Thanatology

Autopsy (1890) by Enrique Simonet

Thanatology is the scientific study of death. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the post-mortem period, as well as wider psychological and social aspects related to death. It is primarily an interdisciplinary study offered as a course of study at numerous colleges and universities.

The word is derived from the Greek language. In Greek mythology, Thanatos (θάνατος: "death") is the personification of death.^[1] The English suffix -ology derives from the Greek suffix -logia (-λογια: "speaking").

History

Russian scientist, Élie Metchnikoff was famous for his work in microbiology and the discovery of phagocytosis. “Phagocytosis is the process by which a cell – often a phagocyte or protist – engulfs a solid particle to form an internal compartment known as a phagosome.”^[2] In 1903, he established a scientific discipline devoted to the study of death. He argued that those who were dying had few or no resources for the experience of dying and that an academic study would help those facing death to have a better understanding of the phenomenon and reduce their fear of it.^[3]

Metchnikoff based his ideas for an interdisciplinary study on the fact that while medical students had their obligatory encounters with cadavers through anatomical studies, there was almost no instruction on how to care for the dying, nor was there any research into death included in the curriculum. Because few scholars and educators agreed with Metchnikoff, the support he needed for the realization of his suggestion did not materialize for decades.

Metchnikoff chose to focus on two new areas of study, gerontology and thanatology. Contrary to gerontology, thanatology took about 47 years for most people to accept it as a science. Therefore, the science of thanatology is fairly new for the most part. The altered viewpoints people developed when it came to viewing and coping with death was one reason that thanatology became more accepted across societies.

Thanatology arose with the 'Death with Dignity' movement of the early 1970s as an interdisciplinary category for the study of death.^[4] The Death with Dignity movement allows Americans to decide what happens to their cadaver after death.^[5]

Following World War II, the world was haunted with the memories of the many casualties. During this period of reflection many existential philosophers began considering life-and-death issues. One in particular was Herman Feifel, an American psychologist who is considered the pioneer of the modern death movement.^[6] Feifel broke the taboo on discussions of death and dying with the publication of his book The Meaning of Death.^[7] In this book, Feifel^[8] dispelled myths held by scientists and practitioners about death and the denial of its importance for human behaviour. It earned wide attention and became a classic in the new field, including as it did contributions from eminent thinkers such as psychiatrist Carl Jung, theologian Paul Tillich and philosopher Herbert Marcuse. Through The Meaning of Death, Feifel was able to lay the foundation for a field that would eventually be known as Thanatology. The field was to improve death education and grief counselling by the use of valid death-related data, methodology and theory.

However, this is only one of several important books in the field of thanatology. Other key texts include The Experience of Death by Paul-Louis Landsberg, the sections on temporality and death from Martin Heidegger's Being and Time, as well as works of a fictional nature, such as Leo Tolstoy's The Death of Ivan Ilyich and As I Lay Dying by William Faulkner.

Goals

In most cases, thanatology is not directly related to palliative care, which aims to provide treatment for dying individuals and their families. According to the World Health Organization, "palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, involving the "treatment of pain and other problems, physical, psychosocial and spiritual".^[9]

Thanatology does not directly explore the meaning of life and of death. Such questions are irrelevant to those studying the medical aspects. However, the question is very relevant to the psychological health of those involved in the dying process: individuals, families, communities, and cultures.

As a consequence of thanatology becoming so prominent, there has been a tremendous increase of education at universities surrounding death. A continuing goal of this science is to improve the communication between practice and research since that is something that has been lacking. Thanatology has come a long way and will keep evolving to better our understanding of death.^[10]

Forensic Science

Forensic science deals with sudden and unexpected deaths. “Forensic medicine is the application of medical knowledge for the scientific investigation of facts and causal relationships, as well as the analysis and interpretation thereof in the service of the law in its broadest sense; moreover, it addresses all legal aspects of the practice of medicine during teaching, medical training, and specialist training.” This process used to study the deceased was brought about in Europe and has been struggling to make its way globally.^[11] A large portion of a forensic physician’s duty is to be present for sudden and suspicious deaths, examine person post sexual offense situations, organize statements for legal purposes and attend court to represent the individual.^[12]

Physicians rules for forensic science: Every physician is responsible for having excellent forensic medical knowledge.^[13]

There is a handful of forensic doctors work closely with prisoners to provide them with clinical assessments. They also put together care plans moving forward with these prisoners. These plans can include prescribing and obtaining medicine and monitoring them from a physical and mental health perspective.^[14]

Coping with Death

Research/Studies:

Elisabeth Kubler-Ross' five stages of coping with terminal illness are: denial, anger, bargaining, depression, and acceptance. Many thanatologists accept these stages but believe that they do not occur in any particular order or have any definite duration.^[15]

Studies show that in the case of losing a partner to death, if one’s self-esteem is lower, the death of their partner will result in both a lower social and emotional loneliness. A lower social and emotional level of loneliness results in a feeling of perceiving less support.^[16]

Mortality awareness is essential to our overall well-being as we confront the aging of world societies, global health disparities, emerging biomedical technologies, and shifting understandings of good deaths and lives worth living.^[17]

Hospice Care:

Another more popular way to cope with death is utilizing hospice care facilities. Hospice care is focused primarily on caring and not curing a patient’s illness. It is mainly used to help cope with the loss of a loved one before they pass away. The services provided in a hospice facility include the following: managing the patient's pain and symptoms, providing needed drugs, medical supplies and equipment, assisting the patient with emotional, psychological and spiritual aspects of dying, coaching the family on how to care for the patient and delivering special services such as speech and physical therapy when needed.^[18]

A common myth about hospice care is that someone must be in their last days of life, be bedridden or be unable to communicate with others to receive hospice help. However, that is simply not the case. Hospice care is appropriate for those who have been given a prognosis around 12 months or less. Choosing to use hospice care means the patient will spend more quality time with the people they love and they will have time to look back on life during this peaceful, meaningful time.

Another common myth is that hospice care means giving up hope. Hospice involves coping with death and part of that means acknowledging that most diseases or illnesses in their advanced stages cannot be cured. The idea of hope varies from person to person while, in hospice care, patients and their loved ones will often try to seek any form of hope that they can.^[19]

However, various private insurance plans such as Medicare, Medicaid, and HMO will take care of the costs of hospice care, helping it be less detrimental on the family. This helps avoid more trauma to the family by reducing the enormous medical bill necessary to support their loved ones who fighting the illness.

Fields of study

As an interdisciplinary study, thanatology relies on collaboration with many different fields of study. Death is a universal human concern; it has been examined and re-examined in a wide variety of disciplines, dating back to pre-history. Some of these fields of study are academic in nature; others have evolved throughout history as cultural traditions.

The humanities are, perhaps, the very oldest disciplines to explore death. Historically, the average human had a significantly lower standard of living and lifespan than he or she would today. Wars, famine, and disease always kept death close at hand. Artists, authors, and poets often employed the universality of death as a motif in their works; this trend continues today.

The social sciences are often involved on both the individual and on the cultural level. The individual level is primarily covered by psychology, the study of individual minds. Avoiding (or, in some cases, seeking) death is an important human motive; the fear of death affects many individuals' actions.

Several social sciences focus on the broad picture, and they frequently encounter the issue of death. Sociology is the study of social rules. Sub-disciplines within sociology, such as the sociology of disaster, focus more narrowly on the issue of how societies handle death. Likewise, cultural anthropology and archeology are concerned with how current and past cultures have dealt with death, respectively. Society and culture are similar concepts, but their scopes are different. A society is an interdependent community, while culture is an attribute of a community: the complex web of shifting patterns that link individuals together. In any case, both cultures and societies must deal with death; the various cultural studies (many of which overlap with each other) examine this response using a variety of approaches.

Thanatology is a section of Forensic Sciences. The biological study of death helps explain what happens, physically, to individuals in the moment of dying and after-death bodily changes, so that the events that took place at the time of death and post-mortem can be clarified. In Psychiatry, the medical application of psychological principles and therapeutic drugs, is also involved; many licensed psychiatrists are required to take courses on thanatology during training. Medical ethics are also an important area of study, especially on the issue of euthanasia ("right to die").

There is also a branch of thanatology called music-thanatology which focuses on the use of "music vigils" to help the individual and their family.^[20] A vigil consists of one or a team of music-thanatologists who visit the dying person. They play the harp and sing music based on changes that they observe in patient physiology as well as in interpersonal family dynamics. The music tends toward the meditative, and can be very helpful to the patient and others that are present. Often after a vigil, the dying person is more relaxed, less agitated, and is in less pain. Most music-thanatologists are certified by the Music-Thanatology Association International, and they use the initials "CM-Th" to designate certification by this professional organization. Many hospitals and hospices now have professional music-thanatologists on their staff.^[21]

In 2009, Lakhmir S. Chawla discovered surges of brainwaves (γ neural oscillation) in dying patients.^[22] The γ neural oscillation had already been found in long-term meditators.^[23] In 2013, Jimo Borjigin discovered four states of brainwaves including γ neural oscillation in dying rats.^[24]

See also

• Fascination with death
• Taboo against naming the dead
• Thanatopsis
• Thanatosensitivity

References