Instructor ’ s Manual with Test Bank to Accompany Leming and Dickinson ’ s UNDERSTANDING DYING, DEATH , AND BEREAVEMENT Seventh Edition Prepared by Michael R. Leming St. Olaf College Northfield, MN 55057 George E. Dickinson College o f Charleston Charleston, SC 29424 PREFACE The intent of this instructor ’ s manual is to assist you in using Understanding Dying, Death , and Bereavement (7th Edition), in a course on death and dying. Test questions (true - false, multiple - choice, and essay) are included for your use in making examinations. Also included are list s of questions for selected death - related professionals. In addition to reading assignments and classroom audio visua ls, we suggest inviting speakers for classes on death and dying. A physician and/or a nurse can discuss how they relate to terminally ill patients. Discussing preventive measures of illness such as diet, exercise , and daily habits can make for an informati ve session with a medical doctor. Invite a social worker from a nursing home or hospice to share experiences of working with terminally ill patients. Contact your local or state American Cancer Society about bringing in a cancer patient to discuss death an d dying from a patient ’ s perspective. A clinical psychologist can talk about signs of suicide and how to react to a suicidal person. A nutritionist speaking on cancer and diet can contribute to the class and give practical advice toward better eating habit s. Side effects of medications are a good topic for a pharmacist to present in your class. An insurance agent can discuss various kinds of life insurance. A panel of clergy representing various faiths can relate to dealing with dying, death , and bereavemen t. A coroner can discuss his or her role in the community and can contribute toward a most interesting class session. A funeral director or cemetery superintendent can talk about his or her legal and social responsibilities. Invite a memorial society repre sentative to discuss the goals of this organization. Ask a veterinarian to come to your class to discuss death and pets. A philosopher can speak on medical ethics , and an attorney can discuss the importance of having a will and recent legislation on living wills. We also encourage field trips to enhance classroom activities. Take your class to a local funeral home. Let the students have a question and answer session with the funeral director prior to viewing the casket selection room, the viewing rooms, an d the embalming room. Visit local cemeteries to observe epitaphs, dates of deaths, size of monuments for males and females, symbols on gravestones, and the overall neatness (or lack thereof) of cemeteries. If one is nearby, visit a crematory. Ask students to write a brief reaction paper to each of the field trips to ensure that they reflect on this experience. A combination of speakers on specific topics and leaving the classroom for field trips can enhance classroom discussions and reading materials. In a ddition, we recommend that you ask students to write their own obituaries stating how, when, and where they died. The students may tell anything they wish about themselves in the obituaries and should include final disposition of the body. When you are dis cussing children and death, ask students to recall their own first experience with death. Instruct them to write about their first experience with death, to give their age at the time, relate who or what died, and note anything remembered about that event. Such an exercise can be rather revealing about how vivid these early experience s were for students . For individual or group term projects, we suggest the following topics as starters: Children ’ s attitudes toward death (ask them to draw pictures of deat h) Interviews with the elderly about funeral customs when they were young Religious beliefs related to death attitudes Death attitudes of various professional groups (nurses, physicians, funeral directors, teachers, attorneys) Death themes in classica l music, rock music, and poetry College students ’ perceptions of dying and death Death themes in the visual arts Death in literature History of the funeral industry Death as depicted in movies Death on television Death humor Veterinarians and eutha nasia Roadside memorials Internet obituaries Evolution of the funeral industry to meet the needs of Baby Boomers Art therapists and end - of - life issues Attitudes of different age groups toward death Death education in public schools Comparison of epi taphs on grave markers in ethnic cemeteries College student s ’ knowledge of hospice History of gravestones Music therapists and end - of - life issues Internet suicide chat rooms End - of - life issues with health care professionals Cross - cultural analysis of funeral customs Current ethical issues about death Cross - cultural views on suicide Hospice evolution since the 1970s Physician - assisted suicide Child - life specialists (play therapy) and end - of - life issues Best of luck as you tea ch your death and dy ing course. M ichael R. Leming and George E. Dickinson T ABLE OF CONTENTS Chapter 1 STUDYING DYING, DEATH, AND BERE A VEME NT 2 Chapter 2 THE AMERICAN EXPERIENCE OF DEATH 15 Chapter 3 GROWING UP WITH DEATH 24 Chapter 4 PERSPECTIVES ON DEATH AND LIFE AFTER D EATH 32 Chapter 5 THE DYING PROCESS 40 Chapter 6 LIVING WITH DYING 50 Chapter 7 DYING IN THE AMERICAN HEALTH CA RE SYSTEM 60 Chapter 8 BIOMEDICAL ISSUES AND EUTHANASIA 68 Chapter 9 SUICIDE 7 8 Chapter 10 DIVERSITY IN DEATH RITUALS 89 Chap ter 11 THE BUSINESS OF DYING 102 Chapter 12 THE LEGAL ASPECTS OF DYING 113 Chapter 13 COPING WITH LOSS 1 23 Chapter 14 GRIEVING THROUGHOUT THE LIFE C YCLE 130 SAMPLE SYLLABUS ES 136 2 CHAPTER 1 STUDYING DYING, DEATH, AND BERE A VEMENT Ch apter Outline Current Interest in Death and Dying Why the Increased Interest? The Mystery of Death Terrorism Ethical Issues Popular Culture Death Education Thanatology Classes Thanatology Publications Mortality Statistics Death Etiology an d Life Expectancy Gender Differences in Mortality Rates Approaches to the Study of Dying and Death The Biological Approach The Psychological Approach The Philosophical Approach The Anthropological Approach The Sociological Approach Structural - Funct ional Theory Conflict Theory Social Exchange Theory Symbolic Interactionist Theory Conclusion Summary Discussion Questions Glossary Suggested Readings 3 True - False Questions 1. The interdisciplinary study of dying, death , and bereavement is called “ thanatology. ” True 2. American society formally prepares individuals to deal with dying and death on both personal and emotional levels. False 3. Death appears to be more abstract for those growing up today than for previous generations. True 4. In th e early 1940s Hollywood began to produce films around the theme of death when the “ good guy ” died. False 5. Television specials with a theme of dying and death began emerging in the 1970s in the United States. True 6. Currently there is almost an obsessi on, and certainly a fascination, with death - related themes in American movies. True 7. The “ s uicide doctor ” in Michigan in the late 20th century was Dr. Jack Kevorkian. True 8. A program for the elderly called Elderhostel does not allow the topic of dyin g and death to be presented. True 9. A text published in 1959 for thanatology was an anthology by psychologist Herman Feifel titled The Meaning of Death . True 10. Jessica Mitford ’ s The American Way of Death in 1963 was very favorable toward the funeral i ndustry. False 11. Conflict theory is concerned with explaining the stability of society. False 12. Exchange theory is primarily concerned with the issue of societal maintenance and social equilibrium. False 13. The leading cause of death in the United States today is cardiovascular disease. True 14. Life expectancy in the United States is greater for males than females. False 4 15. The conception sex ratio and the sex ratio at birth in the United States favors males over females. True 16. Anthropolog ist Ashley Montagu suggested that women have a superior use of emotions because they are more likely to cry than men. True 17. Biological death has remained much the same over the years and so has the manner in which humans experience death. False 18. Ge rontophobia is the fear of dying of a debilitating disease. False 19. Physical anthropologists who study death - related phenomena have a special interest in death rituals in different cultures. False 20. Sociology is a multi paradigm science. True 21. Sym bolic interactionism is an approach stressing the importance of interpretation of others ’ behavior. True 22. A major assumption of social exchange theory is that the profit motive governs social situations. True 23. The events of September 11, 2001, have caused our society to become more paranoid. True 24. Kubler - Ross ’ On Death and Dying , published in 1969, sparked a lot of interest in the topic of dying and death. True 25. Jessica Mitford ’ s The American Way of Death , published in 1963, played a critica l role in changes in the funeral industry. True 26. Leading causes of death in 1900 were cardiovascular diseases and cancer. False 27. Terror management theory (TMT) suggests that people adhere to cultural worldviews and beliefs in order to suppress deat h and morality - related thoughts. True 28. A popular book about a professor dying of ALS in the 1990s is titled Tuesdays with Morrie and was written by Mitch Albom. True 29. Smoking kills approximately 434,000 Americans each year. True 30. S moking accoun ts for approximately 5 percent of all deaths globally each year. True 5 31. A ban was imposed on public smoking in the United Kingdom in 2007. True 32. Cigarette smoking in movies today is becoming more popular. True 33. Infant mortality rates in the Unit ed States are the lowest of all post industrial countries in the world today. False 34. In modern Western countries life expectancy is longer for women than for men. True 3 5 . Women have a higher morbidity rate than men. True 3 6 . A longitudinal study is a study done at one point in time. False 3 7 . The psychological approach looks at dying from a developmental perspective. True 3 8 . An existentialist appro a ch looks at dying and death from an anthropological persp e ctive. False 39 . The phenomenology approac h to dying and death studies “ the thing ” itself. True 4 0 . Fictive kin refers to terms for individuals who are not related via kinship. True 4 1 . A latent function of a funeral is that a funeral is a family reunion. True 6 Multiple - Choice Questions 1. A communicable disease (such as pneumonia) caused by a number of microorganisms including viruses, fungi, and bacteria is known as a. a chronic disease . * b. an acute disease c. a slow death disease . d. both a and c above . e. none of the above . 2. The inte rdisciplinary study of death - related behavior is known as a. death etiology . * b. thanatology . c. anthropometry . d. gerontology . e. geriatrics . 3. Which was not cited in the text as a reason for the increased interest in the study of dying, death , and ber eavement? a. An aura of mystery developed with deaths occurring in institutional settings b. Prolonged life as a result of medical and scientific breakthroughs resulting in numerous ethical issues * c. Large percentages of the population leaving urban area s and returning to the farm where death is a daily event d. A ll of the above were cited . 4. Television specials on death and dying first emerged in the a. 1940s . b. 1950s . c. 1960s . * d. 1970s . e. 1980s . 7 5. Published in 1963, this book was most critical of the funeral industry . * a. Jessica Mitford ’ s The American Way of Death b. Elizabeth Kubler - Ross ’ s On Death and Dying c. Herman Feifel ’ s The Meaning of Death d. Ernest Becker ’ s The Denial of Death e. None of the above 6. The best selling book on death a nd dying published in 1969 is a. Jessica Mitford ’ s The American Way of Death . * b. Elizabeth Kubler - Ross ’ s On Death and Dying . c. Herman Feifel ’ s The Meaning of Death . d. Ernest Becker ’ s The Denial of Death . e. Raymond Moody ’ s Life After Life . 7. Two prof essional journals in death and dying today are a. Death Education and Death and Life . b. Alpha and Omega . * c. Omega and Death Studies . d. Thanatology Studies and Death and Dying . e. Death and Dying and Death Studies . 8. Courses on death and dying began t o flourish in the United States in the a. 1930s . b. 1950s . *c. 1970s . d. 1990s . e. 2010s . 9. The primary cause of death in the United States today is a. accidents . b. old age . * c. cardiovascular disease . d. pneumonia . e. AIDS . 8 10. Which of the followi ng is an example of an acute disease ? * a. Pneumonia b. AIDS c. Cancer d. Arthritis e. Diabetes 11. Most people dying in the U.S. today die a. at home . b. on the highways . * c. in a hospital or nursing home . d. on city streets . e. in their sleep at the of fice . 12. Death etiology refers to * a. the causes of death . b. a contagious disease . c. a new type of AIDS . d. death with dignity . e. death during the winter months . 13. The “ suicide physician ” in Michigan who assisted with individual deaths in the 1990 s was a. Michael DeBakey . b. Elisabeth Kubler - Ross . c. Earl Grollman . * d. Jack Kevorkian . e. none of the above . 14. A sociological study of death is likely to include a. an effort to determine whether certain death - related behavior is moral or ethical. b. a consideration of how biological organs function to produce death. c. a consideration of how humans originally became subject to death. * d. a consideration of how social factors influence biological factors related death. 9 15. The ISAS interpretation of death - related behavior emphasizes that a. use of any given meaning for some item o f behavior always has the same consequences. b. any given behavior pattern always stems from the same biological condition. c. all individuals experience death in the sam e way. * d. the meaning of death may change even though t he biological aspects do not change. 16. Emphasizing the organization of the funeral industry and its relationship with other social structures in a society would be important in which of the se conce ptual frameworks? a. Social conflict * b. Structural - functional c. Social exchange d. Symbolic interaction 17. Structural - functional theory can be best described as a theory stressing a. roles and role expectations . * b. the interaction of parts and the w hole . c. the interaction of families in a symbolic manner . d. the independence of societal units . 18. Conflict theory a. emphasizes the undesirability of social change . b. represents an equilibrium theory . * c. is associated with an analysis of disruption and change as being potentially useful . d. does none of the above . 19. The premise that reinforcement and mutual benefit are important in sus taining relations is associated w ith which theory or frame of reference? a. Social conflict b. Structural - functional * c. Social exchange d. Symbolic interaction 10 20. Which theoretical framework would investigate the following research question: “ What are the rewards and costs involved in developing relationships that are inevitably ended by death? ” a. Social conflict b. Structural - functional * c. Social exchange d. Symbolic interaction 21. Which theoretical framework would investigate the following research question: “ How do funerals help to promote relationships between kinship groups (grandparents, aunts and uncles, cousins, etc.)? ” a. Social conflict * b. Structural - functional c. Social exchange d. Symbolic interaction 22. Which theoretical framework would investigate the following research question: “ Are adult children who care for their elderly parents more likely to receive a greater share of their parents ’ inheritance than children who do not participate in the terminal care? ” a. Social conflict b. Structural - functional * c. Social exchange d. Symbolic interaction 23. Which theoretical framework would investigat e the following research question: “ What are the dysfunctional consequences of parental inheritance bequests for relationships between children? ” * a. Social conflict b. Structural - functional c. Social exchange d. Symbolic interaction 24. Regarding death anxiety and death education, thanatologists a. agree that death education relieves death anxiety . b. agree that death education does not relieve death anxiety . *c. cannot agree on whether or not death education relieves death anxiety . 25. The ISAS paradi gm for doing research in the social sciences, especially sociology, is the shorthand formula for 11 a. structural functionalism . b. the conflict perspective . c. social exchange . *d. symbolic interactionism . 26. The sex ratio is the number of *a. males per 100 females . b. females per 100 males . c. males per 1 , 000 females . d. females per 1 , 000 males . 27. A popular 1990s book about a professor dying of ALS and written by his former student is titled a. Fridays with Fre d . *b. Tuesdays with Morrie . c. Saturday s with Sarah . d. Dying of ALS . 28. Smoking kills approximately ______ Americans each year. a. 50,000 b. 200,000 *c. 450,000 d. 750,000 29. Cigarette smoking in movies is becoming *a. more popular today. b. less popular today. c. about as popular as in the 1950s. d. less trendy. 30. Morbidity rates for women in the United States *a. are higher than for men. b. are lower than for men . c. are no different than for men . d. cannot be determined . 31. A psychological approach to dying looks at dying from a . a developmental perspective . 12 b. a life stages perspective . c. a biological perspective . * d. both a and b . 32. A philosophical approach to dying and deat h may approach the topic from a. a phenomenology perspective . b. an existentialist perspective . c. a psychological perspective . * d. both a and b . 33. Regarding death and dying, cultural anthropologists study *a. rituals through which individuals deal with death and hence celebrate life . b. the biological aspects of dying. c. human remains and try to reconstruct the behavior . d. none of the above . 13 Essay Questions 1. Discuss why women outlive men in the United States and most countries of the world. In the few countries where men outlive women, what is the primary cause for this? 2. Compare and co ntrast the relative advantages and disadvantages of dying from acute and chronic diseases. What effects do each of these causes have on the abilities of families to cope with the death of a family member? 3. Why did death “ come out of the closet ” in the 1 970s? What events related to the “ thanatology movement ” helped change American s’ awareness of dying and death? 4. What is the “ all - American way to die ” ? Contrast this way of death with the way most Americans die today. 5. Contrast the causes of death in the United States today with those in 1900. Why have the main causes of death shifted since the beginning of the 20th century? 6. Cite examples to show how mass media have increased the emphasis on death and dying in the United States today. 7. Discuss t he differences between biological and symbolic death. 8. Why do sociologists need different theoretical paradigms? Why is one not enough? 9. Compare and contrast the structural - functional and conflict orientations for research on death - related behavior. 10. Compare and contrast the symbolic interactionist and exchange orientations for research on death - related behavior. 11. Each act of dying has three interconnected characteristics: shared, symboled, and situated. How does this relate to the statement t hat more dies than a biological body? 1 2 . Discuss how terror management theory might help individuals adjust to death situations. 1 3 . Discuss how popular culture affects attitudes toward dying and death. 1 4 . Discuss a television program or movie you hav e seen recently that included the topic of dying and death. In what way did it deal with the topic? 1 5 . Why do you think horror movies appeal to teenagers and young people? 14 1 6 . How might death education help an individual deal with dying and death? 1 7 . Why do you think women have a higher morbidity rate than men, yet a lower mortality rate? 18 . Discuss recent bans on smoking in public places in the U . K . and the United States . Do you favor these bans? 19 . How does a philosophical approach to dying and d eath differ from a biological approach? 2 0 . How does a cultural anthropological approach to dying and death differ from a sociological approach? 15 CHAPTER 2 THE AMERICAN EXPERIENCE OF DEATH Chapter Outline Defining Death International Definitions American Definitions The Meaning of Dying and Death The Social Meaning Deriving Meaning from the Audience Deriving Meaning from the Situation Death as a Lost Relationship Creating and Changing Death - Related Meaning The American Experience of Death Living Death (1600 - 1830) The Dying of Death (1830 - 1945) The Resurrection of Death (1945 to the P resent) Contemporary Attitudes Toward Death Denial or Acceptance of Death? Fearing Death Content of Death Fears Death Fears, Gender, and Age Relievi ng Death Anxiety Through Religion Contemplating One ’ s Own Death Conclusion Summary Discussion Questions Glossary Suggested Readings 16 True - False Questions 1. Eighty percent of current deaths in the United States occur in institutional settings — hospitals and nursing homes. True 2. According to the United Nations ’ definition of death, a death cannot occur until a live birth has taken place. True 3. The Harvard definition of death defines death in terms of respiration and heart functioning. False 4. Ultim ately, all deaths are brain deaths. True 5. The death of an individual is a personal, not a social , experience. False 6. When a person dies, many “ person ” or role occupants die. True 7. Using euphemisms for death suggests that the United States is a dea th - denying society. True 8. According to Leming and Dickinson, the fear of the unknown and the fate of the body are the two areas of greatest anxiety for most people . False 9. For most people the process of dying causes less concern than the event of dea th. False 10. In thanatology “ death fear ” and “ death anxiety ” are used synonymously. True 11. Death anxiety is a multidimensional concept. True 12. It is only in recent years that we have been able to scientifically determine the real meaning of death. False 13. The meaning of death is socially determined by human beings rather than determined biologically. True 14. In all likelihood, the meaning of death may change in the future as it has in the past. True 15. Cryonics suggests a denial of death. Tru e 16. According to Radcliffe - Brown, religion provides individuals with a sense of comfort and anxiety relief. False 17 17. Death is inherently fearful — all people fear death by nature. False 18. Malinowski viewed religion as the “ great anxiety reliever. ” Tr ue 19. The empirical research by Michael Leming supported Homans ’ s theorizing on the relationship between religion and death anxiety. True 20. People tend to fear the process of dying more than the event of death. True 21. Between 1600 and 1830, death w as a living part of the American experience. True 22. Like modern thanatologists, Puritans felt an awareness of death could improve the quality of life. True 23. Puritans encouraged each other to fear death. True 24. At the time of death , the Puritan fa mily usually sent for a medical doctor to care for the corpse. False 25. It was customary for Puritans to embalm the body before burial. False 26. Puritans were more likely to pray for the soul of the deceased than they were for the comfort of the bereav ed. False 27. At the beginning of the 20th century, the funeral industry attempted to keep death out of sight and out of mind. True 28. Middle - class Americans in the late 19th century wished to experience death with order. True 29. The “ ideology of sepa rate spheres ” in the late 19th century contributed to more open discussion of death in American society. False 30. During the Victorian era in American society, grievers were encouraged to express their emotions in response to the death of a loved one. Fa lse 31, Scientific naturalism contributed to the hope that physical immortality might be a possibility for future Americans. True 32. The threat of “ megadeath ” war inherently calls into question the possibility of all forms of immortality. True 33. Deat h was “ resurrected ” in America after World War I , the first truly global war. False 18 34. Perhaps the most accurate way to determine death is via brain death using an EEG. True 35. The case of Terri Schiavo in Florida in 2004 - 2005 illustrates the importanc e of an advanced directive. True 36. The Living Death period of the history of death was from 1830 to 1945. False 37. Whether or not the United States is a death - denying society is not agreed upon, according to your text. True 19 Multiple - Choice Questions 1. The Harvard definition of death refers to a. no heartbeat . b. no longer breathing . * c. brain stops functioning . d. both a and b . e. none of the above . 2 . The centralist theory of the diagnosis of death a. was the prominent view in the 14th century . b. proposed that the entire body and every organ and cell possessed the life force. * c. has been resurrected by the modern theory of brain death . d. includes both a and b . e. includes none of the above . 3 . The President ’ s Commission for the study of Bio medical and Behavioral Research to study ethical and legal implications regarding death definitions was established by President a. Carter . b. Clinton . c. Eisenhower . d. Bush . * e. Reagan . 4 . Which is not evidence that the United States is a death - denying society? a. Euphemisms are used for death . b. A taboo on death conversation c. Cryonics * d. Having life insurance e. Calling in a professional to handle the body 5 . According to Leming and Dickinson, which of the following is true ? a. People who have w eak religious commitments are most likely to fear death. b. People who have strong religious commitments are most likely to fear death. * c. People who have moderate religious commitments are most likely to fear death. d. None of the above have been demonst rated by empirical research. 6 . Which of the following is true ? 20 a. According to Radcliffe - Brown, religion provides individuals with a sense of comfort and anxiety relief. b. W hat a person believes about dying has more influence than how deeply he or she believes it. c. George Homans disagreed with both Malinowski and Radcliffe - Brown, arguing that death anxiety is highest for both the very religious and the non believer. * d. The empirical research by Michael Leming supported Homans ’ s theorizing on the rela tionship between religion and death anxiety. e. All of the above. 7 . The middle class in the late 19th century achieved “ death with order ” by a. making sure the death of loved ones occurred in full view of the family . b. preparing funeral arrangements fa r in advance. * c. creating sep arate sphere ideology: men ’ s work away from the home, women ’ s work from men ’ s, specialists (medical, clerical, etc.) . d. None of the above. 8 . Death was “ resurrected ” after 1945, why? * a. The atomic age brought about the pos sible annihilation of the entire human race . b. The losses of millions of soldiers in WWII “ brought death home ” for the world . c. People began to fear death more because of the increase in infant death s. d. S ociety began to look inward for answers, and dea th as a topic naturally evolved . 9 . The Puritans encouraged each other to _____________ death. a. look forward to b. think about c. be anxious toward * d. fear 21 1 0 . Which of the following statements is false concerning death - related behavior of the Purit ans? a. Puritans felt that an awareness of death could improve the quality of life. b. Puritans encouraged each other to fear death. * c. It was customary for Puritans to embalm the body before the burial. d. The Puritans felt that death was a living part of the American experience. 1 1 . Which of the following statements is false ? a. In most areas of America, a basically “ Puritan Way of Death ” persisted until the 19th century. * b. The “ ideology of separate spheres ” contributed to more open discussion of de ath in American society. c. At the turn of the 20th century, the funeral industry attempted to keep death out of sight and out of mind. d. Middle - class Americans wished to experience death with order . 1 2 . Which of the following statements is false concern ing death - related behavior of Americans during the Victorian period of history? * a. Grievers were encouraged to express their emotions in response to the death of a loved one. b. A more elaborate funeral ritual involving “ therapeutic self - indulgence ” was encouraged. c. Mourning clothes were worn as one method for extending the period of lamentation. d. None of the above . 1 3 . During the Dying of Death Period (1830 – 1945), which did not occur? a. Landscaped rural cemeteries b. Life insurance * c. Fall of th e middle class d. Professional funeral organizations 1 4 . The case in Florida of Terri Schiavo in 2004 - 2005 illustrates the importance of *a. an advanced directive . b. a will . c. dying without a will . d. stem - cell research . 22 Essay Questions 1. Discuss the differences between biological and symbolic death. 2. What arguments can you offer to reject the following premise: In death, biology is primary, meaning is peripheral? 3. Discuss the implications of the following quote: “ Even though it is but one bi ological body that dies, many ‘ role holes ’ or vacancies are left with the death of that one person. ” 4. In making decisions about death meaning, how does the treatment of the dying patient affect that patient ’ s understanding of death and his or her role i n the dying process? 5. What are some of the meanings of “ Not Dying? ” 6. Refute or support this statement: “The United States is a death - denying society. ” 7. What factors have contributed to the American avoidance of death and dying? 8. How has the def inition of death changed over the years? What complications has this created for the American way of dying? 9 . Write a brief essay on putting a price on human life. Include in your discussion why a monetary value seems of importance in today ’ s way of life . 1 0 . What types of death fears are the most salient for Americans? How might you explain why these fears are more intense than other fears? 1 1 . Why is death in the United States viewed as fearful? 1 2 . What effect did dropping the atom bomb during WWII have on American death conceptions? 1 3 . What do you think should have happened in the Terri Schiavo case in Florida in 2005? Should she have been allowed to live , or was the action taken appropriate? 1 4 . What is meant by the “ medicalization of death ” ? Ci te specific examples. 23 CHAPTER 3 GROWING UP WITH DEATH Chapter Outline Childhood How Do Children Learn About Death? Personal Experiences Mass Media Religion Children ’ s Understanding of Death Birth to Age Three Ages Three Through Five Ag es Six to Twelve Explaining Death and Dying to Children Be Open and Honest Avoid Euphemisms Show Emotion Adolescence Identity Crisis and Death Anxiety The Experience of Death in Violent Neighborhoods Media Influences Learning Adult Rituals Comm unicating About Death Adulthood Young Adulthood Middle - Aged Adulthood Panic and Denial Reflection and Acceptance Personal Growth Older Adulthood Achieving Integrity Diminishing Death Fears Choosing a Place to Die Conclusion Summary Discussio n Questions Glossary Suggested Readings 24 True - False Questions 1. Death on television is often viewed as reversible. True 2 . By 6 months of age most infants can conceptualize death. False 3 . According to some psycholoigsts, children ’ s capacity to grieve is related to their level of cognitive development. True 4 . The permanency of death is usually clear to a 3 - year - old child. False 5 . Media deaths allow children to learn about the true consequences of someone dying and to learn that death is a part of t he real world. False 6 . Between the ages of 6 and 12 , the evolution of the concept of death as a permanent cessation of life begins. True 7 . Psychologist Robert Kavanaugh refers to children as “ little people ” or “ compact cars, ” as contrasted with Cadilla cs (big people), and notes that they should be able to handle any situation adults can handle comfortably. True 8 . An adult should not be honest with children when talking about dying and death. False 9 . Direct answers to children ’ s questions about dying and death only confuse them, thus one should be indirect with responses. False 1 0 . If possible, euphemisms should be avoided when talking to children about death. True 1 1 . Anthropologist Colin Turnbull describes death as being like it was before birth — a state of nothingness. True 1 2 . Children should be discouraged from crying when someone dies because crying reveals weakness and immaturity. False 1 3 . Mother Goose nursery rhymes are uniformly ideal stories to help a child go to sleep at night. False 1 4 . Ernest Becker in The Denial of Death argues that fear and denial of death are basic dynamics for everyone. True 1 5 . Swiss developmental psychologist Jean Piaget argued that it is not until the late t e en years and early 20s that one is capable of genuine ly abstract thought processes. 25 False 1 6 . The two periods of adolescence are 12 to 15 and 16 to 19. True 1 7 . There seems to be a fascination with death during the adolescent years as witnessed by films and music produced for adolescents. True 1 8 . Society is held together by rituals. True 19 . The middle - age years have been labeled the “ novice phase ” of the developmental c y cle. False 2 0 . Though the elderly tend to think of death more often than younger adults, they appear to have less fear concerning deat h. True 2 1 . Research findings suggest that differences in death anxiety appear to be more a function of religiosity than age. True 2 2 . Gerontology is the study of the biological, psychological, and social aspects of aging. True 2 3 . Emily Dickinson wrote extensively about death and dying. True 2 4 . According to the Census Bureau, middle age is between 30 and 45 . False . 2 5 . Baby Boomers are individuals born between 1946 and 1964. True 2 6 . The sandwich generation refers to middle - aged individuals who must take care of young adult children and elderly parents at the same time . True 26 Multiple - Choice Questions 1. The use of a word or phrase that is less expressive or direct but considered less distasteful or less offensive than another wor d or phrase is cal led a(n) * a. euphemism . b. etiology . c. cryonic . d. cultigen . e. apnea . 2. Jean Piaget ’ s third cognitive stage of development is called a. sensorimotor . *b. concrete operational . c. preoperational stage . d. formal operations . 3. In explaining death to c hildren one should * a. avoid euphemisms . b. use only euphemisms . c. be dishonest . d. not answer the child ’ s questions . e. do both c and d . 4. Regarding children and death, the text advises that a. if a child cries, he or she should be spanked . b. the ch ild should be warned that crying reveals weakness and immaturity and that only a “ sissy ” cries . * c. the child should be told that it is okay to cry and that crying is a normal behavior . d. both a and b are correct . e. none of the above is correct. 5. Erik Erikson organized life into eight developmental stages. Joan Erikson later added a ninth stage , which she called *a. old older adults . b. ancient people . c. really old folks . d. elderly individuals . e. over the hill folks . 6. The first childhood death ex perience occurs around the average age of ________ years. a. 3 27 b. 6 * c. 8 d. 11 e. None of the above . 7. Young adults reject death because a. they probably have not faced the death of a significant other . b. they do not yet accept the inevitability of d eath . * c. they are just preparing for the hopes, challenges, and success of life . d. of all of the above . e. of both a and b above . 8. Sigmund Freud traced conceptions of death to a. our need to strive and overcome our early sensitivity to death . * b. our earliest feelings concerning sexuality and fears of being punished for them . c. our socialization during adolescence . d. our elementary school days when first leaving the security of the home and entering a new and different world of peers . e. both a and c above . 9. The social scientist who argued that fear and denial of death are basic dynamics for everyone was a. Sigmund Freud . b. Alfred Adler . * c. Ernest Becker . d. Jean Piaget . e. Erik Erikson . 10. A school of psychology that moved away from Freud to ward more emphasis in therapy on coping strategies and strengths of the person rather than on the unconscious is called _____ psychology. * a. ego b. developmental c. clinical d. life cycle e. behaviorist 11 . The individual who encouraged psychologists to employ better methods of research in the developmental approach to understanding concepts of death was a. Sigmund Freud .