Category Archives: Cultural Attitudes toward Death

Euthanasia: An Introduction

In popular media, the question often posed is: should euthanasia be legal? 

There are several things about the phrasing of this question that are misleading.  First–and this may surprise you–certain forms of euthanasia are in fact legal in the United States.  Second, the question regarding euthanasia and legality, as most popular media refers to it, is actually a question of active/voluntary/physician-assisted euthanasia and its subsequent legality. And lastly, contention with regards to euthanasia is most often connected with the idea or possibility of the occurrence of passive or active/involuntary/physician-assisted euthanasia or as it is more commonly called: a form of homicide. 

It is clear that popular media does little to distinguish between various forms of euthanasia and at best conflates a large number of issues surrounding euthanasia.  This in turn serves to further complicate any discussion regarding it.   With that being said and given that the passing/rejecting of some landmark legislation is in the not too distant past, I want to take this opportunity to consider the topic of euthanasia.  Because the topic is incredibly complex, this will most likely be one of several posts concerning itself with euthanasia.  In this post, I simply intend to present and generally define some terms and provide an overview of euthanasia in the United States*.  In (a) later post(s), I intend to look more closely at the euthanasia debate itself.

*Note: I will only be discussing states that have legislation regarding euthanasia; I am not treating states that have case precedents regarding euthanasia (i.e. Montana, Texas, etc.)

An Introduction

The euthanasia debate spans a large number of fields and theoretical orientations and I believe it can be agreed upon that decisions regarding euthanasia are incredibly complicated due to a confluence of factors encompassing religious, medical and philosophical changes over the centuries.  The complicated nature of this social issue necessitates defining euthanasia as well as utilizing a structure of conceptualization that is categorical in nature.  According to Pfeifer and Brigham (1996), euthanasia, as an overarching concept, refers to any action or inaction by an individual to encourage the death of another who is suffering from a terminal condition.  There are three subcategorical distinctions: active and passive; voluntary,  nonvoluntary, and involuntary; and physician-assisted and nonphysician assisted.  Conceptualizing euthanasia in this manner enables one to concretely and distinctly describe an act of euthanasia (e.g. passive/physician-assisted/ voluntary euthanasia, active/nonphysician assisted/voluntary euthanasia, etc.).  Moreover, it also, according to  Pfeifer and Brigham (1996), enables one to begin to investigate and gain a more concise understanding of current attitudes toward euthanasia.

The terminology and subsequent definitions you encounter below were taken from the introduction written by Pfeifer and Brigham for the Journal of Social Issues: Psychological Perspectives on Euthanasia (1996) unless otherwise stated.

Active and Passive

Active euthanasia is defined as an act of commission in which a person engages in some direct action in order to hasten the death of a terminally-ill individual.

Passive euthanasia is defined as an act of omission such as the issuance of a DNR instruction by a physician that results in the death of a terminally-ill patient.

Voluntary, Involuntary, and Nonvoluntary

Pfeifer and Brigham (1996) do not distinguish between, and actually conflate, involuntary and nonvoluntary euthanasia.  Recently, and in particular among journals concerned with ethics and/or law, a distinction between these two terms is prevalent.

Voluntary euthanasia applies to circumstances in which an individual’s wish to die is known and/or expressed through directives such as verbal statements, living wills, etc.

Harris (2001) and Jackson (2006) are more specific in their language and apply voluntary euthanasia to circumstances in which a patient is able to and does provide informed consent.  This encompasses directives such as verbal statements, living wills, etc.

Nonvoluntary euthanasia applies to circumstances in which the individual is unable to specifically indicate his or her wish regarding death.

Harris (2001) and Jackson (2006) are more specific, stating that nonvoluntary euthanasia applies to circumstances in which the patient is unable to give informed consent, for example when a patient is in a persistent vegetative state, if the patient is a child, etc.  Nonvoluntary contrasts with involuntary, according to Jackson (2006), as follows:

Involuntary euthanasia applies to circumstances in which euthanasia is performed on a person who is able to provide informed consent, but does not either because they do not wish to be euthanized or because they were not asked.

Physician-assisted and Nonphysician assisted

Physician-assisted euthanasia applies to circumstances in which a physician assists an individual.

Nonphysician assisted euthanasia applies to circumstances in which a nonphysician assists an individual.

Euthanasia in the United States

We have, over the years, witnessed cases and lawsuits arise due to acts involving active/voluntary/physician-assisted euthanasia (i.e. Dr. Kevorkian, etc.); active and passive/voluntary/nonphysician assisted euthanasia (i.e. cases in which someone fulfills the request to die of another); and active and passive/nonvoluntary/physician-assisted euthanasia (i.e. Terri Schiavo, etc.).  Given this and the outcomes of these various cases, it is obvious that euthanasia is both contentious and complicated at best nor entirely legal or illegal.

Death With Dignity Movement

Typically within the United States patients retain rights to refuse medical treatment and elect appropriate management of pain even if it may hasten their death via explicit consent, advanced directives, living wills, etc..  Even though the average American may not conceptualize this as a form of euthanasia, it is. And, more specifically, it is a passive/voluntary/physician-assisted form of euthanasia.  In popular media, I have rarely seen these rights referred to, let alone referred to in the context of euthanasia. However, a lot of media attention is given to active euthanasia, especially cases in which the euthanasia is contested by a party to have been involuntary.  Active euthanasia of any kind is not legal in most states.  However, there are exceptions. According to the Death with Dignity National Center (2012), two states enacted acts legalizing and allowing residents to elect active/voluntary/physician-assisted euthanasia.   These two states are Oregon and Washington.  In Oregon and Washington, these acts allow “mentally competent, terminally-ill adult state residents to voluntarily request and receive a prescription medication to hasten their death” (Death With Dignity National Center, 2012).  The acts passed in both Oregon and Washington have their origins in a movement referred to as the Death with Dignity movement.  This movement’s purpose is to provide options ranging from advance directives to physician-assisted dying so that those facing terminal conditions may take control of their own end-of-life care.

Currently, according to the Death with Dignity National Center (2012), there are six states (Hawaii, New York, Massachusetts, New Jersey, Vermont and Pennsylvania) considering death with dignity-related legislation and two states that have banned death with dignity-related legislation concerning active/voluntary/physician-assisted euthanasia (Georgia and Louisiana).  In Hawaii, legislation was introduced in 2011 and carried over to the 2012 Regular Session, which adjourned May 3; The bills have not moved forward.  In New York, legislation was introduced in February; the legislature enacted clause stricken on May 9th.  On November 7th, Massachusetts voters defeated the bill introduced to their legislature by a narrow margin of 51 percent to 49 percent with 96 percent of precincts counted (Boston Globe, 2012).  In New Jersey as of September 27th, the legislation has been referred to Assembly Health and Senior Services Committee. In Pennsylvania, their bill was referred to Judiciary committee in February of 2011 and is currently active for consideration. And in Vermont, their bill was referred to Senate Committee on Judiciary in March 2011 and the House Committee on Human Services in February 2011. The bill received a hearing in Senate Judiciary Committee on March 2012.  Supporters of the bill worked to give all the Senators an opportunity to vote, and, according to the Death with Dignity National Center (2012), used a Senate rule which allows certain pieces of legislation to be voted on as an amendment instead of as a self-standing bill.  Vermont’s legislative session adjourned on May 5th.*  

Considering the number of states that have/are entertaining death with dignity-related legislation, it is apparent that the death with dignity movement has made considerable advances both in its visibility and its number of proponents since the late 70s/early 80s.  While I am not sure I can agree that euthanasia is “the most pressing social issue of our time” (Pfeifer and Brigham, 1996), I do believe it may be one of the most ethically complicated and contentious.   

*NOTE: For more specific information about these bills or the acts in Oregon and Washington, please visit the Death with Dignity National Center website and follow the links to the appropriate resources.  You may also visit your state legislature’s website.

SOURCES

Boston Globe, The. (7 Nov 2012). Mass. doctor-assisted suicide measure fails. Retrieved 8 Nov 2012 from http://www.boston.com/news/local/massachusetts/2012/11/07/backers-mass-doctor-assisted-suicide-concede/oXZDcgOUbqwhlqzb63FSPO/story.html.

Death with Dignity National Center. (2012). “Research Center: national efforts.” Retrieved 9 Nov 2012 from http://www.deathwithdignity.org/advocates/national

Harris, N.M. (2001). “The euthanasia debate.”J R Army Med Corps 147 (3): 367–70.

Jackson, J. (2006). Ethics in medicine. Polity. ISBN 0-7456-2569-X.

Pfeifer, J.E., Brigham, J.C. (1996). Psychological Perspectives on Euthanasia. Journal of Social Issues 52 (2): 1-11.

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Filed under Academic Resources, Cultural Attitudes toward Death, Culture, Introduction, News

Before I die, I Want To…

Photo of the ‘Before I Die’ project in New Orleans.

To the left is a picture of an abandoned building in New Orleans. What you see on the the side of the building started out as an experiment by Candy Chang. Candy had lost someone she loved. In writing about this experiment and the impetus for it, she said, “I thought about death a lot. This helped clarify my life but I struggled to maintain perspective. I wanted to know what was important to the people around me and I wanted a daily reminder.”

Candy and her friends painted the side of an abandoned house in their neighborhood with chalkboard paint. They then stenciled the sentence “Before I die I want to _______.” and left chalk in little baskets along the walls so anyone walking by would be able reflect on their lives and share their aspirations in public space.  

I stumbled upon this project while perusing the world wide web via ‘Stumble Upon’ the other day.  As I looked through the

Before I Die in Minneapolis

photos of various walls across the U.S. and several other countries, I came across the wall in Minneapolis.  I scanned through the photos quickly, looking for the address where the wall was located, but had no luck.  Upon google searching the Minneapolis project, I found that Before I Die in Minneapolis, according to the Startribune, “is on a wall at 2609 Stevens Avenue in Whittier, part of that neighborhood’s ‘Artists in Storefronts.'”  The project ran April 27 through June 10 of this year (2012).  So, I had missed it by a good two months.  

Anyway, I know this is a departure from what I listed in my previous post concerning up and coming blog topics, but because these art projects are more time sensitive than the topics I am working on currently. Thus, I figured it would be best to post about this before other drafts.  

Projects like these are always very interesting to me.  So, I encourage you to look for your city on the Before I Die Project Website and go have a look.  And take some pictures.  Maybe even write a little something of your own on the wall for others to see.  Or, if like me, you missed the project in your city, see if you can catch one in a city near you because as Candy Chang said, “it’s easy to get caught up in the day-to-day and forget what really matters to you.” And sometimes all you really need is a little reminder.

SOURCE: CandyChang.com

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Filed under Art, Cultural Attitudes toward Death, Culture

You Want a Physicist to Speak at Your Funeral.

I came across this the other day while on tumblr searching the tag “funeral.”  I found it to be rather poignant, not to mention a manner of looking at death that is quite similar to my own.  I shared this on practically every other forum available to me.  Thus, I thought I would also share it here.

Transcript for Planning Ahead Can Make a Difference in the End, Aaron Freeman, from NPR All Things Considered

You want a physicist to speak at your funeral.

You want the physicist to talk to your grieving family about the conservation of energy, so they will understand that your energy has not died. You want the physicist to remind your sobbing mother about the first law of thermodynamics; that no energy gets created in the universe, and none is destroyed. You want your mother to know that all your energy, every vibration, every Btu of heat, every wave of every particle that was her beloved child remains with her in this world. You want the physicist to tell your weeping father that amid energies of the cosmos, you gave as good as you got.

And at one point you’d hope that the physicist would step down from the pulpit and walk to your brokenhearted spouse there in the pew and tell him that all the photons that ever bounced off your face, all the particles whose paths were interrupted by your smile, by the touch of your hair, hundreds of trillions of particles, have raced off like children, their ways forever changed by you. And as your widow rocks in the arms of a loving family, may the physicist let her know that all the photons that bounced from you were gathered in the particle detectors that are her eyes, that those photons created within her constellations of electromagnetically charged neurons whose energy will go on forever.

And the physicist will remind the congregation of how much of all our energy is given off as heat. There may be a few fanning themselves with their programs as he says it. And he will tell them that the warmth that flowed through you in life is still here, still part of all that we are, even as we who mourn continue the heat of our own lives.

And you’ll want the physicist to explain to those who loved you that they need not have faith; indeed, they should not have faith. Let them know that they can measure, that scientists have measured precisely the conservation of energy and found it accurate, verifiable and consistent across space and time. You can hope your family will examine the evidence and satisfy themselves that the science is sound and that they’ll be comforted to know your energy’s still around. According to the law of the conservation of energy, not a bit of you is gone; you’re just less orderly.

Amen.

–Aaron Freeman

To listen to the soundbite, please follow the link at the top or click here.

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Filed under Cultural Attitudes toward Death, Eulogy

So, What Would You Ask a Mortician?

Before I go into this post, I want to apologize for my absence this past month. I needed a little break from everything and to finish midterms, but I’m back!

I want to start March off with a “fellow-blogger-spotlight” type of post. Who is in the spotlight? Caitlin Doughty. Maybe some of you have heard of her from Connecting Directors, Jezebel, or the Huffington Post. Or maybe you’ve seen one of her youtube videos from the series “Ask A Mortician.”

Who is Caitlin? Caitlin is a licensed funeral director in Los Angeles.  She decided to put herself out there to give people a chance to ask questions and hopefully change the way people think about death.

I came across Caitlin through a friend of mine who sent me a link to an article about her in Jezebel. Caitlin is founder of Order of the Good Death, a site containing Caitlin’s blog, collections of essays, and other things related to death. Here’s what Caitlin says about herself on her bio page:

Caitlin, your mortician, was born on a balmy August evening on the cruel, unforgiving shores of O’ahu, Hawai’i.

An even tempered, bookish child, there was little reason to believe that she would ultimately seek the life of a psychopomp, tiptoeing the line between the living and dead. It was only when she began to ask the pertinent questions that her parents began to suspect a proclivity towards the macabre….

After completing high school, Caitlin fled her island home on the first plane east to Chicago. In the comparatively frigid halls of the University of Chicago, she worked towards her degree in Medieval History. Her thesis, entitled “In Our Image: The Suppression of Demonic Births In Late Medieval Witchcraft Theory,” is a must read for all lovers of demon sex and the medieval church.

A year out of college found your mortician living in California, where she began to apply to crematories in an attempt to put into practice her theoretical death interests. Since her first job as a funeral arranger she has worked as a crematory operator, a body van transport driver, and returned to school for her degree in Mortuary Science. She is currently a licensed funeral director in Los Angeles.

After reading the Jezebel article, visiting her website, and watching the first installment of “Ask a Mortician,” I must say I’m glad that there are others out there who are passionate about this profession and are able and willing to write about it.  It’s definitely getting people talking and I think that is great. Of course, I do not necessarily agree with everything she writes, but I do give her props.  Her website is an interesting collaborative work and her blog contains many interesting topics.  So, if you’re looking for something interesting and aren’t afraid to face one of your fears, stop by and check out Caitlin’s space!

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Filed under Blogger Spotlight, Cultural Attitudes toward Death, Humor, News

If I Die– Hey, There’s an App for That!

Yes, seriously.  It’s true.  If I Die is a relatively new Facebook App that allows its users to create a video or a text message that will be published once the users’ death has been verified.  While this may seem morbid, Eran Alfonta, co-founder and CEO, sees it this way: “We all have things to say and don’t necessarily have the audience with the patience to hear us.  Actually, we all want to leave something behind, we all want to leave a stamp behind us.”

Now that you’re curious and contemplating your mortality, let’s get to how it all works.  It’s simple!  Download (or install) the app, create a message or two, or three, or more and then select three people, called “trustees,” who will verify your death.  And you’re set!  It’s just that easy.

Click to see ‘If I Die’ youtube video advertisement

As of today, according to Sinderman’s article on Mashable: Social Media, “If I Die currently only publishes to a user’s public profile, but the team is working on features to allow for discrete messages and even messages that can be sent to people not on Facebook.  The public postings will be free to use, though the discrete messages will work on an annual subscription model.”

Now, some of you may be thinking: doesn’t Facebook already have something in the case that a user dies?  Facebook does have an official process to aid family members in the memorialization of their deceased relatives but, according to Powell from Daily Dot, “Facebook is quickly becoming the world’s largest e-cemetery [and therefore,] there’s a legitimate need for this (If I Die) sort of service.”

So, just how popular it this little app?  According to Sniderman, it is unknown how many active users If I Die has, as the team has been fairly silent when asked, but Alfonta expects to reach 100,000 in a few months.  And guess what, there’s more!  If I Die isn’t the only death-focused digital service out there to help you manage your virtual life.   Here are seven others: Entrustet, Legacy Locker, My Webwill, Futuris.tk, Deathswitch, Great Goodbye and AssetLock.

All of this brings me to a bigger theme: technology and death.  Is it good?  Is it bad?

I already did  encounter one less than optimistic response, specifically to If I Die.  Hehir, of the Nerve, generally expresses the sentiment that “life has gotten unnatural enough with social networking.”   She sees the potential for one too many “inarticulate, embarrassing, and self-indulgent rants [with] far too many people us[ing] it just to spit vitriol, spite their enemies, and further desecrate whatever good merit they managed to hustle for themselves while they were alive.”  (FYI: ifidie’s youtube video even explicitly mentions “settling an old score.”)

While I do not disagree with Hehir’s sentiment entirely, my interest at this particular time is concerned with the American attitude toward death rather than a critique of the flaws of human nature and judgement.  With that being said, according to anthropologists, there are three different cultural responses to death: acceptance, denial or defiance with American culture exhibiting that of denial.  Defiance and denial are associated with cultures in which there is a strong belief in or desire for immortality.  There are a multitude of aspects in American culture that scholars use to argue for (and against) American denial: life insurance policies, euphemisms, taboo on death conversation, cryonics, the way in which caskets are styled, medicalization of death, the process of preparation, the committal itself, “pornography” of death, etc.. And now with the advent of social media and other technology, this list just might be growing.

Social media technology (TV and video gaming included) is impersonal; it creates distance–a kind of bubble–allowing the user to create, perpetuate, and live in their own reality in many ways, in addition to the opportunity to distort and thereby control a situation.  This, over time, can (or may) succeed in lessening the weight of reality itself whether by desensitization or separation, or a combination of the two.  For example, consider  Digital Death (Buy A Life).  The premise is that, through a donation, the donor can “buy life” or resurrect a famous individual from the dead (albeit digital death).  It’s the most blatant example of the user controlling death, specifically the death of another. All this being said, digital life– life after death– begs several questions: is this simply an extension of our denial?  Is this an attempt at immortality?  Is it representative of another shift in the American perspective on death? How will this affect the mourning process?  Will it result in emotional stunting?  Will it present or lend itself to the creation of complicated grief?  Will it help families grieve more fully…?

Where do you stand? What do you think social technology will do to death?

For another interesting article relating to technology and death, please see: Life After Death, in Digital Form

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Filed under Cultural Attitudes toward Death, Technology