2.2.8 Campaigns for change Here we consider where some of the pressure for change was coming from in the earlier part of the twentieth century. Throughout the period of institutional domination there were, as we've seen from the early 1800s, voices which called out for change. Some contrasted the treatment of the sick and disabled poor with their richer counterparts in the private asylums. Others protested at the general inhumanity of regimented, mass care. Patients and their relatives had mixed experiences to draw on,
2.2.2 Treatment regimes As well as asylums which housed people with mental illness and learning difficulties there was a turn towards a style of mass provision generally. Development of special schools for disabled children began in 1750 when the first private schools for blind and deaf children were opened in Britain. The earliest public institution, run on a charitable basis, the London Asylum for the ‘support and education of the deaf and dumb children of the poor’, was opened in Bermondsey, south Londo
2.2 1 Social Darwinism and eugenics Nineteenth century reformers combined their new medical diagnoses with a concern to tackle what they saw as the social causes of cruelty and incapacity. Two theories dominated: social Darwinism and eugenics. Social Darwinism drew on Darwin's ideas of natural selection and emphasised the contribution of the fittest and most superior individuals to the survival of the human species. The social Darwinists, who included some of the most prominent thinkers of their time, believed that social
1.7 Establishing boundaries Imagine now that you are Marie's manager and you decide to call in at the unit on your way back from a day out. You ofte 3: The five giants At this point let us examine the idea of the ‘five giants’ (Want, Ignorance, Disease, Squalor and Idleness). Beveridge, remember, was not just writing about income protection; he had a vision of social reconstruction and social progress. The five giants represented the key areas of need for all of us – the areas where we should pool resources to tackle our needs collectively (see the box below). 1.2.3 Did Beveridge wear blinkers? Jacobs singled out several groups who were not covered by the insurance scheme. They include: 1.4.13 Defining a ‘good death’ 1.4.12 Bad deaths What about the other end of the spectrum? What constitutes a bad death? Is there less contention about what constitutes a bad death? Extreme pain and discomfort, humiliating dependence and being a burden are obvious, but what about being alone? Many people say they fear dying alone but there are others who would prefer it. Sudden, unexpected deaths are clearly bad for those left behind but are they also bad for those who die in such circumstances? Sudden unexpected deaths used to be considere 1.4.10 Unfinished business When people die suddenly we can never be sure that they have done and said what they want and are able to do. Meg’s long term-illness gave her a lot of time for reflection and preparation, so that while her death was sudden and she was unable to see her younger son, she also had the opportunity for conversations with people about her death. However, there may have been last-minute wishes that Meg was unable to express. Li’s sudden stroke may have left her with things unsaid, but her 1.3.8 Separation from the physical body Very common is the experience of floating, sometimes on the ceiling, looking down on the body – a sense that the essential part of the person has separated from the physical body. In Michael Sabom’s survey of near-death experiences among non-surgical cases everyone had this sensation, but other studies indicate it is not universal. One woman recorded these feelings in a poem. Hovering beneath the ceiling, I looked down Upon a body 1.3.4 Sense of timelessness In Sabom’s study, everyone described their near-death experience as if it had occurred in a timeless dimension: people were unable to make any judgement about how long the experience lasted. ‘There was no measurement of time. I don’t know if it was a minute or five or ten hours’, commented one. 1.3.3 Ineffability Most people who speak of their near-death experience say they have great difficulty putting it into words because, as one person put it, ‘There is no feeling you experience in normal life that is anything like this’. 1.3.2 Recurrent themes When the accounts of people who have described a near-death experience are looked at side by side it is possible to identify some common features. This isn’t to say that all of these features are present in every account, but that amidst variations there are certainly recurrent themes. The following list is compiled from a variety of studies, including the important study undertaken by Sabom (1982), himself initially sceptical. 1.3.1 Reactions to near-death experiences A number of people have claimed that they have been at death’s door and can recall some of the sensations. Attempts to speak about near-death experiences (a term used to describe the extra-ordinary experiences some people have when close to death or when deeply unconscious) can meet with incomprehension, fear and hostility from friends as well as medical experts and researchers, many of whom refute the existence of near-death experiences. As Toates (1999, p. 1) says: 1.2.7 Margaret Margaret was in her thirties when she learnt she had breast cancer. Some three years later, after the removal of the affected breast, she was leading a very busy life working full-time at the Open University, studying part-time for an OU degree and running a family. Fitness activities such as jogging and various sports had become very important in her life. She was also very involved in cancer research fundraising activities. She described the impact of her brush with death in this way: 1.2.6 Encounters with death Although we each die only once, there may be many a brush with death throughout the course of a person’s life. The experience of having been close to death can have a major impact on the way in which a person continues living. For Elaine, the awareness that she might be about to die has affected the way she lives now that her prognosis is good. She describes herself as prepared for death and impatient of those who are not. She also has difficulty entering fully back into life. Learning outcomes After studying this unit you should be able to: outline how encouraging people to talk about the past can be a way of helping them to manage change in their lives and establish identity in the present; demonstrate an understanding of the basic principles in life story work which could apply at any age or stage of life; appreciate that life story work is as much about dealing with the present and preparing for the future as it is sorting out feelings 1.5.4 The patient’s role The patient is entirely passive in this scene. Does that mean that she has no role and is unimportant to the scene? Does her silence 1.5.2 Playing doctors, nurses and patients It is easy to see how junior doctors can see themselves as bei 1.2.2 Everyday scenes Think of examples of everyday scenes, at home or a work, which could be radically reshaped by an opening remark
Activity 6 Managing the hidden culture
Author(s):
Activity 2: Who isn't mentioned?
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Activity 8: The passive actor
Activity 7: The doctor role
Activity 3: Openings to everyday scene
