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Work 50 (2015) 511–526 511 DOI 10.3233/WOR-141957 IOS Press Excluding parental grief: A critical discourse analysis of bereavement accommodation in Canadian labour standards Mary Ellen Macdonald a,, Kimberly Kennedy b , Sandra Moll c , Carolina Pineda a , Lisa M. Mitchell d , Peter H. Stephenson d,e and Susan Cadell b a Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada b School of Social Work, Renison University College, University of Waterloo, Waterloo, ON, Canada c School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada d Department of Anthropology, University of Victoria, Victoria, BC, Canada e School of Environmental Studies, University of Victoria, Victoria, BC, Canada Received 18 May 2013 Accepted 8 September 2013 Abstract. BACKGROUND: Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss. OBJECTIVE: The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereave- ment. METHODS: Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards. RESULTS: Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues. CONCLUSIONS: Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity. Keywords: Child death, parental bereavement, bereavement leave, labour standards, discourse analysis Corresponding author: Mary Ellen Macdonald, Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 530, Montreal, QC, Canada, H3A 1G1. Tel.: +1 514 398 7203 x089405; Fax: +1 514 398 7220; E-mail: [email protected]. 1. Introduction Parental grief following the death of a child can be intense and enduring [1,2]; parental bereavement has been described as a fundamentally incomprehensible and devastating loss [3,4]. A broad range of literature – from psychosocial to sociocultural – suggests the death of a child is the worst kind of loss an individual could endure, a profoundly disruptive and traumatic event for 1051-9815/15/$35.00 c 2015 – IOS Press and the authors. All rights reserved AUTHOR COPY

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Work 50 (2015) 511–526 511DOI 10.3233/WOR-141957IOS Press

Excluding parental grief: A critical discourseanalysis of bereavement accommodation inCanadian labour standards

Mary Ellen Macdonalda,∗, Kimberly Kennedyb, Sandra Mollc, Carolina Pinedaa, Lisa M. Mitchelld,Peter H. Stephensond,e and Susan CadellbaDivision of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, CanadabSchool of Social Work, Renison University College, University of Waterloo, Waterloo, ON, CanadacSchool of Rehabilitation Science, McMaster University, Hamilton, ON, CanadadDepartment of Anthropology, University of Victoria, Victoria, BC, CanadaeSchool of Environmental Studies, University of Victoria, Victoria, BC, Canada

Received 18 May 2013

Accepted 8 September 2013

Abstract.BACKGROUND: Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereavedparents. Employed parents may need time away from work to deal with this loss.OBJECTIVE: The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereave-ment.METHODS: Critical discourse analysis was used to examine labour policies and practices related to employment leave forbereaved parents in Canada. Results were compared to international labour standards.RESULTS: Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is threedays, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by griefor the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policiesefface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues.CONCLUSIONS: Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks andceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences forwhich healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employeewellbeing, reintegration and workplace productivity.

Keywords: Child death, parental bereavement, bereavement leave, labour standards, discourse analysis

∗Corresponding author: Mary Ellen Macdonald, Division of OralHealth and Society, Faculty of Dentistry, McGill University, 2001McGill College Avenue, Suite 530, Montreal, QC, Canada, H3A1G1. Tel.: +1 514 398 7203 x089405; Fax: +1 514 398 7220; E-mail:[email protected].

1. Introduction

Parental grief following the death of a child can beintense and enduring [1,2]; parental bereavement hasbeen described as a fundamentally incomprehensibleand devastating loss [3,4]. A broad range of literature –from psychosocial to sociocultural – suggests the deathof a child is the worst kind of loss an individual couldendure, a profoundly disruptive and traumatic event for

1051-9815/15/$35.00 c© 2015 – IOS Press and the authors. All rights reserved

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parents and the entire family. For example, many par-ents experience a child’s death as an unnatural viola-tion of the life cycle, representing the loss of connec-tion to the future and unfulfilled dreams and plans [5,6]. The grief that follows may never go away, causingphysical, emotional, and mental health consequencesthat can be debilitating for months or years [6–9]. Se-quelae of bereavement include increased risk of mor-bidity and mortality [10–13]. While acknowledgementof positive aspects of stressful experiences is increas-ing [14], and there is evidence that grieving parentsalso experience benefit [15], stress co-occurs with pos-itive aspects [16].

The subsequent suffering can greatly impact a par-ent’s ability to continue their prior involvement in so-cial activities; this is especially true of participating inthe workforce. As part of a larger program of socio-cultural research on child loss in Canada, we wantedto know how the workplace acknowledges and alignsitself with the needs of this population. To do so, weconducted an analysis of Canadian and internationallabour standards, looking specifically at provisions forparental bereavement. We approached these texts ascultural documents; they provide both concrete indica-tions of workplace realities for these parents, as wellas reflect broader sociocultural discourses expressingattitudes, values and understandings vis-à-vis this pop-ulation.

2. Background

The psychosocial research literature shows the deathof a child is profoundly disrupting and destabilizingfor a parent. The nature of the experience is shapedby many factors; as discussed below, these include theparent’s grief response, the age of the child, the natureof the parent-child relationship, reactions of others intheir social circle, and their financial situation.

The intensity and longevity of the grief experiencefor parents is profound. Health sequelae after child lossinclude a long list of emotional and physical symp-toms, such as intense loneliness, emptiness, sadness,emotional and physical pain, and anger [17]. Researchwith bereaved parents suggests the loss is “the mostunbearable pain” resulting in an “emotional and phys-ical wreck . . . aches, pains, tired all the time, stom-ach pains, nausea, vertigo, ringing ears” [6]. Recent re-search is starting to show increased mortality amongbereaved parents, especially for mothers [11–13]. Riskof these repercussions is not fleeting, nor does it nec-

essarily diminish with time; research suggests psy-chosocial and physical health consequences associatedwith parental grief can be long lasting. The fundamen-tal sense of depletion and loss, as well as recoveryfrom grief is not directly related to the time elapsedsince the child’s death [7,9,10]. Over the long-term,bereaved parents report significantly more depressivesymptoms, poorer well-being, and more health prob-lems than non-bereaved [18]. Many parents live theloss as a massive invalidation of how the world issupposed to operate, leaving them with a sense ofchaos and unpredictability that manifests as emotionaland physical vulnerability, including a fear of ongoingtrauma, loss and a fear for the safety of surviving fam-ily members [2]. While all grief may contain this senseof disruption, research suggests it is heightened in par-ents after the death of a child given the loss of socialrole uniquely central to their self-identity. Importantly,the relationship between parent and child is central tothe parent’s sense of self and the metaphor of amputa-tion is often used by bereaved parents to characterizetheir loss [7].

A question that recurs in this literature is if, andhow, the age of the child at the point of death affectsbereavement outcomes. To date, research is inconclu-sive on the subject [19,20]. As authors have shown [1,21], the death of an adult child is also devastating toaging parents; one must remember that to a parent, achild does not stop being a child after they reach adult-hood. According to some scholars, parents who lose anadult child feel their loss may be harder than the deathof a younger child because of all the memories andexperiences the child and parent had shared over theyears [6]. Older parents who have lost an adult childsay they have lost both a child and a friend [5]. On theother hand, parents experiencing perinatal loss and thedeath of infants mourn the lost potential of the childthey were unable to know [22].

Another theme in the literature on parental bereave-ment attends to social assumptions about grief. Thisliterature shows how the bereaved can feel rushedthrough their grief by friends, colleagues, and evenfamily. Walter refers to this as the “policing ofgrief” [23]: grief is regulated by societal conventionsand rituals that dictate how much mourners shouldspeak about the dead and express their feelings openly,and for how long. There is an expectation that afterthe funeral, the bereaved person will return to “nor-mal;” this often includes returning to work. These ex-pectations are fraught for bereaved parents; they oftenexperience their loss as ‘insiders’, meaning that only

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those who have experienced child loss first-hand canunderstand the intensity of their experience [1,6,17].Although bereaved parents typically receive an out-pouring of social and emotional support from individ-uals and institutions immediately following the death,after the initial few weeks these supports often dwin-dle. This can leave families feeling abandoned and iso-lated [24]. Bereaved parents have found family mem-bers and friends to be less helpful and available thanwhat they had expected [2]. These societal realities andpressures may contribute to growing stress, as parentsstruggle with their grief more and more silently overtime.

Especially concerning the pediatric population,many bereaved parents are of working age. This statis-tic is compounded by the fact that a majority of fam-ilies in Canada now have two working partners [25],and there is an increasing number of single-parent fam-ilies [26]. Children in the younger age ranges (i.e., lessthan 15 years) could have two parents (and upwardsof four grandparents) still working. Over 13,000 peo-ple under 45 years die each year in Canada [26,27],which leaves potentially 26,000 bereaved parents andas many as 52,000 bereaved grandparents in the work-place.

Many families experience financial hardships dur-ing a child’s illness that may actually increase after thedeath. For instance, if a child had been suffering a pro-tracted and/or disabling illness, the parents may haveincurred expenses related to caregiving, medical bills,equipment, travel costs, and in addition may have losttime from work in order to stay with the child [28–30]. With a death, the financial burden could be com-pounded by funeral expenses, the loss of benefits to theliving child and unpaid time away from work to grievethe death [28–30]. Consequently, the parent may expe-rience pressure to return to paid work.

3. Study rationale and design

As part of our larger sociocultural study on childloss in Canada, reviewing this literature and listeningto bereaved parents led us to ask if and/or how theworkplace acknowledges and aligns itself with the spe-cific needs of bereaved parents. An entry point to ad-dressing these questions is through an examination oflabour standards. Labour standards have historicallyfunctioned to protect the most vulnerable members ofthe workforce by upholding employee rights to de-cent employment conditions. For example, they regu-

late work hours, minimum wages, statutory holidays,vacations, statutory leaves (e.g., maternity, parental,compassionate care, bereavement, sick leave) and thetermination of contracts. In addition, labour standardsoutline procedures for workers to challenge unjust dis-missal, to recover unpaid wages, and attend to humanrights in the workplace (e.g., pay equity, sexual harass-ment) [25]. Labour standards generally express a min-imum, not a “best possible” standard [25], althoughthey are often enhanced by additional terms agreed toby employers, workers or unions.

As a labour standard, bereavement leave in Canadahas a two-fold purpose: to allow the employee to planand attend ceremonial obligations, such as funerals,and to allow time to mourn the loss of a loved one [31].Bereavement leave is provided through federal labourstandards for federally regulated private sector indus-tries (e.g., banks, telecommunications, postal service,air and road transportation), and First Nations gov-ernments; this includes approximately 1.132 millionworkers or 8.4% of the Canadian workforce. The con-stitutional reality, however, is such that the federal gov-ernment has no power to enact labour standards legis-lation outside its own domain [25]. Bereavement leaveis also provided through employment standards in mostprovinces and territories (exceptions include Alberta,Nunavut and Ontario). Provincial jurisdictions includeemployment in manufacturing firms, restaurants, retailstores, timber and mining companies [25]. The ma-jority of employees in Canada fall under the jurisdic-tion of the province or territory in which they live andwork; approximately 10 per cent of Canadian work-ers are employed in federally regulated sectors. Labourstandards do not apply to self-employed workers.

In our analysis of Canadian and international labourstandards, the goal was to examine if and how em-ployee benefits accommodate the uniqueness of paren-tal experience of loss. We approached these documentsas more than concrete indications of workplace re-ality; we also saw them as sociocultural scripts thatexpose broader social policy discourses vis-à-vis atti-tudes, values and understandings of parental bereave-ment.

4. Methods

4.1. Sample and document selection process

We used a systematic approach to access labourstandards from provincial, national and internationaljurisdictions. Our review was completed by August2012.

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4.1.1. CanadianTo access official labour standards, we searched fed-

eral, provincial, and territorial government websites.We also reviewed the Canadian Human Rights Act, theEmployment Insurance Act, as well as discussion doc-uments outlining work place policies and recommen-dations for legislation. Finally, we reviewed legisla-tion enabling employees to care for sick family mem-bers (e.g., compassionate care leave) across the juris-dictions, our goal being to understand if and how pol-icy may anticipate bereavement. In total, this producedsix federal, 12 provincial and three territorial web-accessed sources (see Table 1).

4.1.2. InternationalComparing labour standards across international ju-

risdictions has inherent limitations given different na-tional strategies to protect workers and ensure ‘accept-able’ conditions in the workplace. Looking broadlyat similarities and differences among jurisdictions canbe instructive in terms of how they reflect local val-ues and expectations of workers, employers, and thegeneral public [25]. It is known that Canada’s labourstandards are similar to other industrialized nations interms of economic cost and flexibility, and that mater-nity, parental and compassionate care leave fall withinthe middle of the range of approaches taken by mostof its industrialized counterparts [25]. We are unaware,however, of any reviews comparing bereavement leaveentitlements among countries. Thus, to obtain an ad-ditional international perspective, we searched individ-ual governmental websites choosing a variety of indus-trialized countries (n = 7). We looked at internationallabour policies and organizations, including the Inter-national Labour Organization, a specialized agency ofthe United Nations with 183 member countries, the Eu-ropean Union, and the World Health Organization (seeTable 1).

4.2. Analysis

Our initial analytic technique was descriptive: weextracted qualitative data on a number of variablesfrom documents, including: amount of time allotted forbereavement leave, terms and conditions of the leaveincluding eligibility (e.g., length of service require-ments, an employee’s relationship to the deceased),and we noted bereavement provisions that fell outsidebereavement leave subsections (e.g., perinatal loss un-der maternity leave).

Next, we analyzed the extracted data using criticaldiscourse analysis. The objective was to use the labourpolicies as cultural lenses through which to reflect onhow Canadian society understands bereavement, espe-cially as related to child loss. Policy-making is a so-cial practice [32,33]; therefore, our analysis of labourpolicies included careful consideration of the socio-cultural and historical context from which they aredrawn, the claims, concerns and agendas of actors whocontribute to their development, and the moral natureand value judgments involved in policy choices thattarget specific social groups [32,34,35] Through crit-ical analysis of the language (discourse) used in con-structing policies, it becomes possible to explore theirunderlying ideological foundations, and expose thesefor what they accomplish (e.g., maintaining status hi-erarchies, entitlements) and the messages they reflect(e.g., societal values) [36–38].

We begin with Part one, which reviews our descrip-tive analysis followed by a brief discussion of thesalient issues. Part two then discusses four social dis-courses embedded in these descriptions. We reflect ontensions apparent between the psychosocial researchevidence outlined above and the policy reality for be-reaved parents in Canada and include suggestions to-wards improving the misalignments.

5. Part one: Descriptive analysis

5.1. Canada

Labour standards regarding bereavement leave areremarkably homogenous across Canada. Where statu-tory provision is not legislated, other workplace poli-cies and collective agreements provide entitlements.Upwards of 90% of collective agreements in Canadainclude some provision for bereavement leave [31]. Forexample, Ontario does not have bereavement leave;however, its Employee Standards Act has compara-ble provisions through a subsection called “PersonalEmergency Leave.” Five deductive variables help de-scribe the Canadian status quo vis-a-vis standards forbereavement: duration of leave, wage status, eligibil-ity, timing, and compassionate care provisions. Pleasenote, data is taken from the official labour standards aslisted in Table 1; any in-text references below refer toreviews and discussion papers.

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Table 1Data sources

1. Canada: FederalCanada Labour Code, R.S.C., 1985, c. L-2: 210. http://laws-lois.justice.gc.ca/PDF/L-2.pdf. Current to 2012-06-27; Last amended on January1, 2010; Published by the Minister of JusticeCanadian Human Rights Act, R.S.C., 1985, c. H-6. http://laws-lois.justice.gc.ca/eng/acts/h-6/ Current to 2012-06-27; Last amended on2012-03-13. Published by the Minister of Justice.Employment Insurance Act (S.C. 1996, c. 23). http://laws-lois.justice.gc.ca/PDF/E-5.6.pdf. Act current to 2012-06-27 and last amended on2011-12-15. Published by the Minister of JusticeHuman Resources and Skills Development Canada. Fairness at work: Federal labour standards for the 21st century. Ottawa: Government ofCanada; 2006. http://www.hrsdc.gc.ca/eng/labour/employment_standards/fls/pdf/final_report.pdfHuman Resources and Skills Development Canada. Discussion Paper on the Review of Labour Standards in the Canada Labour Code.Ottawa, ON: Government of Canada; 2009. http://www.rhdcc-hrsdc.gc.ca/eng/labour/employment_standards/fls/pdf/discussion_paper.pdfService Canada Compassionate Care Benefits http://www.servicecanada.gc.ca/eng/ei/publications/compassionate.pdfService Canada Federal Income Support for Parents of Murdered or Missing Children http://www.servicecanada.gc.ca/eng/sc/pmmc/ebrochure.shtml2. Canada: ProvincialAlbertaEmployment Standards Code, R.S.A.2000, c.E-9. http://www.qp.alberta.ca/574.cfm?page=E09.cfm&leg_type=Acts&isbncln=9780779725663British ColumbiaEmployment Standards Act, R.S.B.C. 1996, c. 113 : 53. http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96113_01/ManitobaThe Employment Standards Code, C.C.S.M. c. E110: 59.4. http://web2.gov.mb.ca/laws/statutes/ccsm/_pdf.php?cap=E110New BrunswickEmployment Standards Act, S.N.B. 1982, c. E-7.2: 44.03. http://laws.gnb.ca/en/showfulldoc/cs/E-7.2//20120808Newfoundland and LabradorLabour Standards Act, R.S.N.L. 1990, c. L-2: 43.10. http://assembly.nl.ca/legislation/sr/statutes/l02.htmNorthwest TerritoriesEmployment Standards Act, S.N.W.T. 2007, c.13: 31. http://www.ece.gov.nt.ca/Divisions/Labour/Laour_pdf/Regulations/Employment_Standards_Act_3-2011.pdfNova ScotiaLabour Standards Code, R.S.N.S. 1989, c. 246: 60. http://nslegislature.ca/legc/statutes/labourst.htmNunavutLabour Standards Act, R.S.N.W.T. 1988, c.L-1. http://www.canlii.org/en/nu/laws/stat/rsnwt-nu-1988-c-l-1/latest/part-1/rsnwt-nu-1988-c-l-1-part-1.pdfOntarioEmployment Standards Act, 2000, S.O. 2000, c. 41: 50. http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_00e41_e.htmPrince Edward IslandPrince Edward Island. Employment Standards Act, R.S.P.E.I. 1988, c. E-6.2: 23. http://www.gov.pe.ca/law/statutes/pdf/e-06_2.pdfQuebecLabour standards, An Act respecting, R.S.Q. c. N-1.1: 80,80.1, 79.11, 79.12. http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=2&file=/N_1_1/N1_1_A.htmlQuebec Commission des normes du travail. Death & Suicide http://www.cnt.gouv.qc.ca/en/leaves-and-absences/family-events/death-suicide/index.htmlQuebec Commission des normes du travail. Victim of a crime and his family circle. http://www.cnt.gouv.qc.ca/en/leaves-and-absences/victim-of-a-crime-and-his-family-circle/index.htmlSaskatchewanThe Labour Standards Act, R.S.S. 1978, c. L-1: 29.3. http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/L1.pdfYukon TerritoryEmployment Standards Act, R.S.Y. 2002, c. 72: 60. http://www.gov.yk.ca/legislation/acts/emst.pdf3. InternationalInternational Labour OrganizationInternational Labour Organization. National Labour Law Profile. International Labour Organization; 2011 [August 28, 2012]; Availablefrom: http://www.ilo.org/ifpdial/information-resources/national-labour-law-profiles/lang–en/index.htmGermanyJung L. Federal Republic of Germany. [Webpage]: International Labour Organization 2001 [August 14, 2012]; Available from: http://www.ilo.org/ifpdial/information-resources/national-labour-law-profiles/WCMS_158899/lang–en/index.htm.IrelandCitizens Information Board. Citizens Information: Leave and Holidays. Government of Ireland; 2012 [August 28 2012]; Available from:http://www. citizensinformation.ie/en/employment/employment_rights_and_conditions/leave_and_holidays/SwitzerlandPetersen N, Muller A. The Swiss Confederation International Labour Organization; 2007 [August 14, 2012]; Available from: http://www.ilo.org/ifpdial/information-resources/national-labour-law-profiles/WCMS_158921/lang–en/index.htm

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Table 1, continued

European UnionEuropean Foundation for the Improvement of Living and Working Conditions. Reconciliation of work, private and family life in the EuropeanUnion. Dublin, Ireland: European Foundation for the Improvement of Living and Working Conditions; 2011.European Foundation for the Improvement of Living and Working Conditions. Annual Review of Working Conditions in the EU 2008-2009Luxembourg: Office for Official Publications of the European Communities; 2009.AustraliaAustralian Government. Personal/carer’s leave and compassionate leave and the National Employment Standards: Fairwork Ombudsman;2011.New ZealandNew Zealand Department of Labour. Bereavement leave – general entitlements; 2004 [August 14, 2012]; Available from: http://www.ers.dol.govt.nz/holidays_act_2003/bereavement.htmlRepublic of South AfricaZopedol. Basic Guide to Family Responsibility Leave; 2012 [August 14, 2012]; Available from: http://www.labour.gov.za/legislation/acts/basic-guides/basic-guide-to-family-responsibility-leaveUnited StatesU.S. Office of Personnel Management. Sick Leave for Family Care or Bereavement Purposes; No date [August 14, 2012]; Available from:http://www.opm.gov/oca/leave/HTML/sickfam.aspU.S. Office of Personnel Management. Sick Leave to Care for a Family Member with a Serious Health Condition; No date [August 14,2012]; Available from: http://www.opm.gov/OCA/LEAVE/HTML/12week.aspSociety for Human Resource Management. Examining Paid Leave in the Workplace. USA: Society for Human Resource Management; 2008.World Health OrganizationWorld Health Organization. Preventing suicide: How to start a survivors group. Geneva: World Health Organization; 2008.World Health Organization. Mental Health in Emergencies: Mental and Social Aspects of Health of Populations Exposed to Extreme Stres-sors. Geneva: World Health Organization; 2003.World Health Organization. World day of remembrance for road traffic victims: A guide for organizers. Geneva: World Health Organization;2006.Partnership for Maternal Newborn & Child Health. Stillbirths – The invisible public health problem; 2012 [August 14, 2012]; Availablefrom: http://www.who.int/pmnch/media/news/2011/20110414_pmnch_pr_stillbirths/en/index.htmlWorld Health Organization. WHO definition of palliative care; 2010 [August 14, 2012]; Available from: http://www.who.int/cancer/palliative/definition/en//

5.1.1. Duration of leaveAcross the Canadian jurisdictions, bereavement

leave provisions range from one to seven days, withcollective agreements generally providing three to fivedays leave [39]. Ontario is the only jurisdiction thatcaps the leave annually: they provide 10 days per year,but this includes personal illness, injury or medicalemergency and the death, illness, injury, medical emer-gency of, or urgent matter relating to close relatives.

Additional variables affect duration of leave acrosslocal jurisdictions. For example, in Northwest Terri-tories, geographic proximity affects the duration ofleave: leave is increased from three to seven days if thefuneral service is held outside the community wherethe bereaved employee resides. Cultural affiliation alsocan affect duration. In Yukon, First Nations employ-ees are entitled to extra leave (up to seven days un-paid) should they be designated by the family of the de-ceased person as the person responsible for organizingthe funeral potlatch.

Relational proximity affects leave duration in somejurisdictions. For example, in Nova Scotia, Prince Ed-ward Island and Quebec, a death in the immediate fam-ily has a longer leave entitlement (three to five days)than the death of grandparents, grandchildren and in-

laws (one day). In Nova Scotia, extended family in-cludes siblings; in Prince Edward Island, it includesaunts and uncles.

The circumstances of the death affects duration inQuebec where an employee is entitled to a maximumleave of 52 weeks, without pay, after a suicide or adisappearance of a child (minor or otherwise); and104 weeks if the child dies as the result of a crimi-nal offence. Saskatchewan has also considered adopt-ing these extensive provisions [40]. Recently (January2013) the federal government introduced similar leg-islation in reference to Criminal Code offences forparents of minor children who are either missing ormurdered, providing up to 35 weeks of income sup-port [41].

5.1.2. Wage statusWhereas most jurisdictions only offer unpaid leave,

in some there is a combination of paid and unpaidleave depending on either the time employed (federal,Newfoundland and Labrador) or relational proximityto the deceased. In Prince Edward Island and Que-bec, leave is partially paid if the death in question isthat of an immediate family member. Collective agree-ments often offer a combination of both paid and un-paid leaves [39].

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5.1.3. EligibilityThere is slight variation in eligibility for bereave-

ment leave across federal and provincial jurisdictions.Eligibility varies with time employed: for example inManitoba, leave only covers employees already em-ployed 30 days whereas in Saskatchewan it is only forindividuals employed for three months of continuousemployment. In contrast, Ontario provides leave basedupon the size of the employment establishment (leaveis formalized if there are at least 50 employees).

Eligibility also is tied to the employee’s relationto the deceased, with leave generally following thedeath of a “family” member. “Family” is broadly de-fined, however, and minimally includes spouse or com-mon law partner and child. In Manitoba and Que-bec, the child of a spouse is also included; in Yukon,step-children are included as is “a child to whomemployee stands in the place of parent.” Nova Sco-tia legislation includes “wards” and Ontario men-tions “foster” children. Parent and guardian are alsocommon categories; in Manitoba, Newfoundland andLabrador, and Yukon this includes parents-in-law,in Yukon, it also includes step-parents, and in On-tario foster parents and foster parents in-law. Sib-lings are generally included and in Newfoundland andLabrador and Saskatchewan this also includes siblings-in-law. Grandchildren and grandparents are generallyincluded and in Ontario, step-grandparents and step-grandchildren are also named.

In British Columbia, the definition of family extendsto include any person who lives with an employee asa member of the employee’s family. In Ontario, familyis defined as a “relative of the employee who is depen-dent on the employee for care or assistance.” In NewBrunswick the description is precise: any person in a“close family relationship” which “includes a relation-ship between persons who, though not married to oneanother and whether or not a blood relationship exists,demonstrate an intention to extend to one another themutual affection and support normally associated withthose relationships first mentioned.” In Yukon, familyalso includes “any relative permanently residing in theemployee’s household or with whom the employee re-sides.”

Perinatal loss is singled out as worthy of some pro-vision in a few jurisdictions; however, this provisionappears under maternity leave and not bereavementleave. For instance, British Columbia, Newfoundlandand Labrador, Ontario, Quebec, Saskatchewan, andYukon include some provision for maternity leave tocontinue (e.g., for an additional 6 weeks), unpaid, after

a stillbirth or miscarriage. Quebec is the most attentiveto such provisions. In Quebec, if a pregnancy is termi-nated in or after the 20th week, an employee may beabsent from work for five days; the first two days areremunerated if the employee is credited with 60 daysof uninterrupted service. The employee [in Quebec]is also entitled to a maternity leave, without pay, of amaximum duration of 18 consecutive weeks beginningfrom the week of the pregnancy loss. Where there istermination of pregnancy before the beginning of the20th week, the employee is entitled to maternity leave,without pay, for a period of up to three weeks.

5.1.4. TimingThe commencement of the leave varies slightly

across jurisdiction. In New Brunswick and Prince Ed-ward Island, leave must start no later than the dayof the funeral or other ceremonial obligations. InSaskatchewan, the leave must be taken within the pe-riod commencing one week before and ending oneweek after the funeral. Similarly, in Yukon the funeralmust take place during the week that the leave is taken.In Nova Scotia, the employee can choose when theleave starts.

5.1.5. Compassionate careMany jurisdictions include some provision for short-

term family responsibility leave (e.g., to care for asick child, attend parent-teacher conference, arrangehome care for an elderly parent) ranging from threeto 12 days. Further, Compassionate Care Leave wasadded to the Canada Labour Code in 2003 as a strat-egy to better assist employees with balancing both fam-ily and work responsibilities [25]. Federally and inmost provincial/territorial jurisdictions, Compassion-ate Care Leave (in Ontario similar provision exist un-der the title “Family Medical Leave”) provides eightweeks job protected leave to care for or support a fam-ily member who has a serious illness and a signifi-cant risk of dying within 26 weeks. In two jurisdic-tions (Alberta and Yukon) there are no compassionatecare provisions. In two other jurisdictions (Quebec andSaskatchewan), more generous coverage is provided.

An Employment Insurance Benefit also exists for allemployees in Canada, operating as a contributory ben-efits social program aimed at informal palliative/endof life caregivers [42]. To be eligible, the employee’sregular weekly earnings must have decreased by morethan 40 per cent, and the employee must have accumu-lated 600 insured hours of work in 52 weeks preced-ing the leave. This benefit will cover 55% of the em-

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ployee’s average insurable earnings, up to a maximumof $485 per week (in 2012) for six weeks. Job protec-tion and the definition of “family member” depends onthe labour code of the jurisdictions in which the jobfalls; in Alberta, for example, where there is no com-passionate care leave, while employees can receive thefederal wage replacement, they may not have job pro-tection. In none of the jurisdictions does the compas-sionate care leave cover the employees’ bereavementafter the death of the one for whom they are caring.

In sum, in Canada there is some variation from onejurisdiction to the next, but overall there is little in anylabour code to support a grieving parent beyond a fewdays leave to attend ceremonial obligations.

5.2. International

According to the Work, Family, and Equity Index, anindex which contains data on labour practices from 180countries, at least 41 countries guarantee a form of paidbereavement leave [43]. Further, 39 countries guaran-tee Long-term Family Leave with pay, including 16 of30 OECD (Organization for Economic Co-operationand Development) members [43]. Bereavement leaveand compassionate care leave throughout the coun-tries of the European Union are variable, with provi-sions ranging from statutory obligations to those at anemployer’s discretion. There is no binding legislationfor the European Union stipulating minimum entitle-ments [44]. For example, Germany entitles employeesto claim wages if they are prevented from working “forpersonal reasons such as e.g. death, birth or funeraland the absence is for an insignificant period;” how-ever, “the employee is not always entitled to entirelyclaim such leave, because sec.616 of the Civil Codemay be, and in practice often is, limited or even unrec-ognized by collective or contractual agreements” [45].In Switzerland, while free days are provided to attenda family event (e.g., birth, marriage, serious illness,death), the precise conditions are determined by col-lective agreements, most stipulating one to three daysdepending on the nature of the event [46]. In Ireland,employees can take up to 104 weeks of unpaid carer’sleave to attend to a family member who requires full-time care and attention, and civil service employeescan take up to five days paid bereavement leave; how-ever, there is no general statutory entitlement [47,48].

In some countries, bereavement leave is considereda possible criterion for sick leave. For example, in theUnited States, federal employees are entitled to up to13 workdays of “sick leave” each year, which applies

to personal sick leave as well as time needed to carefor family member or to attend/arrange a funeral of afamily member [49]. According to a 2008 survey, how-ever, 90 per cent of human resources respondents in-dicated that their organizations offered paid bereave-ment leave [50]. In these cases, bereavement leave wasseparate from leave available from paid time off, vaca-tion, sick and personal leave plans. The availability andamount of paid bereavement leave varied dependingupon individual circumstances; however it was gener-ally three days. Interestingly, 62 per cent of respon-dents stated this leave was available after miscarriageand/or stillbirth [50]. As well, the US Family and Med-ical Leave Act includes an additional leave entitlementto care for a family member with a serious health con-dition (e.g., cancer, heart attacks, severe injuries, preg-nancy). This leave provides up to 12 weeks per year;however, this includes the 13 days of sick leave de-scribed above [51].

In some countries, bereavement falls under generalfamily leave. For example, in the Republic of SouthAfrica, the Family Responsibility Act outlines that em-ployees are entitled to three days of paid family leaveper annual cycle that may be used for bereavement pur-poses, as well as to cover time away due to a child’sbirth or child’s illness [52].

In Australia, bereavement leave is under both sickleave and general family leave. Through the Fair WorkAct 2009, the Australian Government provides paidand unpaid “personal/carer’s leave,” which combinessick leave and caregiver leave. These forms of leave aredesigned to help an employee deal with personal ill-ness, caring responsibilities, family emergencies, andthe death or serious illness of close family members.The minimum entitlement for paid personal/carer’sleave is 10 days per year; this leave accrues progres-sively depending on years of service and accumulatesfrom year to year. Employees are also entitled to twodays of unpaid carer’s leave for each occasion when amember of the immediate family or household requirescare. In addition, paid leave called “CompassionateLeave” entitles employees to two days to spend timewith a member of their immediate family or householdwho has sustained a life-threatening illness or injury. Itmay also be taken after the death of a member of theemployee’s immediate family or household [53].

Some countries include bereavement under vacationleave. For example, New Zealand’s Holiday Act 2003outlines time allotted for bereavement purposes. Simi-lar to Canadian federal policy, New Zealand’s HolidayAct 2003 provides a minimum of three days paid leave

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when a family member dies. In the case of a death out-side the immediate family, one day with pay is allot-ted; however, this is at the discretion of the employerwho must decide if the employee is actually bereavedby this death. Bereavement leave can be taken at anytime and does not have to be taken consecutively. Em-ployees generally have up to five days paid sick leaveannually, and an additional five days after each subse-quent 12-month period; further, the leave can accumu-late up to 20 days if unused. It can be used for personalillness to care for a family member [54].

5.3. Discussion

Overall, bereavement leave in Canadian labour stan-dards appears to be similar to other industrializedcountries. Globally, the intention behind bereavementleave is to provide minimal time for an employee to or-ganize and/or travel to a ceremony. Most labour stan-dard provisions barely provide the time to do this andthey certainly do not provide the time for other prac-tical responsibilities following the death of a lovedone (e.g., dealing with the estate) nor the time to at-tend to the long-term suffering and disablement causedby the grief. Compassionate care leave is also uni-form across jurisdictions; this caregiver support endswhen the ill family member dies. In no jurisdictiondoes this caregiver benefit extend into the bereavementperiod. Further, there is little in any policy that dif-ferentiates among kinds of loss. If any stipulation ismade, it is to divide immediate from extended fam-ily; child loss is not singled out. Perinatal loss is notmentioned in any bereavement legislation; while someprovisions are made under maternity leave, the inten-tion of this provision is not explained. The only otherprovisions for parental bereavement are after a child’ssuicide (Quebec, Canada) or criminal offence causingdeath or abduction of a child (in Canada, Quebec andfederally).

According to this review, there is a hierarchy of sup-port within child loss. Perinatal loss, child abductionand murder entitle parents to considerably more leavethan death from trauma or illness. Reforms have beenrecommended to federal bereavement standards to in-crease leave (three days paid plus four days unpaid)and to be more sensitive to cultural and geographiccontexts [25,40]. Unfortunately, these reforms barelytouch the substantive issues of parental bereavement.Furthermore, compassionate care policy has been cri-tiqued for only including terminal illness [25,40], andexcluding bereavement support [55]. This is another

example where substantive parental issues are not ad-dressed.

It is important to note that many bereaved employ-ees work in environments that do not strictly adhereto labour standards. Employers in jurisdictions with-out legislated bereavement leave may still accommo-date the needs of bereaved employees through non-statutory policies and practices using ad hoc systems.Deliberation often depends on how many employees abusiness has, how easy it is to juggle workplace sched-ules, the relationship between the employer and em-ployees, as well as prevailing workplace cultures [39].Further, creative models exist outside formal standardsfor individual employers to support their workers. Forexample, the US Voluntary Leave Transfer Programis a leave-sharing program that allows co-workers todonate their unused personal time to a colleague inneed [56]. Another model includes an emergency loanprogram to help employees pay for funeral and relatedexpenses [57]. Chaussard and colleagues caution, how-ever, that “even when benefits to society would be sig-nificant, firms have little incentive to improve workingconditions and benefits; in fact, there is often a disin-centive if it means the company will have to bear thecost while its competitors may choose not to provideany coverage” [43]. The private sector does not seemaccountable to solving work-life balance problems; in-deed, bereavement leave is not even included in the se-lection criteria for the annual Canada’s Top 100 Em-ployers [58]. Thus, it seems to be up to public legisla-tion to improve the treatment of workers in the privatesector.

Not attending to bereavement also has financialrepercussions for the employer. According to TheGrief Recovery Institute, the death of a loved one isthe loss event found to have the greatest probabilityof affecting an individual’s ability to function in theworkplace [59]. This loss costs US companies an es-timated $37.5 billion annually [59]. (No dollar esti-mate could be found for Canada.) Another related con-cern in the workplace is the safety of co-workers whocan be placed at risk when bereaved employees re-turn to work too early. Grief can reduce concentra-tion, thereby both lowering personal productivity andpotentially negatively affecting decision-making andreaction times that in the wrong setting could be fa-tal. Ninety per cent of bereaved individuals workingin blue collar and other physical labour categories re-ported much higher occurrence of injury in the weeksand months following the death due to decreased con-centration [59]. Also affecting workplace performance

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and safety can be a use of illicit substances; studiesreport increased consumption of alcohol or illicit sub-stances in the period of six months following a majorloss [59].

6. Part two: Discursive analysis

It is apparent that bereavement leave policies do notreflect the evidence gathered and observations madeby health care professionals, support workers, and re-searchers in the fields of palliative and bereavementcare, as discussed above. The minimalist allocationfor bereavement leave appears to be a generic andinstrumental managerial response to an intense andhighly personal human experience. While the intentionis to ensure that employees can attend to the socially-sanctioned funerary obligations that follow the deathof a loved one, this leave barely even accomplishes thisgoal; it certainly cannot provide the time to grieve theloss of a loved one, and especially not the death of achild.

Why this misalignment between labour standardsand employee experience? Unpacking the implicit as-sumptions manifest in these labour policies can help toexplain, and start to rectify, this disconnect. Our criticaldiscursive analysis revealed multiple social discoursesreproduced in and through this legislation, each whichcan be read for implicit assumptions about parental be-reavement. The following discussion focuses on whereand how these discourses sit in tension with what isknown about the experiences of bereaved parents, andinclude suggestions for how to better support these em-ployees.

6.1. Labour and the public good

One question that begs answering from our reviewis why, contrary to maternity, parental and compas-sionate care leave, bereavement is not one of the en-titlements provided with generous leave provisionsthrough labour standards and remunerated through leg-islation. Possible answers can be found by looking athow two discourses – labour and the public good –overlap and justify certain entitlements while exclud-ing others. Canadian social policy, and that of manycountries, has come to see the justice in gender equityand to reward childbearing as a public good: support-ing pregnant women and supporting both genders asthey parent has become standard in human rights andlabour codes. Another public good is caregiving [60].

In Canada, informal caregivers of terminally ill pa-tients are rewarded both morally and economicallythrough the compassionate care leave and accompany-ing benefits for contributing to society and working inthe public interest. Not only do these caregivers en-able the dying to stay home or in community settings,the choice of the majority of dying Canadians [61,62],they are also providing an informal service which re-duces reliance on state-funded health care [63]. Im-portantly, caregiving (like childrearing) is remuneratedas labour through employment insurance. These care-givers are remunerated, however, only when they areworking; that is, while the loved one is alive. Whenthe family member dies, the benefit ceases. Once be-reaved, the employee is no longer entitled to support.The employee’s emotional response to a death – that is,their grief – is neither considered labour nor a publicgood.

In contrast, bereavement can be reframed as bothlabour and a public good. Health care providers areincreasingly realizing the importance of what is re-ferred to as “self-care” to prevent, reduce and/or re-lieve workplace burnout, and thereby maintain bothstaff health and productivity [64,65]. A similar logichas been applied to family caregivers who are atrisk of a phenomenon called “caregiver burden” [66].Williams and colleagues argue that the compassionatecare benefit has the potential to alleviate caregiver bur-den if amended to better support these caregivers bothwhile caring and in their bereavement [55]. Followingtheir lead, bereavement leave could be redesigned asa “healthy public policy,” [67] one that would serveas a public health intervention through supporting theself-care labour necessary for these employees to ade-quately grieve their loss before trying to return to work.

6.2. Life and death

Another potential explanation for the limited pro-visions for bereavement leave relates to the ways inwhich social groups are constructed within normativesocial discourses about life and death. A classic po-litical science article by Schneider and Ingram on thesocial construction of policy populations has helpedscholars think about power in and of public policy byexamining how certain social groups – “target pop-ulations” – are socially constructed through the do-main of public policy [68]. These constructions arebased upon normative and evaluative characterizationsand stereotypes, and conveyed via “symbolic language,metaphors, and stories.” [68]. How target populations

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are socially constructed – for example, the positive ornegative descriptors – influences how they are, or arenot, accommodated by policy makers, policy agendas,policy tools, and the rationales used to legitimize pol-icy choices. For example, the target population of preg-nant women has grown into a positive population tobe nurtured, protected and supported, whereas the sub-population of teen-aged mothers still carries a negativevalence of deviance for which policies are designed tocure, punish or erase [68].

Social constructions become reinforced in the mes-sages carried through public policies, conveying to cit-izens their social status vis-à-vis other groups: that is,who is most deserving, what attitudes or actions areappropriate, how governments should respond to cer-tain populations, and how citizens should expect to betreated by their government. These messages therebyinfluence citizen engagement and participation as theyconvey and reinforce the relative weight of each pop-ulation’s voice [68]. Ultimately, this theory helps toexplain how, in Western democratic societies, certaingroups become more advantaged than others and howpolicy has the power to reinforce or alter this advan-tage [68].

Employees are the general target population oflabour standards. Subpopulations of this larger popu-lation include, for example, pregnant women, new par-ents and informal family caregivers. Using a norma-tive frame, it appears that discourses of life and fam-ily are rewarded through generous benefits (e.g., mater-nity, family leave, compassionate care) whereas deathis disqualified and effaced. The bereaved are a sub-population without the same entitlements or resources;they are entitled to a few days to attend to ceremonialobligations after which they are expected to return towork and reunite with the larger population of “em-ployees.” International, federal, provincial, and privatesector collective agreements all reproduce this under-standing: the socially-sanctioned provisions are mini-mal, generic and strictly attend to activities surround-ing the death. There is little in any jurisdiction to singleout a target population of bereaved parents and theirneeds beyond this minimal period of sanctioned activ-ity.

What messages do these labour standards send tocitizens regarding bereavement in general and parentalbereavement more specifically? How do they repro-duce societal and cultural beliefs about death? Thatthere is no “bereaved parents” target population is nosurprise; this is a population that has not traditionallyhad any power, and on the contrary, tends to be stig-

matized, isolated, and misunderstood [69]. If they haveany capital at all, it is simply the moral capital thatsympathy and vulnerability can bestow. As suggestedbelow, however, the inherent vulnerability that comesfrom the loss of a child is not currently enough to mo-tivate public policy change.

6.3. Human rights and vulnerability

A third perspective that shapes our understandingof limitations in bereavement leave relates to the waysin which bereavement is positioned within the moralintersection of social policy and labour standards.Labour standards are primarily rules. While they makean important contribution to protect workers againstthe consequences of vulnerability, they are not meantto be a panacea for social issues. They can and shouldsupport decency in the workplace, and in so doing, pro-mote “fair, safe, healthy, stable, cooperative and pro-ductive workplaces that contribute to the social andeconomic well-being of all Canadians” [25]. Socialpolicy requires the power of social and communityaction to re-allocate resources in order to turn socialagendas into practical reality; labour standards do notpossess such power. Further, there are important com-peting interests within the labour context for any poten-tial reform to consider: the labour market, worker pro-ductivity, profitability, consumer pricing, and the na-tional economy [25]. While labour standards set min-imum expectations, they do not require employers toestablish extensive benefit plans or provide income re-placement [25]. Instead, it is the ambit of other socialand economic developments and public policy initia-tives that must be called upon to support social policyreform. For social reform, numerous factors need to beconsidered; the list includes “the overall strength of theeconomy, general labour market conditions and condi-tions within particular sectors, the redistributive effectsof tax and welfare policies, the availability of child careand social housing, strong public education and skillstraining programs, effective human rights protectionsand other public policies” [25].

Labour standards historically have engaged two re-lated moral discourses: vulnerability and human rights.Labour standards enact a moral imperative to protectthe vulnerable from discrimination through provisionsdealing with human rights, such as sexual harassment,pay equity, childbearing, job-related sick leave andphysical disability. This imperative ensures they aredesigned in consort with the broader agendas of so-cial policy, namely family policy, human rights, so-

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cial inclusion, skills training and workforce develop-ment [25]. Importantly, vulnerability is not just a re-sult of social discrimination and human rights abuses;it can also be caused when labour standards and pub-lic policy are misaligned with experiential phenomena.As our review shows, even where employees meet therequirements for bereavement leave, the provisions areminimal. Current labour standards assume a manage-rial frame that casts bereavement as a generic, time-limited process involving instrumental tasks that areresolved within a discrete time frame (e.g., three daysto plan and attend a funeral). Implied in this model isthat work disruption should be minimal, and that theemployee is expected to return to former levels of pro-ductivity and performance once the instrumental tasksare resolved. Also embedded in this model are prede-termined categories of eligibility defined for example,through years of service; in so doing, a worker can ac-tually ‘earn the right’ to grieve. Effaced by this frameis the intensely personal experience of grief, especiallywhen the deceased is the employee’s child. If employ-ees are made to return to work too early after experi-encing a loss, this can result in intense vulnerability:that is, detrimental health and social consequences forthe employee and also potentially others in the workenvironment.

The maternity, parental and compassionate careleave provisions in Canada are especially successfulbecause they were designed specifically in consort withthe corresponding income support programs providedunder the Employment Insurance Act [25]. These ex-amples of labour standards working with social policydomains shows how an increased breadth of supportcan be ensured. A recent review of the federal labourstandards recommends this trend continue in relateddomains: “The federal government should review theextent to which existing programs of income supportare consistent with provisions designed to protect newand prospective mothers, ill and disabled workers andother categories of workers protected by the CanadianHuman Rights Act” [25]. Similarly, evaluations of theCompassionate Care Benefit have put forth key recom-mendations to improve the coverage of the policy forvulnerable populations, including broadening eligibil-ity requirements to ensure those not eligible for em-ployment insurance can still access the benefits (e.g.,low-income families) [70], and extending the leave toinclude time for bereavement [42]. In these examples,moral arguments are made to reform current policyto better protect the rights of vulnerable citizens. Be-reaved workers are also at risk of human rights abusesand vulnerability.

6.4. Neoliberalism, productivity and medicalization

The fourth and final perspective that shapes our un-derstanding of bereavement leave within public pol-icy is informed by a neoliberal discourse. Writtenthroughout labour standards is an assumption abouthighly functioning, highly available bodies needed forproductive work environments. Concerns for workerssafety and rights to a healthy environment sit in ten-sion with these discourses. Just as the discourse of pro-ductivity makes impossible demands on chronically illbodies [71], the same can be said for the bereaved. Theexperiential suffering, grief, loss, and identity transfor-mation that are part of grieving challenges a notion ofproductivity that requires workers to tame their bodiesand emotions in order to successfully reintegrate intothe workplace.

Current labour policies individualize bereavementby making grief the responsibility solely of the be-reaved worker. Those who do not ‘move on’ in the al-located time are framed as ’costing’ the workplace sig-nificantly. It is only through such a neoliberal framethat grief is even conceived in financial terms: calcu-lations are used to demonstrate the financial amountthe bereaved cost the workplace due to errors, acci-dents, absenteeism and lost retention [57,59,72]. Ac-cording to one US survey, upwards of $37.5 million islost yearly in United States because of grief [59]. Lan-nen and colleagues found that sleep disturbances per-sisted for bereaved fathers even up to nine years afterthe loss [10]; thus, the bereaved employee is seen to beat risk for accidents to themselves, as well as to jeopar-dize the safety of co-workers and cause costly damageto equipment and infrastructure.

One way the bereaved currently protect themselvesfrom the neoliberal discourse that emphasizes produc-tivity is through the medicalization process. Currently,the only socially legitimized response to prolongedgrief in the workplace is to seek a physician’s noteto request sick leave. In the United Kingdom, for ex-ample, bereaved persons are more likely to consulttheir medical doctor than any other helping profes-sional [23]. Medicalizing grief transforms the intensityand longevity of the worker‘s experience into a cate-gory that aligns with the entitlements of sick benefits.And, as we saw in our review, in some jurisdictionsbereavement leave is directly tied to sick leave.

If we accept the premise that the bereaved are indeedsuffering an illness, theirs is more akin to a chronicillness than physical disablement or acute infectiousdisease. Whereas the social model of disability frames

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the sources of disablement in social and environmentalfactors [71], bereavement is necessarily individual andembodied; no level of workplace accommodation canenable the grieving body to perform to the same qual-ity and degree as their non-grieving colleagues. Theaccommodation these workers would require thereforemight be hard to negotiate because disability and sickprovisions generally assume that employees are eitherable to work full time or not at all, which, for ex-ample, leaves people with chronic illness in impossi-ble positions: “Either they must push themselves be-yond endurance to appear to be capable of workingfull-time or dishonestly declare themselves unable towork at all, often when they want very much to con-tinue working” [73]. For some bereaved, returning towork may be instrumental in their process of healing;however the flexibility to pace the return would haveto be controlled by the worker. An important startingpoint to think about this integration is research on suc-cessful return to work programs for workers living withchronic pain and mental illness which shows the needfor collaboration and partnership between the work-ers, their health professionals (e.g., occupational ther-apists) as well as knowledge sharing with employersand coworkers to increase support and understandingof the individualized experience [74–77].

It is important to ask what is gained and lost by fram-ing bereavement as an illness. On one hand, medical-izing grief gives the medical profession power to di-agnose suffering and translate it into a work benefit,giving employees better access to psychotherapy andpharmaceutical therapies and employment insurancebenefits. A contentious public debate ensued, however,after the American Psychiatric Association releaseda draft of the latest Diagnostic and Statistical Man-ual of Mental Disorders in which the “bereavementexclusion” criteria was removed from Major Depres-sive Disorder; consequently, an individual who was de-pressed two weeks after experiencing the death of aloved one would meet criteria for a mental illness [78,79]. In contrast, the palliative care community hasworked hard to normalize grief. A document outlin-ing the guiding principles for pediatric hospice pallia-tive care, for example, claims that bereavement careshould be delivered to bereaved families in the con-text of wellness, not pathology [80]. Care should fo-cus on identifying family strengths and mobilizing var-ious supports – not treatment – for people experiencinggrief and bereavement [81]. This sentiment is echoedby a number of professional associations and volunteersupport organizations [82–84].

And finally, within the discourse of productivity sits‘return to work’ programs. The intention of return towork programs is to assist an employee to return, afteran illness, to similar levels of productivity they wereachieving before their leave. Research on other vulner-able populations has shown the difficulty workers withpersistent conditions have integrating into the work-force with their ongoing disabilities, pain, and men-tal health condition [85–87]. The ‘return to work’ phe-nomenon is further challenged by how bereavementchanges people: the person returning has undergone aprofound rupture which can precipitate a fundamen-tal shift in an employee’s identity. They are no longerthe same individual who left the workplace; they arereturning not as parents but as bereaved parents. Bra-bant and colleagues ask, “What, in fact, does constituterecovery from the death of a child?” [88]. As with achronic illness, being bereaved is not a state; it is anongoing process without a predictable or fixed presen-tation or course. Thus, returning to work after a be-reavement leave is fundamentally not the same as re-turning after recovering from a short sickness or injury,or needing new accommodation for a physical disabil-ity. It cannot be assumed that these parents have ‘re-covered.’ As was posted on the website of a bereavedparent’s support group: “The expectation that you can‘get over’ your grief is a ridiculous one. Death changesthe person we once were forever and we can never re-turn to be that person again. It is possible to heal, youwill always carry the scars of your loss, but to recoverwould mean to continue life without those scars” [89].While research has begun to addressed return to workprogram for workers living with disabilities, chronicpain and mental illness [74–76], how bereavement fitsinto workplace policy has yet to be adequately theo-rized. Our paper is meant to advance this conversation.

7. Conclusion

How bereavement leave appears in labour standardssuggests it is a response to a generic, time-limited statewhich involves instrumental tasks aimed at ceremo-nial obligations. This depiction of bereavement standsin stark contrast to research which characterize re-sponse to child loss as an intense, highly personal hu-man experience with a process of healing and recov-ery that can take a life time. This disconnect is espe-cially problematic when viewed through the lens ofemployee wellbeing, reintegration and workplace pro-ductivity. Our analysis provides insight into sociocul-

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tural assumptions about grief and loss, demonstratinghow current labour practice reproduces common so-cietal misunderstandings about parental bereavement.The workplace reproduces a sociocultural world thatis highly ambivalent about death [90,91]. As such, theworkplace lacks the social tools to support the be-reaved in a way that acknowledges and affirms theirsuffering as a normal part of the human condition.

Bereavement leave needs to be re-framed such thatemployees who experience bereavement are not ex-cluded from the protection from vulnerability thatlabour standards should afford. There are creative waysto better support workers. Through contrasting empir-ical research with labour codes and standards, this pa-per recommends policy changes to both better supportbereaved parents as well as to educate the broader pub-lic about the needs of this population.

Acknowledgements

We would like to acknowledge funding throughthe Social Sciences and Humanities Research Coun-cil (Grant #410-2007-0709) and to thank Jen Scarbor-ough, MSW, for her research assistance and enthusi-asm.

References

[1] Dean M, McClement S, Bond J, Daeninck P, Nelson F.Parental experiences of adult child death from cancer. Journalof Palliative Medicine. 2005;8(4):751-65.

[2] Romanoff BD. When a child dies: special considerationsfor providing mental health counseling for bereaved parents.Journal of Mental Health Counseling. 1993;15(4):384-93.

[3] American Academy of Pediatrics Committee on Bioethicsand Committee on Hospital Care. Palliative care for children.Pediatrics. 2000;106(2 Pt 1):351-7.

[4] Arnold J, Buschman GP. The continuing process of parentalgrief. Death Studies. 2008;32:658–73.

[5] de Vries B, Dalla Lana R, Falick V. Parental bereavement overthe life course: a theoretical intersection and empirical review.Omega: Journal of Death and Dying. 1994;29(1):47-69.

[6] Cacace M, Williamson E. Grieving the death of an adult child.Journal of Gerontological Nursing. 1996;22(2):16-22.

[7] Klass D, Marwit SJ. Toward a model of parental grief. Omega:Journal of Death and Dying. 1989;19(1):31-50.

[8] Li J, Laursen TM, Precht DH, Olsen J, Mortensen PB. Hospi-talization for mental illness among parents after the death of achild. New England Journal of Medicine. 2005;352(12):1190-6.

[9] Rogers CF, Floyd FJ, Seltzer MM, Greenberg J, Hong J.Long-term effects of the death of a child on parents’ adjust-ment in midlife. J Fam Psychol. 2008;22(2):203-11.

[10] Lannen PK, Wolfe J, Prigerson HG, Onelov E, KreicbergsUC. Unresolved Grief in a national sample of bereaved par-ents: impaired mental and physical health 4 to 9 years later.Journal of Clinical Oncology. 2008;26(36):5870-6.

[11] Harper M, O’Connor RE, O’Carroll RC. Increased mortalityin parents bereaved in the first year of their child’s life. BMJSupportive & Palliative Care. 2011;1:306-9.

[12] Espinosa J, Evans W. Maternal bereavement: The heightenedmortality of mothers after the death of a child. Economics &Human Biology. 2012;online 22 June 2012.

[13] Li J, Precht DH, Mortensen PB, Olsen J. Mortality in par-ents after death of a child in Denmark: a nationwide follow-upstudy. The Lancet. 2003;361(9355):363-7.

[14] Folkman S. The case for positive emotions in the stress pro-cess. Anxiety, Stress & Coping: An International Journal.2008;21(1):3-14.

[15] Cadell S. Stress, coping, growth and spirituality in grief. In:Groen J, Coholic D, Graham J, editors. Spirituality in educa-tion and social work: an interdisciplinary dialogue. Kitchener,ON: Wilfrid Laurier University Press; 2012. p. 217-32.

[16] Cadell S, Kennedy K, Hemsworth D. Informing social workpractice through research with parent caregivers of a childwith a life-limiting illness. Journal of Social Work in End-of-Life & Palliative Care. 2012;8(4):356-81.

[17] Barrera M, O’Connor K, D’Agostino NM, Spencer L,Nicholas D, Jovcevska V, et al. Early parental adjustmentand bereavement after childhood cancer death. Death Studies.2009;33:497-520.

[18] Murphy SA, Das Gupta A, Cain KC, Johnson LC, Lohan J,Wu L, et al. Changes in parents’ mental distress after the vio-lent death of an adolescent or young adult child: a longitudinalprospective analysis. Death Studies. 1999;23(2):129-59.

[19] Wijngaards-de Meij L, Stroebe M, Schut H, Stroebe W, vanden Bout J, van der Heijden P, et al. Couples at risk fol-lowing the death of their child: predictors of grief versusdepression Journal of Consulting and Clinical Psychology.2005;73(4):617-23.

[20] Keesee NJ, Currier JM, Neimeyer RA. Predictors of grief fol-lowing the death of one’s child: the contribution of findingmeaning. Journal of Clinical Psychology. 2008;64(10):1145-63.

[21] Malkinson R, Bar-Tur L. The aging of grief in Israel: a per-spective of bereaved parents. Death Studies. 1999;23(5):413-31.

[22] Layne L. Motherhood lost: a feminist account of pregnancyloss in America. New York, NY: Routledge; 2002.

[23] Walter T. Grief narratives: The role of medicine in the policingof grief. Anthropology & Medicine. 2000;7(1):97-114.

[24] Fischhoff J, O’Brien N. After the child dies. Journal of Pedi-atrics. 1976;88(1):140-6.

[25] Human Resources and Skills Development Canada. Fairnessat work: federal labour standards for the 21st century. Ottawa:Government of Canada; 2006.

[26] Statistics Canada. Census families, number and average size.Ottawa: Government of Canada; 2012 [May 03, 2013]; Avail-able from: http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/famil40-eng.htm.

[27] Statistics Canada. Estimates of deaths, by sex and age group,Canada, provinces and territories. Ottawa: Government ofCanada; 2012 [May 03, 2013]; Available from: http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510002&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=.

[28] Dussel V, Bona K, Heath JA, Hilden JM, Weeks JC, Wolfe J.

AUTH

OR

COPY

M.E. Macdonald et al. / A critical discourse analysis of bereavement accommodation in Canadian labour standards 525

Unmeasured costs of a child’s death: perceived financial bur-den, work disruptions, and economic coping strategies usedby American and Australian families who lost children to can-cer. Journal of Clinical Oncology. 2011;29(8):1007-13.

[29] Corden A, Sloper P, Sainsbury R. Financial effects for fam-ilies after the death of a disabled or chronically ill child: aneglected dimension of bereavement. Child: Care, Health, &Development. 2002;28:199-204.

[30] Dockerty JD, Skegg DCG, Williams SM. Economic effects ofchildhood cancer on families. Journal of Paediatrics and ChildHealth. 2003;39(4):254-8.

[31] Human Resources and Skills Development Canada. Work andfamily provisions in Canadian collective agreements. Ottawa:Government of Canada; 2000.

[32] Shaw S, Greenhalgh T. Best research – for what? Besthealth – for whom? A critical exploration of primary care re-search using discourse analysis. Social Science & Medicine.2008;66(12):2506-19.

[33] Fuller S. The governance of science: ideology and the fu-ture of the open society. Buckingham: Open University Press;2000.

[34] Fischer F. Reframing public policy: Discursive politics anddeliberative practices. Oxford: Oxford University Press; 2003.

[35] Sanderson I. Complexity, ‘practical rationality,’ and evidence-based policy making. Policy & Politics. 2006;34(1):115-32.

[36] Fairclough N. Discourse and social change. Cambridge:Polity Press; 1992.

[37] Fairclough N. Critical discourse analysis. London: Longman;1995.

[38] van Dijk T. Principles of critical discourse analysis. Discourseand Society. 1993;4:249-83.

[39] Saint-Cyr Y. Bereavement leave. First Reference Inc.; 2007[cited May 01 2012]; Available from: http://www.hrinfodesk.com/preview.asp?article=23673.

[40] Human Resources and Skills Development Canada. Discus-sion paper on the review of labour standards in the CanadaLabour Code. Ottawa, ON: Government of Canada; 2009.

[41] Service Canada. Federal income support for parents of mur-dered or missing children grant – eBrochure. Ottawa: Gov-ernment of Canada; 2013 [cited February 05 2013]; Availablefrom: http://www.servicecanada.gc.ca/eng/sc/pmmc/ebrochure.shtml.

[42] Williams A, Crooks VA, Giesbrecht M, Dykeman S. Evalu-ating Canada’s compassionate care benefit: from the perspec-tive of family caregivers. Hamilton, ON: School of Geogra-phy and Earth Sciences, McMaster University. 2010.

[43] Chaussard M, Gerecke M, Heymann J. The work equityCanada index: where the provinces and territories stand Mon-treal, QC: McGill Institute for Health and Social Policy; 2008.

[44] European Foundation for the Improvement of Living andWorking Conditions. Reconciliation of work, private and fam-ily life in the European Union. Dublin, Ireland: EuropeanFoundation for the Improvement of Living and Working Con-ditions 2011.

[45] Jung L. National labour law profile. Federal Republic ofGermany: International Labour Organization; 2001 [citedAugust 14 2012]; Available from: http://www.ilo.org/ifpdial/information-resources/national-labour-law-profiles/kWCMS_158899/lang–en/index.htm.

[46] Petersen N, Muller A. National labour law profile. TheSwiss Confederation International Labour Organization;2007 [cited August 14 2012]; Available from: http://www.ilo.org/ifpdial/information-resources/national-labour-law-profiles/WCMS_158921/lang–en/index.htm.

[47] Citizens Information Board. Citizens information: leave andholidays. Dublin: Government of Ireland; 2012 [cited August28 2012]; Available from: http://www.citizensinformation.ie/en/employment/employment_rights_and_conditions/leave_and_holidays/.

[48] Human Resource Management in the Civil Service. Specialand other leave. Dublin, Ireland: Human Resource Manage-ment in the Civil Service; 2012 [cited August 30, 2012].

[49] U.S. Office of Personnel Management. Sick leave for familycare or bereavement purposes. Washington, DC: U.S. Officeof Personnel Management No date [cited August 14 2012];Available from: http://www.opm.gov/oca/leave/HTML/sickfam.asp.

[50] Society for Human Resource Management. Examining paidleave in the workplace. Alexandria, VA: Society for HumanResource Management 2008.

[51] U.S. Office of Personnel Management. Sick leave to care fora family member with a serious health condition. Washing-ton, DC: Office of Personnel Management; No date [citedAugust 14 2012]; Available from: http://www.opm.gov/OCA/LEAVE/HTML/12week.asp.

[52] Zopedol. Basic guide to family responsibility leave. Republicof South Africa: Department of Labour; 2012 [cited August14 2012]; Available from: http://www.labour.gov.za/responlegislation/acts/basic-guides/basic-guide-to-family-sibility-leave.

[53] Australian Government. Personal/carer’s leave and compas-sionate leave and the National Employment Standards. Fair-work Ombudsman; 2011.

[54] New Zealand. Holidays and leave. New Zealand: Ministry ofBusiness, Innovation, and Employment; 2012.

[55] Williams A, Eby J, Crooks V, Stajduhar K, Giesbrecht M,Vuksan M, et al. Canada’s compassionate care benefit: is itan adequate public health response to addressing the issueof caregiver burden in end-of-life care? BMC Public Health.2011;11(1):335.

[56] U.S. Office of Personnel Management. Fact Sheet: Voluntaryleave transfer program. Washington, DC: U.S. Office of Per-sonnel Management No date [cited February 6 2012]; Avail-able from: http://www.opm.gov/policy-data-oversight/pay-leave/leave-administration/fact-sheets/voluntary-leave-transfer-program/.

[57] Tyler K. Coping with grief. HR Magazine. 2003;48(9):66-73.[58] Boeving CA. Adjustment to Childhood Chronic Illness: Pre-

diction of Psychological Adjustment with an Investigationinto Spiritual Coping. 2000.

[59] The Grief Recovery Institute Educational Foundation. GriefIndex: the “hidden” annual costs of grief in America’s work-place, 2003 Report. Sherman Oaks, CA: Grief Recovery In-stitute Educational Foundation, Inc.; 2003.

[60] Fast J, Niehaus L, Eales J, Keating N. A profile of Canadianchronic care providers. Edmonton, AB: Research on Aging,Policies and Practice, Department of Human Ecology Univer-sity of Alberta 2002.

[61] Bacon J. Hospice palliative home care in Canada: A progressreport. Ottawa, ON: Quality End-of-Life Care Coalition ofCanada; 2008.

[62] Stajduhar KI, Allan DE, Cohen SR, Heyland DK. Short Re-port: Preferences for location of death of seriously ill hospi-talized patients: Perspectives from Canadian patients and theirfamily caregivers. Palliative Medicine. 2008;22(1):85-8.

[63] Williams A. Evaluating Canada’s compassionate care bene-fit using a utilization-focused evaluation framework: success-

AUTH

OR

COPY

526 M.E. Macdonald et al. / A critical discourse analysis of bereavement accommodation in Canadian labour standards

ful strategies and prerequisite conditions. Evaluation and Pro-gram Planning. 2010;33(2):91-7.

[64] Cadell S, Johnston M, Bosma H, Wainwright W. An overviewof contemporary social work practice. Progress in Pallia-tive Care, Special Edition on Social Work in Palliative Care.2012;18(4):205-11.

[65] Irving J, Dobkin P, Park J. Cultivating mindfulness in healthcare professionals: a review of studies of mindfulness-basedstress reduction. Complementary Therapies in Clinical Prac-tice. 2009;15:61-6.

[66] Bevans M, Sternberg E. Caregiving burden, stress, and healtheffects among family caregivers of adult cancer patients.JAMA. 2012;307(4):398-403.

[67] Hamilton N, Bhatti T. Population health promotion: An inte-grated model of population health and health promotion. Ot-tawa, ON: Health Canada; 1996.

[68] Schneider A, Ingram H. Social construction of target popula-tions: implications for politics and policy. American PoliticalScience Review. 1993;87(2):334-47.

[69] Mitchell L, Stephenson P, Cadell S, Macdonald M. Death andgrief on-line: virtual memorialization and changing conceptsof childhood death and parental bereavement on the Internet.Health Sociology Review. 2013;21(4):413-31.

[70] Flagler J, Weizhen Dong. The uncompassionate elements ofthe Compassionate Care Benefits Program: A critical analysis.Global Health Promotion. 2010 March 1, 2010;17(1):50-9.

[71] Driedger D, Owen M. Introduction. In: Driedger D, Owen M,editors. Dissonant disabilities: women with chronic illness ex-plore their lives. Toronto, ON: Women’s Press; 2008. p. 1-13.

[72] Tyler K. Giving time to grieve: When an employee losesa loved one, be prepared to offer time off. HR Magazine.1999;44(12):66-73.

[73] Wendell S. The rejected body: feminist philosophical reflec-tions on disability. New York, NY: Routledge; 1996.

[74] Rebeiro-Gruhl KL, Laporte R. “I’m still swimming”. Work:A Journal of Prevention, Assessment and Rehabilitation.2008;30(3):323-8.

[75] Antao L, Shaw L, Ollson K, Reen K, To F, Bossers A, et al.Chronic pain in episodic illness and its influence on work oc-cupations: A scoping review. Work: A Journal of Prevention,Assessment and Rehabilitation. 2013;44(1):11-36.

[76] Lysaght RM, Larmour-Trode S. An exploration of socialsupport as a factor in the return-to-work process. Work:A Journal of Prevention, Assessment and Rehabilitation.2008;30(3):255-66.

[77] Wallstedt-Paulsson E, Eklund M. Outcome of work rehabilita-tion for people with various disabilities and stability at a one-year follow-up. Work: A Journal of Prevention, Assessmentand Rehabilitation. 2008;31(4):473-81.

[78] Kendler KS, Myers J, Zisook S. Does bereavement-relatedmajor depression differ from major depression associatedwith other stressful life events? Am J Psychiatry. 2008;165(11):1449-55.

[79] Wakefield J, First M. Validity of the bereavement exclusionto major depression: does the empirical evidence support theproposal to eliminate the exclusion in DSM-5? World Psychi-atry. 2012;11(1):3-10.

[80] Canadian Hospice Palliative Care Association and CanadianNetwork of Palliative Care for Children. Pediatric hospice pal-liative care: guiding principles and norms of practice. Ottawa:Canadian Hospice Palliative Care Association 2006.

[81] Cadell S, Shermak S, Johnston M. Discovering strengths andgrowth in palliative care. In: Altilio T, Otis-Green S, editors.Oxford Textbook of Palliative Social Work. Oxford: OxfordUniversity Press; 2011. p. 215-22.

[82] Silverman P. Charter for the normalization of dying, death andloss. Omega. 2004-2005;50(4):331-6.

[83] Clark EJ. The end of the continuum: bereavement care for theadult. Cancer Practice. 1997;5:252-4.

[84] British Columbia Hospice Palliative Care Association. Aguide to hospice volunteer training in British Columbia:British Columbia Hospice Palliative Care Association; 2008.

[85] Gewurtz R, Kirsh B. Disruption, disbelief and resistance:A meta-synthesis of disability in the workplace. Work: AJournal of Prevention, Assessment and Rehabilitation. 2009;34(1):33-44.

[86] Rosenfeld M, Hay C. Managing chronic pain and return towork in the “real world”: A case study. Work: A Journal ofPrevention, Assessment and Rehabilitation. 2008;30(3):317-21.

[87] Shaw L, Sumsion T. There is so much more to do: Strategiesand research needs to support work transitions for personswith chronic mental health conditions. Work: A Journal ofPrevention, Assessment and Rehabilitation. 2009;33(4):377-9.

[88] Brabant S, Forsyth C, McFarlain G. The impact of the deathof a child on meaning and purpose in life. Journal of Personaland Interpersonal Loss. 1997;2(3):255-66.

[89] Bereaved Families of Ontario. Frequently asked questions.Toronto: Bereaved Families of Ontario, Hamilton/Peel Re-gion; 2011 [cited August 29 2012]; Available from: http://www.bereavedfamilies.ca/faqs.htm.

[90] Aries P. The hour of our death. New York: Alfred A. Knopf;1981.

[91] Seale C. Constructing death: the sociology of dying andbereavement. Cambridge, UK: Cambridge University Press;1998.

AUTH

OR

COPY