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

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.Good death Cultural scripts Revivalism in dying Personhood Japan United States

Roles, careers and femininity in biomedicine: Women physicians and nurses in Japan

This paper explores the relationship between gender and work roles in Japan by comparing women physicians and nurses. After reviewing women's roles and definitions of femininity in Japan, contrasts are described in socioeconomic background, educational levels, career patterns and patient perceptions. Despite these contrasts, neither women physicians nor nurses are likely to reject the sociocultural expectations of Japanese women and most define their role as housewife/mother as their first priority. This preserves male dominance of the biomedical system by reinforcing both the subordinate status of nursing as a profession and the woman physician's lack of power in the medical system.