Some end-of-life aspects have become a significant political and social issue such as elderly care and euthanasia. But hardly anything is known about how the general public in Germany thinks about death and dying more generally. Therefore, we conducted a representative online survey (N = 997) regarding 21 end-of-life aspects. Differences between subgroups were analyzed by conducting analyses of variance and Tukey honestly significance difference post hoc tests and by performing t tests. The findings revealed that the general public is open to engaging with topics of death, dying, and grief and that death education might even be promoted for children. Most participants appraised dealing with the finitude of life as part of a good life, but few have contemplated death and dying themselves so far. Attitudes and perceptions were related to age, subjective health, religious denomination, and gender. The survey provides useful implications for community palliative care, death education, and communication with dying people.
Stress is a commonly reported concern of individuals with chronical diseases, including multiple sclerosis (MS). This study sought to investigate the relationships between self-transcendence, death anxiety, and perceived stress among individuals with MS from Iran. A second aim of the study was to assess the buffering effect of self-transcendence in the relationship between death anxiety and perceived stress. Two hundred and fifteen participants with MS from four hospitals completed measures assessing self-transcendence, death anxiety, and perceived stress. Using structural equation modeling, death anxiety was found to be positively related to perceived stress. In addition, there was a negative relationship between self-transcendence and perceived stress. Results of the study suggest that self-transcendence is a buffer in the link between death anxiety and perceived stress for individuals with MS. The findings demonstrate the importance of self-transcendence in decreasing the effects of death anxiety on perceived stress and have clinical implications for health professionals.
The study examined the influence of training on first-year nursing department students’ attitudes on death and caring for dying patients. Utilizing the experimental model, the study sample consisted of 81 first-year students attending the nursing department of a university. Death Attitude Profile-Revised and Frommelt Attitude toward Care of the Dying Scale were used for data collection. Data analysis included means, standard deviation, and t test for related samples. Student attitudes toward death were measured as 146.43 (16.741) and 152.75 (15.132) for pre- and posttraining, respectively. Student attitudes toward caring for dying patients were established to be 103.02 (7.655) during pretraining period and 111.02 (10.359) at posttraining period. The difference between pre- and posttests for mean attitudes toward death and caring for the dying patient was statistically significant. Study results determined that training was effective in forming positive student attitudes toward death and caring for dying patients.
The study investigated the traumatic impact of the Dana 2012 plane crash in Lagos, Nigeria. Using a cross-sectional survey, the roles of quality of life (QoL) and impact of event were examined against death anxiety of the proximate inhabitants of the crash site. Result showed significant influence of QoL on death anxiety, with higher QoL participants manifesting higher levels of death anxiety. However, impact of the crash event and demographic indicators such as age, sex, pilot preference, and belief-in-life after death did not influence death anxiety of participants. It can be concluded from these results that the perception of higher QoL has a profound influence on death anxiety of people reminiscing mortality reminders no matter their age, sex, beliefs, and life preferences. It is recommended that anxious death-related experiences be prevented in all spheres of life in pursuit of safety and sound mental health of the people.
Le moment de la mort est symbolisé par le spectre squelettique de la MORT avec sa faux et son sablier. Le sablier dans la main de la MORT indique que l’heure ne sonne pas avant que la Destinée n’ait été complètement accomplie selon des lois invariables. Le squelette représente la partie du corps relativement durable. La faux rappelle que la partie permanente sur le point d’être moissonnée par l’ESPRIT est la récolte de la vie qui se termine et se traduit par l’expression :
"Ce qu’un homme sème, il le moissonnera."
C’est la loi de cause à effet qui régit toute chose dans tous les domaines de la Nature, physique, mentale, morale.
Un livre audacieux qui ose parler de la mort sans tabous.
La mort, on n’en veut rien savoir, ou le moins possible ! Tête dans le sable, oreilles bouchées, position de fuite immédiate dès que le sujet est levé. Or il faut bien, tout au long de notre vie, oser la regarder. Qu’on le veuille ou non, elle s’impose à nous à travers les pertes, les deuils, et en vieillissant avec la perspective de sa propre disparition.
Paule Giron relève le défi. Avec son regard aigu et sa plume acérée – sans se départir de son humour – elle nous entraîne dans une exploration de nos attitudes face à la mort : du déni à la peur de disparaître ; de l’espoir d’un au-delà au rationalisme « scientifique »…
Sans complaisance et avec lucidité, elle évoque le temps de la douleur, le temps du souvenir, le temps de l’attente avant la mort… Autant de moments où sont mobilisées en nous forces et faiblesses contradictoires, qu’il s’agisse de ceux que l’on aime ou de nous-même.
[Extrait résumé éditeur]
Le Catalogue de la mort est une exploration décomplexée de la dernière grande étape de notre existence : la mort. Dans cet ouvrage à la fois drôle et érudit, Bunpei Yorifuji aborde tous les aspects imaginables du « passage vers l’au-delà » : où meurt-on le plus ? De quelles causes ? Qui vit le plus longtemps ? Quelles sont les cultures où l’on craint le plus la mort et comment la représentent-ils ? Quelles sont les meilleures (et pires) façons de mourir ? Bref : qu’est-ce que la mort ?
À cette interrogation naïve, l’auteur répond comme à son habitude en texte et en image, mêlant dessins humoristiques, anecdotes et recherches approfondies. Fort d’une culture japonaise où ce sujet est appréhendé sans tabou, Bunpei Yorifuji s’adresse dans cet ouvrage autant aux adultes qu’aux plus jeunes. Un livre à mettre entre les mains de toutes celles et ceux qui cherchent à aborder avec finesse et humour le thème de la mort.
Depuis la seconde moitié du XXe siècle, de nombreux sociologues, anthropologues et historiens, ont souligné le fait que la civilisation occidentale se caractérisait par un "déni social de la mort" et qu'elle procédait ainsi à une occultation dramatique des personnes en fin de vie. La mort et le mourir seraient devenus " tabous " et notre culture jeuniste et consumériste nous inciterait à en détourner nos regards.
Vouloir éloigner le tragique, faire décliner l'importance traditionnellement accordée aux rituels funéraires et au deuil, tel serait un des aspects majeurs de notre culture. Les sciences sociales étaient alors accusatrices : elles dénonçaient le " mal mourir " et faisaient la critique d'un monde où le rapport à la mort avait globalement cessé d'être familier. Ce constat exigeait donc un remède : dès les années 80, se sont développés en France les soins palliatifs et de nombreux débats sur la fin de vie ont fait leur apparition dans l'espace public (notamment la question de l'euthanasie et celle du refus de l'acharnement thérapeutique).
Pour autant, avons-nous aujourd'hui réussi à modifier notre rapport au mourir, à "resocialiser la mort" et à mieux accompagner les personnes en fin de vie ? Avons-nous trouvé les moyens d'enrayer le processus d'occultation de la mort dont beaucoup pensent qu'il est inévitablement pathologique ?
Five decades ago, Henry Knowles Beecher, a renowned professor of research anesthesiology, sought to solve a problem created by modern medicine. The solution proposed by Beecher and his colleagues on the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proved very influential.1 Indeed, other contemporaneous medical developments magnified its significance yet also made the solution it offered somewhat problematic. As we mark this fiftieth anniversary, at a time when concerns about the conceptual model on which its recommendations rested are being voiced by critics from medicine as well as philosophy, it is worthwhile to view the committee's report in relation to the problem that prompted its existence as well as the one to which it was quickly applied.
Constantin Reliu had been working for twenty years as a cook in Turkey when he returned to his hometown of Barlad, Romania, to discover that, there, he was dead. His former wife had, unbeknownst to him, at some point during his stay in Turkey registered him as deceased in Romania. He has since been living a legal nightmare trying to prove to Romanian authorities that he is, in fact, alive. Reliu is not alone in finding out that the legal system is not as attuned to physiological activity or biological assessment by doctors in determining death as one might think. If one starts with the assumption that death is a purely biological concept, solely the province of doctors, Reliu's story seems entirely unrelated to the concept of death in the medical context. A brain scan would not lead to a reversal of his being assessed as dead. The story is a reminder, however, that how death is used is not just biological, and therefore that the standard of death even in the clinic must answer to cultural considerations. Values, the law, and custom matter a great deal in determining who is alive and who is not, whether in the courtroom, the coroner's office, or the clinic.
Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; in fact, there has never been a case of a person correctly diagnosed as brain-dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright-line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions.
It has been fifty years since a report by an ad hoc committee of Harvard Medical School ushered in the widespread adoption of brain death as a definition of death. Yet brain death remains disputed as an acceptable definition within bioethics. The continuous debate among bioethicists has had three key recurring features: first and foremost, argument over alleged flaws in the conceptual logic and consistency of the "whole-brain" approach as a description of the meaning of death; second, efforts to fix perceived limitations of brain death-based practices to optimize transplantation, especially given that transplantation was the presumed original intended purpose of the definition; and third, a basic unease provoked by the experience of using the criteria and managing a body in this state of "irreversible coma." The third feature is the one I find the most compelling, though it is less explored, and it persists because of the failures of the prior two. Brain death remains strange-to medical personnel, families, philosophers. That is not because it hasn't yet been logically argued well enough or conceptually framed adequately, but because those things don't matter as much to resolving this strangeness as the bioethical approach to brain death over the last fifty years has assumed it does. It is necessary to look to other things that can anchor the aims of medicine in the midst of this strangeness.
Guest deaths are an inevitable aspect of the hospitality industry. In Study 1, participants read a vignette in which the previous guest died of natural causes, suicide, or homicide. Those who learned of a death (a) saw the room as less valuable, (b) opted to stay in a more basic room in which no death occurred, despite both rooms being offered for free, and (c) anticipated feeling uneasy when imagining an overnight stay. In Study 2, we investigated the persistence of this bias. Perceived room value and anticipatory well-being can be expected to return to baseline levels only many years after the death event. Similar to “stigmatized properties” in real estate, these data confirm an irrational and recalcitrant cognitive bias surrounding consumers’ views of death-affected hotel rooms.
PURPOSE: To analyze the concept of "Death anxiety" (00147) and to propose modifications in the components of this diagnosis in Taxonomy II of NANDA-I.
METHODS: A conceptual analysis was developed based on the eight steps proposed by Walker and Avant.
FINDINGS: Twenty-six articles were included from a search in four databases. Three defining attributes, nine antecedents, and two consequent ones were identified from concept analysis.
CONCLUSIONS: Conceptual analysis made possible the clarification of this diagnosis and the proposition of modifications in its components, which could provide a diagnostic accuracy.
IMPLICATIONS FOR NURSING PRACTICE: Clarification of the diagnosis will allow the accurate identification of this phenomenon in clinical practice and, consequently, more appropriate nursing interventions.
Death discourse provides interesting material to determine how societies and cultures cope with death and the sorrow of losing a beloved one. Several aspects can be analyzed: content, language, design, and so on. This article describes a diachronic bottom-up analysis of the metaphorical language in 150 epitaphs from Belgian cemeteries. The analysis allows us to determine whether attitudes toward death and the taboo to talk directly about it have changed. Based on the existing frameworks, 13 recurring metaphors were identified and analyzed. Their occurrences are linked to the period in which they were written and the age and the gender of the deceased. Epitaphs are a stable genre on all levels of analysis. The results indicate that people are still reluctant to talk in a straightforward way about death as metaphors with positive connotations prevail.
In 2013, 3 systematic reviews of fear of cancer recurrence (FCR) and its predictors were published. All 3 concurred that FCR is a highly prevalent problem and amongst the largest unmet needs of cancer survivors, even 5 or more years after treatment. However, between them they identified only 1 study that had investigated the relationship between death anxiety and FCR. This is surprising because it is well acknowledged that a diagnosis of cancer, a potentially life-threatening illness, is associated with a number of existential issues that give rise to psychological sequelae such as intrusive thoughts about death and other post-traumatic symptoms. Outside the cancer literature, there has recently been a call to identify death anxiety as a transdiagnostic construct that underlies many anxiety disorders even in healthy people. And yet, the relevance of death anxiety to FCR has not been studied. We explore the barriers to the study of death anxiety and FCR and the reasons that a potential link between the 2 might have important theoretical and clinical implications. We conclude that establishing the relationship between death anxiety, FCR and other existential issues is essential in order to fully understand FCR, particularly in the context of advanced disease. We further conclude that whether death anxiety underlies FCR has important clinical implications which would potentially allow us to optimise currently available evidence-based treatments.
This article analyzes suicidal behavior and how its inherent processes of death ideation can overlap with those seeking euthanasia. We present a literature review of three main events in suicide (suicidal ideation, suicide attempt, and suicide) in different populations and evaluate implications for health-care practice and risk assessment taking into account the context of euthanasia. We ponder upon the motives behind suicide and its link with wish to die requests to hasten death. We discuss the possibility of the reversal of a wish to die as well as a potential process of differentiating between individuals who would maintain their wish and benefit from termination of life and others who would later change their minds.
OBJECTIVES: In Singapore, the core curriculum for end-of-life (EOL) care used in nurse training courses is limited. Only 45% of nurses indicated familiarity with inpatient palliative care. Nurses who lack skills in palliative care may develop anxiety and negative attitudes towards caring for dying patients. We explored whether a two-day, multimodal EOL care workshop could reduce nurses' death anxiety and improve nurses' skills, knowledge, and attitude towards palliative care.
METHODS: Forty-five nurses participated in the workshop. At baseline before and at six weeks after, a 20-item knowledge-based questionnaire and the Death Attitude Profile-Revised (DAP-R) were administered. Six weeks post-workshop, in-depth interviews were conducted. We employed descriptive statistics, student paired samples t-test and inductive thematic analysis.
RESULTS: There was a significant improvement in nurses' knowledge score (p < 0.01) and reduction in their death anxiety score (p < 0.01). Fear of Death (p = 0.025) and Death Avoidance (p = 0.047) sub-scores decreased significantly. However, the remaining domains such as Neutral Acceptance, Approach Acceptance, and Escape Acceptance did not show any significant difference, although Escape Acceptance showed a trend towards a reduced score (p = 0.063). After the workshop, more nurses adopted the Neutral Acceptance stance (76.2%), and none of them fell into the Fear of Death subdomain. Most nurses interviewed reported a positive change in their knowledge, attitudes, and practice even after the workshop.
SIGNIFICANCE OF RESULTS: The multimodal palliative care workshop was useful in improving nurses' EOL knowledge and reducing their anxiety towards death. The positive change in nurses' attitudes and practices were noted to be sustained for at least six weeks after the intervention.