Learning objectives

By the end of this chapter you should be able to:

• discuss variations in mortality and influences on rates of death;

• describe different types of death and the changing constructions of death over time;

• comment on the ways in which a ‘good death’ is constructed;

• review research on how people face death and adjust to dying;

• discuss bereavement and the relation of the bereaved to the deceased;

• comment on the role of medical technology in death and dying;

• outline the effects of dying on health professionals and caregivers;

• argue why death and dying are essentially social processes.

In health research, particularly in epidemiology, death is often taken as a ‘hard’ data point, a status that cannot be disputed – a person is either dead or alive. However, dying is much more complex than this. There is substantial variation in rates of death around the world; the pace of death varies by country, by ethnicity, by gender, by age and by SES. Further, the process of dying can be highly variable. A person dying slowly from emphysema goes through a very different experience from a person who dies suddenly from a heart attack; a person dying peacefully in his or her sleep at home aged 85 is understood quite differently from an 18-year-old dying in agony in a car accident. Some people want to die and others resist dying.