Module 9 - Managing Mortality and Difficult Passages

Summary

Death must be managed, cognitively, so that we can function, and practically, to maintain the health of the living. Deaths happen in predictable patterns, once diagnosis is made; it may be fast, slow, or halting in its progression, and chronic conditions may take years for eventual decline. These can be described as dying trajectories and cultures usually have expectations based on scripts derived from worldview, experience, and health epistemology. Communicating across cultures brings challenges of language, but also of worldview and expectations. Relaying the bad news of a terminal diagnosis is never easy, but becomes even more difficult if a culture has proscriptions against mention of death. Informed consent becomes particularly burdensome when patients’ cultures are more collectivistic and/or agency is not individualized. Arts provide fertile bodies of information about how cultures think about and approach mortality.