Awareness of Dying: Prevalence, Causes and Consequences
Опубликовано на портале: 22-03-2007
Social science and medicine.
1997.
Vol. 45.
No. 3.
P. 477-484.
Тематический раздел:
Analysis of a subset of data from a survey of 3696 relatives, friends and others
who knew a sample of people dying in 1990 who lived in 20 areas of the United Kingdom
(the Regional Study of Care for the Dying) is reported. Using the typology of awareness
contexts developed by Glaser and Strauss [(1965) Awareness of Dying, Aldine, Chicago],
the prevalence of different awareness contexts is described and compared with an
earlier survey done in 1969. Open awareness of dying, where both the dying person
and the respondent knew that the person was dying, is the most prevalent awareness
context. This is particularly so in cancer and represents a change since 1969 when
closed awareness (where the respondent knows, but the dying person does not) was
more common. The characteristics of those dying in open and closed awareness contexts
are then compared, suggesting that having cancer, not being mentally confused, having
a respondent who knew for some time that the person was dying, and being of higher
social class are independently predictive of full open awareness, a condition marked
both by knowledge of dying, and a value commitment towards openness. Compared with
people in closed awareness, people dying in full awareness are more able to plan
their dying careers, so that they and their respondents are more satisfied with the
degree of choice over the place of death, they are less likely to die alone, and
are more likely to die in their own homes. Additionally, these individuals are more
likely to have spoken of their wishes for euthanasia, another indicator of their
desire to control the manner and timing of death. If dying from cancer, people in
full open awareness are more likely to have received hospice care. It is suggested
that underlying these patterns, and in contrast with some other cultures where awareness
of dying is seen as less desirable, people dying in Anglophone countries are particularly
concerned to maintain control over projects of self-identity. Their approach to death
is a reflection of this individualism.
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