Palliative Care Nursing: Principles and Evidence for Practice

By Sheila Payne; Jane Seymour et al. | Go to book overview

20
The impact of socialization on the
dying process

Kay Mitchell

There are many aspects that are common across cultures (culture-common) rather than specific to one culture only (culture-specific) and there are certain values related to the dying experience that appear to be universally shared. This includes the hope that death will be achieved peacefully with minimal suffering and in the way preferred by the dying person (Kashiwagi 1991). However, the way this goal is achieved may differ between cultures and these differences may render some aspects of the death and dying experience 'culture-specific'. We are born, live and die within a social context and this chapter is an attempt to explore how socialization within such a context may impact on the dying experience. Here, I take culture to refer to the social context within which the person lives and works – the macroculture of country of domicile, but also the institutions that form microcultures within each country, such as professional discipline, religion and ethnicity. The term 'society' is taken to refer to the wider social context, which may contain many micro-cultures.

Cultural relativism, a theory about the nature of morality, reminds us that many of our own beliefs probably owe more to cultural teaching than absolute truth (Rachels 1993). The social institutions that inform end-of-life care may be comparable on a macro level across many countries (e.g. the law, health, medicine and social values). However, the interpretation and application of philosophical values within these institutions may differ and it is here that the value of comparison becomes evident in exposing the culturally relevant perspective. Viewing seemingly different perspectives of two cultures through an ethnocentric lens, we may sometimes overestimate these differences.

Rachels (1993) uses the example of a very poor culture who believe that it is wrong to eat cows. Although people may starve, the cows remain untouched. The values in this culture appear very different from the values of a culture that puts the life of humans before the life of animals. However, the difference is in the significance of the cow. While one culture believes it is an animal less than human and to be used by humans, the other believes the

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