The Medicalization of Death: A Mini-Essay

     As historian Philippe Ariès reveals, death has always possessed a communal nature: “Like every great milestone in life, death is celebrated by a ceremony that is always more or less solemn and whose purpose is to express the individual’s solidarity with his family and community.”[1] Throughout much of Western history, the scholar explains, there was constantly a public element to dying: the deathbed was attended by a swarm of loved ones; a bereavement notice was posted on the door for all passersby; the front door was left ajar to admit anyone wishing to make a final visit; church services and the procession to the graveyard involved the entire community; and the mourning family was frequently visited for days and weeks following the funeral.[2] The second half of the nineteenth century, however, brought an enormous change to the act of dying through the medicalization of death. Witnessed throughout Western civilization and even literature of the era, including Leo Tolstoy’s “The Death of Ivan Ilyich” (1886), care of the dying moved from the hands of relatives and into the hands of the medical profession.[3] Likewise, commencing in the 1930s and progressing throughout the 1940s and 1950s, the deathbed migrated from the home, where the burden of caring for the dying was the task of sympathetic family and friends, and into the hospital, where the responsibility was relegated to trained medical personnel.[4] Furthermore, the funeral and mourning process experienced a similar solitude, with the community rituals of wakes, processions, and receptions no longer open to society as a whole, but immediate acquaintances and relatives who knew the deceased in varying degrees of intimacy.[5] All of this, Ariès argues, “eliminated [death’s] character of public ceremony, and made it a private act.”[6] It also, the scholar maintains, makes the act of death invisible by relegating its presence to the hospital, the time of death controllable by allowing medicalization to lengthen or shorten its duration to suit the doctor’s desires, and the process of mourning a private affair by masking its sorrows in the confines of the home rather than the streets of the community.[7] Indeed, as Ariès laments: “we ignore the existence of a scandal that we have been unable to prevent; we act as if it did not exist; and thus mercilessly force the bereaved to say nothing.”[8]

Works Referenced 

Ariès, Philippe. The Hour of Our Death: The Classic History of Western Attitudes Toward Death Over the Last One Thousand Years. 1977. Trans. Helen Weaver. New York: Barnes and Noble Books, 2000. 
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[1] Ariès, 603.
[2] Ariès, 559-560.
[3] Ariès, 561-570.
[4] Ariès, 570-571.
[5] Ariès, 575-579.
[6] Ariès, 575.
[7] Ariès, 579-601.
[8] Ariès, 613-614.