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Outline
I. Introduction
II. The Past and Present in Thanatology
A. The Popularity of Death Studies
B. The Future
III. The Aging of America
I. Introduction
Death and attendant matters have been seminal topics of reflection, disputatious debate, and other modes of social discourse since the dawn of civilization and, presumably, also among the people who predate civilization.
Over the centuries, scholars of many stripes have spoken to the matter of death and documented their musings. Philosophers have pondered the meaning of life and death. Theologians have posited notions and persuasions with regard to eschatological scenarios. Historians have documented myriad configurations of death-related behavior from the past. Poets and novelists have waxed eloquently on their conceptualizations of death and dying. Archeologists have discovered ancient ruins and artifacts and interpreted the meanings of such discoveries with concern for the patterns of life and death among ancient peoples. Scientists and medical doctors have probed the physiological dimensions of life and death. Missionaries have reported unfamiliar patterns of death-related behavior and beliefs of the exotic people with whom they have lived and to whom they have ministered. More recently, anthropologists have observed and analyzed death-related values, rituals, and ceremonies of the preliterate and folk groups they study.
Thus, by the twentieth century, an enormous body of literature, information, and knowledge focusing on death and dying, and related matters from many intellectual and academic perspectives, had accumulated. Curiously missing from this corpus of knowledge was any significant contributions from the academic disciplines of psychology and sociology, although it is true that Freud (whose life and career spanned the nineteenth and twentieth centuries) had spoken of topics such as the difference between mourning and melancholia and the process of dealing with death (Freud [1917] 1959). Mourning is the normal process that attends the grief experienced when a loved one dies. Melancholia is the malady that attends depression. He also discussed the notion of the human belief in personal immortality. In effect, Freud ([1913] 1954) posited that we could not experience anxiety about our own death and observed that “our own death is indeed quite unimaginable . . . at bottom nobody believes in his own death . . . [and] in the unconscious everyone of us is convinced of his own immortality” (p. 304).
On the sociological side, Emile Durkheim, the early French sociologist, conducted extensive research on suicide rates and how they were related to different aspects of social solidarity. He published the results of his research on suicide at the turn of the century, and his monograph (1951) became a classic over time.
II. The Past and Present in Thanatology
It is challenging to relate the historical development of the sociology of death and dying because the study of death has been so interdisciplinary that it is difficult to disentangle the many strands of research and scholarship from the different disciplines that have addressed the social dimensions of death and dying.
Because of the complex blend of interdisciplinary social science research and scholarship that has made up the corpus of knowledge in the study of death and dying, some writers have been more prone to use somewhat more generic labels than the sociology of death, the psychology of death, and so on. Some have grouped the literature on this topic into the more general topic of “death education” (Pine 1977), while others have spoken on the subject of the “death awareness movement” (Doka 2003). In the case of the former, Pine (1977) reflects that “Death Education as an academic discipline [italics added] is a fairly recent phenomenon, dating from the early 1960’s” (p. 57).
This label refers to the interest in death and dying that arose among social science scholars in the mid- to late 1950s and the 1960s, which led to the development of college courses in various disciplinary departments that address various aspects of death and dying; the inauguration of several scientific journals focusing on the topic; the convening of conferences and workshops; and the publishing of textbooks, monographs, and anthologies on the subject of death and dying.
The label death awareness movement refers to the reawakening of scholarly (and public) interest in death and dying after a half-century hiatus during the “death denial” period. Of this renewal of interest, Doka (2003) observes,
The term death awareness movement refers to a somewhat amorphous yet interconnected network of individuals, organizations, and groups. . . . The individuals and groups involved in this amorphous and far-reaching network—in reality a social movement—share a common focus (although not necessarily common goals, models or methods); that focus is dying, death, and bereavement. (P. 50)
Many scholars who address death and dying simply use the generic label of “thanatology” to refer to the extensive interdisciplinary, intertwined, and often fugitive literature, as well as the various research theoretical and methodological perspectives and strategies used in the examination of the social dimensions of death, dying, and bereavement.
During the first two decades of the twentieth century, social science literature was silent on the topic, save, perhaps, some anthropological literature that focused on the customs and behavior of some preliterate and folk cultures, including their funeral practices (see, e.g., Frazer 1913; Rivers [1911] 1926; Tylor 1926; Malinowski 1938).
By the 1920s, social science scholars were beginning to develop a modest interest in the topics of death and dying. Vanderlyn R. Pine (1977:59–60), in his very definitive and meticulous exposition on the sociohistorical development of death education, reports that there were a handful of social science books and articles that appeared during the 1920s and 1930s. In his elaborate exposition, Pine specifically mentions Gebhart’s (1928) critical analysis of the American funeral and the undertaker. His essential focus was on the cost of funerals, which he believed to be excessively high. Interestingly, this criticism of the high cost of funerals has continued to be a topic of scholarly discourse for more than 70 years. The focus on the funeral director, the funeral home, and the social dynamics of the funeral has been one of the major strands of research until today.
Pine (1977:59) also mentions the research work of Thomas D. Eliot, a sociologist, who focused his attention on grief and bereavement (1930a, 1930b, 1933). This focus on grief and bereavement has also become a major research strand in the social sciences. Pine (1977:60), in his comprehensive treatment of the topic, also mentions two other pieces of death-related scholarship that appeared in the 1940s. He mentions The Child’s Discovery of Death authored by Sylvia Anthony (1940). Anthony’s book called attention to the awareness of death experiences by children. The concern with the awareness of death became an important strand of research in later years. Pine (1977:60) additionally discussed the importance of the work of the psychiatrist Erich Lindemann, who published an article in 1944 that focused on the topic of acute grief and how it could be managed. Lindemann posited the notion that grief was normal and that it could be resolved. His research was based on the survivors of the Coconut Grove disastrous fire in Boston in 1942, in which 490 persons died (Doka 2003:51).
After upward of a half-century of cultural avoidance of the subject of death and dying in the United States, the human toll of World War II could not be ignored or hidden. Several of the countries involved in World War II, such as Russia and Germany, suffered enormous losses in both military and civilian populations. Rosenberg and Peck (2003:224) report that during World War II, there were 20 million military deaths and 30 million civilian deaths. Firebomb air raids such as those that destroyed Hamburg and Dresden in Germany and the atomic bomb raids of Hiroshima and Nagasaki in Japan took the lives of more than 100,000 civilians per bombing raid. The specter of the atomic bomb with the capability of killing millions could not be erased from our minds, and death was again a seminal preoccupation of the population (see Lifton 1963; Pine 1977:63; Doka 1983:41–42). With television, the public could have immediate access to wars, natural disasters, and accidents and the megadeaths that accompanied such events. It was inevitable that death would again emerge as a topic of public and private discourse and academic and scientific scrutiny.
This reawakening of interest in death became known as the death awareness movement (Doka 2003:50). Component to this movement were scholarly efforts to explore, examine, and analyze the social dimensions of death and dying. Although the movement got under way with some momentum in the 1950s, the precise origin of the emergent, large-scale scholarly interest in death is subject to disputatious debate. Doka (2003:50) suggests that the movement originated at a symposium arranged by Herman Feifel at the 1956 American Psychological Association convention. A group of scholars interested in the field of death and dying participated in the symposium. Doka describes this event as follows:
As a social movement, the death awareness movement had considerable success in the last half of the 20th century. From a small gathering of scholars at a 1956 professional meeting, thousands of college-level courses on the topics of death and dying are now offered. (P. 50)
Pine (1977:60), however, notes that the sociologist William M. Kephart published the first empirical, sociological study of death in 1950, examining the question of status after death. The reawakening of interest in death at a national level, however, may well have started a few years earlier with a fictional narrative. In 1948, Evelyn Waugh’s (Evelyn Waugh was the author’s pen name; his full name was Evelyn Arthur St. John Waugh) scathing and satirical novella The Loved One was published. This book was about a lavish and ostentatious cemetery (a thinly disguised Forest Lawn Cemetery), a pet cemetery, and the morbid activities of some of the people who worked at both. It was a national hit and very popular reading on many college campuses.
This novel demonstrated that death had a humorous (even if doleful) aspect. It demonstrated that one could laugh at death and be entertained by it. If the public could respond in a positive fashion to a satirically humorous novel about death (and the public did), then death could once again be a topic of public, and subsequently scholarly, interest. Robert W. Habenstein’s (1949) early scholarly effort, his master’s thesis, A Sociological Study of the Cremation Movement in the United States, was defended at the University of Chicago in 1949. It would appear that Habenstein’s scholarly attention to the topic of death and dying actually preceded Kephart’s research.
Further sociological interest in death and dying was demonstrated by Habenstein’s (1955) doctoral dissertation, The American Funeral Director: A Study in The Sociology of Work, at the University of Chicago. It is interesting to note that, as the title implies, Habenstein apparently considered his research on funeral directors to be more research in the sociology of work than research on death and dying. In the same year, Habenstein and William M. Lamers (1955) published The History of American Funeral Directing. They followed this book with a second book, Funeral Customs the World Over, in 1960. The first book was rich in historical detail, and the second was an extensive cross-cultural survey. No doubt a number of scholars in the area of death and dying became involved in research on this topic through an original interest and research in the sociology of work and occupational sociology.
At about this time, a number of scholarly publications on death and dying appeared that provided some significant momentum to the death awareness movement. In 1955, a British social anthropologist, Geoffrey Gorer, authored an entry in a book that he edited. Gorer discussed modern society’s cultural tendency to deny or ignore death and explored the background factors that gave impetus to this tendency (Doka 2003:51). In 1965, Gorer’s book was reprinted and became one of the seminal works in the study of death and dying.
In 1959, the American sociologist LeRoy Bowman published The American Funeral. Bowman’s book was very critical of what he perceived as the excessively high cost of funerals, the overly extravagant funeral practices, and the funeral industry. This book was not widely cited at that time or even today and has not been very influential in academic circles since then, but it has, however, provided a jaundiced template for various books subsequently published that were also very critical of, if not hostile to, American funeral practices, the high cost of funerals, and the funeral industry.
Pine (1977:63) makes mention of a similarly critical book, The High Cost of Dying (Harmer 1963), which had an extremely negative perception of the high cost of American funerals. This book may well have been something of a product of Bowman’s book. This book was also not very influential in academic circles.
In the same year, a trade book, The American Way of Death, authored by Jessica Mitford (1963), had a sensational impact on the American public and became an overnight bestseller. The book essentially covered the same criticisms related in Bowman’s earlier book, but in a more journalistic and jaundiced fashion. Doka (2003:51) speaks of Mitford’s work as being from “the muckraking tradition.” Mitford’s book was not only a national bestseller, its theme was also very influential. Doka (2003:51), for example, asserts that the later interest in memorial societies and the possibility of less expensive arrangements for the funeralization of a deceased loved one was spawned by Mitford’s book. As Doka (2003) details this impetus,
The American Way of Death also generated interest in memorial societies and led to the development of local associations that would offer or arrange for members to receive dignified funeral services at reasonable cost, sometimes in conjunction with specified funeral service firms. This movement represented an early attempt on the part of Americans to organize collectively around areas related to dying and death and to gain a sense of control over the process. (P. 51)
As Doka (2003:51) also points out, Mitford’s book and the popular interest in death and dying, and most especially the high cost of funerals, generated governmental interest in the cost and pricing practices associated with funeralization. The Federal Trade Commission (FTC) began to examine these matters, and in 1984, the FTC required that all funeral homes in the United States “itemize their fees and that consumers can have access to pricing information over the phone” (Leming and Dickinson 2006:397).
One widely cited work on death and dying is the psychologist Herman Feifel’s (1959) edited book The Meaning of Death. In this collection of essays, a number of seminal dimensions of death and dying, such as the dying patient, suicide, the fear of death, modern art and death, death and religion, children’s view of death, and various essays on philosophy and death, to mention but a few, were explored. A number of contemporary scholars, such as Pine (1977) and Doka (2003), consider Feifel’s anthology to be one of the more influential scholarly works of the time. Doka, for example, asserts that “this book clearly established death studies as an academic discipline and offered scholars clear evidence of the wide range of issues encompassed by the study of death and dying” (p. 51).
In a similar, very positive assessment of Feifel’s edited work, Pine (1977:62) observes that most authorities agree that it was the most important single work that familiarized the scholarly community with the issues and concerns of dying and death. Moreover, it provided a landmark of legitimacy for the newly emerging field.
It is curious that the emergence of the death awareness movement and the scholarly examination of death and dying by social scientists have been attributed in large measure to Feifel’s edited book, inasmuch as other books and articles on death and dying had been previously published. These previous publications, however, did have a disciplinary perspective, such as psychological or sociological. Feifel’s book contained essays that addressed a variety of issues related to death and dying and featured authors from a number of disciplines, including the humanities as well as the behavioral sciences, and provided an interdisciplinary perspective.
In 1958, various sociological scholars began to come to the forefront with consciousness-raising publications that gave momentum to the sociological examination of death and dying and also attempted to legitimate it as a compelling area of research. Particularly notable in this endeavor were William Faunce and Robert Fulton (1958), who published their provocative article “The Sociology of Death: A Neglected Area of Research.” While recognizing the contributions of earlier scholars such as Eliot (1930a, 1930b, 1933) and Kephart (1950), Faunce and Fulton presented and discussed a number of death-related social behaviors and the attendant “rich research possibilities,” as they phrased it. Certainly, their article generated a much wider range of interest among sociologists, inasmuch as articles and books concerning death-related issues were subsequently published in the years following.
The study of death and dying, however, continued as an interdisciplinary effort, and does so today. In this regard, in May 1963, the journal The American Behavioral Scientist published a special issue, “Social Research and Life Insurance” (Riley 1963). The articles focusing on social research mostly dealt with death and dying, and certainly the topic of life insurance. Contributors to this issue included individuals from the life insurance industry and authors from several of the social sciences, including some prominent sociologists. Some of the sociological notables were Robert K. Merton, Talcott Parsons, Kingsley Davis, and Matilda White Riley. Parson’s (1963) article in this special issue, “Death in American Society: A Brief Working Paper,” took issue with the axiom that American society is a death-denying culture and posited several societal postures toward death that suggested more an effort toward handling or controlling death than denial.
Pine (1977:64) indicates that Fulton went on to offer the first course at an American University on death and dying at Minnesota in 1963. It has been reported, however, that John D. Morgan, an academic philosopher, may have been the first person to offer a course on death and dying at a Canadian university at or about the same time, if not earlier. If that is the case, Morgan then was the first to offer such a course in North America.
Other milestones in the sociology of death and dying occurred in the mid- to late 1960s. Fulton (1965) followed up his article with an edited book titled Death and Identity. The book was multidisciplinary in its focus, and Fulton drew on scholars from many disciplines and backgrounds. Pine (1977) describes the anthology as “a collection of some of the finest essays available at that time” (p. 64). He went on to say, “It also included the most extensive bibliography on death ever assembled.”
In the same year, sociologists Barney Glaser and Anselm Strauss (1965) published their book Awareness of Dying. Their work focused on the social process of dying and, in this instance, dying in the hospital. These two researchers examined the meaning of death in the hospital and the interaction between and among patients, medical staff, and family members as a social process. In 1968, Glaser and Strauss followed their first book with another, Time for Dying (actually the third monograph in a series of four based on their research over a period of six years). In this book, Glaser and Strauss conceptualized the notion of death as having a “trajectory of dying,” by which they referred to the patient’s course or pattern of dying. Their book explores how the patterns of dying temporality affect and interact with medical staff and family and the social interpretation and meaning of various trajectories of death. Another significant publication in this period was Passing On: The Social Organization of Dying (Sudnow 1967). This book also examines the context of institutionalized dying “and the social organization of hospital care and the dying patient” (Pine 1977:66).
In 1966, Pine first offered an interdisciplinary course titled “Death” at Dartmouth College (Pine 1977:65). Three other publications on death in the late 1960s deserve mention. Robert Blauner (1966) published an article “Death and Social Structure” in the journal Psychiatry. Basically, Blauner posited that death has a disruptive effect on the social enterprise in terms of social relationships. Accordingly, society shapes social structure to constrain and contain the disruptive effects of death. One example of his hypothesis would be that of society reducing the importance of those who die by devaluating the social worth of the elderly, thereby diluting or mitigating the disruptive effects of death.
Perhaps a scholarly milestone in the development of the social study of death and dying was the book On Death and Dying by Dr. Elisabeth Kubler-Ross (1969), a psychiatrist. Dr. Kubler-Ross articulated five sociopsychological stages of dying and suggested that terminally ill patients move through these stages as the terminal illness progressed. Ultimately, the patient achieves the fifth and final stage, that of acceptance, at which point he or she can face death with equanimity and serenity. Kubler-Ross’s book and her other writings are among the most widely cited publications in the field of thanatology. Her theory of the five stages of dying is today a component of the curricula of many specialties, such as medicine, nursing, psychiatry, and several of the behavioral sciences. In speaking of Kubler-Ross, Doka (2003) observes that “her message was one that rejected dehumanizing technology, embraced a normal death, and saw opportunities for growth even at the end of life—all of which resonated well with American culture in the 1960’s” (p. 51).
In 1968, Clifton Bryant founded a new journal titled Sociological Symposium2 at Western Kentucky University. As the title of the journal implies, each issue was topical. The inaugural issue was dedicated to the topic of death. This issue, “death,” attracted wide attention and was well received. In 1966, Richard Kalish and Robert Kastenbaum, two psychologists, founded and coedited a mimeographed newsletter called Omega (Pine 1977:6). In 1970, this newsletter was formalized into a scholarly journal titled Omega, which was coedited by the same two men (Doka 2003:52).
By the last years of the 1960s, the study of death and dying had been legitimated and normalized. Thanatology had come into its own. Courses in death and dying were appearing with regularity in colleges and universities across the country, and the next few years saw a surge of publications, books, and articles addressing the topic of death.
The sociology of death was now an accepted specialty area, but the growth and development of a thanatological literature in this specialty continued to be very much an interdisciplinary effort, and it was still difficult to disentangle the sociological enterprise from that of other behavioral sciences. As Doka (2003) concluded, “In summary, the 1960s provided a firm foundation for death studies to emerge as an established academic discipline with its own models, controversies, journals, and organizations” (p. 51).
The 1970s and 1980s were very productive years for thanatology in terms of research and scholarship, and the momentum of these efforts continued to increase until today in the new millennium. As part of the thanatological enterprise, the sociology of death (as part of the generic field thanatology) has also enjoyed vigorous growth, and the literature has expanded accordingly. The period from 1970 through 2006 has been productive.
In 1970, the first textbook in the field of the sociology of death was published, a sure sign that this specialty area of sociology had been legitimated, accepted, and normalized (e.g., removed from the category of esoteric). The textbook, authored by Glenn M. Vernon, was aptly titled The Sociology of Death: An Analysis of Death-Related Behavior (1970). The book followed the research strands that had evolved during the early years. These loosely included the meaning and interpretation of death, the fear of death and dying, dying as a social process, the timing of death and the preservation of life, funeralization (although not under this name), bereavement, and reestablishing equilibrium in death-disrupted social systems. The text was widely used in thanatology courses, and especially those located in sociology departments. It did not go into subsequent editions. Interestingly, this was the first text to be titled The Sociology of Death. The study of death and dying was so multidisciplinary that such a title tended to discourage sales for those death and dying courses situated in other departments. All subsequent textbooks, with one exception years later, in the area of death and dying had more generic titles, regardless of the academic discipline of the author.
A number of other texts on thanatology have been published over the years. One of these is Edwin S. Shneidman’s (1976) (edited) anthology Death: Current Perspectives, published and widely used as a text in death and dying courses. A particularly popular (and durable) text was Robert J. Kastenbaum’s (1977) Death, Society and Human Experience (now in its seventh edition). Another text that came out at this time was Understanding Death and Dying by Sandra Galadiers Wilcox and Marilyn Sutton (1977). In 1979, Hannelore Wass published her introductory text Dying: Facing the Facts. It went through a number of editions. Dale V. Hardt (1979) authored Death: The Final Frontier, and the next year, Kathy Charmaz (1980) published The Social Reality of Death.
During the 1980s, a number of other texts on death and dying appeared. One of the first basic text volumes to be published in that decade was Death, Grief, and Caring Relationships by Richard A. Kalish (1981). It went into a second edition in 1985. Kalish (1980) had earlier published an edited anthology that examined death and dying from cross-cultural perspectives. In 1983, a particularly notable text appeared: The Last Dance: Encountering Death and Dying by Lynne Ann DeSpelder and Albert Lee Strickland. This text was (and still is) very widely used in courses addressing death and dying. It has proved also to be extremely durable and is now (2006) in its seventh edition. The year 1985 seems to have been very much a “bumper year.” Lewis R. Aiken’s (1985) Dying, Death, and Bereavement was published then. So, too, was John S. Stephenson’s (1985) splendid exposition, Death, Grief, and Mourning. Another text on death and dying published in that year was Dying in the Life Cycle: Psychological, Biomedical, and Social Perspectives, authored by Walter J. Smith (1985). Yet another text published in 1985 was Understanding Dying, Death, and Bereavement by Michael R. Leming and George E. Dickinson. This book was widely used in the classroom and also proved to be very durable. It is now in its sixth edition (2006).
In the late 1980s, several more basic thanatology texts were published. One text that appeared in 1987 was Dying and Death: Coping, Caring, Understanding by Judy Oakes and Gene Ezell. Among other introductory thanatology books published during this period were Death in the Midst of Life: Social and Cultural Influences on Death, Grief, and Mourning by Jack B. Kamerman (1988) and Endings: A Sociology of Death and Dying by the sociologist Michael C. Kearl (1989). This is the first basic text since Vernon’s book back in 1970 that had the words “sociology of death” in its title—a brave gesture by the author. Yet another text published in this area was Dying and Grieving: Lifespan and Family Perspectives by Alicia Skinner Cook and Kevin Ann Oltjenbruns (1989).
Since 1990, a few other introductions to death and dying have been published. The first was Death and Dying, Life and Living (Corr, Nabe, and Corr 1994). This text is now (2006) in its fifth edition. Some others are Death, Mourning, and Caring by Robert Maronne (1997) and Janet Lembke’s (2003) The Quality of Life: Living Well, Dying Well, although the format and topics of the latter text depart somewhat from the traditional model of topics found in most introductory thanatology textbooks.
This list of introductory thanatology texts is not exhaustive. There are others, and there are also innumerable edited anthologies that have been used in thanatology courses.
Of the array of books cited, some are authored by psychologists, some by sociologists, some by gerontologists, and some by individuals from other disciplines, both behavioral sciences and the humanities. Most, if not all, of the texts, however, have been (at one time or other) adopted by sociologists for use in their introductory sociology of death courses, and the same is true for psychologists and for thanatologists from other disciplines.
The basic texts over the last 36 years (from 1970 when the first text appeared) represent the history and development of the study (including the sociological study) of death and dying. Their respective perspectives, list of topics covered, and orientation show the changes in thanatological pedagogy. The reader is invited to review this progression of texts over the years, to obtain better insight into the recent history of thanatology, including the component sociology of death strands.
In examining these texts over the years, it is interesting to note that the coverage of these books, in terms of topics addressed, has hardly changed over the last one-third of a century. It would appear that there has been a common pool of topics shared by all the disciplines in the area of death education, and the authors of the books simply develop their texts using some, but not all, of the topics. Each book has a unique mix of topics and coverage, and this different mix is what makes each text distinctive. A number of books employ a mix of topics relatively similar to others. Some give more emphasis to some of the topics than others do.
This difference in coverage results in two distinctive categories in terms of orientation. Some of the texts devote more coverage and emphasis to topics that focus on interpersonal interaction, emotions, and the subjective aspects of deaths. The emphasis here is on topics such as the fear of death; the social process of dying; the interaction between and among terminal patients, family members, and medical personnel; and grief, mourning, and bereavement. This category of basic texts essentially looks at subjective death-related matters. It also has more of an applied orientation in the sense of seeking to prepare individuals in the health or helping vocations, such as nurses, social workers, or those in counseling. This type of book is more frequently authored by psychologists, gerontologists, persons in the health or medical fields, or those who are involved in spiritual matters, such as ministers, philosophers, or theologians. The Corr text, for example, has such authorship. These texts have a sociopsychological or sociomedical perspective. Such books can be termed clinical in orientation.
The other category of texts is socio-anthropological in orientation. These texts focus more on objective concerns such as funerals, body disposition, death rates, causes of death, the etiology of death, an objective review of escatologies, and related topics such as near-death experiences, suicide rates and causes, and the legalities of death. This category of basic text is more detached and descriptive than applied and can be termed informative in orientation. This type of book is more likely to be authored by a sociologist.
Inasmuch as basic courses in death and dying tend to be multidisciplinary and are offered in departments of various disciplines, the market tends to be generic and the publishers and authors strive to include multiple perspectives and orientations and appeal to all disciplines represented in thanatology and death studies.
It is instructive to note that while the newer textbooks are more replete with photos, charts, diagrams, and “boxes,” when their table of contents is compared with that of the Vernon text (the first textbook published in 1970), the topics listed are essentially the same, albeit in somewhat different sequence. Some of the newer texts have added a topic or so since the Vernon text—a chapter on the legalities of death or discussions of near-death experiences, war, and terrorism. Other than these topics, they are essentially “old wine in new bottles.” The most notable difference in the newer texts is that the chapter discussions are based on a far more extensive literature and tend to cite more publications and research.
The fact remains, however, that it is difficult to distinguish sociological writings or perspectives from a number of other disciplines with a thanatological interest. There is not as much a sociology of death and dying as there is a significant sociological contribution to the literature of thanatology, or death and dying studies, if you will. It would appear that the basic parameters of thanatology have been established and only the gaps need to be filled and the nuances explored.
A. The Popularity of Death Studies
As mentioned earlier, there were only a few scattered course offerings in death and dying in the early and mid-1960s—most conspicuously, Fulton’s course, first offered in 1963, and Pine’s course, first offered in 1966. By the late 1960s, however, courses in death and dying began to appear in colleges and universities across the nation, offered by psychologists, sociologists, and others in both the social sciences and the humanities. The topic of death education itself developed quite a following, attracting both academics and individuals in the health and counseling fields, and this generated greater demand for college courses in death and dying. Centers for death education were also being established. To mention one early center, Robert Kastenbaum, a psychologist, organized and directed the Center for Psychological Studies of Dying, Death, and Lethal Behavior at Wayne State University in April 1969 (Pine 1977:68). Another early center, the Center for Death Education and Research, was established by Robert Fulton, a sociologist, at the University of Minnesota in July 1969 (Pine 1977:68). After Fulton retired, the center was moved to the University of Wisconsin–LaCrosse, and Robert Bendiksen became its director (Doka 2003:52). According to Doka (2003:52), two researchers (Green and Irish 1971) found that there were more than 600 courses on death and dying by 1971. Doka (2003:52) also reported that one researcher (Cummins 1978) indicated that five years later, there were more than 1,000 death and dying courses in the United States, with the total enrollment exceeding 30,000 students. The number of such courses today is, undoubtedly, much increased, as is the total enrollment.
As collegiate interest in death and dying increased and spread, many teaching resources, such as films, filmstrips, videotapes, cassettes, were produced (Pine 1977:71–72). The availability of such material was likely one of the factors in the increase in death and dying courses. Instructors with an interest in, but little formal preparation for, the subject of death and dying could more easily develop and teach courses on these topics. The availability of such teaching aids and instructional material was probably a factor in the introduction of death and dying units or segments in both elementary and secondary schools (Pine 1977:72).
A multidisciplinary professional organization called the Forum for Death Education was organized and inaugurated in 1976. The name of the organization was later changed to the Association for Death Education and Counseling (Doka 2003:52). This organization, since its founding, has had a position of centrality in the growth and development of death education and the death awareness movement. The Journal of Thanatology was founded in 1971 but did not continue beyond 1977. In 1977, Hannelore Wass founded and edited a new journal, Death Education. The name was later changed to a more generic title, Death Studies. This journal and the earlier journal Omega, first published in 1970, subsequently came to be regarded as official journals of the Association for Death Education and Counseling (Doka 2003:52). In 1977, another journal in the field of death and dying, but perhaps peripheral to the mainstream, was founded. This journal was Markers, founded in 1980 and published by the Association for Gravestone Studies. The Journal of Near Death Studies was founded in the spring of 1988.
Two more journals, the American journal Loss, Grief, and Care, later titled Journal of Social Work in End of Life & Palliative Care, and the British journal Mortality, which first appeared in 1996, have become additional publishing venues for thanatologists, and both feature articles of broad interest and high scholarly quality.
During the years when the basic texts on death and dying were being published in sporadic profusion, there were many anthologies (some edited by sociologists and others by scholars from a number of disciplines) also being published. Most of them did not appear in second or subsequent editions. During this period there were also a number of seminal monographs published that were incorporated into the corpus of thanatological knowledge shared by sociology and numerous other disciplines. Curiously, one of the earlier and more important monographs on death was Warner’s (1959) The Living and the Dead. The curious aspect of the book and its findings is that it grew out of a community study and was not generally intended (or recognized) as a contribution to the sociology of death. One part of the book examines certain aspects of community symbolism and community attitudes regarding death and the dead and local cemeteries. Another notable example was Death, Grief, and Mourning by Geoffrey Gorer (1965), a British social anthropologist. In 1968, Paul Irion published his comprehensive history of cremation, aptly titled Cremation. Another very influential book was The Denial of Death by Ernest Becker (1973), an American cultural anthropologist. Two very useful and often cited historical monographs are The Puritan Way of Death: A Study in Religion, Culture, and Social Change by David E. Stannard (1977), an American historian, and Death in Early America by Margaret Coffin (1976), an antiques expert. Other useful monographs include Paul E. Irion’s (1954) The Funeral and the Mourners and, later, The Funeral: Vestige or Value (1966). A particularly widely cited anthropological work is Celebrations of Death: The Anthropology of Mortuary Ritual by Richard Huntington and Peter Metcalf (1979).
In terms of definitive scholarship, a towering, if not monumental, monograph in the historical study of death and dying is The Hour of Our Death by Philippe Aries (1981), a French social historian. Aries’s thesis is that in the distant past, death was “tamed” (viewed as inevitable and normal, accepted with equanimity, and assimilated by society). Over the centuries, this view changed, so that by modern times, death was feared, denied, hidden, “medicalized,” “dirty,” and “excluded.” A very useful and wonderfully detailed monograph is Purified by Fire, a social history of cremation in the United States, authored by Stephen Prothero (2001), assistant professor of Religion at Boston University.
Some of the monographs on death have addressed death in other cultures. A particularly relevant and interesting example of such a monograph is Price of Death: The Funeral Industry in Japan by Hikaru Suzuki (2001).
Recent years have seen the publication of a number of comprehensive reference works—handbooks and encyclopedias— addressing various aspects of death and dying, authored or edited by sociologists and scholars from various disciplines that incorporate thanatology into their research and scholarship.
A limited set of examples here might include the Encyclopedia of Death, edited by Robert Kastenbaum, a gerontologist, and Beatrice Kastenbaum (1989), a nurse in academia. This book was one of the earlier works of this genre. It is still in print (1993), although by a different publisher. Other subsequent reference works were the Encyclopedia of Afterlife Beliefs and Phenomena by James R. Lewis (1995), professor of Religious Studies, and a later edition, The Death and Afterlife Book: The Encyclopedia of Death, Near Death, and Life after Death (2001).
Other recent reference works on some aspects of death are Death and the Afterlife: A Cultural Encyclopedia by Richard P. Taylor (2000), professor of Religious Studies, and the Encyclopedia of Death and Dying, edited by Glenny Howarth, a sociologist, and Oliver Leaman (2001), a philosopher. One recent, lengthy and relatively definitive reference work is the Handbook of Death and Dying, edited by Clifton D. Bryant (2003), a sociologist. Another definitive reference work also appeared in 2003, this time an encyclopedia: Robert Kastenbaum’s (a psychologist) Macmillan’s Encyclopedia of Death and Dying.
The most recent reference books include Cassell, Salinas, and Winn’s (2005) The Encyclopedia of Death and Dying. Two of the three authors are medical doctors. The other most recent reference book addresses a somewhat different aspect of death—cremation: the Encyclopedia of Cremation (2005), edited by Douglas J. Davies, professor of Religious Studies and Theology.
It is interesting to note that these various reference works, speaking of some aspect of death, dying, and the afterlife, were authored or edited by scholars from a number of different academic disciplines and are, no doubt, used by academicians in a number of different disciplines, including sociologists. All these books were significant contributions to the corpus of knowledge in thanatology and, by extension, sociology. The sociology of death and dying is simply too intertwined with other disciplines to be easily examined outside of the mainstream of thanatology.
Of course, death-related articles appeared in many other more general journals. Many such articles look at relatively new areas of death and dying that have not been addressed in the thanatological texts. One illustrative example of articles on new topics is Vinitzky-Seroussi and Ben-Ari’s (2000) “‘A Knock on the Door’: Managing Death in the Israeli Defense Forces,” which appeared in the journal The Sociological Quarterly. Another example is Ben-Ari’s (2005) “Epilogue: A ‘Good’ Military Death,” which appeared in Armed Forces and Society.
The various thanatological journals today carry articles that focus on many of the same topics as in their early years. The basic parameters of thanatology appear to have changed little since the time they were first published; however, the articles today often tend to be more sophisticated, imaginative, esoteric, and, in some instances, colorful. Two examples from the journal Omega may serve to illustrate this trend: Cox, Garrett, and Graham’s (2004–2005) “Death in Disney Films: Implications for Children’s Understanding of Death” and Goodrum’s (2005) “The Interaction between Thoughts and Emotions Following the News of a Loved One’s Murder.”
Another example of the “new” genre of more untraditional topics is Breen’s (2004) article “The Dead and the Living in the Land of Peace: A Sociology of the Yasukuni Shrine,” which appeared in the journal Mortality.
The journal articles that address death, dying, and death-related behavior are too numerous to enumerate or discuss. It suffices to say that today, the body of thanatological literature is quite robust and there is a substantial body of knowledge in this field on which to build in the future.
The research undertaken by thanatologists, including sociologists, has by and large been atheoretical. Or, conversely, it might be said that such theories that have driven research in the area of death and dying have been theories “of the middle range.” Thanatological research has included efforts such as demographic analyses of death rates, life expectancy, and disease etiology; attitudinal studies of death anxiety and preferences in funeral styles, body disposition, and euthanasia; ethnographic analyses of funeral behavior; the history and ecology of cemeteries; interactional analyses of medical staff/patient behavior; dramaturgical analyses of funeral and funeral home behavior; historical analyses of changes in eschatology, funeral format, and body disposition; participant observation studies of executions, funeral behavior, dying behavior, and the behavior of medical staff toward terminally ill patients; and cross-cultural studies of death-related behavior, such as funeral and body disposition, to mention but some thanatological research strategies.
Perhaps some of the most productive, and theoretically fruitful, research on death and dying has been the development of conceptual paradigms and analytical typologies regarding death-related behavior. Examples are Kubler- Ross’s (1969) stages of dying; Salamone’s (1972) idealtype bifurcation of funeral homes into “local” and “mass” mortuaries; Stephenson’s (1985) historical evolution of eschatology, funerals, and body disposition and his resultant “Eras of Death”; and Worden’s (1982) four tasks of mourning, to cite a few.
Given the extensive body of research literature that has been developed and the very insightful conceptual schemes and analytical typologies that have emerged from this literature, there is little doubt that thanatological research, including the contributions of the sociology of death and dying, will become more and more theoretical with time.
B. The Future
Few specialty areas in sociology have broader or richer vistas of research opportunities in the future than the sociology of death and dying (or the more generic thanatology). The very nature and context of death, in terms of the frequency and modes of death, the meaning and fear of death, the dynamics of dying, the funeralization process, body disposition, the experience of grief and mourning, memorialization, and suicide and euthanasia, to mention but a few, are now undergoing, and will continue to undergo, profound transformations. These changes will have very significant import for many areas of our social lives and, indeed, will affect the total collective order. The scholars of the sociology of death and dying will have very full research agendas in the future.
III. The Aging of America
During the twentieth century, the percentage of elderly persons (aged 65 or older) has increased very dramatically. As Bryant (2003) describes the process,
At the turn of the 20th century (1900) only about 4.1% of our population was aged 65 or older—about 1 person out of every 20. By 1940, the percentage rose to 6.8%, and by 1960, 9.2% of the population was 65 or older. That figure increased to 12.3% by 2000 (World Almanac 2002:3385). (P. 1030)
We have an aging population, and the trend will continue throughout the twenty-first century. By 2010, the percentage of those 65 and older will rise to 13.2, and 18.5 percent of the population will be 65 or older by 2025. This figure will further rise to 20.3 percent in 2050. Thus, one person of every five will be elderly (Bryant 2003:1030). It has been projected that by 2100, one of every four persons will be 65 or older (World Almanac 2002:3385). Such demographic changes will “reshape our culture during the 21st century and will have enormous implications for death-related activities” (Bryant 2003:1030). The research opportunities attendant on these demographic trends will be extensive and inviting.
As opposed to a century ago, when the young (especially infants and children) died in both greater numbers and greater percentages than other segments of the population, in the twenty-first century, the elderly will die in dramatically larger numbers and percentages. For the past 45 years or so, the death rate in the United States has remained relatively stable at a range of about 8.5–9.5 deaths per 1,000 population. The death rate in the United States will begin to increase by 2030, and by 2060, the death rate will stand at 13.17 percent, some 52 percent higher than in 2001. Taking into account the natural increase in population and the projected increase in the death rate, the actual number of deaths in the United States will be 6,500,000 in 2080 as opposed to 1,711,982 in 1960, almost four times as large. As Bryant (2003) suggests, “In effect, death will be a growth industry in the United States for much of the 21st century” (p. 1030). Again, the growth of the death industry will offer some very attractive research possibilities.
The demographic changes will have dramatic effects on our society. One effect is that more medical facilities and facilities for the care of the elderly, such as nursing homes and assisted living facilities, will have to be built in large numbers and on an ongoing basis to meet the increasing demand. Such facilities will, in turn, require increasingly large numbers of staff members, such as nurses, practical nurses, orderlies, cooks, and cleanup personnel, to mention but a few vocations that will come to be in very short supply. The need for staff will generate other problems in a chain reaction fashion and will be rife with research opportunities, and sociologists in the field of death and dying will have very full research agendas exploring the social impact of these demographic trends.
The elderly are, in effect, dying, both metaphorically and medically. In centuries past, most individuals died of acute illnesses, such as typhoid, diphtheria, or cholera, and died promptly, while today the causes of death are likely to be chronic illnesses such as cardiac problems or cancer. With chronic diseases, an individual may well live for years beyond the diagnosis. Thus, in effect, those individuals with terminal conditions, primarily the elderly, make up a subpopulation of considerable size, and this group can be aggregated with those who die, for purposes of better understanding the social dimensions of death in our society. The increase in the rates and number of natural deaths will be augmented by the possibility of mass unnatural deaths caused by massive terrorist attacks and epidemics, if not pandemics of deathly diseases, such as avian flu, Spanish flu, Ebola, AIDS, and other yet unnoted diseases. The sociological significance of such megadeaths is obvious.
Inasmuch as individuals can often live for many months, and even years, after the diagnosis of terminal illness, and this medical accomplishment will, no doubt, dramatically improve in the future, the number of persons so diagnosed will expand significantly. There will be millions of persons who are classified as terminal. At this point, dying will take on much greater social and even political importance. With additional medical breakthroughs in chemotherapy and other additional technological advances, death can be more easily “postponed” temporarily, and the process of dying can be prolonged. In short, people can be aided to die slowly instead of dropping dead (as with a massive heart attack) or dying quickly. More persons will be dying slowly, and more attention will be given to dying. There will be a need for more specialized facilities, such as hospices, and more concern addressing the quality of life while dying. There will be efforts to “ease” patients into death using psychedelic and hallucinogenic drugs, hypnosis, and so on. Dying will assume more of a social status dimension such as with the elderly or persons who are disabled, and the dying as a group may become something of a political entity in the sense of being a voting block with special demands and needs, which they will attempt to see implemented, much in the fashion of the efforts of organizations such as the American Association of Retired Persons. This aggregation of dying people who will come to identify themselves with others in similar straits will be a social entity to be reckoned with, and they will undoubtedly come to have a significant influence on social policy. Such an aggregated group will likely influence the agendas of both state legislatures and the U.S. Congress. Even a political party made up of the dying is not beyond the realm of possibility. Sociologists in this field can and will likely conduct research on the growing political influence of the dying and how they will wield their political clout in the distribution of economic and social resources.
In the twenty-first century, death and dying will be more visible, more omnipresent, more seminal topics of social concern, and a much more pressing economic reality. All this will have an impact on our culture and our social lives. Old age must be considered a component topic of death and dying inasmuch as old age is the final phase of life and many elderly persons are, indeed, dying. Already, we are seeing death, dying, and elderly products and services being advertised on television. These products include adult diapers for incontinent elderly persons, food supplements for the elderly whose appetites have diminished and who need additional nutrition, and burial insurance. Also being advertised are medications for persons who are undergoing chemotherapy or radiation treatment for cancer. Such medications are intended (and needed) to mitigate the side effects of such treatment. Funeral homes and cemeteries are also beginning to advertise on television as well as in newspapers. Such trends in death-related advertising will dramatically expand to include many more avenues of advertising and a much broader array of products and services. Sociologists in the area of death and dying will turn their attention to the study of greater death orientation in the mass media, such as the study of consumer behavior, and how this, in turn, will shape the direction of our cultural evolution.
Students of American culture should find fertile opportunities for research in examining the impact of the increasing rate and number of deaths on our culture. Culture determines the way in which we think and feel and confront death. Death, in turn, has an impact on and changes culture. In the nineteenth century, the cultural posture toward death was one of acceptance and integration. During the first half of the twentieth century, ours was a death denial culture, which succeeded in hiding, avoiding, and ignoring death. During the second half of the twentieth century, the death awareness movement again refocused our attention on death. In the twenty-first century, we are going to be inundated with death issues to the point of cultural overload. Research interest in the cultural accommodation of this death overload and in the dynamics of personal confrontation with and the transcending of death will provide rich and pressing opportunities for sociological research on the changing attitudinal and value postures of Americans toward death and dying.
Already, our language is beginning to reflect the increased awareness of death in the form of an expanded vocabulary of death-related words, such as oncology, metastasis, columbarium, clinical death, near-death experiences, postself, postself career, memorialization, self-deliverance, viatical settlements, memory picture of the dead, physician-assisted suicide, postvention (providing emotional support for suicide survivors), lethal injection (as in executions), advance directives, trajectory of dying, aftercare (assisting the bereaved), harvesting body parts, virtual cemeteries, sudden infant death syndrome, cryonics, cyber funerals, death denial, AIDS, and megadeath, to name but a few. These are no longer technical words and phrases. Some come from medicine, some from law, some from the funeral industry, and some from thanatology. They are now part of common discourse, for example, social conversation, newspaper articles, and television programming. This was not the case 50 years ago. Now they are a component of everyday conversation. With time, our death-related vocabulary will expand at an exponential rate. The expansion of death-related vocabulary may represent an indicator of the degree of our preoccupation with death and our orientation toward death. Researchers will likely come to demonstrate a much-enhanced interest in death linguistics, and even a scientific journal in this area may likely emerge. Language reflects culture, and sociological researchers will likely examine changes in culture as reflected by language. The increasing use of deathrelated words and phrases in our language may well have import for our general orientation toward death itself, and this invites sociological exploration.
Other areas of change in death-related behavior in the future will likely encourage sociological research. One such area is the changing social dynamics in funeralization. In this regard, funeral homes themselves are changing and will continue to change. Some years ago, Salomone (1972) provided a sociological analysis of the historical metamorphosis of the American funeral home from what he termed the local mortuary, which was essentially a “Mom and Pop” business enterprise with emphasis on personal service and observance of local customs, to the more contemporary mass mortuary. These mortuaries, with larger and more elaborate bureaucratic staffing, are more likely to offer less personalized and more standardized type of funeralization. Some of these mortuaries are part of a larger chain enterprise. The trends in the future will include almost all funeral homes being large-scale, corporate-owned chain businesses. Funeral homes in the future will be more and more aggregated into corporate chains and conglomerates. Such chains will increasingly be owned by a few national corporations, who will also acquire related businesses, such as casket-manufacturing companies, cemeteries, crematoria, and hearse-manufacturing firms, to name but a few. Many funeral homes in large cities already have satellite facilities in the suburbs to make visitations and funerals more convenient for those living in the areas just outside the city proper. Bodies are being embalmed in the central facility and delivered to the satellite locations, thus saving the cost of an embalmer in all but the central facilities. This particular trend has gone even further. In some localities, there are embalming firms with a staff of salaried embalmers who are not connected to any funeral home. Such firms operate as a kind of embalming “wholesaler,” doing contract embalming for a number of different funeral homes. The funeral homes will pick up the dead body from the hospital, hospice, home, or morgue and deliver it to the embalming firm. The firm will embalm and otherwise prepare the body for a set fee. The body will then be picked up by funeral home employees and brought back to the funeral home for visitation, viewing, and the funeral. Where such wholesale embalming firms exist, the local funeral homes do not have to have an embalmer on the staff, thereby saving the cost of the embalmer’s salary and fringe benefits. The contract fees for embalming bodies are much lower than salary and fringe benefits. Other cost-cutting trends, including practices such as renting a hearse for a funeral, rather than owning one, are already taking place and will continue and proliferate in the future. Again, research opportunities will abound.
Funerals themselves are changing and will continue to change and evolve in the future: for instance, practices such as having funeral services that are less formal, more secular, and briefer and more perfunctory—more “packaged” as it were—in the interest of the busy schedules of those who attend. Even now, some funeral homes are using “drive-through” windows to display the body of the deceased as a means of expediting visitation and viewing and to save time for the visitors. Still other time-saving devices may be adapted and routinized. Increasingly, eulogies (and even sermons) will be delivered by friends or relatives of the deceased. There will be a greater emphasis on more “practical” and more economical funerals. Toward this end, there will be discount funeral homes and do-it-yourself efforts, such as purchasing caskets through discount sources. Technology, such as computers and television, will alter funeralization activities, and new practices, such as virtual attendance at funerals via computer viewing and viewing funerals on videotape sent to relatives who could not attend, will emerge.
In the future, death-related behavior will be dramatically changed, and sociology, as well as other disciplines with a thanatological curiosity will experience unlimited opportunities for documenting and exploring these changes.
See also:
Bibliography:
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