Reclaiming Traditional End-of-Life Wisdom

By Gary Wederspahn

“It is difficult to accept death in this society because it is unfamiliar. In spite of the fact that it happens all the time, we never see it”, Dr. Elisabeth Kübler-Ross

When I was born in 1940, nearly all people in the U.S. died at home. Dying was generally a family, community, and religious event, not a medical one. Because people were directly and personally involved in caring for dying relatives, death was considered something natural, not a forbidden subject. Three decades later, Elisabeth Kübler-Ross, in her landmark book, On Death and Dying, warned that we had become a “…society in which death is viewed as a taboo, discussion of it regarded as morbid and children are excluded with the presumption and pretext that it would be ‘too much’ for them. We use euphemisms and we make the dead look as if they are asleep.”

I spent most of the 1960s and 70s living and working abroad in countries where the cultural attitudes remained traditionally accepting of death and dying. As a professional intercultural consultant, I was keenly interested in the local end-of-life customs and especially in the inner meaning people experienced around death, dying, and grieving. So I listened closely to their explanations and beliefs about mortality and frequently was deeply impressed by their wisdom and compassion. Their stories helped me see healthy alternatives to the death denial and avoidance that had become common in my own country.

For example, in Guatemala and Mexico, I participated in many Day of the Dead celebrations. The preparation of the food and drink, decoration of the gravesite, and creation of the elaborate ofrenda shrine to the deceased person involves the entire family. There is often music and laughter. Children are included. No one denies the reality and inevitability of death. It is accepted as normal and an occasion for the celebration of life. The grieving was blended with togetherness, joy, and even humor. Once I noticed an eight-year-old boy holding a candy skull with his name on it. He giggled and said, “I’m eating death!” The exaggerated costumes, puppets, and displays generally are designed to be funny. The cultural meaning seemed clear: There is no need for exaggerated fear or denial.
But Asunción Álvarez, Bioethics Professor at the Universidad Nacional Autónoma de México cautions: “We Mexicans are supposed to have a good relationship with death so that we can think and talk about it and prepare to face it when the time comes. This is not entirely true; only those communities that preserve ancestral customs do so.” She agrees with Kübler-Ross, who wrote “…such ‘old fashioned’ customs, I think, are an indication of our acceptance of a fatal outcome, and they help the dying patient, as well as his family, accept the loss of a loved one.” Ironically, Mexico City had long abandoned its Día de Los Muertos festival and parade until Hollywood revived it in the opening scene of the 2015 James Bond movie “Spectre.” Now it is a popular annual event.

In contrast, to help immigrants understand our attitudes toward mortality, the Life in the USA guide explains:

“Americans do not speak very openly or in much detail about death. Rather they allude to it, avoiding tackling the subject directly, as they would talk about sexual matters. Americans do not die. They “pass away, “expire,” “kick the bucket,” “go to their reward,” “breathe their last,” “cash in their chips,” “meet their maker,” “depart this life,” “give up the ghost,” or other avoidances. Insurance companies advertise plans designed to meet “your final expenses.” Once death arrives, its victims are not “dead.” Instead, they are “loved ones,” “the departed,” “the deceased,” the “late so and so.” Rather than being buried, the dead are “laid to rest” or “sent to their reward.” Those about to die are “terminally ill.”

I believe the way forward for us is a back to the future kind of effort. By reviving the traditional wisdom we once had and by learning from cultures that have preserved it, our conversations about death can be much more honest, candid, and healthy. The educational work of EKR Foundation, Death with Dignity National Center, The Conversation Project, the Completed Life Initiative, Final Exit Network, and Compassion and Choices is making progress. But much remains to be done. The 2019 AARP End-of-Life Survey reported that four in ten respondents say the topic of death and dying is not discussed enough in our communities.

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Gary Wederspahn is a Board Member of Final Exit Network. He is the author of Intercultural Services: A Worldwide Guide and Sourcebook and many articles on cross-cultural communications and relations. He has traveled in over 20 countries and served as Peace Corps Director in Guatemala, Costa Rica, and Ecuador.

Sources
1. On Death and Dying, Elisabeth Kübler-Ross, 1969.
2. 6/4/20 Email from Asunción Álvarez, Professor at the Faculty of Medicine. Universidad Nacional Autónoma de México and Vice-president World Federation of Right to Die Societies.
3. Life in the USA: A complete guide to American life for immigrants and Americans, Elliot Essman, 2014.
4. End of Life Survey: Thoughts and Attitudes on Death and Dying, AARP, 2019.

Declaration and Call-to-Action on Palliative Care & COVID-19

Witnessing, with the rest of the world, the overwhelming physical, social, emotional and spiritual suffering COVID-19 is inflicting on infected persons and their families globally;

Recognizing that palliative care is aimed at prevention and management of serious health-related suffering;

Observing with great concern that the persons infected with COVID-19 are isolated from their families, and may never see them again;

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