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Saturday, September 27, 2008
Star Books Review

Of death, science and matters of faith

Mohammad Nuruddin studies an unusual book and comes away impressed

Mohammad Samir Hossain is a physician and teacher of psychiatry at Medical College for Women and Hospital in Dhaka, Bangladesh. His book, Quest for a new death, is unique in its methodological focus on the phenomenon of death and our human reactions to it (Concept of death and adjustment, 2007

While dealing with death as a natural phenomenon for every individual and society, this work abandons a focus on the point of death or dying, and instead investigates the more exclusive concepts pertaining to death as an ongoing state. The 'death' it speaks of is truly new for science. Thus, the book's subtitle is apt Death and adjustment hypothesesas it draws on a foundation of the author's empirical research on Islamic death attitudes as an example of nonscientific conceptions of death (10% of the book) to build a theoretical framework (90% of the contents). The empirical parts are informed by conventional statistical analyses on death attitudes, whereas the conceptual parts mainly follow epistemological methodology, a less conventional way of conducting research in behavioral science. I think a small section describing its methodology could have clarified it for readers, especially for those who are not much acquainted with epistemological methods.

The book is presented in four main sections. Hossain begins, appropriately, by discussing different relevant topics on death. He then clarifies the concept of death, especially in the sense it will concern him in the pages that follow. With these matters of definition accomplished, he highlights the relationship of death as a universal phenomenon to people's mental health, a topic that he explores in some depth as it applies to the problem that death represents for otherwise healthy adults who have to adjust to this reality. Helpfully for his readers, Hossain discusses several of the specific scales he developed for his research, which are not very available otherwise, such as the Death Rejection Score Scale (DRS), Neurotic Symptom Score Scale (NSS), and others, and puts these to use in the context of a formal research project whose results he summarises. In summary, this section serves to specify some unfamiliar concepts and methods used in this book.

The second section of the book concentrates on the central argument of the death and adjustment hypothesis. In comparison with the other sections it is a vast one, describing the hypothesis in nineteen parts. The overarching focus of this section is directed towards the proposition that the way we understand the relationship of death and existence is incorrect and that this misunderstanding is harmful for us as human beings. The topics discussed in different parts are 1) the experience of death in vivo and in vitro, 2) the process of identifying a truth, 3) our current stance toward death, 4) people with exceptional attitudes towards death, 5) major non-scientific concepts of death, 6) the way death challenges our wellbeing, 7) traditional scientific attitudes towards death and their validity, 8) basic criteria of life, 9) the possibility of death's ending one's existence, 10) logical considerations of the criteria of death, 11) the necessity of evaluating these criteria, 12) death anxiety and adjustment, 13) the history of attitudes towards death and stages of adjustment with death, 14) the popular adoption of stage theories of adaptation to death in mass culture, 15) consequences of maladjustment with death, 16) the ambiguity of death and our dissociation from it, 17) the vicious cycle of ambiguity and dissociation, 18) comparison of the practical impacts of different concepts of death, and 19) declaration of the hypothesis. Rather boldly, Hossain's hypothesis ultimately demands the installment of the concept, universally, that our existence does not end with death. Also, it indicates that we are now dissociated from the phenomenon of death due to our maladjustment in this respect.

Substantively, this sweeping section of Hossain's argument draws upon the important work of Kubler-Ross (1997) in discussing stages of dying, and perhaps more significantly and pervasively, the cultural perspective on death attitudes developed most eloquently by Aries (1974), which informs this book as a whole. Finally, in the last part of this section, Hossain shares some personal feelings concerning the hypothesis and its impact on his life, as well as some discussion of the concept of death and its relevance for Muslim terrorism, which adds to the scientific and social value of the work. But these last commentaries are actually footnotes to the research, as the author also candidly admits.

Section three of the book is on our attitude towards death. It begins by discussing the problematic aspects of the attitude, mainly the defensive ones that exclude death from conscious thought. Hossain then undertakes a detailed analysis of this attitude from a psychological point of view, explaining why this prevalent attitude is problematic, and how gaps exist between our death-related activities and formal beliefs. Interestingly, this analysis has an historical dimension, revealing the progressive deterioration in the attitude across the course of civilisation, considering the etiology of the changes and their related psychological processes.

The fourth section is the most important of the book, as it represents a synopsis of all the previous parts. Careful reading also reveals that it is a total reconstructive approach for the whole work. The concise primary version of the hypothesis has been installed in this section and a second part has also been developed as a new extension of this basic thesis. This second part ultimately emphasises the importance of morality for a genuine accommodation of death in human life as implied by the first hypothesis. In this section the author tests his hypotheses, conceptually using the theories of Hamlyn (1970) and proposes a new psychiatric diagnosis, termed Death Adjustment Disorder (DAD). This is a bold proposal, as the number of DAD patients will be numerous if such a proposal were taken seriously, as we all tend to experience some kind of difficulty in integrating the reality of death. Thus, the various strands of argument in this section are very important from a practical point of view. They also clarify the primary purpose of the book and thus the whole research.

Following section four of the book, Hossain provides an “inference” or summary statement to present more succinctly the scientific concern of the work, especially about our current condition and the unknown future. This section clearly elaborates all the aspects of his multifaceted argument in brief. But unlike the summary chapters of many other books, it requires a thorough reading of the whole preceding volume, especially to accept Hossain's statements as scientific ones. Of all the parts of the book, the portion entitled “A Final Statement” is the liveliest, conveying the core of the author's argument with passion as well as a sense of truth. It also acknowledges that the book goes against the traditions of many in contemporary civilisation.

How successful is Hossain in achieving his stated purposes? The major steps he proposes are impossible to complete in a single small book, however much it is anchored in provisional data, theory, and passionate belief. In particular, the book's core hypothesis that death is not the end of human life, and that integration of this knowledge would transform human beings and cultures would require many further steps and analyses to be implemented practically.

The historical and psychological development of the book's thesis is intriguing and persuasive, and its implications practical and useful. Hopefully, further works in this line will continue to flourish for the benefits they could carry at both a scientific and social level. As a book for ordinary readers, this work is unlikely to be a bestseller, as it lacks the ease of understanding and pleasurable focus required for popular success. But it surely is a pacemaker in one important movement in science, and in this sense could have a different sort of impact on civilisation, given the centrality of death for human life.

Mohammad Nuruddin is a retired government official.

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