Category Archives: the process of death

What Would You Do?

Equality.

A term flaunted in many public circles, political campaigns, and social justice movements. In these instances, “equality” refers to fairness and justice in life; the act of viewing all people without bias or discrimination. Our society is obsessed with rallying behind crusades that foster impartiality in every aspect of life…but what about death? Is there equality in dying?

With current advancements in artificial intelligence, it is no surprise that self driving cars are on the horizon.  In an effort to gather information about how humans make decisions, researchers at MIT created the “Moral Machine.” This database contains a variety of what-would-you-do scenarios involving car crashes and vehicular manslaughter in attempt to create an algorithm for decision making based on how humans act in life-and-death situations.  For example:

This scenario incites intense debate over what the car should or should not do. If the car continues in a straight path, one woman and her unborn child will die. However, if the car is programmed to swerve, five people will die. If only provided with the number of deaths, many people would choose to have the car continue straight, saving the most lives. But what happens when we place value on those lives? When the victims are women and children, versus criminals, how do we decide which lives to value more and which deaths to value less?  That is the heart of what the Moral Machine aims to uncover.  By categorizing people into different groups based on their social value, we assign significance to individual deaths. After perceiving the criminals’ role in society, many people may change their minds and program the car to swerve, taking a greater number of lives but saving (arguably) more important or worthy ones.

The dilemma in the various circumstances boils down to the modern perception of death and the processes to follow. Our society has cultivated an environment that fights against death. People do not want to die “before their time” and thus are bred to accept death only when they feel that their life is complete or that they have nothing more to give. These personal sentiments are subconsciously broadcast into situations like the self-driving car, where knowing the demographics of a person ranks them on a scale ranging between “worth-saving-at-any-cost” to “not-a-huge-loss.”  It sounds gruesome but it’s true. 

Additionally, our determination of what the car should do originates in the process after a death. We can justify the decision to kill the five criminals if we consider that the pregnant woman and baby would be heavily mourned and grieved whereas the convicts probably would not.

Inadvertently, we place values on life and death based on our culture’s view of death and the proceedings to follow. Death and life seem to have an linear relationship; the more we value someone’s life the more we value their death. Is this a true embodiment of equality though? Can equality be extended to the grave? And lastly, what would you do?

 

To see other related scenarios, click here.

References

http://moralmachine.mit.edu/

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“7 Reasons Not to Be an Organ Donor”

I was scrolling through my News Feed on Facebook, and I came across this post by the Odyssey:

Screenshot of Facebook post

“7 Reasons Not to Be an Organ Donor”

I stopped scrolling. As a student in this class and as an organ donor myself, I was intrigued to discover the reasons for denouncing organ donation. So, I clicked. And this is what I saw:

Screenshot of Odyssey article

“Actually, there aren’t any.”

I chastised myself for succumbing to click bait, but I marveled at the brilliance of the tactic.

This post attracts organ donors like myself because it challenges our beliefs. I wanted to know how someone could possibly come up with seven valid reasons for not becoming an organ donor. Yet, it also appeals to those who are not organ donors by validating their decision.

The article begins with statistics on the disparity between the number of people who support organ donation and the number of people who demonstrate their support by donating their organs. In the United States, the demand for organs is much greater than the supply. People die every day waiting on the organ transplant list.

In an attempt to amend these inequalities, the author dispels seven rumors that might persuade one to not become an organ donor.

Two rumors addressed in the article were previously discussed in class: “If doctors know that I am an organ donor, they won’t try to save my life as hard” and “Doctors might not be 100 percent sure that I am dead.” These rumors are not unfounded. Instances of supposedly brain dead patients that “wake up” during organ harvesting do exist, like this woman from New York. However, laws and practices are now in place to prevent these gross oversights from happening again.

Another common rumor, one that I even believed myself, is that organ donation precludes you from having an open casket funeral. If Americans harbor the misconception that organ donation will interfere with customary funeral practices, I can understand the decision to not become donors. The challenge, nonetheless, will be to educate people on the realities of organ donation.

I think this article is an excellent first step in informing the public about organ donation. In this age of technology, many people formulate their opinions from posts such as this one on Facebook. While the argument becomes too emotional at times, it is backed by evidence. To continue learning about other common rumors about organ donation, read the original article here.

 

 

References:

theodysseyonline.com/reasons-organ-donor

abcnews.go.com/…ctors-remove-organs/story

The Desire and Fear of the Immortal

A phrase from the immensely popular series, A Song of Ice and Fire, valar morghulis is translated as “all men must die,” an idea prevalent in human culture.  Humans tend to define many things in duality: light and darkness, positive and negative, life and death. These concepts are thought of to only exist in relation to one another; without light, there can be no darkness. So, can life as we define it exist without the notion of death; in other words, is something that doesn’t die even alive.

The Fantasy

From the desire to create Philosopher’s Stone, to the search for the Fountain of Youth, to modern stories of vampires, the idea of immortality pervades much of human history. What exactly about the notion is so fascinating? I believe it stems from a fear of death, or the unknown that follows. It is a completely normal fear to have due to the modern world’s obsession with “cheating death.” The idea of living indefinitely seems great, ignoring the looming downsides. These include the loneliness that comes with knowing everything around you is mortal or becoming bored when you’ve seen  and done everything. Immortality is rarely depicted as perfect; however, it is still viewed romantically and longed for.

However, even if someone doesn’t long for immortality, it seems that almost everyone is afraid of another’s immortality. This can be most readily seen in fiction writing. For example, the demon or such that cannot be killed by normal means (i.e. Voldemort, Dracula). This is typically shown as being achieved through a Faustian deal or something similar. The soul is given up, but the consciousness remains in the body. Is this why the notion is scary? Why are these characters shown as bad for achieving something that is so desired? I really can’t answer this, but it is an interesting double-standard nonetheless.

The “Reality”

Aside from the fantasy of immortality, the actualization of immortality is becoming not so far off. For better or worse, it may not be humans that will attain this immortal status. Research into AI (artificial intelligence) is moving forward every single day. In my biology classes, we discussed that consciousness is probably not be a single entity, but rather the various regions of the brain all working together (this theory is called the neural correlates of consciousness).

This theory is what many researchers in AC (artificial consciousness) are studying; although they must first discover what a consciousness is. But is it possible to synthetically create a consciousness? Is the consciousness equivalent to the soul, is the AC truly alive, can humans use similar technology to extend their existences? These have always been topics in science-fiction, but it may eventually become science-fact. Regardless if an AC is created in a decade, a century, or never, it still remains that we need to redefine life and death. How can we define a living being if it is no longer a requirement that it will eventually die?

The Obsession with Death, But Fear of Dying

In my observation of society there has always been an obsession with death. Death is everywhere in pop culture from blazing articles on tabloid pages at the supermarket to brutal deaths being common place on the television screen. Yet as a culture we also seem to have this intense fear of dying.

Painting of a mourning female statue

Mount Olivet Cemetery – Nashville, TN by Don

Recently I found myself binge watching Buzzfeed’s Unsolved series, a YouTube series where two men try to prove that ghosts are real or dig into famous mysteries usually pertaining to gruesome, to unsolved deaths. I do not know why I started watching it, but clearly other people are doing the same for their most recent video, posted less than 24-hours ago, has over a million views. While the ghost and demon episodes will often get my heart racing, it is the one’s that explore real unsolved deaths or murders that stick with me. In a completely morbid sense it is compelling. One would think that because we are so open about death and exploring how someone might have died, that the process of dying should not be a taboo topic. But, as soon as death is brought up in the personal sense the discussion ends. Suddenly, it is completely unreasonable to talk about death. A guy’s head being put on a spike on Game of Thrones = fine, but talking about your own opinions surrounding your unavoidable death = over sharing.

There are exceptions to this of course. I am very lucky to still have three of my grandparents alive, and recently the topic of dying has been a discussion between my maternal grandparents and me. While at first I was uncomfortable, after taking a deep breath I realized the topic was not morbid at all. In fact, it was in some ways heartwarming. My grandfather described his desire to have his and my grandmother’s ashes mixed and my grandmother told me their plan to meet at “the pearly gates of heaven,” though they have yet to decide on which side of the gate. Here were two people I love with all my heart talking about their own deaths and it brought a smile to my face. 

 

Heavenly image of a sun peaking through the clouds

susan.clue_n_you

But, this is a discussion I know many do not have. My grandmother recounted a story of her friend that refuses to talk about his own imminent death with his grandchildren, “because it is too sad.” And I can understand that point of view. Everyone should be able to make their own decision on their level of comfort when it comes to discussing death, but from my personal experience I feel reassured after my discussions with my grandparents. While the thought of losing them breaks my heart, it is also mended by the fact that I know that they are not scared of what death may bring. I am becoming more and more curious as to why these conversations on death cannot be public discussions, as well as private ones.

Older couple hugging

Hug by Namor Trebat

 

A History of Poppies, War, and Death

Source: http://wellcomeimages.org/ixbin/hixclient.exe?MIROPAC=N0021523

The opium poppy, effortlessly sprouting across several continents, has captured the attention of humankind for thousands of years.  Likely due to its sedative effects, the ubiquitous scarlet flower has consistently been associated with death.  The Greeks depicted Hypnos and Thanatos, the gods of sleep and death, donning crowns of red poppies.  After World War I, millions of people began to line their pockets with the same red petals in remembrance of the fallen soldiers.  Today in the US, the flower reminds us an alarming epidemic, claiming thousands of lives each year: the opioid crisis.  But before that, another opiate crisis loomed large in a different empire: the Qing dynasty.

Throughout the 18th century, Britain facilitated unbalanced trade with China that heavily consisted of opium exports to China; by 1767, Britain was exporting two thousand chests of opium to the country each year.  In 1839, Lin Zexu, the Chinese imperial commissioner, put a foot down on its trade and enacted laws banning the substance from the country.  In a letter to Queen Victoria, Lin Zexu questioned why Britain continued to supply opium to China, considering that it was banned in Britain:

I have heard that you strictly prohibit opium in your own country, indicating unmistakably that you know how harmful opium is. You do not wish opium to harm your own country, but you choose to bring that harm to other countries such as China. Why?

There was no response to the letter.  What followed was two opium wars, eventually forcing China to legalize the importation of opium.  The effects ultimately derailed the country and toppled the Qing Dynasty.

Fast forward to 2018: America is facing a public health emergency, wrangling with the devastating consequences of opioid addiction.  Back in November, President Donald Trump announced that he would discuss with Chinese President Xi Jinping on how to stop the “flood of cheap and deadly” fentanyl “manufactured in China” into the United States.  (Fentanyl is a particularly deadly type of opioid, 50 to 100 times stronger than morphine; large quantities of the substance are reportedly being illegally shipped to the US.) 

The very mechanism that makes opioid highs so euphoric is also what makes them so deadly: once opioids enter the bloodstream, they bind to receptors in the brain, producing effects that block pain and provide relief, but also slow breathing.  Victims of overdose often die from respiratory depression, physically unable to breathe in enough oxygen to keep their organs alive.  Perhaps this is why humankind cannot seem to shake its toxic obsession with the opium poppy, century after century being lulled into the sweet calm it provides, only be led into a tortured death by addiction.  One thing is for certain: the United States must take urgent action to address the epidemic, lest we see the fall of another empire.

Sources:

“Lin Zexu: Letter to Queen Victoria, 1839.” Longman World History, wps.pearsoncustom.com/wps/media/objects/2427/2486120/chap_assets/documents/doc24_1.html.

Maron, Dina Fine. “How Opioids Kill.” Scientific American, 8 Jan. 2018, www.scientificamerican.com/article/how-opioids-kill/.

“Opium Throughout History.” PBS, Public Broadcasting Service, www.pbs.org/wgbh/pages/frontline/shows/heroin/etc/history.html.

Pletcher, Kenneth. “Opium Wars.” Encyclopædia Britannica, Encyclopædia Britannica, inc., 9 Mar. 2017, www.britannica.com/topic/Opium-Wars.

Wee, Sui-lee, and Javier C. Hernandez. “Despite Trumps Pleas, Chinas Online Opioid Bazaar Is Booming.” The New York Times, The New York Times, 8 Nov. 2017, www.nytimes.com/2017/11/08/world/asia/china-opioid-trump.html.

Psychoactive Drugs: A Change in End of Life Practices

 

 

Humans seem to have both a strong anxiety and fascination with death, having a profound awareness of our own mortality from a young age. We seem to do everything in our power to avoid death and prolong the inevitable, but often very little to change how we perceive death. For those that see their death coming, such as in the case of a terminal illness, is there something we could do to change how they process their own deaths? There is evidence that psychoactive drugs could provide this change.

Most research and investigation into the possible effects, both negative and positive, of psychoactive drugs were extinguished with the birth of the Controlled Substance Act in 1970. This act classified all psychoactive drugs as schedule 1 substances, categorizing them as unsafe and lacking any potential medical value. In recent years, however, we have seen an increasing amount of research on psychoactive drugs such as dimethyltryptamine (DMT) and psilocybin with one incredible possibility stemming from their use; the ability to change one’s perception of death.

Research has found that the use of these substances allows patients who are diagnosed with terminal illnesses to approach the existential crisis of death in a different way, one that common medications do not provide. Cancer patients receiving a single moderate dose of psilocybin with guidance of a counselor reported a change in the way they perceive the world around them, their families and relationships, and death. One dose of psilocybin was also found to have the lasting effect of lowering depression and anxiety levels in these patients, measured at both two and fourteen months after the experience.
Most interesting of possible psychoactive chemicals for use in end of life practices is DMT. DMT is an endogenous chemical produced by the pineal gland released by our brains most notably during dreaming and death. People who have tried this drug often describe seeing similar structures and often report a similar experience independent of culture. This calls into question what people experience when taking the so-called “God-molecule” and if this molecule creates a after death experience. Could this chemical provide people with a chance to experience death before it happens? Could this help people process what it will be like to die, before they do?

When talking about this topic, it is important to note that these recent studies have had a small sample size, due to their drug classification and social stigma surrounding them. While further studies must be conducted to determine possible uses for these drugs, I find it incredible that naturally occurring substances can have the power to change one’s entire perspective on life and death. The common end of life practice today is to provide the patient with comfort in the form of benzodiazepines and opioids. I am hopeful that these psychoactive chemicals can be used as an alternative to provide a different type of end of life care.

 

 

Sources:

https://www.ncbi.nlm.nih.gov/pubmed/23104218

http://www.newyorker.com/magazine/2015/02/09/trip-treatment

https://www.ncbi.nlm.nih.gov/pubmed/25173780

Cotard’s Syndrome: The Disorder That Makes You Think You’re Dead

Cotard’s syndrome (also known as Cotard’s delusion) is an extremely rare condition in which patients believe that they—or parts of their body—are dead.

In 1788, the earliest recorded case of this puzzling disorder, an elderly woman was preparing a meal when she suddenly became paralyzed on one side of her body (a condition we would now probably characterize as a stroke). However, at the time, the woman was convinced that she was dead. She demanded that her daughters treat her as a corpse, and they eventually humored her. They wrapped her in a shroud, and displayed her publicly so that people could “mourn” her. After her “wake,” her family tried to treat her with opium and other eighteenth-century medications, but her delusions never fully went away.

Jules Cotard, who first described the disease and who it is named after. Source: Wikipedia

About a century later, in 1882, French neurologist Jules Cotard finally coined the description of this disorder, which was then named after him. He encountered a patient he dubbed “Mademoiselle X,” who complained that she had “no brain, no nerves, no chest, no stomach and no intestines.” She refused to eat, because she believed she didn’t have innards anyway, and eventually starved to death. Cotard was so puzzled that he published this case widely in journals, and his description of Mademoiselle X’s condition became an influential, foundational text on this bizarre disorder.

Today, hundreds of years after the first report of the condition, we are still baffled by Cotard’s syndrome. We don’t have a clear understanding of its etiology or pathophysiology. We do know, though, that afflicted people can recover, with the right combination of electroconvulsive treatment (ECT) and pharmacological treatment (usually antipsychotics, antidepressants, and mood stabilizing drugs).

In 2008, for example, a 53-year-old patient called Ms. Lee complained that she was dead and smelled like rotting flesh. She asked her family to take her to a morgue so that she could be with other dead people. Her symptoms were severe; however, after a month of a strict drug regimen in conjunction with ECT, she greatly improved, and now functions normally.

So what is Cotard’s syndrome? What causes it? Why does it afflict the people it afflicts? We don’t have answers yet, but that just means there’s a lot of fascinating work to do in this area. Considering the disorder in the context of our class renders it even more intriguing. For instance, connecting this to our discussions about the importance of mortuary rituals, we can ponder what it would be like to perform these rituals for someone who believes she is dead, but isn’t. If she were your family member or loved one, how would you feel? What new significance or symbolism would the execution of this ritual take on?

References:

Ruminjo, Anne, and Boris Mekinulov. “A Case Report of Cotard’s Syndrome.” Psychiatry (Edgmont). Matrix Medical Communications, June 2008. Web. 24 Mar. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695744/

Berios, G.E., and R. Luque. “Cotard’s Delusion or syndrome?: A Conceptual History. “Cotard’s Delusion or Syndrome?: A Conceptual History.” Comprehensive Psychiatry, May-June 1995. Web. 2 Mar. 2017.
http://www.sciencedirect.com/science/article/pii/0010440X9590085A

 

Death – The Great (In)Equalizer

A traditional Western European plague doctor; they were hired en masse during the “Black Death” epidemic. Retrieved from http://www.themiddleages.net/plague.html

Death is an omnipotent force, inescapable and looming. For this reason, it has been quite often referred to as the “Great Equalizer.” This designation masks the inequality of death as a culturally constructed process affected by social power dynamics. A quintessential case in the regard is the relationship between African-Americans in the United States and death.

The social oppression of individuals of African descent in the United States has been subject to scrutiny since the inception of American slavery, a “peculiar institution,” according to Frederick Douglass via his published autobiography (1845). Hence, we know that there is no facet of African-American culture that remains unaffected by the history of racism and prejudice in the United States. The experience of death is no different.

For African-Americans (and perhaps other marginalized groups) death remains a queer dyad, consisting of the social death in addition to the physical death. The concept of social death was originally described by Orlando Patterson in Slavery and Social Death: A Comparative Study (1982) where he argued that the dehumanization of enslaved Africans related to the enforced erasure of their culture and deprivation of what are now more widely considered universal human rights constructed a slave as a “socially dead person.” He writes: “Alienated from all “rights” or claims of birth, he [the slave] ceased to belong in his own right to any legitimate social order.” In other words, an individual who does not possess capacities that are conventionally seen as common to all living humans cannot be rightfully considered to be alive in the typical sense. This state of existence can, and should, be applied contemporarily to African-Americans who still do not have equitable access to fundamental resources such as housing, education, healthcare, and education. It should also be noted that physical death rates between Blacks and whites in the United States are also still unequal (Payne & Freeman, 2006). The realization of the tension African-Americans may feel between the social death and physical death can be seen in literature. August Wilson’s 1983 play Fences (and its 2016 film adaptation), an enduring gem of playwriting on African-American experiences, provides a stellar example of this.

Viola Davis and Denzel Washington in their roles as Rose Maxson and Troy Maxson, respectively, in the 2016 film Fences

Viola Davis and Denzel Washington in their roles as Rose Maxson and Troy Maxson, respectively, in the 2016 film Fences. Retrieved fromhttp://www.npr.org/templates/story/story.php?storyId=126195963. Taken by Joan Marcus

(**Spoiler Alert**) Though the protagonist of Fences, Troy Maxson, dies physically at the age of 62, the story told by the play is very much concerned with the social death. Frequent references to death and dying throughout the play avail readers of the characters’ relationship with the end of life. Gabriel, Troy’s younger brother, who was wounded in World War 1 causing him to have a mental disability, says of St. Peter, the Christian apostle: “[He] Ain’t got my name in the book. Don’t have to have my name. I done died and went to heaven. He got your name though. One morning St. Peter was looking at his book, marking it up for the judgment, and he let me see your name.” This is a representation of the social death Gabriel underwent, as his disability caused him to become a ward of the state, unable to make decisions for himself.

Troy, a sanitation worker, expresses his dissatisfaction with his own life several times throughout the play, illuminating his awareness of his social death. He says: “Woman . . . I do the best I can do. I come in here every Friday. I carry a sack of potatoes and a bucket of lard. You all line up at the door with your hands out. I give you the lint from my pockets. I give you my sweat and my blood. I ain’t got no tears. I done spent them[…] I go out. Make my way. Find my strength to carry me through to the next Friday. (Pause.) That’s all I got, Rose. That’s all I got to give. I can’t give nothing else.”

By characterizing tears and strength as objects external to himself, Troy positions himself here without basic characteristics of humans. This aligns with Patterson’s above definition of socially dead.

Finally, the following impassioned dialogue occurs between Troy and Rose, who are married:

“Troy: Rose, you’re not listening to me. I’m trying the best I can to explain it to you. It’s not easy for me to admit that I been standing in the same place for eighteen years.

Rose: I been standing with you! I been right here with you, Troy. I got a life too. I gave eighteen years of my life to stand in the same spot with you. Don’t you think I ever wanted other things? Don’t you think I had dreams and hopes? What about my life? What about me?”

During the exchange, which occurs following Troy’s reveal that he has impregnated another woman, both Troy and Rose lament their long unfulfilled, i.e. dead, hopes and dreams, cuing us in to the social death they have experienced as a poor African-American couple circa 1960.

Nina Simone once said, “An artist’s duty, as far as I’m concerned, is to reflect the times.” August Wilson beautifully reflected the aberrant relationship between African-Americans and death by telling the story of the two deaths, which serve as a testament to the inequality of death.

 Works Cited

DOUGLASS, F., & GARRISON, W. L. (1845). Narrative of the life of Frederick Douglass, an American slave. Boston: Anti-slavery Office.

PATTERSON, O. (1982). Slavery and Social Death: A Comparative Study. Cambridge, MA: Harvard University Press.

PAYNE, R., & FREEMAN, H. (2006). Racial Attitudes and Health Care Disparities in African American Communities: Historical Perspectives and Implications for End-of-Life Decision- Making” in Key Topics on End-of-Life Care for African Americans. North Carolina: Duke University

WILSON, A. (1983). Fences. New York: Plume.

The Importance of Mortuary Rituals

Written by Saher Fatteh

After listening to the podcast How Stuff Works in which Dr. Stutz discusses mortuary rituals and their importance, I thought of a specific scene in The Undertaking. The movie includes a heartbreaking story of a young family in which the only child had been diagnosed with a neurological disease that would take his life before he reached three years. The parents sought refuge in the structure of rituals involving death in our society. The young mother explained the calming effect of arranging for funeral services before her son’s death. It seemed as though having the funeral service in place allowed the parents to answer the question, “What now?” after their son’s death. As discussed in the podcast, ritual is powerful as a transformative tool. The ritual of funerals and burial allowed the parents to have a set time in which they could transition into their new life. Although they knew that their son was dying, the process of burial allowed them to cope in steps and at their own speed. Each part of the burial process served an important role in their processing of death. The mother explained that the closing of the casket was extremely symbolic and powerful. It allowed her to accept for the first time the loss of her son’s physical body. To me, this scene illuminates the vital importance of mortuary rituals. Though at times they may seem silly or unnecessary, they allow a slight measure of control in an uncontrollable situation.

Dealing with Dead Bodies

Written by Saher Fatteh

During class on Tuesday, we watched a short film called The Undertaking. The movie investigates the life and work of Thomas Lynch, the director of a funeral home. The film follows three independent stories of death ranging in age and type and in doing so, comments on the way that Americans perceive death and dying. One aspect of the film that stood out to me was my immediate aversion to the idea of dressing and embalming a corpse. As I watched the funeral home worker paint the face of a deceased elderly woman in preparation for her funeral service, I thought about if I could ever carry out the same task. Each time I thought about placing myself in his shoes, I felt an innate sense of discomfort. I began to think about why I might react so strongly and negatively to the idea of dressing a body for a funeral service. This made me begin to think about the aspects of death that make me most uncomfortable and why that might be. After some reflection, I realized that the dead body itself, in its absolute stillness, is quite unnerving to think about. Maybe this is because, as a society, we are constantly shielded from ever viewing death in its physical state. We rarely ever see dead bodies outside of certain contexts including hospitals and funeral services. Perhaps if we were exposed to death and dead bodies more often, I would not have felt so uneasy watching a man prepare a dead body for a service. I began to wonder how people who work in the funeral service industry become adjusted to constantly seeing dead bodies and discussing death. Do they also have the same immediate negative reaction that most of us do towards seeing a dead body?

http://www.sfirishfilm.com/media/pressphotos/2008/Learning%20Gravity%20(The%20Undertaking)/The%20Undertaking:LG%206%20-%20Prep%20Room.jpg