Since the 1960s, psychologists known as Thanatologists have given especial attention to the needs of the patients who know they are dying. The Thanatologists study and analyze the surroundings of persons who approach death. These psychologists also examine the inner experiences of such persons. These experts have identified many stages that these patients as well as their near and dear ones experience. The Thanatologists have identified the following stages of dying persons, viz., No, Not me! (isolation and denial); Why me (anger, rage, envy, and resentment); If I am good, can I then live (bargaining); What’s the use (depression); and acceptance. However, these stages do not occur in any predictable order. They may be also intermingled with terror, anguish and hope.
Bereavement has also been a serious issue of psychological study. Bereavement is anticipatory in nature and it follows a regular pattern. The kith and kin of the dead also experience the stages of acceptance and denial. Bereavement has two stages. Bereavement commences before a dying person dies. At the same time, such an anticipatory psychological stage also diffuses subsequent distress. The second stage of bereavement lasts longer. This stage can be more severe if the death is unexpected. The mourners exhibit some common symptoms during the second stage. They lose sleep and appetite. They also cry immensely. At times, the mourners can also have problems in crying. At such stages, attempts are made to make them cry forcefully. There can also be feelings of alarm, anger and/or grief at being deserted. The grief can subsequently transform into depression. Such depression can also be precipitated if there is no conventional support, solace or help. This may again lead to loneliness. With time, the survivor or the person regains strength, feels assured and restores ties with the society.
CARE OF TERMINALLY ILL PATIENTS
First and foremost, the terminally ill patients are taken care of in special clinics called hospices. The psychologists and physicians involved in these typical hospitals must themselves be well equipped psychologically to deal with this abnormally serious situation. These experts must first conquer any fear of death. It is only then that they would be able to offer comfort to the patients.
SHOULD PATIENTS BE TOLD THEY ARE DYING?
Nowadays, there is conformity among the experts that the dying patients must be told of their typical stage. But, this is not an easy task and it has to be done with caring and tact. Once such openness is initiated, there is no pretense. The informed dying person can also embrace death with serenity and dignity. Clergy and therapists or clergy can also lend a helping hand in this regard. Their communication can aid the patient to express the inner feelings, thoughts, and memories. These intermediaries can also substitute the anxious family members and help in normalizing the situation as the dying patient starts speaking of death.
THEORIES OF DEATH
The common concept is that death happens when the body?s vital functions including breathing and circulation (perceptible through the beating of the heart) ceases. However, the ?Brain death theory? challenges this conception of death. The new theory maintains that breakthroughs in medical sciences have evolved artificial means to sustain respiration and even the functions of the heart. The protagonists of this new school of thought state that death takes place when there is an irreversible loss of brain activity. This stand gained worldwide acceptance. After the 1980s, most of the US States also accepted brain death as one of the inevitable symptoms of death.
But now, even this concept of brain death has been challenged, because a person can lose all capacity for higher mental functioning while the lower portion of the brain keeps on functioning. Mention may be made of spontaneous respiration which keeps on functioning. For this reason, some authorities now argue that death should be deemed the loss of the capacity for consciousness or social interaction. This sign of death, they opine, is the absence of activity in the higher centers of the brain, primarily the neo-cortex region.
The West has been viewing death as the departure of the soul from the body. According to the Western philosophy, death takes place the moment breathing ceases. This interpretation also states that the soul does not possess any corporeal form. So, one can?t determine or objectively witness the soul departing from the body. Moreover, the West keeps the concept of ?human? free from the physical properties.
HOW DIFFERENT CULTURES VIEW DEATH?
Different cultures have been viewing death from different angles. As a result, there have been interesting and fascinating interpretations. Academic interpretations have also influenced the society?s concept of death. Besides, moral issues have also added a new dimension to the debate on willful precipitation of death. Moreover, fast advancing medical advances and legal pursuits have opened up a new dimension in the definition of death.
Here?s a list of the new debatable issues concerning death. The questions that they elicit have assumed urgency against the possibility of human tissue transplantation. There is also the issue of the need for organs to be weighed against the rights of the dying donor. Nonetheless the issues are as follows:
Who will decide the criteria for death? Will it be the physician, or the legislature, or will it be each person for himself or herself?
Is it morally and legally permissible to advance the moment of death by severing the artificial support?
Do people possess the right to demand that the extraordinary or artificial means or measures be curtailed so that they can die in peace?
Can a legal guardian or the next of kin act for the comatose (dying) person under such situations?
Taking into perspective such pressing issues, many people as well as several groups have moved to set up an individual’s right to die. This is again sought to be done via the legal means of living wills. Through the Living Will, an individual confers the right to withdraw the life-sustaining treatment upon family members or legal figures. In the USA, as many as 40 states recognized the validity of some form of living-will arrangement by 1991. However, complex ancillary questions still remain to be settled.
Nilutpal Gogoi is a writer and a freelance journalist having more than 18 years of service in several audio-visual and print media reputed organizations in North East India. He has published one popular adventure book for children and has published more than 1000 articles for various sites, as such
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