The Cause of Hiding the Death in Australia - Essay Example

PORTFOLIO 18TH June, 2008 IS AUSTRALIA A DEATH-DENYING SOCIETY? IS THIS SUPPORTED BY CURRENT PREHOSPITAL PARAMEDIC PRACTICES? It has been a debatable question since years, where people have poured their views regarding life after death. But is death taken to be a sign of quietude or is it a cause of anxiety among few? Western countries have taken death and dying as symbols of angst and distress. In countries like Australia which is known as the Death Denying Society, people hesitate to speak about death. In hospitals it is more likely that people try to prolong life instead of accepting death. The Sydney Daily Telegraph in 1983 clearly revealed the fact that the Australian society is the hardest hit death denial society where many people die lonely and cynical death. The cause of hiding the death cases in the country is that other patients get upset or find themselves in a state of shock when exposed to the reality of death. However, such assumptions are not widely accepted as they lack medical evidences to justify the statement. There is a deep trepidation grounded in the hearts of people belonging to the western culture, who are terrified to confront death (Solomon, S., Greenberg, J., Pyszczynski, T, 2003), therefore it’s a normal practice in hospitals to hide and conceal dead bodies in various manners as they can (Bryan L, 2007). Nobody can avoid death, not even saint and sages; it is a fact of life from which people try to escape, since ancient time’s men have tried to protect the species but have not been able to succeed. Australian countries find it extremely awkward and humiliated if a patient dies in open, as a result hospitals try to hide the even normal deaths from other patients. We have to admit the fact that we all live in a death denying society where people are unaware, and society needs a humanitarian structure to deal with the problem. The paramedic practices have tried to put the use of modern medicines which have the capacity to preclude death at times of incurable medical conditions. Techniques and methods have been explored through which the life span has been elongated but results in acute harmful and dehumanized effects such as alienated, estranged ways to keep aloof from the society. Death can be dawdled for patients who are utterly in a state of incurability; such denying fails to recognize the dignity and poise of death. Death Denial especially in the cases of women patients violates the norms of self respect and pride of an individual. Dying is the most vital part of one’s existence; hence the quality of life is reflected in an individual’s death, to ease out the torment of death, Euthanasia is practice in Australia. According to Andrew Taylor, who is the spokesperson for the South Australia’s Palliative Care Council, (Paula Doran , 2003)death denial is considerably more prevalent in the native culture, where a person who has passed away cannot be addressed by his name, or customs prevent a person to enter the room where the death occurs for a stipulated time period. Palliative care is the solution to aid in the process of dying but is the obstruction. The very essence of death denial is a hindrance to the acceptance of dying as a natural phenomenon. An individual struggle with transience has become an important mechanism in the managing of the dying process (Zimmermann, 2007) How people live and take there final abode in Australia has changed a lot in the past decade, death is inevitable and acceptance of the fact helps in combating the challenges posed up by the changing death denial attitude of the Australian people. Palliative care helps in relieving the pain and anxiety suffered by the people and improving the quality of life of the bereaved patients (Care Australia, 2005). WHAT ARE THE MAJOR HEALTH INEQUITIES YOU HAVE OBSERVED IN YOU LOCAL AREA? PROVIDE A SOCIOLOGICAL PERSPECTIVE AND REASONING BEHIND THESE INEQUITIES. Health inequity is the presence of unsystematic and disorganized system of health treatments, the imbalances and disparities in the determinants of health create social and economic advantages and restraints for different groups formed in a society classified on the basis of wealth, power, status, esteem etc. Health related injustice and inequities have been prevalent since ages and still persist. One segment of the population is found sicker than the other, unequal and unfair distribution of health and disease is common among the masses. Health inequities create differences in health care facilities, whereby some segments of the population are treated better than the rest. The forms of health inequities which can be observed in the region are behavior and cultural practices towards the different categorized segments. The low paid, poor and underprivileged class is treated inferior to the educated high earning bracket class. The cultural practices restrain people to adopt modern means of health care. The orthodox means of health care and prevention enhances the inequities. The socioeconomic and educational status widens the disparities among the awareness and responsiveness among the different sections of society. The availability of facilities for health care is one of the major factors responsible in the soaring disparity graph structure. Environmental factors, communication barriers and accessibility to the health care aids and resources also affect the bridging of the disparity gap. People have severely suffered and are still struggling from the corollary of racism and castism, the two modes of discrimination which have affected the amenities and services provided to the needy and affected people. The reason for the display of such attitude is the perception of the people. Apart from this factors related to the patients, organizations are also responsible. Patient’s behavior, response, belief, ignorance, stereotype attitude, language constraints, legal policy framework are few of the reasons behind the rapidly increasing health inequities. Weak social structure augments the discrepancies and parity status. Major differences can be noticed among the rural and urban residents, among the male and the female, environmental differences in the form of water supply, waste management, ease of access to resources. People, who live under the poverty conditions, have an adverse effect on the safeguard factors such as provision of healthy nutrition, hygienic living conditions, education etc. The hardest hit groups are those who live in slums and wastelands where there is no water supply, or sanitation assistance, almost no health facility is provided to them neither private or public aid. Environmental risk, exposures to pesticides, chemical substances are borne by the poor due to lack of the basic necessities of life. Medical statistics have proved that maximum number of abortions and miscarriages are found in the rural areas, numerous of them being unreported due to the inadequate, insufficient and untimely medical aid. Another area where the poor and the needy are down struck is the awareness and access to information (Hofrichter R, 2006), some people are not informed about the schemes or free services which are provided by the government for the social welfare while others who are entitled to the health services in organizations don’t avail them due to lack of information of their rights. Organizations for whom imparting of such medical services is obligatory easily escape from the brunt due to the ignorance of the masses or their weak constitution. Equality in health services is providing same kind of opportunities to all the people which is not true seeing the current scenario. Inequities are present in both the formal and the informal sectors of the society. Health promotions and prevention panning should be upgraded in all spheres and at all levels to curb the disparity level among the people. ACCORDING TO FEMINISTS, WHAT ARE THE WAYS IN WHICH MEDICINE HAS CONTROLLED AND DISCRIMINATED AGAINST WOMEN? IS THIS RELEVANT TO PARAMEDICINE? Women have been deprived and disadvantaged at many ends, may it be corporate or the educational sector, they have been suffering the brunt of discrimination from the past decades. Medicine, considered to be one of the noblest professions is not free from the clutches of the disparity confronted by the women. On papers women are supposed to take the lead, they are shown as the headers of the major fields of medicine, such as gynecology, physicians, surgeons and many more. The statistics reveal that the percentage of female students in the medical has increased by more than 40% in the last two decades but the reality speaks something else only on a students level does the female category excels but at the top levels or the execution level women are not featured in large numbers, neither are they making any substantial gains. It is a general observation worldwide that women’s partake in the medicine profession has been restricted, though their informal practice in the medical career or the related health professions has been enormous. That is the paramedicine field has grown tremendously but not the formal medicine channel. Medical education is imparted uniformly but the employment opportunities are unequal. Gender parity is a social issue which is yet to be resolved within the medical specializations worldwide. According to the feminists, women’s are further discriminated on the grounds of racism, color. White color women are generally preferred over the black. Even in the educational front women are the one’s who are paid less in comparison to men; they are promoted much more slowly than their male colleagues. Even though the women are recruited more at the academic level but are obstructed in the race of development and growth. Among the role of physicians women are cluttered in just four very low paid jobs like general family practice, pediatrics, psychiatry, and internal medicine. High paid areas such as Surgery and various similar professions do not entail females hardly 8% in all. (Feminist Research Center, 2007) The American College of Obstetricians and Gynecologists (ACOG), are working for the upliftment of the women, imparting them excellent health care and prevention facilities never had more than two top designations for female candidates in totality to 17 offices which are headed by males. Nothing can be more obvious to stand by the discrimination offered in the organizations who themselves re working for women liberation. The nursing profession which is wholly associated with the women is the least paid in medical and has negligible changes of promotion to a higher cadre; infact nurses represent the highest number of health care professionals. Though females have shown progress, but they still continue to be placed in the minority positions of leadership. Looking from another perspective, a female is supposed to look after the family and a combination of career and family in opinion of others is a difficult task. Women are underestimated by many thus offered an easy going or not so challenging task. The disparities in the medical scenario even in the paramedicine field are due to the ever spread of gender biasness, increasing cases of sexual harassment, and role conflict (Gundersen, viewed on 18th June, 2008). According to the feminists in Medical professional a number of sexual harassment cases have been reported mainly by the female trainees and the practicing physicians. The highest sex imbalances are reported in the medical profession (Andrew Cole, June 2007) have forced the women’s to take charge, the segment has to stand aloof on its own to safeguard the health, no external source of time can bridge the gap, it is the united effort on the part of the female force that can change the current market discrepancies. WHAT IS MEANT BY "DYSAPPEARANCE" OF THE BODY? IN WHAT WAYS IS THIS RELEVANT TO PREHOSPITAL CARE? As per Drew Leder, who coined the term Dysappearance, is referred to a body’s loss of taken for grantedness at the time of illness. The body’s appearance to realization, results from the dysfunction due to the illness, hence resulting in the dysappearance of the body. He developed a new form of it, called as social dysappearance where due to various reasons the body splits open between self and the body due to the gawk of people standing at a wide distance, adversary in nature, in other words it is referred to as interrupted or dislocated co subjectivity. Dysappearance of the body deals with the deforming, warping and distorting of the human body. Many observations regarding the ubiquity of the body have been made, especially at the times of post mortem revealing the connection which the body has with the theory and application of medicine. This is one perspective which has been talked about and featured in lot many literatures writings, infact this is an area where the human body is the focal point. Many famous works have been published to highlight new approaches, opinions and views regarding the ethical issues involved in the Dysappearance of the body, including issues such as increasing rates of abortion, depersonalization of health services, organ transplantation etc. According to the researchers body is a structure composed of multiple elements religious, social, philosophical, rational, medical etc, the impact of each of these components on the discourse of the body is studied deeply in context to the dysappreance of the body which has a deep relation between the bioethical practices and the health care services. The prime focus here is to find a link between the body to world and body to self. (Bahnsen G (Viewed on 18TH June, 2008). It is been observed that ill body has obvious and perceptible self evidence at the time of departure. The dysappearance of the body or the body moving outside itself is both unstable and unhinged between the diagnostic category and a social experience. The concept of dysappearance deals with self consciousness, how people make use of the body along with the study of various fields of Anthropology, Cultural science and History. A study of physiological and psychological viewpoints defines the body image and its dysappearance. According to Arthur Klein man, the social world penetrates into different aspects of cardiovascular, endocrinological and neurobiological processes to mark the different prototypes of responses and reactions which in turn the body and its self consciousness depict in its social space; a body is a recursive process of writing and protrusion. The taken for granted body becomes an inevitable personification when things don’t work as should be. When the body becomes ill, it loses its acquaintance. In case of a woman, a multiple disadvantage is noticed because it is believed that a woman can never be as pure as a man presence. A disabled woman’s body separates the self from the physiological to the psychological thereby herself diminishing rather than what others treat her as.. Further deterioration in health may cause her tom loose control of her bladder and the bowel which turns to alienation of body from self. The pregnancy experience also turns away the body from not being its original self. The medication of body is also the estrangement of the body and the self. In the modern times, the approach has been changed from the dysappearance to the hyper appearance of the body; however it is supposed to be a virtual body. Different methods such as cosmetic surgery can help in transacting the dysappearance of the body to a near to self form of hyperapperance. WHAT ARE THE STRENGTHS AND WEAKNESSES OF EACH OF THE MODELS OF MENTAL ILLNESS? WHICH MODEL/S DO YOU PREFER AND IS OF MOST RELEVANCE TO YOU AS A PARAMEDIC? Mental Illness is a term used to relate with distress or disability which a not a part of the normal development of a person. Mental disorder a term associated with the erratic patterns of psychological and physiological structure of an individual. Mental illness can be in various forms, pattern of behaviour which is abnormal can be taken as a disorder, and even anxiety disorders can be a part of it. Psychological disorders can result in the mental illness which causes distress or dysfunctional behaviour in the daily activities performed by an individual. Whether any disease is a form of mental illness or not is diagnosed through various symptoms related with peculiar behaviour. Many models of mental illness have been put into practice for the cure of the disease; few of them are the medical model of mental illness(Jonathan Whittenhall,2007), which conceptualizes the categorical approach to diagnose mental illness, by presenting common occurrence of symptoms into groups that are furthered down into syndromes. However the major limitations of medical model are the problem of assessment, missing information which could lead to inaccurate results. Stigma problem also affects the model as well as the personal and societal biasness linked with the whole procedure of assessment. The Biopsychiatric Model of "Mental Illness” (Mosher L, 2002) is based on the ground that serious mental illness is caused to the disturbing behaviour of an individual such as in the case of patients suffering from schizophrenia. The weaknesses of the model are more then its strengths, it is been said that the anti-psychotic drugs have a negative result ion a long term basis. The critics have also questioned on the shortened life expectancy probed by the usage of the anti-psychotic drug treatment. The level of mental illness is affected by the interaction of the individual with the social network, discrimination grounds and the medicalization received. There is no one specific model to deal with the problem of mental illness; the situation has to be looked upon from Psychoanalysis perspective, the childhood experience, the bodily mechanisms, cognitive social learning perspective, and Humanistic perspective. Based on a culminated analysis of all the angles a treatment is proposed. The socio cultural model of dealing with the mental illness involve, the type of stresses, disorders through which a person is exposed to, diagnosis using DSM-IV can also be applied for fruitful results. According to me the Trauma model of mental disorder would be preferred as it deals with the psychological trauma right in the initial level of disorder. Traumatic experiences are fatal and more serious; they highlight the stressful factors that are responsible in the development of interpersonal relationships. The major strength of this model is that it deeply penetrates into the causes that are faced by patients who grow in an unhealthy, inconsistent and abnormal circumstance. Extreme traumatic conditions which are faced by the individual right from its foetus state to its childhood and further are dwelled into. The recent approaches in the trauma field such as Dissociative identity disorder, biological reductionism, criminology have emerged as the strength of the model, however the model is not free from criticism, according to the model childhood trauma causes insanity which is not true in all the cases, further if the model is analyzed , it is found that extreme poverty or personal tragedies are not the only cause of diseases such as schizophrenia, such critics weaken up the model. Further an eclectic or pluralistic mix of models can also be used to explain particular disorders. Many people try to keep the sickness as a secret due to the fear and stigma attached with it, and people who face do not receive proper treatment which worsens the situation even more. Efforts are being made worldwide to cope up with the increasing intensity of the illness but still a lot more has to be achieved to combat the threat. DISCUSS THE PROS AND CONS OF PROVIDING ETHNO SPECIFIC HEALTH CARE SERVICE? IS THIS RELEVANT IN YOUR REGION OF PRACTICE? Development support of a person takes into account an individual in totality. Health care services worldwide are divided into different parts such as traditional or original health system, colonial medicine system, hybrid of old and new or the modern scientific medicine etc. However, an ethno specific health care system provides a harmonious coordination of indigenous remedial measures. It is observed that health care services must adapt to these ethical conditions and conventional patterns should be imbibed by the modern physicians in order to balance the situation. Diversity entails a number of challenges, especially when health care services are taken into account. Australia is the shelter borne by many ethnic, religious and language groups. It has adopted multiculturalism as its national policy; even the health care services provide ethno services by giving importance to the linguistic and cultural diversity which certainly strengthen the health care system. Some crucial developments in Australia in incorporating the ethno health care service has been the establishment of transcultural mental health centers, special services for the refugees, bilingual clinical services and many more (Minas H, Klimidis S, Kokanovic R, 2007) this shows the considerate and compassionate attitude of the government towards the people and humanity . The Ethnic minority communities in Australia have different categories depending upon their age, migration time, religion and other variants, these segregations do affect the normal course of health services as a lot of fund and resources have to be allocated in serving such groups. The Australian population diversity poses a challenge for the health system to respond to the complexity created by the different ethno services rendered among various cultures and languages. The limitations of ethno health care system emerges when people of different cultures are treated, culture is a dominant factor in treating diseases like depression, personal viewpoints, perceptions all vary with the cultural background a person possess, the persons response to treatment varies depending upon the notions he adheres to which definitively is a vital problem in establishing such systems. Language and communication barriers cause interruptions in translation and interpretation increasing the chances of errors and poor treatment results. A special cultural consultation service programme was designed for health service providers in Australia to improve the mental health services catering to a culturally diverse population including immigrants and ethno cultural minority groups but the results of effort were not so positive, inadequate assessments, weak diagnoses and negative medical results . For this a number of interpreters and cultural brokers were required to overcome the problem. Another drawback of such ethno specific health care services is that no specific of patient turnover or cost efficiency can be measures or recorded. Limited human workforce also poses a number of problems in curing and prevention services. In many frameworks, the populace prevents the development ethno specific services, thus general strategies are combined and correlated with the resources channelized for specific patients (Kirmayer L, Groleau D, Guzder J, Blake C, Jarvis E, 2003). It can be concluded that the spread of ethno specific services need awareness and a change of perception among the masses to deal with the cultural issues and problems. Training among the primary care clinicians and the voluntary social activists is needed in the development and expansion of the new ideas and strategies to promote the ethno specific health care services. As far as the problem of cost effectiveness is concerned, a large patient group could be formed which can be further segregated based on some homogeneous characteristics to save resources. There is also a need to build healthy relations with other health care professionals for apt assistance for the social care of the needy. FEMINISTS ARGUE THAT DISABILITY IS A 'GENDERED' EXPERIENCE. WHAT IS MEANT BY THIS AND COULD THIS IMPACT AT ALL ON THE PREHOSPITAL MANAGEMENT OF THE DISABLED PATIENT? Disability generally mistaken for being completely handicap but disability is the disadvantage pondered by the society for the impaired by rejecting them as a human being apt for participating in the mainstream activities. The bodily restraints are not so much responsible to dampen the spirits than the disabling social, environmental and attitudinal rejection but the society. And if the disability is featured in women then that’s a cause of double disadvantage or the gendered disability, firstly the sexism and secondly the disability itself. Feminists have argued over the time that disability is a gendered experience, feminist analyses of disabled women‘s coercion is a self struggle against defeat. A third disadvantage or layer of disability forms when color biasness with the other restraints culminates with the discrimination of racism. Based on the structure of social relations, and sex classification gender in disabilities have emerged. In what manner are the men's and women's experience of disability different, to what extent is the disability associated with feminism? Such questions have always been the focal point of discussions. Though disability is a universal term, still the image and presence of the term is exaggerated when focused on women, hence called as a gendered experience. This gender biasness results in a deep impact on the pre-hospital management of a female patient especially in terms of exploring meager opportunities of education, employment, personal relations, abuse, maltreatment, exploitation, invectism etc. The experience of disability in terms of gender reveals a continual pattern of treatment between men and women. The pre hospital management for the disabled women is pitiful; statistics reveal that the women are poorer than the men, their educational level is lower, they are discriminated on the grounds of wage and salary and moreover the rehabilitation and indulgence is detriment to males. Sexual violence, negligence, dejection on the family and social front is the impact of gender disability faced by women to a large extent. At the time of distribution of property ownership females are the worst affected. The feminist disability studies have tried to bring forth the hard realties confronted by the female victims. The viewpoint that still prevails in the society , such as disabled people do worse than non-disabled people , all women perform less in comparison to men and do worse than all men in all spheres has to be transformed. According to Nosek and Hughes (2003), disabled women have to face serious psycho social problems such as acute state of depression, stress, isolation in comparison to the male disabled group. They are more engrossed with the homely affairs rather than being a part of contemporary, outward and broad minded world. The young women and girls are most affected by the stereotyped attitude of the society towards disability. The complication of gender identity for the female has associated the disability as a feminist issue. The pre hospital management conditions exclude the basic necessities such as the medical, educational, emotional, sexual and recreational needs of disabled women; they are the most deprived segment of the underprivileged categories. They are susceptible to both physical and mental ill treatment and abuse. Feminist theorists have sternly held on to the argument that defamed identities of women restrain the crucial analysis of their experiences. The social acceptance of the disable women makes her an incomplete individual in comparison to the non-disabled. A feminist theory reveals how the gender interacts with the social norms; it throws light on the lives of many people making the theory more inclusive and complicated. Though there are organizations who work for the social service but people with disabilities are even deprived of such services made for the welfare and social developments of the needy. ACCORDING TO SOME, AGEISM IS BASED ON CERTAIN 'MYTHS' OR STEREOTYPES ABOUT OLDER PEOPLE. WHAT ARE THESE MYTHS OF AGEING IN OUR CULTURE AND DO THESE PREVAIL THROUGH TO AND IMPACT ON PREHOSPITAL CARE? The term ‘Ageism’ was first coined by the US psychiatrist Robert Butler in 1968 (Robinson B, 1994). The most widespread definition of ageism deals with the discrimination among individuals due to the age factor in other terms it is also addressed with ‘age discrimination’. The inequalities or disparities among the individuals in the different phases of life cycle give birth to the stereotyping and myths in our culture. All such biasness has a deep impact on the prehospital care imparted to a older people who need extreme attention, care, affection and love. Ageism is a natural process, a social mind set; it’s a viewpoint that stereotypes older people. It’s the attitude due to which people believe that older matured adults can be treated in undignified and humiliating manner. As the age progresses the treatment and the attitude of others changes, old people are considered less valuable or less capable among the rest. Myths are reflected in young generation’s outlook, as per them they get more responsible towards the family and social needs and requirement. Younger generation often stereotype the older people as weak, feeble, flimsy and disabled. Ageism engulfs myths where older people are neglected and avoided at workplace, home, and social gatherings. They are being discriminated on the grounds of age when any employment opportunity can be availed off though they may abundant knowledge and wisdom from their past experiences. Old age is a phenomenon where social, economic and cultural changes affect the experiences of the human life cycle. The stereotype accompanies the old age where the status of a person gets dwindled with the increasing number of years of his existence. The sources of ageism range from the psychological perspectives of fear and illness to the social and cultural perspective such as the value systems. The health care services are also under extreme pressurized conditions in ageing societies. The pre and the post medical aid given to the older are discriminated on the grounds of age, even the doctors carry a negative attitude towards older patients just because they need more time and patience. Because they are a little difficult to handle and have multiple health problems medical treatment becomes discriminatory. Even the society denies the acceptance of the old; they are unwelcome, ill-treated and disguised as a respectable citizen of the society. Abuse and victimization by the family, staff and neighborhood as well are the serious consequences of ageism. Myths about the old age such as older people are less productive and valuable or are less deserving among the younger ones, or that old people are less sentimental and emotional to the changing environment or have subdues sexual feelings or they need extreme health care services and are a burden to the family supporting them, all such myths have to be challenged and eradicated from the evils of our society and culture (Easteal P, Cheung C, Priest S, 2007). The stereotypes of age do not reveal the attitude and nature of a person, his capability and ability. The traditional and orthodox stereotypes related with the old age have to be changed, older adults have to be treated as individual rather objects of possession, they have to recognize older generation as valuable contribution to society other than being a burden or a matter of encumbrance. The concept of ageism has to be well understood so that it could be widely accepted and negative stereotype behaviour associated with old age could be eliminated. Ageism should be speaked about and not hided which could result in the rendering of better and improved pre medical care for our own elderly people. BIBLIOGRAPHY 1. Bryan L, 2007, Should ward nurses hide death from other patients? Professional review, End of Life Care, Vol 1, No 1, viewed on 18th June, 2008, http://endoflifecare.co.uk/journal/0101_hide.pdf 2. 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