Have we forgotten how to die?

In a review of seven books on death and dying, Julie-Marie Strange writes:

James Turner was twenty-five when his four-year-old daughter Annice died from a lung condition. She died at home with her parents and grandmother; her sleeping siblings were told of her death the next morning. James did everything to soothe Annice’s last days but, never having encountered death before, he didn’t immediately recognize it. He didn’t know what to do or expect and found it hard to discuss things with his wife Martha. The family received many condolences but kept the funeral private. Losing a child, often described as the hardest bereavement to bear, changed James Turner forever.

Death in the twenty-first century is typified by the paradox contained in this story. Although we greedily consume death at a distance through fiction, drama and the media, we are hamstrung by it up close and personal. In 1955 the commentator Geoffrey Gorer declared that death had become more pornographic than sex. It was, he said, the new taboo and mourning had become “indecent”. Since then, matters have arguably got worse. The decline in institutional Christianity left a spiritual and existential vacuum, while the rise in individual materialism has fragmented family networks and communities. Shared rites of passage that publicly validated grief have receded, and the space of death has moved increasingly from the home to the hospital.

Focusing on the US and, to a lesser extent, Northern Europe, Haider Warraich’s Modern Death: How medicine changed the end of life identifies how far-reaching these changes are. A physician and clinical researcher, Warraich is well placed to observe the dubious implications of an expanded medicalization of death. Most people want to die at home, but the majority continue to die in hospital, surrounded by medical equipment. In general, life expectancy in the past century has increased, but so has the use of medicine to prolong it artificially. Definitions of death have grown more complicated – does it lie in brain function or in the heart and lungs? – and are openly contested. And despite what Warraich calls medicine’s “obsession” with preventing or delaying death, there is no clear provision for bereaved families. That task waits to be taken up. Kathryn Mannix agrees in With the End in Mind: Dying, death and wisdom in an age of denial, suggesting that it “has become taboo to mention dying”. Through a “gradual tran­sition”, Mannix says, we have lost the vocab­ulary for talking about death and depend instead on euphemism, lies and ambiguity; she wants us to “reclaim” a language of death.

This is a recurring theme among these seven books. For some, our inability to talk straight about death and dying is partly about the mystery of the end. Andrew Stark, in The Consolations of Mortality: Making sense of death, identifies the decline in religion in the West and the idea of the afterlife as pivotal to our lack of confidence in confronting death. Robert McCrum, in Every Third Thought: On life, death and the endgame, speculates that ageing and death present a particular conundrum to self-assured baby boomers, who try to give death the slip (“let’s talk about it another time . . .”). In From Here to Eternity: Travelling the world to find the good death, Caitlin Doughty expands the problem into a generic Western culture of death “avoidance” – we duck awkward conversations with the dying, hand our corpses to corporate professionals and, worst of all, treat grief with embarrassment and shame. Kevin Toolis, in My Father’s Wake: How the Irish teach us to live, love and die, describes a veritable “Western Death Machine”, in which public services, health professionals, the media and corporate bodies all conspire towards the removal of death and dying from the purview of ordinary people. A former war correspondent, Toolis has seen more than his fair share of death and is here to shake us out of our complacency. [Continue reading…]

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