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Palliative care Cultural aspects

Human society reacts before the death of a close relative through a collection of phenomenon known as rites. Such rites express our society's reaction to the loss of a relative or friend but also attempt to explain the mystery of death.

All of these rites have a common goal: to totally isolate the living world from the dead world which do not communicate but also which should not communicate. The sailor who has disappeared at sea, the climber whose body is abandoned in a snow storm; their ghosts are a source of terror for the collective subconscious: why try to recover their bodies, why spend so much money and effort if not in an aim to totally separate dead from living persons.

For a doctor, writing death certificates is not only an administrative duty. It is a tangible and material way of separating a body from the living world, it is a ritual. The 'blue paper' (at least in France) clearly confirms the reality of death (hence incredible difficulties when it has been poorly completed - thankfully a rare event). Writing this certificate is the first step for the doctor to begin his/her bereavement of the patient that he/she cared for.

A dead person is truly deceased when the civil registry can prove so: the incredible administrative difficulties encountered by survivors when they cannot produce a death certificate (or even a birth certificate) demonstrate the importance of an official death. The "livret de famille" (family record) is modified: the survivor becoming 'widow from ...' or 'widower from...', a status which will be notified in the case of remarriage. Certain situations require a civil act on which 'not deceased' must be clearly mentioned concerning the survivor. It is evident that such official writings take on a major signification for the living person whereas they are of no consequence for the deceased one.

The 'officially dead person' has the right to be buried or incinerated. One could almost say that it is his/her duty. However, since he/she is no longer able, the mayor must assume the burial (or incineration) if the family cannot do so. In the past the privilege of burying their dead was conceded to communities (or to lay congregations like 'Charitons' in our Normandy region).

After these civil rites, other religious rites will take place: however, our country having a lay constitution, civil rites should be performed first.

We will successively but briefly study the various rites encountered in our country (in order to facilitate the work of caregivers: gross ignorance of such rites can needlessly hurt the dying patient and his/her bereaved family).

What is a rite?,

Christian rites,

Muslim rites,

Jewish rites,

Lay rites.

We could have also briefly treated other cultural situations, however we chose to present the most frequently encountered situations in our country (France) and beg pardon from students originating from other cultures.

There is a quite interesting site (in French) "Le repos de Saint - François d'Assise", which provides many practical references - not particularly useful in France since the website is based in Quebec - however it does offer great detail on many rites.

 

The following chapter will deal with bereavement (page 13).

 

The previous chapter dealt with the terminal phase (page 11).

 
Palliative care in cancer - You are looking at www.oncoprof.net website