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The taboos against an open discussion of death and dying, bereavement and loss have fallen away in recent years. The psychological significance of the bereavement process, for example, is now well documented and widely recognized. There is a great deal of sophisticated knowledge about the effects of loss, the immediate shocking experience of grief for the newly bereaved person and the long-term deleterious effects of unresolved and pathological mourning which can distress and disrupt individual and family life (Parkes; Pincus). Nowadays health practitioners and helping professionals are trained to be aware of and sensitive to these effects in the lives of their patients and clients.
Having spent the last few years teaching on social work training courses and post-registration nursing courses, I have been involved in this work. The students have always found the topics of the effects of loss and the bereavement process particularly interesting and mature students on the nursing courses, for example, have often commented on the changes that have occurred in the way the effects of loss are dealt with since their earlier State Registered Nurse training.
This public acknowledgement and discussion of mourning and grief differs, however, from that of the death—dying process. Here, the focus for the experience is essentially narrower and finite, and the fact of death inevitably separates out the process of dying from the process of bereavement. Moreover, the two are rarely dealt with together in any practical way. The psycho-social context in which dying occurs is usually dominated by the medical and nursing needs of the individual, since people are usually seen to die of an illness or