Is it appropriate to describe the social organisation of death and dying as involving “game” activities

Death is one of the most delicate subjects to deal with, in terms of speaking openly about it. While it is obviously something that we will all inevitably have to face, not just ourselves, but the experience of those close to us, it remains a topic that is unpleasant and uncomfortable to discuss. In addition, it is considered by all to be one of the more serious issues that we must address. It must be treated with delicacy, sensitivity and a level of compassion, and it is for these reasons that, on first glancing at the topic of discussion here, we would jump to the conclusion that death can never be associated with the playing of games.

In fact, the two subjects- death and games can be seen as polar opposites, in terms of views on and reactions to them. Death is associated with sorrow, games with fun, leisure and laughter. However, from a sociological perspective, there are other points that merit discussion here. Firstly, we must ascertain what precisely is meant by “game activities”. Our conventional definition of it clearly has no relevance to this discussion, but perhaps a more in-depth analysis of the concept of game-playing will shed some light.

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Game theory is a component of rational choice theory, and is derived from economics. It is used in situations of interdependence or social interaction; where two or more individuals do not act independently but interact and are mutually dependent. Game theory is mostly concerned with the study of how people behave in strategic situations. By “strategic” we refer to a situation in which each person, when deciding what actions to take must consider how others might respond to that action.

Rational choice theorists are concerned with this strategic interdependence: where the individual, in choosing a course of action, does need to consider what actions others will take in response of his or her decision or in response to what they anticipate his or her decision will be. Game theory assumes that all “players” in a “game” (that is, all the individual actors involved in the interaction) will normally act rationally to promote their own desired outcomes. These assumptions are based on the principles of economics, by which we believe that all individuals attempt to maximise their own positions, while minimising the costs.

I feel that this discussion would be incomplete without making a brief reference to the concept of ethnomethodology. This is a concept invented by Harold Garfinkel which literally means “people’s methods”. It can be described as a special kind of social inquiry, which investigates how people (or members) construct their world. The assumption is made that everyday life is orderly. Members thus work at justifying their own activities to others – making their own activities make sense to others. Ethnomethodology aims to study members’ methods of doing this.

A common form of ethnomethodological investigation is conversation analysis – the study of the social organisation of talk. Many sociologists have in fact made reference to the importance of conversation in the construction of the self, and how that self is perceived by others. George Herbert Mead, who is considered to be the founder of symbolic interactionism, focuses on the idea of society as an exchange of gestures involving the use of symbols. He uses the idea of a conversation of gestures to describe the interaction between people.

Goffman also employed a similar approach to studying social interaction. Based on the assumption that when an individual appears before others, he will have many motives for trying to control the impression they receive of him, Goffman studied the ways in which people sustain such impressions. Interaction was viewed by Goffman as a ‘performance’, constructed to provide others with impressions that are consistent with the desired goals of the actor. These attempts to control and influence the impressions given off during the process of interaction can be seen as forming part of a ‘game’.

As mentioned previously, when considering the process of death and dying, it would seem that it is extremely inappropriate to associate such experiences with the concept of a “game” or “game activities. ” Most people would agree that death is a particularly delicate subject, and is one that is always treated with great sensitivity and compassion. Few would argue that death, or even life, can be considered to be a game, at least in the way that we think of games and what they mean. The word “game” is often thought to refer to a fun activity, and can be associated with sports and other leisure pursuits.

However, in light of the earlier discussion of what precisely is meant by game theory, from a sociological or indeed an economic perspective, perhaps a more in-depth consideration is required. I argued that game-playing refers to the way in which people behave in strategic situations, given the fact that a rational person will usually act on behalf of their own desires, and to improve their own position in the particular interaction. It studies how people respond to the actions of others, or to how they predict someone will react to their own actions.

Using this meaning, perhaps we can find ways in which death and the process of dying can be thought of as a game. In his work “Passing On,” David Sudnow makes reference to death that occurs during surgery. For example, consider a case in which a person is taken in to be operated on, but they die shortly after the surgeon commences the operation. Let us assume that the operation was considered to be relatively low-risk, and the relatives will not be expecting the news that the person has died. Presumably, the surgeon has informed the relatives before commencing, of the type of procedure that will take place during the operation.

We also assume that he will have informed them of the possible risks etc, but let us still assume that the patient’s death will be highly unexpected. At the beginning of his social interaction with the relatives, therefore, he has been open and honest with them. However, given the unexpected and untimely loss of the patient so early in the procedure, the surgeon then must face the prospect of informing the relatives of the situation, and indeed what may be considered by some as his own failure. This is where the concept of game-playing can be introduced.

Before breaking the news to them, it is likely that he will consider their reactions, or what he anticipates their actions to be. He may decide to act differently in order to prepare them for the news, or indeed to save face. One method of doing this would be to come out to the waiting relatives at regular intervals, and describe a scene in the operating theatre in which complications have arisen, the patients condition has deteriorated etc. Then finally, he will announce that the patient has unfortunately died.

By this method he has been open and honest with the relatives at the beginning, and at the very end when he informs them of the death, but the stages in between are a pretence or a game in which he arouses their suspicion of what may be occurring before finally confirming their fears. In this way, he prepares them for the eventuality, and he may improve his own appearance. This example demonstrates how the social organisation of dying may involve “game activities. ” However, we must now consider the appropriateness of this “game. ” It certainly must be argued that this level of dishonesty in such a delicate situation is surely unacceptable.

Many would feel that the family have the right to know the absolute truth about the situation in which a loved one has died. However, there are other elements that must be considered when dealing with death in hospitals, and these are specifically related to the hospital itself and its staff. Barney Glaser speaks of the difficult task that the hospital has to “wind up its relationship with the family. ” (Glaser and Strauss, 1968:206) “Hospitals are well organised for disposing of the body, but they vary in procedures for disposing of the family and have little or no organisation for ending the patient’s story. (Glaser and Strauss, 1968:206) He discusses how it is more difficult to announce death when the family of the lingering patient has been left out of the dying situation. If they don’t anticipate it at all, then the announcement will be difficult for both parties, those telling the story and those hearing it. Announcing death to family members of a patient whose death ended a very short illness will be extremely difficult, again for both parties, as there has been little time for preparation. It will be difficult to provide an acceptable explanation to the relatives, or to provide any form of consolation to them.

While the staff will be as sensitive as possible, it is their duty to convey the news accurately and efficiently, and in a way that will create the least amount of fuss to the running of the hospital. They will try to avoid creating a situation in which the relatives may cause a “scene. ” Although this is generally a rare situation for individual families, and they will understandably be devastated and perhaps entitled to create a “scene” it is a regular occurrence for the staff of hospitals, and they must also consider the well-being of the hospital and its other patients.

For these reasons they may find it appropriate to prepare the family beforehand. Glaser and Strauss (1968) refer to the kind of game outlined in the previous section as a “false preannouncement”. The key to this discussion of appropriateness seems to hinge crucially on the reasons for the fabrication of events by staff. If the patient has died because of negligence or malpractice on the part of a member of staff, then it would appear to be highly inappropriate to create a story in an attempt to save the reputation of the staff.

However, if the patient has genuinely died unexpectedly, despite the best efforts of the staff, then perhaps this method is appropriate. If the reason for its use is merely to soften the blow slightly for the relatives, and prepare them for what is to come, then it is difficult to dispute this method. Although it may appear dishonest, the final result is still the same: the patient has died and the family are informed of his death. If a method exists to prepare them for such news, while also avoiding a scene in front of other patients and their families, then surely it should be used.

On first glancing at the question posed here, the idea that the social organisation of death and dying may involve some form of game activities seems preposterous. However, having examined some of the issues central to this discussion, our answer is somewhat different. Firstly, the theory of “games” suggests that in situations of interaction and interdependence, players will be inclined to behave strategically, sometimes for their own benefit, or perhaps for the benefit of other players. Their actions tend to be influenced by their own desired outcomes, but also by what they perceive the other players responses to be.

In our discussion of conversation, we also saw that a person’s behaviour during a conversation, their language and gestures, can influence outcomes. Sociologists have also referred to this as game-playing, as actors or players attempt to control a situation. In examining how these theories may apply to a situation of death, we saw the example of a patient who dies during surgery. The hospital staff may decide to control their situation by playing a game with the waiting relatives, in which they lead them to believe that the patient’s condition is deteriorating despite their best efforts, when the patient is in fact already dead.

The reason for doing this may be to make their own efforts appear more credible, or it may be to prepare the relatives for the shocking news they are about to receive. In addition, the hospital staff will be keen to control the situation so as not to upset other patients and their visitors. In these circumstances, it must be argued that the playing of such games is justified, and is indeed appropriate.