What Have You Learned?

1. Question 26.1

   Why are people today less familiar with death than people were 100 years ago? What impact might this have?

   One hundred years ago, death often took place at home, where the dying person was surrounded by family and friends. Today, death most often occurs in hospitals, removed from the view of everyday life. Few people have witnessed death firsthand. As death has become less familiar, it has become more feared.

2. Question 26.2

   According to the ancient Egyptians and Greeks, what determined a person’s fate after death?

   The ancient Egyptians believed that one’s fate after death was dependent on a combination of the person’s actions during life, the circumstances of the death, and the propriety of the burial. The ancient Greeks believed that fate after death was dependent on the good and evil deeds a person committed while alive.

3. Question 26.3

   What is one example of contrasting rituals about death?

   Multiple examples appear in the text. One example is that in many Muslim and Hindu cultures, the dead person’s body is bathed by a family member, while in some Native American traditions, no family member is to touch the body.

4. Question 26.4

   What should parents remember when talking with children about death?

   Adults should consider a child’s stage of cognitive development when talking about death and should strive to answer questions honestly. Avoiding the topic may give the impression that death is too terrible to even discuss, which could be very frightening for a child. Children are likely to exhibit signs of mourning, though it can be difficult to anticipate exactly how death might impact them; usually the death of a person or a pet closely involved in their daily lives has more of an impact than the death of a close relative who is generally removed.

5. Question 26.5

   How does terror management theory explain young people’s risk taking?

   Terror management theory helps explain some apparently illogical responses to death. With this in mind, young people may take extraordinary risks and then, when they survive, feel as though they have “proven” that they will not die.

6. Question 26.6

   How does parenthood affect people’s thoughts about their own death?

   When people become parents, they often eliminate many risk-taking behaviors in favor of more cautious practices. They fear death in part because they do not want to abandon family members.

7. Question 26.7

   How do attitudes about death shift in late adulthood? What evidence is there of this shift?

   In late adulthood, anxiety about death decreases while hope increases. Many individuals in this stage write wills, create health care proxies, and take other steps to plan for the moment of their own death; irrational actions associated with terror management theory are less prominent. In addition, priorities shift; many older adults seek to allocate more of their time to their family. Many older adults also express a belief in life after death.

8. Question 26.8

   In what ways do people change after a near-death experience?

   After having a near-death experience, people tend to move toward the same realizations: 1) the limitations of social status; 2) the insignificance of material possessions, and 3) the narrowness of self-centeredness. People tend to emerge more loving and hopeful than they were before.

9. Question 26.9

   What is a good death?

   A good death is typically thought to take place after a long life, peacefully, quickly, in a familiar place, surrounded by loved ones, and without pain or discomfort.

10. Question 26.10

    According to Kübler-Ross, what are the five stages of emotions associated with dying? Why doesn’t everyone agree with Kübler-Ross’s stages?

    Kübler-Ross’s five stages of dying are: 1) denial; 2) anger; 3) bargaining; 4) depression; and 5) acceptance. Some people do not agree with her stages because not everyone moves through all five stages in this order—or at all.

11. Question 26.11

    What determines whether a dying person will receive hospice care? What are the guiding principles of hospice care, and why is each one important?

    Hospice patients must be terminally ill, with death anticipated within six months, and the patient and his or her family must be willing to accept death. In addition, where a person lives and even insurance (or ability to pay) are factors in determining if a person will receive hospice care. Two guiding principles for hospice care are that the dying person’s autonomy and decisions be respected, and that the needs of the mourners be met. By providing the kind of environment and pain management a patient desires, and by supporting mourners during and after the loss of a loved one, hospice aims to make the dying process easier and less frightening.

12. Question 26.12

    Why is the double effect legal everywhere, even though it speeds death?

    Morphine and other opiates have a double effect: They relieve pain (a positive effect), but they also slow down respiration (a negative effect). A painkiller that reduces both pain and breathing is allowed by law, ethics, and medical practice.

13. Question 26.13

    What differences of opinion are there regarding the definition of death?

    While the prevailing opinion for decades was that death occurred when brain waves stopped, many doctors now argue that a person may still have primitive brain waves even after death. Researchers seek to more clearly distinguish between people in a permanent vegetative state and those in a coma, from which they may recover.

14. Question 26.14

    What is the difference between passive and active euthanasia?

    In passive euthanasia, a person is allowed to die naturally, through the cessation of medical intervention. In active euthanasia, someone takes action to bring about another person’s death, with the intention of ending that person’s suffering.

15. Question 26.15

    What are the four conditions of physician-assisted “death with dignity” in Oregon? Why is each condition important?

    The dying person must be an adult and an Oregon resident (which is important since physician-assisted death with dignity is illegal in other states); the person must make the request twice orally and once in writing (which is important to help ensure that the person did not make the request simply as the result of a particularly bad day); fifteen days must pass between the first request and the prescription (which is also important in making sure the person has had time to consider the decision); and two physicians must confirm that the person is terminally ill, has less than six months to live, and is competent (which is important because the law is meant to help only those who are dying and can make the decision with a sound mind).

16. Question 26.16

    Why would a person who has a living will also need a health care proxy?

    Living wills stipulate the medical interventions that people would like to have (or not have) if they are ever unconscious and unable to articulate these preferences for themselves. However, no document can completely cover every circumstance and situation. A health care proxy is a person designated to make medical decisions for another person; in the event that a situation that is not clearly identified in a living will emerges, the person’s health care proxy would be called upon to make decisions for the person.

17. Question 26.17

    What is grief, and what are some of its signs?

    Grief is the powerful sorrow one feels after the death of another. Signs include crying, sleeplessness, delusional thoughts, loneliness, denial, anger, and sorrow. However, grief is highly personal and can manifest itself in many ways.

18. Question 26.18

    List three types of complicated grief. Why is each type considered “complicated”?

    Absent grief is that in which mourners do not or cannot grieve. Disenfranchised grief is that in which some people, even though they are bereaved, are prevented from participating in mourning. Incomplete grief is that in which circumstances interfere with or delay the process of grieving. All three types of grief are considered “complicated” because they impede the person’s future life, usually because he or she clings to sorrow or is buffeted by contradictory emotions.

19. Question 26.19

    What are the differences among grief, mourning, and bereavement?

    Grief is the intense sorrow felt after someone dies. Bereavement is the period of grief following a loss. Mourning is the public or ritualistic expression of bereavement, meant to move survivors from a place of loss to reaffirmation.

20. Question 26.20

    How can a grieving person find meaning in death?

    A grieving person may find meaning in death through engaging in political protests or connecting to causes aimed at improving life for others (for example, joining efforts to end gun violence or drunk driving or to find a cure for cancer), or in reflecting on and sharing the impact that the deceased had on his or her own life.

21. Question 26.21

    How might talking to the deceased make it easier or more difficult to adjust to the death of a loved one?

    Talking to a deceased loved one is one way of creating a continuing bond, though how much such actions help a person deal with grief may be dependent on culture. In China, talking to a deceased person appears to help the healing process; in the United States, it may actually hinder it.

22. Question 26.22

    If a person still feels a loss six months after a death, is that pathological?

    While most people are about as happy and productive six months after a death as they were before the death occurred, current research highlights a diversity of reactions after death. Research also points to the importance of knowing about a grieving person’s psychological history when analyzing his or her response to grief.

23. Question 26.23

    What should friends and relatives remember when helping someone who is grieving?

    Those close to a grieving person should remember that grief involves a variety of complex and powerful emotions, and that there is no one “correct” way to grieve. It is important to listen and sympathize and not to judge, as individuals exhibit a diversity of responses to a loved one’s death.