Person, Culture and Medicine

“Human Behaviour is essentially the same across groups and populations.”
Biological death is inevitable. For all humans, death is the exclamation point marking the end of a life, the end of a journey; however it is approached and for however long. This is the universal biological condition for all humans. According to Benjamin Franklin, “…Everything appears to promise that it will last. But in this world nothing can be said to be certain except death and taxes.” (Curran 1975) It is in how we live our lives that we see the breadth of human cultural and psychological variation (Seeman, 2010), leading us to discover a great diversity of meanings regarding death and dying, spanning across all groups and populations (Charmaz, 1997). “Cross cultural [variation embodies] not just different opinions or beliefs, but different ways of everyday living and different systems.” (Jecker & Carrese & Pearlman, 1995, p. 6)

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At the most basic level we are all “built” the same. Death is a complicated process that is the result of the breakdown of the body’s systems. We all live, until the chaos in our body, caused by either natural causes or a forced external factor, is too much for all the intricate systems to work together as a coherent whole (Badham, 1996). Despite the advancement of technology and medical progress, there is no stopping everyone eventually facing death.
Whilst biologically we are all essentially the same, from a cultural and psychological perspective, we all behave very differently. This can be seen by considering the bond between a parent and a child, which is said to be the most significant, powerful and enduring human relationship (Parkes & Laungani & Young, 2003,). Thus, the death of a child is acknowledged as the worst possible event, one that gives the deepest emotional impact. In this tragic event, we can see marked behavioural differences across and within cultures and so it is a good example to use to examine the differences in human behaviour in the face of death.
Nations, as well as individuals, all live with very distinctive ideas and beliefs around how to deal with death (Charmaz, 1997). Most cultures are similar in that they attribute unique significance to a child’s death. Biologically many aspects of a parent-child relationship are pre-programmed from conception however, each of these characteristics are developed within a specific family, social and cultural context (Parkes & Laungani & Young, 2003,). These wider influences are what greatly shape the meaning and experience of the relationship for both parent and child and thus influence the meaning of death. This makes the emotional impact of parental bereavement unique. For example, in Western Societies, parents are expected to grieve in private and return to normal activities soon after the child’s death, where as in Egypt, a mother may be withdrawn and mute up to seven years after the child’s death and this is considered normal. A Balinese mother would be considered normal if she remained cheerful and calm after her child’s death, as her culture believes that emotional upset makes one vulnerable to illness (Parkes & Laungani & Young, 2003,).
“Grieving and death rituals vary across cultures and are often heavily influenced by religion” (Lobar & Youngblut & Brooten 2006, p. 45). For example whilst the traditional burial is common around the world, the rituals that are associated with it vary. In areas influenced by Islamic and Jewish faiths, the corpse is washed and dressed in a shroud and placed in a simple wooden coffin (in areas where coffins are used). In China, where Confucian beliefs dominate, thick wooden coffins packed with clothing and shrouds are used to delay decay and in Christian-dominated regions, bodies are dressed in normal clothing and placed in a coffin made of either chipboard, wood or metal. (Canning & Szmigin 2010)
The combination of both structural (cultural) and individual factors that impacts the experience of death is dynamic. (Howarth, 2007) Not every member of a particular ethnic group will share the same beliefs and values and other aspects such as social status, economic position, gender, sexuality, age will also have an impact on experiences and beliefs which when combined give meaning to the experiences of death and dying (Howarth, 2007). For example, the prevalence of child mortality also influences the experience of death. In developed countries, where changes to nutrition and sanitation and the evolution of medicine have made childhood mortality rare, a death of a child is more likely to be perceived as tragic. Whereas in developing countries, where the death of a child occurs much more often and thus is considered inevitable, mourning may only last a few days (Parkes & Laungani & Young, 2003,).
Each person has their own beliefs about death, which are generated through experiences at a social, cultural and individual level. Universally, there is a level of respect shown for the dead and there are different “accepted” practices depending on the age, gender, social status and cause of death of the individual. (Bradbury, 1999) However, all of the beliefs around death are determined by the way the individual lives, which is why there is such diversity with regards to the biological condition that is an inevitable human fact. Just in this discussion of how different people across different groups and populations approach death and dying, a lack of conformity with the statement “Human Behaviour is essentially the same across groups and populations,” has been shown. Parallels can be drawn between people, but vast differences can also be highlighted. (Seeman, 2010) We begin and we end in much the same way, but the way we live our lives is remarkably different. Much can be learned about the breadth of human variation by examining the way we approach death and dying:
“Our ways of dying are our ways of living.
Or should I say our ways of living are our ways of dying?”
-Toloki the Professional Mourner (Seeman, 2010, p. 1)
References
Badham, P. & Ballard, P. (1996) Facing Death- An Interdisciplinary Approach. Cardiff, University of Wales Press.
Bradbury, M. (1999) Representations of Death- A Social Psychological Perspective. New York, Routledge.
Canning, L. & Szmigin, I. 2010, ‘Death and disposal: The universal, environmental dilemma,’ Journal of Marketing Management, vol. 26, viewed 28 August 2014, (electronic Scopus).
Charmaz, K. Howarth, G. Kellehear, A. 1997, The Unknown Country: Death in Australia, Britain and the USA. Great Britain, Macmillan Press Ltd.
Curran, C. 1975, ‘Death and Dying’, Journal of Religion and Health, vol. 14, viewed 28 August 2014, (electronic Scopus).
Howarth, G. 2007, Death and Dying- A Sociological Introduction. Cambridge, Polity Press.
Jecker, N. & Carrese, J. & Pearlman, R. 1995, ‘Caring for Patients in Cross-Cultural Settings’, The Hastings Center Report, vol. 25, p.6, viewed 28 August 2014, (electronic Scopus).
Lobar, S. & Youngblut, J. & Brooten, D. 2006, ‘Cross-cultural beliefs, ceremonies, and rituals surrounding death of a loved one,’ Peadiatric Nursin, vol. 32, p. 44, viewed 28 August 2014, (electronic Scopus).
Parkes, C. Laungani, P. & Young, W. 2003, Death and Bereavement Across Cultures. Routledge.
Seeman, E. (2010) Death in the New World- Cross Cultural Encounters. Philadelphia, University of Pennsylvania Press.