Anthropology of Dying: A Participant Observation with Dying Persons in Germany

282 Pages·2018·2.09 MB·English

by  Mira Menzfeld (auth.)

Mira Menzfeld
Anthropology
of Dying
A Participant Observation
with Dying Persons in Germany
Anthropology of Dying
Mira Menzfeld
Anthropology
of Dying
A Participant Observation
with Dying Persons in Germany
With a foreword by Prof. Dr. Michaela Pelican
Mira Menzfeld
Department of Cultural and Social
Anthropology, University of Cologne
Cologne, Germany
Dissertation University of Cologne, Faculty of Humanities, 2017
ISBN 978-3-658-19825-1 ISBN 978-3-658-19826-8 (eBook)
https://doi.org/10.1007/978-3-658-19826-8
Library of Congress Control Number: 2017954938
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Foreword
“The Anthropology of Dying” is an enlightening study for persons, practition-
ers and researchers involved in palliative care situations or with a general inter-
est in what it means to die in the sense of being confronted with one’s imminent
death. The book deals with the question of how people in Germany, who have
been informed by their physician that they are incurably ill and will die within
the foreseeable future, experience and shape their own dying process. Rather
than approaching the topic from the angle of non-dying persons, such as medi-
cal professionals and relatives, the book foregrounds the perspectives and bodily
experiences of dying persons themselves. To achieve this unique point of view,
Mira Menzfeld carried out anthropological research with dying persons in private
and institutional settings in the city of Cologne, one of the leading centres for
palliative research and care in Germany. She entertained in-depth relationships
with sixteen dying persons, accompanying them on their journey over a period of
several weeks to several months, and realized short-term contacts and interviews
with another 45 dying persons.
Mira Menzfeld’s study deals with a topic of current social relevance and is
of outstanding scientifc quality. Due to medical advances, the assessment of ill-
ness and dying is steadily improving. It is estimated that two-thirds of the popula-
tion of Germany will be confronted with a terminal medical diagnosis at some
point in their lives. “The Anthropology of Dying” provides profound insights into
the ensuing process, largely foreclosed to non-dying persons. It introduces us to
the bumpy journey of dying persons, and guides us through moments of confu-
sion, despair, joy, grief, envy and irony that are part and parcel of dying. Through
participant observation – a key method of anthropological research – Mira Men-
zfeld was able to share the physical and sensory experiences of dying persons
and to document the changes and challenges from their own point of view. She
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VI Foreword
convincingly outlines the characteristics of the dying process by drawing on key
concepts in anthropology, while at the same time making it clear that each person
is experiencing and shaping this process in her or his own way.
The book refects Mira Menzfeld's extraordinary ability to develop intimate and
respectful relationships with her dying research participants, and to convey her
insights to an academic and wider audience. The study makes an important and
innovative contribution to interdisciplinary research by applying anthropological
concepts and methods to a palliative care setting. Importantly, Mira Menzfeld’s
fndings suggest possible ways in which dying (and non-dying) persons could pre-
pare themselves and assist each other on this fnal journey.
Cologne, 5.9.2017 Prof. Dr. Michaela Pelican
Department of Cultural and
Social Anthropology
University of Cologne
Acknowledgements
First and foremost, I want to mention all the dying persons I met, and their fami-
lies and friends. I can fnd no way to express my gratitude for what they granted
me: They shared some of their most intimate and important moments with me.
They were willing to establish intense relations with a person they had never met
before, just because they were convinced that this could lead to something ben-
efcial. This is something that cannot be repaid in any way. I will always do my
best to fulfl the potential they saw in this project. I am deeply impressed by their
decisions to allow me into their lives while facing dying, and I am proud to have
known each one of them.
The German National Academic Foundation (Studienstiftung des Deutschen
Volkes) granted a full PhD scholarship for conducting this research. The funding
enabled me to focus intensively on the project. For this, and for many accompa-
nying workshops that offered inspiring academic exchange, I owe many thanks to
this foundation. My supervisors, Prof. Michaela Pelican and Prof. Martin Rössler,
supported the development of this project from the beginning. I want to say thank
you for their encouraging and indispensable intellectual and practical advice.
Prof. Raymond Voltz and Dr. Klaus Maria Perrar from the palliative care unit of
the University of Cologne allowed me to take part in their medical supporting
of dying persons in many ways. Thanks to them and their teams for accepting a
cultural anthropologist as a participant in and observer of their valuable everyday
work. Many thanks to all hospices, palliative home care teams and general prac-
titioners, who made the effort to become familiar with the unusual presence of a
cultural anthropologist. I want to thank Beate Meurer for good conversations and
hot tea. Lin Rujiao was the one person who really opened up China for me – I
owe thanks to her for explaining confusing bus schedules, proper behavior, the
correct pronunciation of words, and how to fnd the best baozi in town. Thanks
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VIII Acknowledgements
also to my colleagues at the Institute for Cultural and Social Anthropology in
Cologne; I deeply appreciate their constant collegiality, constructive support,
and personal interest during the last years. Thanks to my family and friends for
being a joyful counterweight to the sadness and grief I was exposed to, especially
during some weeks when I saw many dead persons. Thank you, Simon Schaad,
for being an unexpected yet exquisite motivation. And thanks fnally to dearest
Thorsten Menzfeld; my highest gratitude and respect for giving me both roots and
wings, because and although you know me best.
Funding
Funded by a full PhD scholarship,
German National Academic Foundation (Studienstiftung des deutschen Volkes).
IX
Contents
1 Introducing dying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Literature on dying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3 Theoretical framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
1.4 Coming to terms: Defnitions . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
1.5 Main arguments and structure of the chapters . . . . . . . . . . . . . . . 31
2 Fieldwork with dying persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
2.1 Research context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
2.2 Research participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
2.3 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
2.4 Research ethics and personal refections . . . . . . . . . . . . . . . . . . . 54
2.5 Fieldwork in the native culture and contrast research . . . . . . . . . 63
2.6 Summary: Refections on feldwork with dying persons . . . . . . . 68
3 Becoming dying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
3.1 The beginning of the end . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
3.2 How dying starts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
3.3 Dying as a vital conjuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
3.4 Summary: Becoming pre-exitally dying in Germany . . . . . . . . . 96
4 First experiences as a dying person . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
4.1 Decision-making processes: Where and how to die . . . . . . . . . . 99
4.2 Dying at home: An ambivalent ideal . . . . . . . . . . . . . . . . . . . . . . 103
4.3 Decisions, requested and revised . . . . . . . . . . . . . . . . . . . . . . . . . 107
4.4 Institutions – gaining attractiveness . . . . . . . . . . . . . . . . . . . . . . . 111
4.5 Stressful movements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
4.6 Summary: Shaping the frst time of dying . . . . . . . . . . . . . . . . . . 121
XI