DISCUSSION 1 Describe the origins and nature of hospice care. What social factors inspired its recent growth? Discuss any experience you have had or heard from others about hospice.  Is there anything you would change or add to the system? DISCUSSION 2 Identify and discuss two aspects of the “death system” which conflict with each other. Comment on the growing concern for the environment around the dying person. Week 3 Essay  Background: Occasionally a dying person seems to pay a preliminary visit to their post death state. In Final Gifts, Chapter 8, Callanan writes about these experiences. What can we know about the after death experience has fascinated mankind and been the topic of sacred texts throughout history. You can explore this topic as discussed in the course texts and web research also, for instance, Dr. Elizabeth Kubler-Ross's work on Out of Body Experiences; The Tibetan Book of the Dead; the Egyptian Book of the Dead, or Bertrand Russell essay on “Do We Survive Death?” or he Navajo understanding of death and many more books and essays on the subject. Your assignment: Using the course texts and internet research  which may include references given just above, respond to this question in an essay of about three-six pages: · Compare the belief systems concerning death for at least three of the religious traditions we have studied so far or others of your choosing. Conclude by stating which of these resonates most strongly with you, and explain why. Your essay should have a minimum of THREE references. From the Expert: The Death System In this course, you are working closely with the text  Death, Society, and Human Experience by Robert K. Kastenbaum. The text explores the nature of dying and death in our society from a multiplicity of perspectives. Kastenbaum defines the death system: “We face death alone in one sense, but in another and equally valid senses, we face death as part of a society whose expectations, rules, motives and symbols influence our individual encounters. …Most of us phase in and out of the death systems as circumstances dictate” (p. 75). Death weaves in and out of our lives from disasters like Hurricane Katrina to the controversy about the war in Iraq to the death of someone we love to the warnings on our medicine vials and late night television ads about life insurance. The fact of death is so integrated into our lives that we rarely are aware of how pervasive the concerns related to it are. The Functions of the Death System The death system in a society serves many functions for its citizens. It includes warnings and predictions such as our weather service does during the hurricane season. It makes billions of dollars available for research on new sources of medicine like Gila monster venom treatment for diabetes. It involves the creation of pet cemeteries as increasingly isolated members of society consider their pets as their family. It encourages development of grief counse.

1. DISCUSSION 1
Describe the origins and nature of hospice care. What social
factors inspired its recent growth? Discuss any experience you
have had or heard from others about hospice. Is there anything
you would change or add to the system?
DISCUSSION 2
Identify and discuss two aspects of the “death system” which
conflict with each other.
Comment on the growing concern for the environment around
the dying person.
Week 3 Essay
Background: Occasionally a dying person seems to pay a
preliminary visit to their post death state. In Final Gifts,
Chapter 8, Callanan writes about these experiences. What can
we know about the after death experience has fascinated
mankind and been the topic of sacred texts throughout history.
You can explore this topic as discussed in the course texts and
web research also, for instance, Dr. Elizabeth Kubler-Ross's
work on Out of Body Experiences; The Tibetan Book of the
Dead; the Egyptian Book of the Dead, or Bertrand Russell essay
on “Do We Survive Death?” or he Navajo understanding of
death and many more books and essays on the subject.
Your assignment: Using the course texts and internet research
which may include references given just above, respond to this
question in an essay of about three-six pages:
· Compare the belief systems concerning death for at least three
of the religious traditions we have studied so far or others of
your choosing. Conclude by stating which of these resonates

2. most strongly with you, and explain why. Your essay should
have a minimum of THREE references.
From the Expert: The Death System
In this course, you are working closely with the text
Death, Society, and Human Experience by Robert K.
Kastenbaum. The text explores the nature of dying and death in
our society from a multiplicity of perspectives. Kastenbaum
defines the death system: “We face death alone in one sense,
but in another and equally valid senses, we face death as part of
a society whose expectations, rules, motives and symbols
influence our individual encounters. …Most of us phase in and
out of the death systems as circumstances dictate” (p. 75).
Death weaves in and out of our lives from disasters like
Hurricane Katrina to the controversy about the war in Iraq to
the death of someone we love to the warnings on our medicine
vials and late night television ads about life insurance. The fact
of death is so integrated into our lives that we rarely are aware
of how pervasive the concerns related to it are.
The Functions of the Death System
The death system in a society serves many functions for its
citizens. It includes warnings and predictions such as our
weather service does during the hurricane season. It makes
billions of dollars available for research on new sources of
medicine like Gila monster venom treatment for diabetes. It
involves the creation of pet cemeteries as increasingly isolated
members of society consider their pets as their family. It
encourages development of grief counseling as a therapeutic
offshoot because society now acknowledges the fact of death

3. and the ongoing impact of unexpressed grief.
Most recently, it has brought us the gift of hospice and
palliative care, both of which concern the emancipation of
powerlessness in the face of death. We have little or no control
over whether and when we die, but we do have power to make
decisions in relationship to our death. This can be a powerful
and persuasive aspect to the spiritual journey toward our end of
time on earth. It represents a paradoxical but hopeful sign that
perhaps we can face the end of death as well as the beginning of
life.
The Development of the Science of Thanatology (Study of
Death)
Until after World War II, death was not a general subject of
conversation, nor the specific objective of scientific,
sociological, psychological and ethical explorations to the
extent it has currently become. The wholesale torture and
killing of noncombatants shocked the world. People began to
talk about death in daily conversations.
Advances in medical technology brought ethical issues about
which lives to save and how far to go in accomplishing this to
the forefront, whereas previously it was a closely held family
and physician decision. The aging of a large sector of society
continues to put pressure on our ideas of how to relate with
death and dying. Significant continuing social changes give
death and its attendant issues a prime seat in our concerns.
From the Expert: The Dying as Social “Nonpersons”
Traditionally, people died in their own homes. Now people
generally go to nursing homes and the hospital to die. Many
factors contribute to this shift: medical technological advances;
the idea that death is so unacceptable that extreme measures
have to be applied to keep someone alive; the fact that now
often both people in a marriage work and so the woman of the
family is no longer available for nursing the elders; and so
forth.
Research has discovered that unless a hospitalized dying person

4. has very strong family ties, they are often left alone 18 and
more hours a day. The generally held perception is that they no
longer have “social value.” Doctors and nurses reduce their
concerns and subsequently the care given diminishes. The
warehousing of the dying has become so extreme that it has
given birth to a social movement to institute proper care for the
dying. There is a growing emphasis on hospice and palliative
care and on legal documents such as The Five Wishes.
Communication
Although pervasive social behavior implies that the comatose,
Alzheimer patients and the dying are beyond the need for
communication, this turns out not to be true. Communication,
speech or physical touch, whether or not the person can
participate, has a significant impact on the dying person's
comfort and ability to die well.
Allowing the dying to talk about what is happening to them and
to review their life is a final gift of love, even from a stranger.
In this way they die as a person rather than with a sense of
being discarded as “something” with no social value.
Do Not Go Gentle into That Good Night
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on that sad height,

5. Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.
— Dylan Thomas
From the Expert: Hospice and Palliative Care
The Hospice Concept
Hospice is a concept of caring derived from medieval times,
symbolizing a place where travelers, pilgrims and the sick,
wounded or dying could find rest and comfort. The
contemporary hospice offers a comprehensive program of care
to patients and families facing a life threatening illness.
Hospice is primarily a concept of care, not a specific place of
care.
Hospice emphasizes palliative rather than curative treatment;
quality rather than quantity of life. The dying are comforted.
Professional medical care is given, and sophisticated symptom
relief provided. The patient and family are both included in the
care plan and emotional, spiritual and practical support is given
based on the patient's wishes and family's needs. Trained
volunteers can offer respite care for family members as well as
meaningful support to the patient.
Hospice affirms life and regards dying as a normal process.
Hospice neither hastens nor postpones death. Hospice provides
personalized services and a caring community so that patients
and families can attain the necessary preparation for a death
that is satisfactory to them.
Those involved in the process of dying have a variety of
physical, spiritual, emotional and social needs. The nature of
dying is so unique that the goal of the hospice team is to be
sensitive and responsive to the special requirements of each
individual and family.
Hospice care is provided to patients who have a limited life
expectancy. Although most hospice patients are cancer patients,
hospices accept anyone regardless of age or type of illness.
These patients have also made a decision to spend their last

6. months at home or in a homelike setting. (
www.hospicenet.org/html/concept.html)
The Parameters of Pain Management
Pain management is a prime aspect of care for the terminally ill
and has, in recent years, become a medical specialty. In some
cases the physician involved in a case may seem unable or
unwilling to provide adequate control pain. This is when a pain
management specialist may be called in.
Aggressive pain management can make the difference between a
peaceful death and one in which suffering is so extreme and
prolonged that assisted suicide becomes a consideration,
although illegal (currently, except in Oregon). The right-to-die
movement maintains that high quality pain management would
lower the number of people who explore voluntarily ending
their life before they would die.
Palliative care or “comfort care” focuses on providing relief to
a terminally ill person. “The goal is not to cure, but to provide
comfort and maintain the highest possible quality of life for as
long as life remains. Well-rounded palliative care programs also
address mental health and spiritual needs. The focus is not on
death, but on compassionate specialized care for the living.” It
offers support for the whole person and those friends and family
who are attending them and sharing their last days. Palliative
care may occur in hospice or hospital facilities or in the home.
(
www.hospicenet.org/html/concept.html)
From the Expert: Overview of Suicide and Identifying Problem
Areas
Most of us, even with our inevitable dramas of hope and fear,
want to live forever. Why, then, are 30,000 Americans
motivated to commit suicide every year? Every 18 minutes,

7. another person commits suicide and every day, 80 Americans
take their own lives and over 1,900 Americans visit emergency
departments because of unsuccessful attempts. The increasing
suicide rates, particularly among teens and young adults and the
elderly, have brought suicide to eleventh place in the list of
leading causes of death for Americans.
Suicide Prevention
Suicide prevention has become a national issue, motivated by
the increasing statistics. The National Strategy for Suicide
Prevention (NSSP) represents the combined work of advocates,
clinicians, researchers and survivors around the nation. It lays
out a framework for action to prevent suicide and guides
development of an array of services and programs that must be
developed. It is designed to be a catalyst for social change with
the power to transform attitudes, policies, and services. The
NSSP Goals and Objectives for Action was published by the
U.S. Department of Health and Human Services in May of 2001,
with leadership from the Surgeon General.
Specific programs are to be developed to address the projected
causes in different age groups and genders. For instance:
Suicidal behaviors in young people are usually the result of a
process that involves multiple social, economic, familial, and
individual risk factors with mental health problems playing an
important part in its development. Identified risk factors for
suicide and attempted suicide for young people include the
following: mood disorders, substance abuse disorders, certain
personality disorders, low socioeconomic status, childhood
maltreatment, parental separation or divorce, inappropriate
access to firearms, and interpersonal conflicts or losses. For
young people 15-24 years old, suicide is among the three
leading causes of death.
The Meanings of Suicide
As with many extreme acts, the antisocial aspect of suicide can
reveal a great deal about our worldview and values. Kastebaum,
(p. 219) discusses the conclusions that Emile Durkheim, the
father of sociology, came to regarding the individual meanings

8. of suicide. These include a desire for reunion with loved ones;
for rest and refuge; for revenge; as a penalty for personal
failure or as a mistake. Durkheim also defines four categories of
suicide: there is egotistic, altruistic, anomic (people cast adrift
by the failure of social institutions like unemployment), and
fatalistic (excessive control by society so that a person feels
totally blocked and oppressed). Examples might include slavery
as a fatalistic situation;
kamikazi pilots in WWII as a heroic and devotional act
rather than revenge.
Religious traditions hold varying views about suicide: In
Judaism and Christianity, only God has the power to grant life
and death, so suicide may be considered a sin. In Buddhism and
Hinduism, generally, suicide will have negative karmic
repercussions and does not lead to everlasting peace but to
reincarnations with intensified suffering. However, centuries
old traditions of the Samurai warrior in Japan allowed for an
honorable suicide called
seppuku. In Islam, martyrdom in the cause of protecting
Islam is celebrated, and the martyr is believed to be rewarded in
heaven immediately.
There is a story about the Rumanian army in WWI which was
surrounded by the enemy and sure to be annihilated. The
soldiers, rather than accept defeat, dressed in their best
uniforms and carrying the national flag, charged towards certain
death. What was the meaning of suicide in this case, a mistake,
egotism, heroism or…?
Famous Suicides
A number of famous individuals are known to have committed
suicide throughout history: Marc Antony and Cleopatra, Vincent
van Gogh, Adolf Hitler, Marilyn Monroe, Sid Vicious, and the
poet Sylvia Plath, among many others.
In 1963, with a growing reputation as a writer, Plath killed
herself at the age of 30. After sealing off the kitchen so that her

9. two young children would not be injured, she put her head in
the oven and died of gas inhalation. (
http://www.poemhunter.com/sylvia-plath/)
She wrote:
I am inhabited by a cry. Nightly it flaps out looking, with its
hooks, for something to love. I am terrified by this dark thing
that sleeps in me; All day I feel its soft, feathery turnings, its
malignity.
Dying is an art, like everything else. I do it exceptionally well.
I do it so it feels like hell. I do it so it feels real. I guess you
could say I've a call.
Perhaps when we find ourselves wanting everything it is
because we are dangerously near wanting nothing.
You don't believe in God, or life-after-death, so you can't hope
for sugar plums when your non–existent soul rises.
I talk to God but the sky is empty.
(
http://womenshistory.about.com/od/quotes/a/sylvia_plath.htm)
From the Expert: Violent Deaths
Murder
Murder is the purposeful taking of another person's life, illegal
in most situations. In the United States murder is considered the
benchmark crime for trends because its statistics are the most
reliable. In 2006, after significantly increasing year by year, the
incidence of murders decreased to a 1960's level. There are
several predominating motives for murder: auxiliary to the
commission of another crime; family conflict; mental illness;
revenge, and so forth.
When we turn to the situation of murder internationally,
Kastenbaum (p. 250) writes “Never before in history has there
been such a degree of infliction of deprivation, cruelty and
death upon millions of people. Never before have there be so
many victims of human violence.” The estimated number of

10. murders is 25 million deaths not including direct war casualties.
Terrorism and Genocide
In the United States our way of life changed forever with the
Islamic attack on the World Trade Center. We had experienced
the Oklahoma City bombing, which was shocking, but it was
perpetrated by our own local terrorists. 9/11 was an invasion
from the outside and we have been looking over our shoulders
ever since. Our shared national sense that we were buffered
from the aggressive actions of the rest of the world was
destroyed. The American spirit, as exemplified in the musical
Oklahoma, which had been previously weakened by our
experiences in the Viet Nam war, was no more.
Elsewhere in the world terrorism has been a way of life for
decades with groups and their issues rising into prominence,
like Black September, and then in a few years being replaced by
another group, al Qaeda or Islamic
Jihad, and other self-proclaimed terrorist with a
different issue with the world outside their cosmos.
Attempts to wipe out entire ethnic groups, like that in Dafur,
have erupted throughout the world. The number of victims has
escalated with our great advances in technology and weaponry.
War
While scholars and politicians wrestle with the question
whether there is such a thing as the “just war,” no one disputes
the fact that wars cost money, enormous collateral damage, and
hundreds to perhaps millions of lives. For example, in World
War I, the Allies alone lost 5.1 million troops. (
www.pbs.org/greatwar/resources/casdeath_pop.html)
War is deadly, and perhaps more tragically so due to the intense
nature of war, its overwhelming consequences socially,
politically, and internationally, and the fact that it is commonly
young men and women who fight and die. In the same way
terrorism and genocide have prevailed through history, despite

11. their horror, war has also sadly marched into every century
since the dawn of time.
Accidents and Disasters
Individual accidental deaths have always occurred. Our
increasingly speedy and pressured lifestyle contributes to the
statistics. Sometimes these deaths are just accidental. Bill H.
lost a leg making skiing history by skiing down a couloir in the
Teton Mountains that no one had dared before. Years later, an
avid sailor, he decided to take a modest sailboat from Hawaii
back to his home in California. He pressured his younger son to
accompany him. The night before setting off, Dylan, the son,
had vivid bad dreams and a strong feeling that he did not want
to make the trip. He reneged. Bill H. was never seen again. All
that was found was a life preserver with the name of his boat on
it.
Manmade accidents on the scale of Chernobyl and Fukushima
Daichi nuclear disasters attest to the dangers of advancing
technology, where we use forces of nature barely understood
and under control. Accidents of nature or natural disasters are
themselves sometimes of such magnitude that the world reels in
the aftermath. Recently events of that ilk include Hurricane
Katrina and the Asian tsunami of 2004.
These devastating phenomena have occurred periodically
throughout history: the ancient city of Tyre was destroyed by a
massive tidal wave; Mt. Vesuvius' eruption destroyed Pompeii.
We may ask the question today, are our modern ways not only
producing global warning, but opening the situation to an
increase in these extreme events? The winter of 2015 in the
northeastern part of the United States is another example
perhaps of global change – or is it just nature doing what it does
every so often?
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