Culture Grief and Mourning

Bioethics practices generally focus on decision making prior to death. Clinical interventions to aid the bereaved—increas-ingly seen as a critical component of services provided to patients and families—must take into account cultural differences. It is critical to acknowledge that Western ways of grieving and disposing of the body are not universally accepted as the right way. It is also likely that our theories of grief and mourning, including definitions of normal, are inappropriately based on Western behavioral norms. For example, a standard way in the West of dealing with grief is to talk-about one's experience, one's relationship with the deceased, one's feelings. But in some cultures, talking may disrupt hard-earned efforts to feel what is appropriate, and to disrupt those efforts may jeopardize one's health. In some cultures, talk is acceptable, but one must never mention the name of the deceased person. In other cultures, talk is acceptable as long as it doesn't focus on oneself. Even in the West, however, not everyone is open to talking. It is important not to label those who do not openly express their emotions as pathological. In fact, the concept of pathological grief is primarily a Western construction. A mother in the slums of Cairo, Egypt, locked for seven years in the depths of a deep depression over the death of a child is not behaving pathologically by the standards of her community (Wikan). There is enormous variation in what is considered appropriate behavior following death. The ideal among traditional Navajo is to express no emotion, while in tribal societies a death may be met with wild outpourings of grief, including self-mutilation (Barley). In contrast to clinical notions of pathological grief, in some Mediterranean societies widowhood was considered a permanent state of mourning, and mourning clothes were worn for years, if not decades. In a compelling book titled Consuming Grief, Conklin describes how native Amazonians assuage their grief by consuming the body of their dead kin (2001). A number of anthologies provide examples of the range of cross-cultural variation in post-death management (Counts and Counts; Metcalf and Huntington; Irish, Lundquist, and Jenkins Nelsen; Parkes, Laungani, and Pittu; Rosenblatt, Walsh, and Jackson).

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