THE FINAL STATUS DEATH

THE FINAL STATUS DEATH

All societies ascribe a status to the dead and a role to the 'survivors. In most societies the dead are not 'really "gone," for their spirits .rematn, Occasionally these spirits are viewed' as benevolent, but more often they are-feared . as dangerous or evil. All societies 'developed norms for treating , the dead; The Tasmanians buried hurriedly, avoided the burial places, feared the dead, and never even mentioned their names [Murdock, 1949, p. 10], while the Tanala revered their dead, treating them as though they were "away" not "dead" and inviting them to aU the ceremonials of the' living [Linton, 193.6, p. 454].

The Eskimo burled their dead quickly .but-followed burial with prolonged mourning, the' Samoans, after a frenzy; of lamentation-at , the moment of death, then followed the burl I with a prolonged party, with feasting, games, and songs [Murdock, '1949, pp. 214,' 78]'. Such ceremonials, however much they may' vary from society to society. have the same basic function in all societies: to comfort the bereaved, to reintegrate surviving friends and relatives into an active social life, and in many societies to protect against the malevolence of the spirits of the dead. Some critics have branded American funeral ceremonies as an =, obscene extravagance and a monument to the cunning greed of morticians [Mitford, 1963] such critiques overlook the important functiop of funeral. ceremonies in helping, the bereaved to accept. the reality of death, to ease feelings of guilt, and to resume active existence [Pincus, 1974; Pine, 19 76; Vernon, 1978j. Funerals .are the last of the "rites of passage", [van Gennep, 1960] and they are regarded as especially important.

The Irish wake, a time when people gathered in the house of the deceased to drink and. socialize as they mourned the dead, was an effective form of social therapy. Preparations-for the wake kept the family busy; lamentation and, weeping provided emotional release, as did the drinking; and visits by friends and neighbors reaffirmed their place in a social network [Kane, 1968]. By contrast, the conventional. middle-class American funeral gives friends and relatives little chance to socialize or to find emotional catharsis through an' unrestrained. expression of grief.

Funeral ceremonies offer the last chance for a 'display of wealth which will show the importance of the deceased and his or her family. Burial In a pauper's grave is the final disgrace, while an elaborate casket and tomb reveal the affection and the status of the  survivors

To some extent, it seems true that " the less prosperity the individual has had in ·life, the more important it. is to make an impressive exit. One survey-found, in fact, that funeral expenses were practically identical for those of high and low income [Salornone, 1968, p. '56]. Whether funeral rites are a meaningless ceremony or a helpful therapeutic process probably depends as. much on the' attitudes with which death is approached as it does on the nature of the ceremony. Some see American society as a youth-oriented society which resists old age and is unprepared for death. , For some people, the acceptance of death is based' on a religious faith that life goes on  and the grave is a new beginning rather than an end. Too many however have not found any rationale which prepares them for acceptance of death, either for themselves or their friends and relatives, so that the last act of life' is seen as empty and meaningless

The definition of death is changing. Now that heroic medical procedures can keep some life processes operating after brain function has ended, the issue of how long to preserve "hum:tn bodies has arisen. The ending of brain . function is the accepted medical test of death, but there is no generally accepted legal definition of death. Thus, the question of when to pull the plug on life-sustaining machines is morally disturbing and legally hazardous. The patient's "right to die" is another unsettled question. Several states have 'laws allowing a hopelessly ill patient to reject medical treatment and die with dignity. The burn center at the Los Angeles County, California, medical center allows hopeless burn patients to choose whether to have maximum medical treatment or to die quietly and more quickly with only pain-controlling medication .. Most of them choose to die quickly [Imbus and Rol and Status Zawacki, 1977].

Whether there is a "right to suicide" is being seriously debated by doctors, theologians, and the public [Portwood, 1978]. The traditional charade in which everyone pretends not to know that th~patient is dying . is today being replaced by realism and candor: Counseling services and group therapy assist both terminal patients and their {families in accepting death [Goleman, 1976; Hotchkiss, 1978; Brim, 1979]. Kubler-Ross [1975] states that terminal patients typically pass through five stages in the process of coming to terms with death: denial, anger, bargaining, depression, and final acceptance. Her analysis has been challenged by empirical research [Kastenbaum, 1976, P: 45] but continues to be influential. The new interest in helping the terminally .ill to face death has brought charges that hospitals are too often concerned only with healing and do not help those who are dying .: [Noyes and Clancy, 1977]. This has led to development  other hospice movement which centers attention on the, patient who is not going to be cured.

The 'effort is to make the patient as comfortable as possible while increasing social contacts with friends and relatives. Most 'are home-care programs, although sometimes special wards are provided. Pain relief. is emphasized, with no costly efforts to prolong life [Wall Street Journal, May  3, 1982j. Like any social innovation, the hospice movement encounters some opposition [Rossman, 1977], yet it will probably endure as it restores the historic place of friends and relatives in this last stage of life.