Thanatology

Thanatology or deathlore is the scientific study of death and the losses brought about as a result. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the post-mortem period, as well as wider psychological and social aspects related to death. It is primarily an interdisciplinary study offered as a course of study at numerous colleges and universities.

The word is derived from the Greek language. In Greek mythology, Thanatos (θάνατος: "death") is the personification of death.[1] The English suffix -ology derives from the Greek suffix -logia (-λογια: "speaking").

Enrique Simonet - La autopsia 1890
Autopsy (1890) by Enrique Simonet

History

Russian scientist Élie Metchnikoff was famous for his work in microbiology and the discovery of phagocytosis. “Phagocytosis is the process by which a cell – often a phagocyte or protist – engulfs a solid particle to form an internal compartment known as a phagosome.” In 1903, he established a scientific discipline devoted to the study of death. He argued that those who were dying had few or no resources for the experience of dying and that an academic study would help those facing death to have a better understanding of the phenomenon and reduce their fear of it.[2]

Metchnikoff based his ideas for an interdisciplinary study on the fact that while medical students had their obligatory encounters with cadavers through anatomical studies, there was almost no instruction on how to care for the dying, nor was there any research into death included in the curriculum. Because few scholars and educators agreed with Metchnikoff, the support he needed for the realization of his suggestion did not materialize for decades.

Metchnikoff chose to focus on two new areas of study, gerontology and thanatology. Contrary to gerontology, it took about 47 years for most people to accept thanatology as a science. Therefore, the science of thanatology is fairly new for the most part. The altered viewpoints people developed when it came to viewing and coping with death was one reason that thanatology became more accepted across societies.

Thanatology arose with the 'Death with Dignity' movement of the early 1970s as an interdisciplinary category for the study of death.[3] The Death with Dignity movement allows Americans to decide what happens to their cadaver after death.[4]

Following World War II, the world was haunted with the memories of the many casualties. During this period of reflection many existential philosophers began considering life-and-death issues. One in particular was Herman Feifel, an American psychologist who is considered the pioneer of the modern death movement.[2] Feifel broke the taboo on discussions of death and dying with the publication of his book The Meaning of Death.[5] In this book, Feifel[6] dispelled myths held by scientists and practitioners about death and the denial of its importance for human behaviour. It earned wide attention and became a classic in the new field, including as it did contributions from eminent thinkers such as psychiatrist Carl Jung, theologian Paul Tillich and philosopher Herbert Marcuse. Through The Meaning of Death, Feifel was able to lay the foundation for a field that would eventually be known as Thanatology. The field was to improve death education and grief counselling by the use of valid death-related data, methodology and theory.

However, this is only one of several important books in the field of thanatology. Other key texts include The Experience of Death by Paul-Louis Landsberg, the sections on temporality and death from Martin Heidegger's Being and Time, as well as works of a fictional nature, such as Leo Tolstoy's The Death of Ivan Ilyich and As I Lay Dying by William Faulkner.

Goals

In most cases, thanatology is not directly related to palliative care, which aims to provide treatment for dying individuals and their families. According to the World Health Organization, "palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, involving the "treatment of pain and other problems, physical, psychosocial and spiritual".[7]

Thanatology does not always directly explore the meaning of life and of death, though such questions are relevant to the psychological health of those involved in the dying process: individuals, families, communities, and cultures.

As a consequence of thanatology becoming so prominent, there has been an increase in university education surrounding death, including courses and degree programs in thanatology.[8][9] A continuing goal of this science is to improve the communication between practice and research since that is something that has been lacking. Thanatology has come a long way and will keep evolving to better our understanding of death.[10][11] Highly regarded certification programs are also available.[12]

Forensic science

Forensic science deals with sudden and unexpected deaths. "Forensic medicine is the application of medical knowledge for the scientific investigation of facts and causal relationships, as well as the analysis and interpretation thereof in the service of the law in its broadest sense; moreover, it addresses all legal aspects of the practice of medicine during teaching, medical training, and specialist training." This process used to study the deceased was brought about in Europe and has been struggling to make its way globally.[13] A large portion of a forensic physician's duty is to be present for sudden and suspicious deaths, examine persons after sexual offense situations, organize statements for legal purposes and attend court to represent the individual.[14]

Physicians' rules for forensic science: Every physician is responsible for having excellent forensic medical knowledge.[15]

There are a handful of forensic doctors who work closely with prisoners to provide them with clinical assessments. They also put together care plans moving forward with these prisoners. These plans can include prescribing and obtaining medicine and monitoring them from a physical and mental health perspective.[14]

Coping with death

Research/studies:

Multiple scholarly journals dedicated specifically to thanatology regularly publish peer-reviewed studies and essays of interest in the field. These include Death Studies, Mortality, Omega:Journal of Death & Dying, Journal of Loss & Trauma, and Illness, Crisis, & Loss. Though Elisabeth Kübler-Ross described five "stages" of coping with terminal illness as: denial, anger, bargaining, depression, and acceptance, thanatologists differ about the actual existence of such stages. Many reject the notion as simplistic and empirically unsupported.[16]

Studies show that in the case of losing a partner to death, if one's self-esteem is lower, the death of their partner will result in both a lower social and emotional loneliness. A lower social and emotional level of loneliness results in a feeling of perceiving less support.[17]

Mortality awareness is essential to our overall well-being as we confront the aging of world societies, global health disparities, emerging biomedical technologies, and shifting understandings of good deaths and lives worth living.[3]

Hospice care:

Another more popular way to cope with death is utilizing hospice care facilities. Hospice care is focused primarily on caring and not curing a patient's illness. It is mainly used to help cope with the loss of a loved one before they pass away. The services provided in a hospice facility include the following: managing the patient's pain and symptoms, providing needed drugs, medical supplies and equipment, assisting the patient with emotional, psychological and spiritual aspects of dying, coaching the family on how to care for the patient and delivering special services such as speech and physical therapy when needed.[18]

A common myth about hospice care is that someone must be in their last days of life, be bedridden or be unable to communicate with others to receive hospice help. However, that is simply not the case. Hospice care is appropriate for those who have been given a prognosis around 12 months or less. Choosing to use hospice care means the patient will spend more quality time with the people they love and they will have time to look back on life during this peaceful, meaningful time.

Another common myth is that hospice care means giving up hope. Hospice involves coping with death and part of that means acknowledging that most diseases or illnesses in their advanced stages cannot be cured. The idea of hope varies from person to person while, in hospice care, patients and their loved ones will often try to seek any form of hope that they can.[19]

However, various private insurance plans such as Medicare, Medicaid, and HMO will take care of the costs of hospice care, helping it be less detrimental on the family. This helps avoid more trauma to the family by reducing the enormous medical bill necessary to support their loved ones who are fighting the illness.

Fields of study

As an interdisciplinary study, thanatology relies on collaboration with many different fields of study. Death is a universal human concern; it has been examined and re-examined in a wide variety of disciplines, dating back to pre-history. Some of these fields of study are academic in nature; others have evolved throughout history as cultural traditions. One of the oldest organizations in the field of thanatology is the U.S.-based Association for Death Education and Counseling [20]

The humanities are, perhaps, the very oldest disciplines to explore death. Historically, the average human had a significantly lower standard of living and lifespan than he or she would today. Wars, famine, and disease always kept death close at hand. Artists, authors, and poets often employed the universality of death as a motif in their works; this trend continues today.

The social sciences are often involved on both the individual and on the cultural level. The individual level is primarily covered by psychology, the study of individual minds. Avoiding (or, in some cases, seeking) death is an important human motive; the fear of death affects many individuals' actions.

Several social sciences focus on the broad picture, and they frequently encounter the issue of death. Sociology is the study of social rules. Sub-disciplines within sociology, such as the sociology of disaster, focus more narrowly on the issue of how societies handle death. Likewise, cultural anthropology and archeology are concerned with how current and past cultures have dealt with death, respectively. Society and culture are similar concepts, but their scopes are different. A society is an interdependent community, while culture is an attribute of a community: the complex web of shifting patterns that link individuals together. In any case, both cultures and societies must deal with death; the various cultural studies (many of which overlap with each other) examine this response using a variety of approaches.

Thanatology is a section of forensic sciences. The biological study of death helps explain what happens, physically, to individuals in the moment of dying and after-death bodily changes, so that the events that took place at the time of death and post-mortem can be clarified. In psychiatry, the medical application of psychological principles and therapeutic drugs, is also involved; many licensed psychiatrists are required to take courses on thanatology during training. Medical ethics are also an important area of study, especially on the issue of euthanasia ("right to die").

There is also a branch of thanatology called music-thanatology which focuses on the use of "music vigils" to help the individual and their family.[21] A vigil consists of one or a team of music-thanatologists who visit the dying person. They play the harp and sing music based on changes that they observe in patient physiology as well as in interpersonal family dynamics. The music tends toward the meditative, and can be very helpful to the patient and others that are present. Often after a vigil, the dying person is more relaxed, less agitated, and is in less pain. Most music-thanatologists are certified by the Music-Thanatology Association International, and they use the initials "CM-Th" to designate certification by this professional organization. Many hospitals and hospices now have professional music-thanatologists on their staff.[22]

In 2009, Lakhmir S. Chawla discovered surges of brainwaves (γ neural oscillation) in dying patients.[23] The γ neural oscillation had already been found in long-term meditators.[24] In 2013, Jimo Borjigin discovered four states of brainwaves including γ neural oscillation in dying rats.[25]

See also

References

  1. ^ "English Dictionary, Thesaurus, & grammar help - Oxford Dictionaries". Oxford Dictionaries - English.
  2. ^ a b "Thanatology - world, body, life". www.deathreference.com. Retrieved 2017-03-31.
  3. ^ a b Barrett, Ron (2011-01-01). "Anthropology at the End of Life". In Singer, Merrill; Erickson, Pamela I. (eds.). A Companion to Medical Anthropology. Wiley-Blackwell. pp. 477–490. doi:10.1002/9781444395303.ch24. ISBN 9781444395303.
  4. ^ "About Us - Death With Dignity". Death With Dignity. Retrieved 2017-04-25.
  5. ^ Feifel, Herman. The Meaning of Death.
  6. ^ "Feifel, Herman - world, body, life, person, human". www.deathreference.com.
  7. ^ "WHO - WHO Definition of Palliative Care". www.who.int.
  8. ^ "Marian University Masters of Science in Thanatology".
  9. ^ "Kings College Thanatology Program".
  10. ^ Fonseca, L. M.; Testoni, I. (2012). "The Emergence of Thanatology and Current Practice in Death Education". OMEGA - Journal of Death and Dying. 64 (2): 157–169. doi:10.2190/om.64.2.d.
  11. ^ Testoni, Ines; Ronconi, Lucia; Palazzo, Lorenza; Galgani, Michele; Stizzi, Antonio; Kirk, Kate (2018). "Psychodrama and Moviemaking in a Death Education Course to Work Through a Case of Suicide Among High School Students in Italy". Frontiers in Psychology. 9: 441. doi:10.3389/fpsyg.2018.00441. ISSN 1664-1078. PMC 5902682. PMID 29692745.
  12. ^ "Certification in Thanatology".
  13. ^ Dettmeyer, Reinhard b. (2014). Forensic Medicine. Europe: Springer. pp. 1–32. ISBN 978-3-642-38817-0.
  14. ^ a b "Forensic Pathologist Salary & Job Description". Forensics Colleges. Retrieved 2017-04-25.
  15. ^ "forensic physician". TheFreeDictionary.com. Retrieved 2017-03-31.
  16. ^ Corr, C.A. (23 October 2018). "The 'five stages' in coping with dying and bereavement: strengths, weaknesses and some alternatives". Mortality: 1–13. doi:10.1080/13576275.2018.1527826.
  17. ^ Berna, van Baarsen (2002-01-01). "Theories on Coping With LossThe Impact of Social Support and Self-Esteem on Adjustment to Emotional and Social Loneliness Following a Partner's Death in Later Life". The Journals of Gerontology: Series B. 57 (1): S33–S42. doi:10.1093/geronb/57.1.S33. ISSN 1079-5014.
  18. ^ "Hospice Care". National Hospice and Palliative Care Organization. Retrieved 2017-04-03.
  19. ^ "What You Should Know First - What is Hospice Care?". communityhospice.com. Retrieved 2017-04-03.
  20. ^ Gamino, L.A. (2017). "ADEC at 40: Second half of life wisdom for the future of death education and counseling". Death Studies. 41 (3): 188–195. doi:10.1080/07481187.2017.1289331. PMID 28151061.
  21. ^ "Music-Thanatology Association International: What Is Music-Thanatology?". www.mtai.org.
  22. ^ Hollis, Jennifer L. (April 2010). Music at the End of Life: Easing the Pain and Preparing the Passage. Praeger. ISBN 0-313-36220-3.
  23. ^ Chawla, Lakhmir S.; Akst, Seth; Junker, Christopher; Jacobs, Barbara; Seneff, Michael G. (5 October 2009). "Surges of Electroencephalogram Activity at the Time of Death: A Case Series". Journal of Palliative Medicine. 12 (12): 1095–1100. doi:10.1089/jpm.2009.0159. PMID 19803731.
  24. ^ Lutz, Antoine; Greischar, Lawrence L.; Rawlings, Nancy B.; Ricard, Matthieu; Davidson, Richard J. (16 November 2004). "Long-term meditators self-induce high-amplitude gamma synchrony during mental practice". Proceedings of the National Academy of Sciences. 101 (46): 16369–16373. doi:10.1073/pnas.0407401101. PMC 526201. PMID 15534199 – via www.pnas.org.
  25. ^ Borjigin, J; Lee, U; Liu, T; Pal, D; Huff, S; Klarr, D; Sloboda, J; Hernandez, J; Wang, MM; Mashour, GA (2013). "Surge of neurophysiological coherence and connectivity in the dying brain". Proc Natl Acad Sci U S A. 110 (35): 14432–7. doi:10.1073/pnas.1308285110. PMC 3761619. PMID 23940340.

External links

Association for Death Education and Counseling

The Association for Death Education and Counseling (ADEC) is a multidisciplinary professional membership organization committed to excellence in death education and supportive counseling in areas related to death, dying processes, loss, and grief.

Death Studies

Death Studies is a peer-reviewed academic journal published ten times a year by Routledge and sponsored by the Association for Death Education and Counseling - The Thanatology Association. It focuses on issues related to death, dying, bereavement, and death education.

Death education

Death education is education about death that focuses on the human and emotional aspects of death. Though it may include teaching on the biological aspects of death, teaching about coping with grief is a primary focus. Death education is formally known as thanatology. Thanatology stems from the Greek word thanatos, meaning death, and ology meaning a science or organized body of knowledge. A specialist in this field is referred to as a thanatologist.

Death education refers to the experiences and activities of death that one deals with. Death education also deals with being able to grasp the different processes of dying, talk about the main topics of attitudes and meanings toward death, and the after effects on how to learn to care for people that are affected by the death. The main focus in death education is teaching people how to cope with grief. Many people feel death education is a taboo and instead of talking about death and grieving, they hide it away and never bring it up to others. With the right education of death, the less of a taboo it will be.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Dysthanasia

In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine.Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive. The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.

Edwin S. Shneidman

Edwin S. Shneidman (May 13, 1918 – May 15, 2009) was an American clinical psychologist, suicidologist and thanatologist. Together with Norman Farberow and Robert Litman, in 1958, he founded the Los Angeles Suicide Prevention Center, where the men were instrumental in researching suicide and developing a crisis center and treatments to prevent deaths.

In 1968, Shneidman founded the American Association of Suicidology and the principal United States journal for suicide studies, Suicide and Life Threatening Behavior. In 1970, he became Professor of Thanatology at the University of California, where he taught for decades. He published 20 books on suicide and its prevention.

Fascination with death

Fascination with death has occurred throughout human history, characterized by obsessions with death and all things related to death and the afterlife.

In past times, people would form cults around death and figures. Famously, Anubis, Osiris, Hades, and La Santa Muerte have all had large cult followings. La Santa Muerte (Saint Death), or the personification of death, is currently worshiped by many in Mexico and other countries in Central America. Day of the Dead (2 November) is a celebration for the dead.

Joy Ufema

Joy Ufema, also known as Joy Counsel (born 1942), is a retired American nurse and thanatologist. She is noted for her work with terminally ill people in the U.S. state of Pennsylvania, and was the first nurse-thanatologist in the country. Ufema garnered national attention after 60 Minutes aired a segment about her, and she became the subject of a television film, A Matter of Life and Death. She was Clinical Specialist in Thanatology for Upper Chesapeake Medical Center/Harford Memorial Hospital.

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus raised from the dead in the Gospel of John.

Louis-Vincent Thomas

Louis-Vincent Thomas (20 May 1922 – 22 January 1994) was a French sociologist, anthropologist, ethnologist, and scholar whose specialty was Africa. He was the founder of thanatology. After having taught at Cheikh Anta Diop University, he became a sociology professor at Paris Descartes University.

His writings deal with socialism, burials, and systems of thought in sub-Saharan Africa. He conducted comparative studies on death in Western culture and African culture. He often denounced the idea that anthropology and sociology are separate areas of study.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Memorain

Memorain is a speed/groove/thrash metal band from Greece, formed by guitarist/vocalist Ilias Papadakis in 1999.

Mohammad Samir Hossain

Mohammad Samir Hossain (born 28 November 1976) is a Bangladeshi theorist living in New Zealand who is one of the few Muslim scientists in the field of Death anxiety (psychology) research. He is the pioneering physician to introduce Scientific Thanatology and Spiritual Psychiatry in Bangladesh. He is also an author of multiple theory books on Death adjustment.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

Pierre A. Riffard

Pierre A. Riffard is a French philosopher and specialist in esotericism. Born in Toulouse (France), he is a professor of pedagogy and philosophy at the University of the French West Indies and Guiana (Université des Antilles et de la Guyane).

Teaching in the French overseas departments and territories and elsewhere: Asia, Oceania, Sub-Saharan Africa, Guiana.

Taboo on the dead

The taboo on the dead includes the taboo against touching of the dead and those surrounding them; the taboo against mourners of the dead; and the taboo against anything associated with the dead.

Thanatotranscriptome

The thanatotranscriptome denotes (in the fields of biochemistry, microbiology and biophysics of thanatology and in particular forensic) all RNA from the transcript of the part of genome still active or awakened in the internal organs of a dead body for 24 to 48 hours following the time of the death. · (It was recently showed that in these 48 hours, some genes continue to be expressed in cells, producing the mRNA and that certain genes are expressed again that had been inhibited since the end of fetal development)

Therese Schroeder-Sheker

Therese Schroeder-Sheker is a musician, educator, clinician, and academic dean of the School of Music-Thanatology, which was housed at St. Patrick Hospital in Missoula, Montana from 1992 to 2002.

Schroeder-Sheker, using voice and harp, works as a music-thanatologist, a relatively new discipline, where the practitioner works with those who are actively dying (24–48 hours) or have received a terminal diagnosis with a life expectancy of less than six months. The goals of music-thanatology include reduction of physical as well as emotional pain, creation of a supportive environment while dying, helping the patient become more conscious of their own death process, and changing the approach to death within established structures (hospices, hospitals, etc.). Schroeder-Sheker was honored by the New York Open Center [1] in 1997 for her "Music Thanatology". Her music has been used in documentaries and released commercially.

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