Taboos and Social Stigma
Death is the greatest mystery of life. Its inevitability has been a source of wonder, fear, hopefulness, and puzzlement throughout history. Humans, being the only species consciously aware of the inescapability of death, have sought from time immemorial to cope with this unique insight. In Western society the traditional patterns of death were shaped by an ancient attitude informed by simplicity, meaningful ceremony, and acceptance. The experience was public; that is to say, a caring community of family and neighbors ministered to the dying person. In the traditional context, death was conspicuously visible throughout society and people went to great lengths to remind themselves of how fragile life is. Reminders of mortality were everywhere, whether they be in literature, paintings, oral traditions, or the cemeteries and churches where the physical remains of death intersected with the daily activities of the community. In this convergence, death held sway over the imagination of individuals, and was a source of elaborate ritual known as the ars moriendi. In these ceremonies that characterized the traditional patterns of death, acceptance and openness were the most important qualities.
Traditional Views of Death Give Way to New Perceptions
Throughout the ages particular rituals, along with their participants and meanings, may have varied. Nonetheless, death, dying, and grieving in the traditional model were an important part of everyday cultural practices. And the rituals they spawned connected dying and grieving persons to a broader community and set of meanings. In this way, the ordeal of dying was never just personal, it was communal. These great ceremonies, along with their deep religious and social meanings, accompanied dying persons into their deaths. They provided a sense of strength for the broader community that was being threatened by the loss of one of its members. Additionally, these traditional rituals were a healing balm to dying persons and their intimates, offering strength and comfort to both.
In the twentieth century, the social and psychological landscape was transformed, redefining American cultural, social, and personal experiences of death. The result of this transformation is that dying, once an integral and meaningful part of social life, has become a source of terror and thus largely vanquished from public visibility. Herman Feifel has argued that this change has produced the American "taboo on death." Four major social trends are responsible: (1) the abdication of community to a pervasive sense of individualism; (2) the replacement of a predominantly religious worldview with one that is secular; (3) the sweeping power that materialism holds on the values, interests, and behaviors in modern society; and (4) the influential place of science and technology in daily life.
As individualism, secularism, materialism, and technicism have become driving forces in modern American culture, the experience of dying and its meanings have been dramatically recast. Specifically, as individualism replaces community in daily life, community presence and support is withdrawn from the dying and grieving processes. Secularism as a way of life offers many opportunities and great pleasures, but is ultimately unable to offer meaning and comfort at the end of life. Like secularism, materialism poorly equips individuals and societies to grapple with the mystery of death. In addition, technological achievement and dependence have enabled humanity to actively fight against dying, thus forestalling death for countless numbers of individuals. In this technological framework, dying is no longer a natural, necessary, and important part of life. Rather, it is as if it has become an enemy. Success lies in its control and defeat; failure becomes defined as the inability to turn it away.
The New Model of Death
These social changes have given rise to a new model of death, wherein dying and grieving are atomized and disconnected from everyday pathways of life, leading to their social isolation. As the historian Philippe Ariès astutely observes, in this context, dying has become deeply feared and a new image has replaced the traditional patterns of acceptance: the ugly and hidden death, hidden because it is ugly and dirty. As death has become frightening and meaningless, a culture of avoidance and denial has correspondingly emerged. Specifically, it has led to widespread pretense that suffering, dying, death, and grief do not exist. When individuals are forced to confront these inevitable experiences in their personal lives, they typically do so without social support and the comfort of participatory rituals or shared meanings. A pattern of death entirely unfamiliar in the traditional era has hence emerged. It is rooted in a sense of separation from the dominant culture and profound feelings of shame, both of which exacerbate the suffering inherent in the experience of dying and grieving.
As the legitimation and comfort of traditional ways of dying have given way to meaninglessness, isolation, and shame, stigma has become attached to suffering, dying, death, and grief. The stigmatization of death, wherein the experience of dying has become shameful, has helped to create an environment in which comfort at the end of life is scarce, and where suffering rages uncontrollably against dying individuals and their loved ones. As
Oh God the pain is so great. To go to sleep and
feel normal, then to awake with such pain! Why
has God deserted me? I want to die. I can't live
with this newness. There are so many tubes in
my body. Every orifice. My hair is gone, my head
a giant bandage. Why can't I just die?
. . . illness creates in me a desire to withdraw from
society . . . I retreat to a resignation that most things
in life are empty-colorless-undesirable.
Because of all this, most days I try not to look in
the mirror, so I can still pretend that I look like
anything other than a cancer patient.
It seems that everything keeps going back to this cancer. It makes me feel so ugly, and it's just so depressing.
I'm not myself anymore. Oh, the way I used to be.
I can't even stand to look in the mirror anymore
(tears begin to stream from her eyes).
I'm no good to anybody. Why am I living? Why
doesn't God just let me die? I feel so useless, and
I'm a burden to everyone. This is no way to live.
The pain, oh why? I'm just no good.
Everything seems to lead me back to my cancer.
Cancer, cancer, that's it! That's all there is.
I'm just wasting my life away. There's absolutely
nothing positive happening. It's (having cancer)
all just so time consuming. It doesn't make me
feel well . . . feel good or happy. It's boring and
painful. Physically and emotionally, it's confusing
and depressing. There's nothing positive! All it
does is hurt. Everybody!
(Moller 2000, pp. 26, 33–35, 144–155)
The portrait that surfaces from these voices is one of agony and regret. It reflects an isolation and terror that was unheard of during the eras of traditional death. Also emerging is a silhouette of evil, whereby the body is being decimated by disease and the very foundation of cultural and social life is being attacked. The result is that dying people and their loved ones often live in a state of social exile, enduring their suffering in isolation. Simply, these people suffer deeply and unnecessarily, and they do so in a societal context where the very idea of death has become inconceivable and unbearable.
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Moller, David. Life's End: Technocratic Dying in an Age of Spiritual Yearning. New York: Bayword, 2000.
Moller, David. Confronting Death: Values, Institutions, and Human Mortality. New York: Oxford University Press, 1996.
Quill, Timothy. Death and Dignity. New York: Norton, 1993.
DAVID WENDELL MOLLER