This definition appears to be more centred around emotional support for the dying and their family, an area sadly lacking in the typical hospital environment with its emphasis on the physical aspects of disease (fenell et al, 1988).
?The authority of (male) clergy to define post-death care in a time when the concern with the spiritual destination of the deceased wanes, is being supplanted by that of (female) bereavement counsellors and befrienders. A re-feminisation of death is under way, led by women?
(Walter, 1993 p277).
Cruse bereavement care is battling against the increasing medicalisation of bereavement and was founded by Margaret Torrie, herself a widow (Field et al, 1997). It would appear that the re-feminisation of dying and death is well-under way prompted by a dissatisfaction in the medicalisation of these areas.
However, although challenging the medicalisation of death in many respects, the hospice organisation has been criticised as offering only a limited number of places, and mainly concentrating on terminal cancer patients (Seale, 1993) although deaths from cancer only account for 26% of all deaths (Victor, 1993). Biswas (1993 p132) maintains that:
?the recent expansion of the hospice movement has seen the increasing medicalisation of hospice care?
and that palliative care has become a part of general medicine and thus it is at the mercy of medical professionals rather than being a patient-led service. There is no denying the success of hospice care for many terminal patients but it would appear that ?creeping medicalisation? is having an effect on the quality of care these institutions provide.
The rising popularity of complementary medicine for the terminally ill may also be seen as a reaction to dissatisfaction with medicalisation. Techniques such as breathing exercises, muscular relaxation, meditation, visualisation, massage, aromatherapy, acupuncture and spiritual healing are more often practised in hospices than within mainstream curative medicine establishments (Pietroni, 1993). Once displaced by medical science, lay medicine is experiencing a re-emergence to provide hope and comfort for those the medics have failed.
In conclusion it appears that the medical profession have successfully monopolised the process of dying and death. Society is becoming increasingly dependent upon the tenets of the medical model although in many areas its contribution to well-being is refuted. With advancements in medical technology and new sophisticated invasive procedures a number of terminal individuals are being kept alive long after all meaning and quality of life have diminished. The inability to cure and control all ailments coupled with a therapeutical relentlessness which refuses to admit to failure has led to dissatisfaction with medical care of the dying. Feminist sociologists particularly are involved with wrestling back control over the process of dying from the medical professionals and seeking alternatives in the re-feminisation of death. The increasing use of complementary medicine would appear to be a response to this dissatisfaction as is the rising popularity of the hospice movement. Euthanasia would seem to be a topic that, as time goes on, is becoming increasing difficult to ignore, although vehemently opposed by the British Medical Association.
REFERENCESAbbott, P. & Wallace, C. (1990) An introduction to Sociology. Routledge: London.
Ahmedzai, S. (1993) The Medicalisation of Dying: A Doctor?s View
IN Clark, D. (Ed) (1993) The Future for Palliative Care: Issues of Policy & Practice. Open University Press: Buckingham.
Arber, S. & Ginn, J. (1991) Gender & Later Life: A Sociological Analysis of Resources & Constraints. Sage: London.
Bilton, T., Bonnet, K., Jones, P., Skinner, D., Stanworth, M. & Webster, A. (1996) Introductory Sociology (3rd ed). Macmillan: Hampshire.
Biswas, B. (1993) The Medicalisation of Dying: A Nurse?s View
IN Clark, D. (Ed) (1993) The Future for Palliative Care: Issues of Policy & Practice. Open University Press: Buckingham.
Blank, R. (1988) cited in
Hoefler, J.M. & Kamoie, B.E. (1994) Deathright: Culture, Medicine, Politics and the Right to Die. Westview: Oxford.
Bradbury, M. (1993) Contemporary Representation of ?good? & ?bad? Deaths
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Clark, D. (1993) Death in Staithes
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Crowther, T. (1993) Euthanasia
IN Clark, D. (Ed) (1993) The Future for Palliative Care: Issues of Policy & Practice. Open University Press: Buckingham.
Dunlop, R.J. & Hockley, J.M. (1998) Hospice-based Palliative Care Teams: The Hospital-Hospice Interface (2nd ed). Oxford University Press: Oxford.
Fennell, G., Phillipson, C. & Evers, H. (1988) The Sociology of Old Age. Open University Press: Milton Keynes.
Field, D. & James, N. (1993) Where & How People Die
IN Clark, D. (Ed) (1993) The Future for Palliative Care: Issues of Policy & Practice. Open University Press: Buckingham.
Field, D. Hockey, J. & Small, N. (1997) Making Sense of Difference: Death, Gender & Ethnicity in Modern Britain
IN Field, D. Hockey, J. & Small, N. (Eds) (1997) Death, Gender & Ethnicity. Routledge: London.
Giddens, A. (1997) Sociology (3rd ed). Polity: Cambridge.
Hoefler, J.M. & Kamoie, B.E. (1994) Deathright: Culture, Medicine, Politics and the Right to Die. Westview: Oxford.
Illich, I. (1976) Limits to Medicine. Medical Nemesis: The Expropriation of Health. Penguin: London.
Jones, L.J. (1994) The Social Context of Health & Health Work. Macmillan: London.
Littlewood, J. (1993) The Denial of Death & Rites of Passage in Contemporary Societies
IN Clark, D. (Ed) (1993) The Sociology of Death. Blackwell: Oxford.
Kearl, M. (1999) Euthanasia & the Right to Die.
AT http://www.Trinity.Edu/~mkearl/dtheuth.htmlKennedy, L. (1990) Euthanasia: The Good Death. Chatto Counterblasts Number 13. Chatto Windus Ltd: London.
Littlewood, J. (1993) The Denial of Death & Rites of Passage in Contemporary Societies
IN Clark, D. (Ed) (1993) The Future for Palliative Care: Issues of Policy & Practice. Open University Press: Buckingham.
Littlewood, J. (1994) Widow?s Weeds & Women?s Needs: The Re-feminisation of Death, Dying & Bereavement
IN Wilkinson, S. & Kitzinger, C. (Eds) (1994) Women & Health: Feminist Perspectives. Taylor & Francis: London.
Mulkay, M. (1993) Social Death in Britain
IN Clark, D. (Ed) (1993) The Sociology of Death. Blackwell: Oxford.
Oakley, A. (1979) cited in
IN Clark, D. (Ed) (1993) The Sociology of Death. Blackwell: Oxford.
Pietroni, P.C. (1993) Complementary Medicine: Its Place in the Care of Dying People
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Rachels, J. (1986) The End of Life: Euthanasia & Morality. Oxford University Press: Oxford.
Scambler, G. (1991) Sociology as Applied to Medicine (3rd ed) Bailliere Tindall: London.
Seale, C. (1993) Demographic Change & Care of the Dying 1969-1987
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Szasz, (1964) cited in
Scambler, G. (1991) Sociology as Applied to Medicine (3rd ed) Bailliere Tindall: London.
Taylor, S. & Field, D. (1997) Sociology of Health & Health Care. Blackwell Science: Oxford.
Thompson, D. F. (1993) Professionalism & Paternalism
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Turner, B.S. (1995) Medical Power & Social Knowledge (2nd ed). Sage: London.
Victor, C.V. (1993) Health Services & Policy for Dying People & their Carers
IN Dickenson, D. & Johnson, M. (Eds) (1993) Death, Dying & Bereavement. Sage: London.
Voluntary Euthanasia Society (1999) The Case for Voluntary Euthanasia
AT http://www.ves.org.uk/factsheets/for.htmWalter, T. (1993) Sociologists Never Die: British Sociology & Death
IN Clark, D. (Ed) (1993) The Sociology of Death. Blackwell: Oxford.
Walter, T. (1999) On Bereavement: The Culture of Grief. Open University Press: Buckingham.
World Health Organisation (1990) cited in
Dunlop, R.J. & Hockley, J.M. (1998) Hospice-based Palliative Care Teams: The Hospital-Hospice Interface (2nd ed). Oxford University Press: Oxford.
Zola (1972) cited in
Armstrong, D. (1989) An Outline of Sociology as Applied to Medicine (3rd ed). Wright: London.
APPENDIX 1Table to show: Percentage of Elderly Males and Females Resident in Communal Establishments by Age: Great Britain 1981
Age GroupsFemaleMaleSex Ratio (F/M)65-91.021.190.8670-41.851.641.1375-94.012.851.4180-48.695.541.5785+20.2712.201.66ALL (65+)4.582.471.85Taken from Arber & Ginn (1991) p115.