Culture
We understand culture to consist of the beliefs, values, behaviours, and dispositions that exist among groups in society. Culture also has a material dimension – in objects, manufactured things, and practical inventions. Through culture, we define who we are, to what extent we conform to shared values, and how we contribute to community and society. There has long been a recognition that end of life care systems must be rooted in specific cultural contexts if they are to thrive and be effective.
Ending life with dignity, with freedom from pain and with appropriate social, psychological, spiritual and medical support are widely accepted as attributes of the ‘good death’ – but the manner in which this can be achieved varies enormously across cultures, jurisdictions and settings. Recently there has been debate about whether palliative care can or should be the answer to good end of life care in all contexts. Some arguments, particularly from the rich world, propose wider access to assisted dying and the legalisation of euthanasia, to extend ‘choice’ at the end of life and promote autonomy. Others seek not elite dying for the few, but palliative care principles embedded across the health and social care system, thereby maximising benefits for the greatest number. Some positions revolve around the need to build community resilience in the face of ageing, dying and death, drawing on perspectives from health promotion and public health to develop strategies for intervention. Our views on life and death are also linked to our understanding of nature and environment, and ultimately ‘death in the anthropocene’. We seek to explore how such themes do or do not relate to fields of practice in end of life care.
Lonely Dying
‘Lonely Dying’ is the most telling theme to emerge in this stream of work in the first iteration of the project. We have explored the phenomenon known as ‘kodokushi’ in the Japanese context and linked this to ideas about ‘social death’ in the UK. It is estimated that c27,000 people die alone each year in Japan. To what extent can such a trend be expected in the UK? How should dying alone be evaluated and what place does it have in the cultural scripts of dying in the two countries?
Dr Gitte Koksvik and Dr Yoshinori Takata lead this aspect of the project.
Dr Gitte Koksvik
Dr Gitte Koksvik is a postdoctoral researcher at the University of Glasgow, and is part of the End of Life Studies Group, working on the Wellcome Trust Project “Global Interventions at the End of Life”. She has an MA in Philosophy (specialisation in health and culture) from Universite Jean Moulin Lyon 3, France, and a PhD in Social Anthropology from the Norwegian University of Science and Technology. Her doctoral dissertation was on the topic of clinical-ethical and existential issues in intensive care, with particular focus on personhood, dignity-in-practice, and the making of a good death in this high-tech, critical context.
Dr Yoshinori Takata
Dr Yoshinori Takata is an adjunct researcher at the Advanced Research Center for Human Sciences at Waseda University, Tokyo. He specialises in medical sociology and thanatology. His doctoral dissertation was on exploring the experiences of parents who have children with cancer from the perspective of narrative theory. During the past ten years, Yoshinori has been studying the division and cooperation between the bereaved at the contemporary Japanese society, especially in the medical area. He is also researching the grieving style of medical staff who have lost their patient. Yoshinori is interested in the Death Awareness Movement (for example, ‘Shu-katsu’ which means taking steps to prepare for the end of life) in Japan.