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What Death Means Now: Thinking Critically about Dying and Grieving
Though death is universal, how we respond to it depends on when and where we live. Dying and grieving continually new preparations for dying, new kinds of funerals, new ways of handling grief and new ways to memorialise are developing all the time. Bringing 25 years of research and teaching in the sociology of death and dying to this important book, Tony Walter engages critically with key questions such should we talk about death more and plan in advance? How effective is this as more people suffer frailty and dementia? How do physical migration and digital connection affect place-bound deathbeds, funerals and graves? Is the traditional funeral still relevant? Can burial and cremation be ecological? And how should we quietly, openly, or online?
136 pages, Paperback
Published September 23, 2017
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Displaying 1 - 3 of 3 reviews
February 6, 2018
Tony Walter is a sociologist with a specialist interest in death and dying and all that goes with them, and this short simple book is a useful summary of what evidence from social science tells us about the subjects. He explodes myths, particularly the myth that death is denied. He accept that death is hidden, unseen by most people except on rare occasions, but he goes as far as to argue that through social media death is becoming pervasive again. Somewhat scornful of what he calls “death entrepreneurs” and the “death awareness movement,” he doesn’t believe that talking about death in any way softens its blow. Indeed, like most people who study death he reaches the conclusion that it cannot be tamed.
He does accept, however, that we are now dying differently from the past and that we need a new art of dying. To that end, talk is good.
I took a good many quotes from the book. The idea that fascinated me the most was that the fact that euthanasia is allowed in the Netherlands makes talking about death much easier, although I wonder about reverse causation--or simple confounding.
Introduction
Death’s contemporary challenges have prompted a raft of what, drawing on the sociological concept of moral entrepreneur, might be termed ‘death entrepreneurs’ – individuals and movements promoting new and, in their view, psychologically healthier and more natural ways to die, funeralise and grieve.
Death entrepreneurs typically urge us to take control of our deaths, to make choices, to express our feelings and to de-medicalise death.
Halpern (2015, 2001) recently observed that ‘no current policy or practice designed to improve care for millions of dying Americans is backed by a fraction of the evidence that the Food and Drug Administration would require to approve even a relatively innocuous drug’. This book, rather than signing up uncritically to the tenets of the death awareness movement, aims to promote critical thinking – to be a loyal critic of the movement.
There was no golden age when every member of society faced death and loss with equanimity; nor will there be.
What’s the problem?
David Clark and colleagues (2017) estimate that global annual deaths, currently around 56 million, will reach an all-time high of around 90 million by the middle of the twenty-first century before going down later in the century.
Managing dying, dead bodies and grief is therefore a major twenty-first century issue
Today, by contrast, humans typically live for months, years or even decades with a disease or diseases that may or will eventually kill them, requiring what Lofland (1978) has called a new craft of dying
As French historian Philippe Ariès (1981) puts it, modern people are largely unfamiliar with death. They have therefore handed knowledge about dying over to healthcare professionals. In sociological language, death has been medicalised.
Poll almost any group of westerners today about what they most fear about death, and losing an intimate will trump fear of one’s own death.
‘Number our days, that our hearts may incline to wisdom.’ Psalm 90
Good to talk?
A better reason to talk is the first one listed in this chapter – what death means now is not what it meant a generation or two ago, so humans need together to develop new crafts of dying and mourning.
American anthropologist Frances Norwood (2009) conducted a valuable ethnography in which she attended Dutch GPs’ home visits to dying patients. She found that in the Netherlands euthanasia is more often a process of talking than of killing. Of the terminally ill who initiate and continue a conversation with their doctor about wanting euthanasia if things get too bad, only a small minority actually go through with it. And among those who are not terminally ill, talking to friends, family and doctors about the circumstances in which one might wish for euthanasia is a normal part of conversation in the Netherlands; it provides Dutch people with a language for talking about their values, standards, loves and loyalties.
The contrast with the UK could not be more striking. A Dutch doctoral student who came to my university to research elderly Britons’ feelings about home as they neared the end of life was surprised to find how talking about when to die, taken for granted in Dutch society, rarely if ever occurred in her conversations with elderly Britons. She herself came to feel awkward talking about something which she had taken for granted before coming to Britain (Visser, 2017, 8–9). More formally, palliative care professionals and initiatives such as Dying Matters encourage people to talk to their family and doctor about where they want to die, and dying in the documented ‘preferred place of care’ is increasingly used as an index of a good death. These initiatives do not encourage people to talk about when they want to die, as this raises the issue of euthanasia, which in the UK is illegal.
A better way to die?
Frailty and dementia are – to use Gilleard and Higgs’ striking analogy (2010) – black holes from which little or no ‘light’ emanates.
Drawing on Tronto’s (1994) four elements of care – attentiveness, responsibility, competence and responsiveness – and refusing to restrict love to the private sphere, Dutch healthcare unions do have a term: professional loving care (van Heijst, 2011).
Authority in dying and mourning has shifted from family/religion, to medicine, to the individual
What are professionals good at?
Sociologist Michael Young, one of the architects of the post-war British welfare state and doyen of community studies, toward the end of his long life interviewed people dying of cancer in London’s East End. He concluded: ‘Death is the common experience which can make all members of the human race feel their common bonds and their common humanity’ (Young and Cullen, 1996, 201).
How to mourn?
Mental health should not be allowed to define good grief, any more than medical expertise should define a good death.
Pervasive death
Social media return death and loss to centre stage.
He does accept, however, that we are now dying differently from the past and that we need a new art of dying. To that end, talk is good.
I took a good many quotes from the book. The idea that fascinated me the most was that the fact that euthanasia is allowed in the Netherlands makes talking about death much easier, although I wonder about reverse causation--or simple confounding.
Introduction
Death’s contemporary challenges have prompted a raft of what, drawing on the sociological concept of moral entrepreneur, might be termed ‘death entrepreneurs’ – individuals and movements promoting new and, in their view, psychologically healthier and more natural ways to die, funeralise and grieve.
Death entrepreneurs typically urge us to take control of our deaths, to make choices, to express our feelings and to de-medicalise death.
Halpern (2015, 2001) recently observed that ‘no current policy or practice designed to improve care for millions of dying Americans is backed by a fraction of the evidence that the Food and Drug Administration would require to approve even a relatively innocuous drug’. This book, rather than signing up uncritically to the tenets of the death awareness movement, aims to promote critical thinking – to be a loyal critic of the movement.
There was no golden age when every member of society faced death and loss with equanimity; nor will there be.
What’s the problem?
David Clark and colleagues (2017) estimate that global annual deaths, currently around 56 million, will reach an all-time high of around 90 million by the middle of the twenty-first century before going down later in the century.
Managing dying, dead bodies and grief is therefore a major twenty-first century issue
Today, by contrast, humans typically live for months, years or even decades with a disease or diseases that may or will eventually kill them, requiring what Lofland (1978) has called a new craft of dying
As French historian Philippe Ariès (1981) puts it, modern people are largely unfamiliar with death. They have therefore handed knowledge about dying over to healthcare professionals. In sociological language, death has been medicalised.
Poll almost any group of westerners today about what they most fear about death, and losing an intimate will trump fear of one’s own death.
‘Number our days, that our hearts may incline to wisdom.’ Psalm 90
Good to talk?
A better reason to talk is the first one listed in this chapter – what death means now is not what it meant a generation or two ago, so humans need together to develop new crafts of dying and mourning.
American anthropologist Frances Norwood (2009) conducted a valuable ethnography in which she attended Dutch GPs’ home visits to dying patients. She found that in the Netherlands euthanasia is more often a process of talking than of killing. Of the terminally ill who initiate and continue a conversation with their doctor about wanting euthanasia if things get too bad, only a small minority actually go through with it. And among those who are not terminally ill, talking to friends, family and doctors about the circumstances in which one might wish for euthanasia is a normal part of conversation in the Netherlands; it provides Dutch people with a language for talking about their values, standards, loves and loyalties.
The contrast with the UK could not be more striking. A Dutch doctoral student who came to my university to research elderly Britons’ feelings about home as they neared the end of life was surprised to find how talking about when to die, taken for granted in Dutch society, rarely if ever occurred in her conversations with elderly Britons. She herself came to feel awkward talking about something which she had taken for granted before coming to Britain (Visser, 2017, 8–9). More formally, palliative care professionals and initiatives such as Dying Matters encourage people to talk to their family and doctor about where they want to die, and dying in the documented ‘preferred place of care’ is increasingly used as an index of a good death. These initiatives do not encourage people to talk about when they want to die, as this raises the issue of euthanasia, which in the UK is illegal.
A better way to die?
Frailty and dementia are – to use Gilleard and Higgs’ striking analogy (2010) – black holes from which little or no ‘light’ emanates.
Drawing on Tronto’s (1994) four elements of care – attentiveness, responsibility, competence and responsiveness – and refusing to restrict love to the private sphere, Dutch healthcare unions do have a term: professional loving care (van Heijst, 2011).
Authority in dying and mourning has shifted from family/religion, to medicine, to the individual
What are professionals good at?
Sociologist Michael Young, one of the architects of the post-war British welfare state and doyen of community studies, toward the end of his long life interviewed people dying of cancer in London’s East End. He concluded: ‘Death is the common experience which can make all members of the human race feel their common bonds and their common humanity’ (Young and Cullen, 1996, 201).
How to mourn?
Mental health should not be allowed to define good grief, any more than medical expertise should define a good death.
Pervasive death
Social media return death and loss to centre stage.
June 2, 2022
Small, quickly-reading but punchy book, describing the issues of death, dying, funerals and such in a Western society (often that of the UK). Useful across disciplines and provoking thought, only some of it properly grim.
October 9, 2019
An interesting book that I really enjoyed. I did however find Caroline Lloyd's 'Grief Demystified: An Introduction' the most helpful and relevant book I've read so far on this subject.
Displaying 1 - 3 of 3 reviews