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Cultural scripts for a good death in Japan and the United States: similarities and differences

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  • Long, Susan Orpett

Abstract

Japan and the United States are both post-industrial societies, characterised by distinct trajectories of dying. Both contain multiple "cultural scripts" of the good death. Seale (Constructing Death: the Sociology of Dying and Bereavement, Cambridge University Press, Cambridge, 1998) has identified at least four "cultural scripts", or ways to die well, that are found in contemporary anglophone countries: modern medicine, revivalism, an anti-revivalist script and a religious script. Although these scripts can also be found in Japan, different historical experiences and religious traditions provide a context in which their content and interpretation sometimes differ from those of the anglophone countries. To understand ordinary people's ideas about dying well and dying poorly, we must recognise not only that post-industrial society offers multiple scripts and varying interpretive frameworks, but also that people actively select from among them in making decisions and explaining their views. Moreover, ideas and metaphors may be based on multiple scripts simultaneously or may offer different interpretations for different social contexts. Based on ethnographic fieldwork in both countries, this paper explores the metaphors that ordinary patients and caregivers draw upon as they use, modify, combine or ignore these cultural scripts of dying. Ideas about choice, time, place and personhood, elements of a good death that were derived inductively from interviews, are described. These Japanese and American data suggest somewhat different concerns and assumptions about human life and the relation of the person to the wider social world, but indicate similar concerns about the process of medicalised dying and the creation of meaning for those involved. While cultural differences do exist, they cannot be explained by reference to 'an American' and 'a Japanese' way to die. Rather, the process of creating and maintaining cultural scripts requires the active participation of ordinary people as they in turn respond to the constraints of post-industrial technology, institutions, demographics and notions of self.

Suggested Citation

  • Long, Susan Orpett, 2004. "Cultural scripts for a good death in Japan and the United States: similarities and differences," Social Science & Medicine, Elsevier, vol. 58(5), pages 913-928, March.
  • Handle: RePEc:eee:socmed:v:58:y:2004:i:5:p:913-928
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    Cited by:

    1. Paolo Rossi & Matteo Crippa & Gianlorenzo Scaccabarozzi, 2021. "The Relationship between Practitioners and Caregivers during a Treatment of Palliative Care: A Grounded Theory of a Challenging Collaborative Process," IJERPH, MDPI, vol. 18(15), pages 1-15, July.
    2. Iedema, Rick & Sorensen, Roslyn & Braithwaite, Jeffrey & Flabouris, Arthas & Turnbull, Liz, 2005. "The teleo-affective limits of end-of-life care in the intensive care unit," Social Science & Medicine, Elsevier, vol. 60(4), pages 845-857, February.
    3. Aita, Kaoruko & Kai, Ichiro, 2010. "Physicians' psychosocial barriers to different modes of withdrawal of life support in critical care: A qualitative study in Japan," Social Science & Medicine, Elsevier, vol. 70(4), pages 616-622, February.
    4. Ikegami, Naoki & Ikezaki, Sumie, 2012. "Japan's policy of promoting end-of-life care in nursing homes: Impact on facility and resident characteristics associated with the site of death," Health Policy, Elsevier, vol. 105(2), pages 303-311.
    5. Takezako, Yayoi & Tamiya, Nanako & Kajii, Eiji, 2007. "The nursing home versus the hospital as the place of dying for nursing home residents in Japan," Health Policy, Elsevier, vol. 81(2-3), pages 280-288, May.

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