By Allan Kellehear
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Extra info for Death, Dying and Loss in the 21st Century
Example text
Customary pre-bereavement practices of seeing loved ones and giving gifts on these occasions are commonly substituted after death with visiting the grave or memorial and placing flowers, greeting cards and other symbolic gifts. This symbolic giving expresses a continuing bond and often mitigates emotions of loss, particularly at times of specific personal remembrance. For many mourners, the cemetery provides an essential place of focus and, for some, is reported to be the only place where vital communication with the decedent may occur on important occasions.
Such a focus on the desired taming or at least management of death in terms of when and why death occurs, applies we argue to practices in relation to the prevention and management of chronic disease. Thus we see the emergence of prescribed and pre determined ways of thinking and acting in relation to how health professionals should think about, and engage with their ‘patients’ in, first the prevention and when that ‘fails’ with the onset of the condition, the management of chronic disease. These predetermined roles are made evident within documents like the National Chronic Disease Strategy (National Health Priority Action Council [NHPAC] 2006) that talk of principles of self management that ‘must be firmly embedded’ in the health system and a person will ‘follow a treatment or care plan’ and ‘adopt a lifestyle that reduces risks’: principles promoted in the context of avoiding an unnecessary death.
When used as an indicator of success, ‘successfully living with chronic disease’ as opposed to dying from it, we argue creates another version of the too early death. For those who succumb to the too early death, new categories of potential shame for those unable to live with that disease, or tame the ever present threat of death from it, emerge. For example, most contemporary health initiatives of western governments are premised on the view that chronic diseases can be prevented by individual people and as such death can be avoided if only people conformed to behaviours that are promoted as enabling or producing a normal/acceptable death in western societies.