Deceased child

The incident

A child in the care of community nurses died (the death was expected, prepared for and managed well).  In the days following, a nurse visited the family to offer support and remove equipment.

The family had prepared a room, with the child’s body on view where food was left.  The nurse was invited to come and spend time in the room, and share the food.  She found this very unsettling, and the fact that the food was of a type she wasn’t used to eating added to her discomfort.

1. Identities of the actors in the situation

Narrator: experienced Community Nurse (a nurse that visits a patient in their home or residential care setting) – Clinical Supervisor (female, white, British, highly trained, lives in Warwickshire).

Child (deceased, 7/8 years, female, Asian, terminally ill, end of life care).

Family (Asian, parents & grandparents, religion unknown) Asian from where – South Asian (that’s all we know).

2. Context of the situation

Home of the family – child’s bedroom.  Pre agreed visiting time. The child’s body was on view and there was catering a refreshments also in the room.  Religion of the boy and family was unknown.

3. Emotional reaction

Unsettled as the child was there 2 days after death.  Uneasy due to the hygiene factor that there was food in the room with a child’s body.  Anxious that they wanted her to eat the food of which was unknown to her, didn’t want to upset or offend the family.

4. Representations, values, norms, ideas, prejudice: The frame of references of the person who experienced the shock.

Separation of the dead and the living:  in the narrator’s practice of Christianity the body would go straight to the undertakers and not on display until the funeral. It is not usual for children to have an open casket due to how distressing this would be, let alone leaving the body on display for two days.

Individualism: Even if there is a viewing, lots of people would not surround a body and people would visit the body in private isolation or small groups. Large groups of people surrounding a small child was very unusual for the narrator.

Hygiene – food should not be in the same room or area as a dead body. On a more spiritual register: the place of food is with the living, not to be confused with the realm of the dead.

Politeness and respect for other cultures – Narrator didn’t want to upset the family and therefore entered the room and tried some of the food despite how uncomfortable this felt. Guests often feel that refusing sharing a meal would be seen as an offence.

5. What image emerges from the analysis of point 4 for the other group (neutral slightly negative, very negative, "stigmatized", positive, very positive, real, unreal) etc?

Confused as to the purpose of this ritual.

6. Representations, values, norms, prejudice: The frame of references of the person or group that is causing the shock / that caused the shock in the narrator.

Rites of separation and grieving process-  cultures differ in how the parting from a dead person is ritualized. In modern western cultures the dead body is parted quite soon from the world of the living, but in many other cultures there is a longer period, possibly lasting days of “coexistence” between the living family members and the body of the dead person.

Tendency towards collectivism / interdependence the parting is not seen as a private issue but one shared with friends and family.

Food during funeral: it is traditional even in some modern Western societies to have a joint meal with the close family and friends after a funeral. The sharing of the food can have many meanings: reinforcing the social connections, compassion with the grieving, and sometimes also proving for the living that they are alive. However, in the west, sharing food usually takes place in a separate space, possibly a restaurant and not in the same space of the viewing. In some religious

7. Does the situation highlight any problem concerning the professional practice, or in general about the respect of cultural differences in intercultural situations?

Death rituals vary from culture to culture, and because death is one of the most sensitive themes we can imagine it is not a surprise that mourning rituals differing from our own can trigger strong emotional reactions. Mostly because they break from the rituals we’re used to and they are no more able to protect us from the awareness of the inevitability of our own death.

A second issue highlighted by the case concerns the respect of the limits of the professionals. Often professionals feel obliged to accept such invitations, as in this case where the protagonist was supporting as a Clinical Supervisor – even when the invitation threatens of breaking one’s own limits.  Limits in intercultural situations are very important to get acquainted with and to protect to some extent. Regularly disregarding one’s personal and cultural limits brings the risk of burn-out.

The narrator of the incident learning from her own reaction decided to have conversation with colleagues that would attend the viewing, before they enter the house to make them aware of the environment and avoid similar culture shock experiences.