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When a person is born, we rejoice, and when they're married, we jubilate,

but when they die, we try to pretend that nothing happened.

--Margaret Mead

Odd as it sounds, there can be little question that some deaths are better than others. People cross-culturally have always made invidious distinctions between good deaths and bad. Compare, for instance, crooner Bing Crosby's sudden death following eighteen rounds of his beloved golf with the slow motion, painful expiration of an eighty-year-old diabetic. Bedridden following the amputation of his leg, the old man eventually began slipping in and out of consciousness. This continues over a period of years, exhausting the emotional, physical. and financial resources of his family. The essence of a "good death" thus involves the needs of the dying (such as coming at the end of full and completed lives, and when death is preferred to continued existence) as well as those of their survivors and the broader society.

Whereas the prevalence of unanticipated and premature deaths led to pre-industrial cultures to focus death fears on individuals' postmortem fates, the death fears of modern cultures are more likely to focus on the processes of dying. Thus contemporary fears of dying involve the anxieties of dying within institutional settings, where often life is structured for the convenience of staff and where residents suffer both physical and psychological pain in their depersonalization. They also involve fears of being victims of advanced Alzheimer's Disease: being socially dead and yet biologically alive. In sum, the dreaded liminality between the worlds of the living and the dead have historically shifted from the period after death to the period preceding it.



Cultural coping mechanisms have not kept pace with the dramatic changes in when and how we die. With a generation or two (rates varying by social class, religion, etc.)...