family members, geographically and emotionally.
9. Death, sudden death of family member due to illness, injury,
accident
Appendix B
1. A geographical move. All primary kin however move together.
Any move or relocation where primary kin unit remains intact.
2. A move has occurred, but not all primary kin members are
included. Some temporary form of agreed upon separation of
family members. Extended periods of time spent away from
family due to work, travel obligations; a college student.
3. A family member experiences some form of loss of status. A
change in socio-economic standing; loss of job, demotion, a
threat to family well being due to loss of financial stability.
4. A family member experiences a developmental obstacle; anxiety,
depression, identity conflict, developmental issues, psychological
distress.
5. A threatening illness, accident or harmful physical threat to life
of family member. A loss of anatomical or physiological
functioning; a recoverable form of trauma.
6. A threatened dissolution of the family. Individuals perceive a
break due to separation or divorce. Also indicates warring
factions amongst family members. Unharmonious atmosphere,
chronic conflict, aggression, violence.
7. A separation, divorce, abandonment; a break occurs. Separation
of family members, geographically and emotionally.
8. A terminal illness or accident/injury of primary kin member.
Eventual loss is perceived; a state of preparedness for loss,
anticipatory grief. Typically the first experience of a family
member dying from a terminal illness is a grandparent.
the Chamorro Sample
___________________________________________________________
9. Death, sudden death of family member due to illness, injury,
accident.
Notes
1
Monica McGoldrick et al. Ethnicity and Family Therapy, 3rd ed. (The
Guilford Press, 2005), 4.
2
Ibid, xv-xix.
3
Don A. Farrell, History of the Northern Marianas Islands, (The Public
School System, Commonwealth of the Northern Marianas Islands, 1991),
60.
4
Ibid.
5
Ibid.
6
Ibid.
7
George Vaillant. ‘Natural History of Male Psychological Health’,
American Journal of Psychiatry, 145 (1990), 31-37.
8
Vaillant, 35.
99
T. Holmes and R. Rahe. ‘The Social Readjustment Scale’, Journal of
Psychosomatic Research, 147 (1967), 215-218.
10
Stephen Kane, ‘Family Crisis: An Attachment Perspective’, The 11th
International Conference for Counselling”, Bangkok, Thailand, December
28th -January 2nd 2005/6
Stephen W. Kane, Ph.D. is Assistant Professor of Counsellor Education,

University of Guam. He is the author of the Family CHORES model of
family therapy published in the American Journal of Family Therapy.
Vera de Oro has her Masters degree in Counsellor Education from the
University of Guam and is employed as a teacher/counsellor in the Adult
Basic Education program at Guam Community College.
Environmental Grief®: Hope and Healing
Kriss A. Kevorkian
Abstract
Earthquakes, hurricanes, tornadoes, landslides, killer storms and
a recent tsunami illustrate the awesome power of Mother Nature. We
pollute, destroy, and reshape our planet, eliminating animal habitats and
ecosystems to fit human needs. People conscious of the plight of these
events react to this decline by experiencing environmental grief®, the
grief reaction stemming from the environmental loss of ecosystems caused
by natural or man-made events. This is a unique form of disenfranchised
grief; grief that is not openly accepted or acknowledged in society. The
foundation for environmental grief lies in the Gaia Theory, which supports
the concept of interconnectedness, and the considerations found in deep
ecology and the ecology of grief. Despite what some theorists believe
about the plight of our environment, grief issues should and can be
acknowledged. Once a name is put to any type of symptom or feeling,
people are generally able to move forward and begin the healing process.
Key words: environmental grief, grief, loss, coping, validation, healing,

disenfranchised grief, Gaia theory, killer whale.
1. Introduction
Grief is the reaction to loss. When we speak of grief, it is usually
in regard to the death of a loved one. Grief can also be a reaction to many
other losses that occur in life. The losses of a job, a house, or even the
experience of having a friend move away are also associated with grief;
however, these kinds of losses are not often considered in discussions of
grief. Grief is very individual: How one person reacts could be very
different from how another might react.
Grief manifests itself in many ways, including the following:
feelings such as sadness, anger, guilt, anxiety, fatigue, and shock; physical
sensations, such as tightness in the throat or chest, dry mouth, lack of
energy, and shortness of breath; cognitive responses, such as disbelief,
confusion, and sometimes a sense of the presence of the deceased; and
behaviours such as disruptions in sleep or appetite, crying, dreaming of the
deceased, loss of interest, and social withdrawal.
Grief can also express itself in social and spiritual manifestations:
problems functioning in an organization or family and difficulties with
interpersonal relationships; and spiritual issues, such as searching for
meaning, anger, or hostility toward a religious figure.
There are many forms of grief, including anticipatory grief - the
reaction to losses associated with an impending death, which may include
250 Environmental Grief: Hope and Healing
___________________________________________________________
past, present, or future losses during the dying process; complicated grief -
“A significant minority of bereaved persons will experience substantial
impairment in their social and occupational functioning for many months
following the loss, accompanied by marked symptoms of emotional
numbness, disbelief, purposelessness, futility, insecurity, and a sense that
a part of the self has died”; 1 uncomplicated grief - a healthy, normal
response to loss; and disenfranchised grief - grief that a person
experiences for a loss that is not acknowledged by society.
2. Environmental grief
‘Environmental grief’ is the grief reaction stemming from the
environmental loss of ecosystems caused by natural or man-made events.
For purposes of this study, we conclude that environmental grief builds on
the research of Dr. Ken Doka 2 regarding disenfranchised grief, including
the following elements: The relationship is not recognized. In our society,
most support is given to people who have lost family members, such as
parents or children, people to whom they are closely related. The many
losses that occur but are not acknowledged are those in which the
relationship to the deceased is that of friend, life partner, or homosexual
life partner or lover. The loss is not acknowledged. Perinatal deaths,
abortion, or placing a child for adoption are all examples of losses not
acknowledged by society. Another loss is pet loss, which is now becoming
more recognized as society becomes increasingly aware of the roles that
animals can and do play in our lives. Other losses include the loss of a job,
which can also contribute to the loss of self-worth, self-esteem, and self-
respect. Doka also mentions infertility as a loss in adulthood causing a
sense of loss not only that one’s body has failed but also that dreams of
having a child are shattered, which can also lead to the loss of a
relationship. The griever is excluded. In some cases, a person may
disenfranchise herself or himself from the grief. In these cases, the person
is not seen socially as being capable of grief. For example, parents may
exclude children from learning about the grieving process or experiencing
the grieving process because the parents don’t believe the child capable of
grief. Children may then disenfranchise from their own grief because that
is what they believe is right, given their role in the family. The
circumstance of the death is questionable in some way. If there is a suicide
in the family or a death from AIDS, for example, there is often a stigma
involved that precludes the survivors from feeling support for their grief.
These circumstances influence the very nature of the grief reaction and at
times cause the griever to inhibit her or his grief responses.
Doka also mentions that many losses might have occurred in the
past, such as a divorce or the end of a relationship, but when someone
Kriss A. Kevorkian 251
___________________________________________________________
learns that an ex-spouse or an ex-friend has died, that loss may still cause
a grief reaction because there is now an end to that given relationship.
“Even though loss is experienced, society as a whole may not perceive
that the loss of a past relationship could or should cause grief reactions” 3
Oftentimes, when an experience is labelled or named, a certain
validity is acknowledged. The term disenfranchised grief has brought
great validation to people who have felt as though they were ostracized by
society for having an abnormal grieving process. Similarly, the guilt and
shame many women faced after having an abortion was increased by the
lack of support they had from society. The idea of disenfranchised grief
offered validation to these women and opened up support groups for
people dealing with this type of grief.
The term environmental grief was developed to put a name to the
grief that many environmentalists and others who are concerned about the
plight of our environment are experiencing. Jane Goodall has expressed
her feelings eloquently:
The emotions triggered by the death of a chimpanzee I

have loved are different again from those that
overwhelm me whenever I think of the vanishing
wildlife of the world, of animals shot by hunters, snared
by poachers, starved by the encroachment of farmers
into their feeding grounds. I am angered, as well as
saddened, when I think how hard it is to help them. The
sight of a rhino killed for his horn is terribly distressing.
It brings tears to my eyes, but the tears are part rage
because we seem unable to stop the slaughter. 4
3. Gaia theory
In 1961, Dr. James Lovelock, a British atmospheric chemist, was
invited to be an experimenter with the National Aeronautics and Space
Administration on its first lunar instrument mission. At that time, NASA
was investigating the possibility of life on Mars. NASA had difficulty
finding experts in the field regarding life on Mars, so they had to settle for
people who were experts regarding life on Earth. Soon after Lovelock
began work on a lunar probe, he was promoted to designing instruments to
analyze the surface and atmospheres of planets.
In 1972, Lovelock published a paper suggesting that life on a
planet would have to use the atmosphere and oceans to produce raw
materials for the products of its metabolism. The gases in Earth’s
atmosphere are in a persistent state of disequilibrium, but a look at Mars
through infrared telescopes revealed that the atmosphere was dominated
___________________________________________________________
by carbon dioxide and was not far from the state of chemical equilibrium,
strongly suggesting that Mars was lifeless. NASA scientists continued to
investigate in hopes that they would find life on Mars or on our other
neighbour planet, Venus. 5
Lovelock created quite a stir with conclusions that ultimately led
to his development of the Gaia hypothesis. 6 Gaia comes from the Greek
word meaning earth or Earth Goddess. The Gaia hypothesis states that the
Earth is a self-regulating living organism. Lovelock realized that science
in the 1960s looked at our world from a reductionist point of view,
meaning that it was seen from the bottom up, which did not take into
account the chemical compositions of the climate of the earth. When he
had the opportunity to view Earth from the top down, he realized that the
atmosphere of the Earth was a living part of the whole organism, that
Earth itself was a living organism. Looking at the planet from the top
down was not a new approach. Lovelock writes that physiologists,
engineers, and inventors have investigated from the top down for some
time. 7
Lovelock has written extensively regarding the fact that the Gaia
theory has not been accepted by all sciences as yet, but it has become
more mainstream. 8
Although Lovelock developed the Gaia theory and he found that
many environmentalists agreed with it; he did not always agree with the
direction environmentalists were taking in regard to protecting the planet.
Environmentalists at the time appeared to be more concerned with human
rights. “If, in caring for people, we fail to care for other forms of life on
Earth then our civilization and we will suffer.” 9 Environmentalists, it
seems, have to find a balance between the needs of humans and the need
to protect our planet without excluding one from the other.
According to Lovelock, once more than 70% to 80% of the
tropical forest is destroyed, the remaining forest will no longer sustain its
climate, meaning that the whole ecosystem will collapse. 10 If that is the
case, and we continue to destroy the tropical forest, it will not be long
before the tropical forests vanish and the people in those regions find
themselves living in a desert. Lovelock expressed it this way in 1999:
It is not enough to be concerned for people; there is no

tenure for anyone on this planet, not even for a species.
If we do not recognize our responsibility to our planet
we may not as a species ever reach our allotted span. So
let us be moderate in our ways and aim for a world that
is healthy and beautiful and which will remain fit for our
grandchildren as well as those of our partners in Gaia. 11
___________________________________________________________
The Gaia theory introduced an awareness not seen in science
previously, an exposure to a relationship more conducive to the health of
our natural world. Lovelock had his share of critics, but a number of
scientists opened their eyes to a new view of the world and to science as a
result of his work.
When science views the earth as a living organism, then we can
also accept that humans are a part of the interconnectedness of life on a
living earth. There is already much information regarding the
interconnectedness of the living earth among many indigenous cultures,
but science tends to ask too many questions and wants to probe deeply
without an awareness of how much damage that probing can cause the
earth.
At one time in human history, when we were hunter-gatherers,
humans lived with nature, not separate from it. We did not think ourselves
superior to nature but connected to it. As science advanced, we became
observers of nature, rather than being a part of it, seeking out how to make
nature work for us. If we can again view our earth as a living organism,
then perhaps we will feel more inclined to live with it and not as though
the earth was a never-ending faucet of resources for our use. Steven
Fenwick put it this way:
To view the earth as a complex, self-regulating, living

being gives new impetus to the need for ecological
protection. If ecosystems are vital parts of the earth
organism, in many respects analogous to organism, then
the death of these ecosystems may eventually lead to the
death of the planet, or at least to the extinction of
humans, since humans appear to be the major threat to
the rest of planetary life. 12
Through the work of Lovelock, scientists now maintain that the

Gaia theory has become serious science. Richard Leakey notes that field
biologists traditionally believed that the interactions among species within
ecosystems were important in maintaining stability. 13 That belief was
based more on intuition before the Gaia theory was developed. Field
biologists as well as other scientists are now able to accept what was
originally intuition thanks to the emergence of the Gaia theory “that
everything has a part to play in the emergence of the whole.” 14
4. Interconnectedness
Rory Spowers, freelance writer and broadcaster, writes that the
common thread that unites much of science today is the recognition of the
___________________________________________________________
interconnectedness in nature of all life. 15 This new paradigm in science
“shares the same vision as the ancient mystics, suggesting that there are no
boundaries between the individual and the rest of the universe.” 16
Knowing that we are connected to the earth and all its
inhabitants, we must now learn to be conscious of our actions toward our
environments. Field biologists, ecologists, botanists, and biologists appear
to have been conscious of their actions on the planet. Most often, people in
the fields of biological sciences are drawn to that field because of a love
for the environment.
Ecologist Phyllis Windle wrote about her connectedness to nature
not only as an ecologist but also on an emotional level.17 In 1990, she read
an article regarding the dogwood trees that were dying due to a fungus that
had been killing dogwood trees since the 1970s. Dr. Windle did not realize
that her reaction to the demise of the dogwoods would be so strong. She
related her reactions to those of grief, but added,
Our external, as well as our internal worlds, may make

environmental losses difficult to grieve. We have almost
no social support for expressing this grief. When I sit
beside a hospital bed as a chaplain, I expect people to
cry about the unwelcome changes they are
experiencing…Their tears (and sometimes my own) are
a sign of work well done. Honest conversations about
grief that come quite naturally at a bedside are far more
difficult at a lab bench or conference table. Thus, it is
harder for me to speak freely about my grief for
dogwoods with ecological colleagues than with fellow
chaplains. 18
There is now a name that describes and validates her grief -

environmental grief. She and her colleagues can share their grief while
they continue to educate those who are not aware of the connection to
nature. This is the first step toward healing our environment.
5. Deep ecology
Bill Devall and George Sessions credit Arne Naess, a Norwegian
philosopher and mountain climber, with coining the terms shallow ecology
and deep ecology in the 1970s. 19 Shallow ecology describes the more
human-centred version of ecology that was mainstream at the time; it
placed the needs of humans over the needs of nonhuman species. Shallow
ecology had more to do with economic well-being, with what the
environment could do to make humans more comfortable. Deep ecology,
___________________________________________________________
on the other hand, involves looking out for the welfare of the whole
system of life, including nonhuman species. The philosophy behind deep
ecology is that it is a long-term process of change for most people,
awakening an environmental ethic, a land ethic, taking into account that
humans are equal to the rocks and rivers, for example, that we are not
better than other species or things on this planet. As Aldo Leopold has
written,
In short, a land ethic changes the role of Homo sapiens

from conqueror of the land-community to plain member
and citizen of it. It implies respect for his fellow-
members, and also respect for the community as such. 20
Environmental grief is a part of deep ecology as we awaken to

our own understandings of the loss that we as humans are perpetrating on
this planet. Humans need to ask themselves deep questions about change
in order to preserve life on earth. Deep ecology has a strong foothold in
environmental activism, where it is understood that there is also a strong
reaction to environmental grief.
Some people cannot see that there is any hope in saving this
environment. They perhaps believe we have destroyed too much of the
earth to heal from our wounds. Deep ecologists are working not only to
save our planet but to shift our consciousness to awaken people to the
beauty that nature holds for all of us, if we choose to be her equal.
6. Hope
Thankfully, many people believe there is still hope for saving our
planet. For example, despite all the destruction that she sees, Dr. Jane
Goodall remains hopeful that humans will soon learn that we must nurture
nature and no longer continue to destroy it. 21 In this respect, our
environmental grief can turn to a state of healing. It is interesting that
when people share their grief with one another, it seems to allow others to
open up and share as well. In that case, they are also sharing their hope
because they have just educated another person about the effects humans
are having on our environment.
Dr. Jane Goodall began her research of wild chimpanzees on the
shore of Lake Tanganyika in 1960. Her study has become the longest field
study of any animal species in its natural surroundings. Dr. Goodall has
seen firsthand the destruction of our environment as she returns to Gombe
National Park where she began all those years ago. Gombe has changed a
great deal, yet Dr. Goodall remains hopeful that our world will be
preserved:
___________________________________________________________
There are many signs of hope. Along a lakeshore in
Tanzania, for example, villagers are planting trees where
all the trees had disappeared. Women are taking more
control over their lives, and, once they become better
educated, then the birth rate begins to drop. And the
children are being taught about the dire effects of habitat
destruction. There is the terrible pollution around the
world, the balance of nature is disturbed, and we are
destroying our beautiful planet…But in spite of all this I
do have hope. 22
Scientists with a great deal of experience in the field and in

education continue to have hope for our future. It might be more difficult
for adults to change their behaviours, so science seems to be relying on the
young, in hopes that they will be taught and made aware of the need to
protect the environment from the very start. Change is not as easy as some
might believe, but it is the only hope for our planet.
7. Healing
As stated earlier, environmental grief is the term that validates all
the emotions of despair, hopelessness, and anger. Joanna Macy discusses
the “despair work” she has created. It is similar to grief work, but she
states that one does not have to accept the loss, given that the loss has not
yet occurred and is “hardly to be accepted.” She does write, however, that
Despair cannot be banished by injections of optimism or

sermons on “positive thinking.” Like grief, it must be
acknowledged and worked through. This means it must
be named and validated as a healthy, normal human
response to the situation we find ourselves in. Faced and
experienced, its power can be used, as the frozen
defences of the psyche thaw and new energies are
released. Something analogous to grief work is in
order. 23
In grief work, it is helpful for the bereaved to accept the reality of

the loss. Doing grief work doesn’t necessarily mean that one must accept
the reality of the loss, but for healthy growth and healing, accepting the
loss is helpful when the bereaved is ready to accept.
___________________________________________________________
8. Conclusion
In the case of environmental grief, when I first considered the
idea, my concern was whether or not I was crazy. Was I the only person in
the world who was grieving over the plight of our environment? I coined
the term after reacting to the loss of marine mammals, particularly whales.
My concerns were validated by the responses and reactions of the co-
researchers, particularly when writer/scientist Leigh Calvez stated that she
felt she was alone in her thinking. “I think it’s incredibly helpful to give
this grief a name. It helps me to hear a term like that. It helps me feel that
I’m not crazy, that I’m not alone.” 24
The term environmental grief was never intended as a label to
explain to people that they are reacting to grief over loss of the
environment. It is intended to validate feelings and, hopefully, to call
people to action to make a change in the way they live so that all beings
on this planet can live as a whole system.
Educating ourselves and those around us is the key to making us
conscious of our actions toward the environment. It is important not to
judge others who are not as conscious. I do not condone any violence
against another person in order to make that person understand what she
or he is doing to the environment. We must be peaceful among ourselves
if we want to make peace with nature.
Notes
1
Robert Neimeyer and Louis A. Gamino, ‘The Experience of Grief and
Bereavement’, In Handbook of Death and Dying, Volume 2, ed. Clifton D.
Bryant (Thousand Oaks, CA: Sage, 2003), 849.
2
Ken J. Doka, ed., Disenfranchised Grief: New Directions, Challenges,
and Strategies for Practice (Champaign, Illinois: Research Books, 2002).
3
Ibid, 11.
4
Jane Goodall, ‘Digging Up the Roots’, Orion 13 (1994), 21.
5
James E. Lovelock, ‘Gaia as Seen Through the Atmosphere’,
Atmospheric Environment, 6 (1972), 579.
6
James E. Lovelock and E. Margulis, ‘Atmospheric Homeostasis by and
for the Biosphere: The Gaia Hypothesis’, Tellus, 26 (1973), 2.
7
James E. Lovelock, ‘The Environment Now and the Gaian Perspective’,
in The Spirit of Science from Experiment to Experience, ed. D. Lorimer,
(New York: Continuum, 1999), 129-148.
8
James E. Lovelock, Homage to Gaia: The Life of an Independent
Scientist (Oxford: Oxford University Press, 2000).
9
Ibid, 4.
___________________________________________________________
10
Ibid.
11
Lovelock, 1999, 148.
12
Steven Fenwick, The Dreaming Earth: Foundations for a Process-
Oriented Approach to Ecopsychology (Ann Arbor, Michigan: UMI, 1998),
88.
13
Richard Leakey and Roger Lewin, The Sixth Extinction: Patterns of Life
and the Future of Humankind (New York: Anchor Books, 1995).
14
Ibid, 139.
15
Rory Spowers, Rising tides: A History of the Environmental Revolution
and Visions for an Ecological Age (Edinburgh: Canongate Books, 2002).
16
Ibid, 232.
17
Phyllis Windle, ‘The Ecology of Grief’, BioScience, 42 (1992).
18
Ibid, 363, 366.
19
Bill Devall and George Sessions, Deep Ecology: Living as if Nature
Mattered (Salt Lake City, Utah: Peregrine Smith Books, 1985).
20
Aldo Leopold, A Sand County Almanac: With Essays on Conservation
(New York: Oxford University Press, 1949), 171.
21
Jane Goodall, ‘My Three Reasons for Hope’, 2001 [article available
online] (accessed 17 November 2003)
<http://www.janegoodall.org/jane/essay.html>
22
Ibid, para. 2.
23
Joanna Macy, World as Lover, World as Self (Berkeley, California:
Parallax Press, 1991), 16.
24
Leigh Calvez, in interview with author, October 2002, quoted in Kriss
Kevorkian, Environmental Grief: Hope and Healing, Ph.D. diss., Union
Institute and University, Cincinatti, Ohio, (2004), 64.
Bibliography
Devall, Bill and George Sessions. Deep Ecology: Living as if Nature

Mattered.( Salt Lake City, Utah: Peregrine Smith Books, 1985).
Doka, Ken J., ed. Disenfranchised Grief: New Directions, Challenges, and
Strategies for Practice. (Champaign, Illinois: Research Books, 2002).
Fenwick, Steven M. The Dreaming Earth: Foundations for a Process-
Oriented Approach to Ecopsychology (UMI Microform 9910825). (Ann
Arbor, Michigan: UMI, 1998).
Goodall, Jane. ‘Digging Up the Roots’, Orion, 13 (1994), 20-21.
Goodall, Jane. ‘My Three Reasons for Hope’ [article online] (2001;
accessed 17 November 2003); available from
http://www.janegoodall.org/jane/essay.html
___________________________________________________________
Kevorkian, Kriss. ‘Environmental Grief: Hope and Healing’, unpublished

Ph.D. dissertation, (Union Institute and University, Cincinatti, Ohio,
2004).
Leakey, Richard and Roger Lewin. The Sixth Extinction: Patterns of Life
and the Future of Humankind. (New York: Anchor Books, 1995).
Leopold, Aldo. A Sand County Almanac: With Essays on Conservation.
(New York: Oxford University Press, 1949).
Lovelock, James E. ‘Gaia as Seen Through the Atmosphere’. Atmospheric
Environment, 6 (1972), 579.
Lovelock, James E. ‘The Environment Now and the Gaian Perspective’. In
The Spirit of Science from Experiment to Experience, edited by D.
Lorimer, 129-148. (New York: Continuum, 1999).
Lovelock, James E. Homage to Gaia: The Life of an Independent
Scientist. (Oxford: Oxford University Press, 2000).
Lovelock, James E. and E. Margulis. ‘Atmospheric Homeostasis by and
for the Biosphere: The Gaia Hypothesis’, Tellus, 26 (1973) 2.
Macy, Joanna. World as Lover, World as Self. (Berkeley, California:
Parallax Press, 1991).
Neimeyer, Robert and Louis A. Gamino. ‘The Experience of Grief and
Bereavement’, In Handbook of Death and Dying Volume 2, edited by
Clifton D. Bryant, 847-854. (Thousand Oaks, California: Sage, 2003).
Spowers, Rory. Rising Tides: A History of the Environmental Revolution
and Visions for an Ecological Age. (Edinburgh: Canongate Books, 2002).
Windle, Phyllis. ‘The Ecology of Grief’. BioScience, 42 (1992), 363-366.
Kriss A. Kevorkian, MSW, Ph.D., holds a doctoral degree in thanatology,

and is the leading authority on environmental grief®. She is an adjunct
professor at Antioch University in Los Angeles, Executive Director of The
Center for Conscious Dying and Grieving, and Co-Chair of the Los
Angeles County Bar Association.

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Papers Presented at the Fourth Global Conference:

Wednesday 12th July – Friday 14th July 2006

Oxford, United Kingdom

Professor Margaret Chatterjee Professor John Parry

First Edition 2007

8 Inter-Disciplinary Press 2007

Family-Assisted Suicide in the British Media

Death and Dying: Making Sense of Life in Post-Soviet Cinemas

The Living Dead as Cinematic Images of Death

Britain’s ‘Punk’ Mourning Culture

The Making of ‘Good’ Memorialisation

Institutional Loss: Dialectical Tensions in Coping with Major Loss

Traumatic Bereavement and Coping: Implications for a Contextual

Can the Dying Mourn?

The Death of Innocents: Noncombatant Immunity vs. the Divine Foetus

Do We Have Moral Obligations to the Dead?

Don’t Fear the Reaper: An Epicurean Answer to Puzzles about Death

Coming to Grips with Death: Explained and Explored in a Children’s

Older People’s Preferences at the End-of-Life: a Review of the Literature

The Wholeness of a Broken Heart

Religion and Medicine in the Process of Managing Death and Dying:

Convenient Arrangements with Death

Death and Funerals in Sunni Communities of Turkey

The Body of Necessities in Finnish Discourse on Euthanasia

Images Of Death, Images Of Society: The Case Of Poland and Polish

Attachment Trauma, Sudden Death and Anticipatory Grief: the

Environmental Grief®: Hope and Healing

This collection of papers originates from the fourth annual

Kate Woodthorpe, October 2006.

Key words: euthanasia, family, assisted suicide, Britain, press, neo-

Biomedicine’s commitment to preserve lives has found one of its

A. The deceased person

Mum went all aggressive with the nurses. She threw a

It is significant that the description was not validated by external

B. Perpetrators and their acts

[E]ven if I had got a life sentence, and that’s what I was

The Voluntary Euthanasia Society welcomed the

Through such fleeting comments journalists bestowed a ‘balanced’

[She] spent Friday afternoon with Gillian, her brother

The consensual impression was affirmed through reports of

D. The State system: Law and judges

Daphna Birenbaum-Carmeli is a medical anthropologist at the University

Key words: death, dying, mask, ghost, body, metanarrative, film

Determines a proponent role of the beginnings and the

The Soviet imaginary as a metanarrative that had its beginning

Irina Novikova is Professor of the Department of Culture and Literature,

Key words: living dead, horror movies, abjection, otherness, narration.

The ‘living dead’ is a term for such fictive creatures as vampires,

1. The living dead as Otherness

2. The living dead as admired creatures

4. First death: death of a person

5. Social death: grieving

7. Death as a threat to body, identity and society

Kirjallisuudentutkijain Seuran vuosikirja 51, osa II, ed. Outi Alanko