Robert Fulton

Death at a Distance: A Study of Family Survivors

This paper reports the findings of a social-psychological investigation of bereavement conducted in the metropolitan area of Minneapolis and St. Paul over a period of twelve months. Information was solicited using both questionnaires and home interviews from 558 bereaved persons, including spouses (434), parents (85), and adult children (39) responding to the death of an elderly parent. Strong emotional ties were evidenced in each of the three subsamples and a wide variety of physical and emotional reactions were demonstrated by all three groups following the death. One of the most important findings of the study is that the type of relationship severed by the death is an important determinant of the nature of the grief experienced by survivors. For example, within the adult child sample, the data suggest that the death of elderly parents is less disruptive, less emotionally debilitating and generally less significant for surviving adult children in terms of the continuity and stability of established behavioral patterns than for the other two groups. The adult child group also displayed less illness during bereavement than either the surviving parents or surviving spouses and were less likely to utilize traditional funerary rituals. It is hypothesized that these observed differences reflect significant changes in the larger society, including 1) the nature and function of the nuclear family and its members, 2) institutionalization of the dying and professionalization of their care, and 3) cultural conceptions of the meaning of life and death. Discussion focuses on the theoretical implications of the findings as they relate to the impact of death, grief and bereavement on the contemporary family, as well as to specific issues relevant to practicing clinicians in their attempts to aid families coping with separation and loss.

The prospective organ transplant donor: Problems and prospects of medical innovation.

With increased sophistication of medical technology and the consequent expansion in the number of organ transplants, the complex of issues involving recipient, donor–related and unrelated–and physician becomes crucial. This discussion is based on preliminary findings of two studies being conducted at the University of Minnesota: (1) a review of 79 kidney transplant cases to examine stress on family when decisions of choosing a donor arise; (2) an analysis of attitudinal characteristics of 82 persons who have considered volunteering their organs for transplantation in the event of their death. Results of these studies reveal often dramatic consequences for those immediately involved, and uncover attitudes in the population sampled which bear on the future of available organs for transplantation.

Death, Grief and Social Recuperation:

IT HAS been almost forty years since Thomas Eliot first called for the objective analysis and comparative study of grief (e.g. Eliot 1930, 1932). Although American anthropologists examined the exotic burial rites and funeral practices of other societies, and social workers explored the economic problems of widows and orphans, medical and behavioral scientists in this country, with few notable exceptions, were virtually silent on the subject of reaction to 1oss.t Freud (1959) and G. Stanley Hall had advanced their theories on the possible causes of melancholia and fear of death and, of course, theologicans discussed death within their different cosmogonies, but little was known in a systematic way about reactions to death. As recently as four decades ago, the social-psychological crisis of grief was not a recognized subject for serious scientific research. It was not until the early nineteen-forties, with Lindemann’s (1949) investigations into the reactions of the survivors of the Cocoanut Grove fire that the situation began to change. Lindemann’s classic report, “Symptomatology and Management of Acute Grief,” dramatically highlighted the medical, psychological, and sociological significance of loss. The study of grief was brought into still sharper focus by wartime studes such as those conducted by Anna Freud (1943) of children separated from their families and by the stark accounts of concentration life. Systematic research into grief, however, began to burgeon only after the appearance in 1959 of Herman Feifel’s book, The Meaning of Death. From that time until the present, studies of grief and the exploration of responses to, and attitudes toward, death have appeared in ever increasing number in the

Death and Society in Twentieth Century America

American attitudes and responses toward death have changed markedly during the twentieth century. This transformation is illustrated through an examination of two age groups: those born prior to the advent of the atomic bomb, and those born into the nuclear age. Each cohort contended with very different patterns of environment and socio-historical experiences, and had differential life expectancies as well. Images of death have changed significantly over this time-span, partially because of the pervasive influence of television and the overall growth in the importance of media. Deaths presence in the media is simultaneously everywhere and nowhere; it is at once illusively fantastical and frighteningly real. Todays youth face the threat of a sudden anonymous death that is counterpoised against a more immediate experience with death that often is either distorted or denied. It is within this context that Americas youth express their fears and frustrations in music, drugs, violence, and vicarious death experiences. The research agenda should include investigation of such phenomena as the rising interest in spirituality and the increase in suicide among adolescents as possible symptoms of despair in an impersonal and threatened world.

Death and the Child: An Anterospective Test of the Childhood Bereavement and Later Behavior Disorder Hypothesis

Does parental loss through death in childhood have a long-term effect on a person, or is the experience generally normalized in a relatively short period of time? Our anterospective identification of a thirty-three year old cohort and the comparative analysis of behavioral and attitudinal data indicates that there are differential consequences in early middle age, but that differences are not as great nor in the direction suggested by previous studies. In particular, the interaction of childhood divorce experience and bereavement emerged as an important sociological pattern.

Loss, social change, and the prospect of mourning

Abstract We would like to discuss the effects of social change on the experience and function of mourning. The question we pose is: What are the implications for the individual as well as for society when the grief expressed by a significant survivor is transitory and the mourning process is not experienced?

Anticipatory Grief, Stress, and the Surrogate Griever

There is nothing like a little stress to enhance our well-being. Stress can serve as a force for growth, or if nothing else it can clear the air. Permit me to respond to the somewhat contending points of view expressed by Dr. Mount and Dr. Luthe.

SIDS: The Survivor as Victim

This article addresses itself to the death-grief constellation precipitated by the Sudden Infant Death Syndrome (SIDS) both in terms of the adjustment problems of the surviving family members and the challenges faced by concerned caregivers. Several features of SIDS create a particularly problematical aftermath for the survivors, including the sudden, unexpected nature of the death itself; the fact that its cause and prevention are unknown; the severing of the mother-infant bond; problems faced by surviving siblings; the multiplicity of agencies involved in the case-management process; and prevailing myths and stereotypes. Several problems for the concerned caregiver posed by SIDS are examined. Potential contributions of one caregiver—the funeral director — are explained.

The Emerging Third Stage of the AIDS Epidemic: The Low-Risk Heterosexual

Using Centers for Disease Control (CDC) data on 420,148 adults with AIDS reported before January 1995, this article documents that certain low-risk categories of heterosexuals with AIDS (1) were likely to have been underreported by the CDC before 1993; (2) were newly emerging in the early 1990s, having had more than half of their total cases diagnosed in 1993 and 1994; (3) were growing in number by 76 percent to 92 percent per year in early 1993; and (4) between 1988 and 1996 had increased their proportion among all AIDS cases reported annually by eight times for women and by thirteen times for men. The authors propose that a third stage of the AIDS epidemic emerged among adults in the early 1990s. The first stage consisted of members of the three original high-risk groups of the 1980s (men who had had male-male sex, IV-drug users, and blood or blood-product recipients). The heterosexual, non-IV-drug-using sex partners of these individuals made up the second stage. The newly emerging third stage is composed of (1) the low-risk heterosexual sex partners of second-stage persons and (2) low-risk people who were subsequently infected with HIV through heterosexual sex with third-stage persons (third- to third-stage sexual transmission).

Book Review: Briefly Noted, AIDS, Fear, and Society: Challenging the Dreaded Disease, Shadows in the Sun: The Experience of Sibling Bereavement in ChildhoodAIDS, Fear, and Society: Challenging the Dreaded Disease by DokaKenneth J.. Washington, DC: Taylor and Francis, 1997.

One of the interesting things about being an editor of a journal is that publishers send items for review. Most I pass on to our excellent book review editor, Heather Servaty. But once in a while, you have something cross your desk that is really not suitable for a full-fledged review, but interesting nonetheless for at least a portion of readers. Two such books have crossed my desk recently, both reminiscent, or rather, complements to other volumes. In 1994, a physician, Sherwin B. Nuland wrote a book entitled How we die: Reflections on life’s final chapters (NY: Knopf). In it, Nuland actually explained the mechanisms of common causes of death. His expressed goal was to demythologize the process of dying. This book, Death to dust: What happens to dead bodies?, authored as well by a physician, Kenneth V. Iverson, seeks to demythologize what happens after death. Iverson asks and answers a series of questions about a variety of topics including brain death, funerals, methods of burial, dissection, and decomposition—over 200 questions ranging from “will the worms crawl in?” to “what will my disposal do to the environment?” Death educators may actually find this a useful reference for all the unusual questions that undergraduates can sometimes ask. As I read through it I could not help but think it was a font of somewhat strange information. It is available from Galen Press in Tucson, AZ for