Death on cameraBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7137.1100 (Published 04 April 1998) Cite this as: BMJ 1998;316:1100
- Julia Neuberger
- author of “Caring for Dying People of Different Faiths” (Mosby) and chief executive of the King's Fund
Rabbi Julia Neuberger looks at how death and dying are now openly discussed in the media and argues that the medical profession needs to keep up with the trend
A few weeks ago, the news that Lord Winston was making a television series in which someone was to be filmed in the process of dying led to much media coverage. Some thought this was important and that modern Britons were sheltered from death as from nothing else. The majority camp argued it was an invasion of a last, very private moment, which the prurient television camera should not rest on even briefly.
Yet there is a strong argument for the sensitive depiction of “real” death, given the amount of violent death we see screened every day, through film drama and in depictions of war and starvation in news stories. We have become inured to death in the big picture. This argument leads to John Morgan's guest editorial in Mortality last month (Mortality 1998;3(1)), “Is there a place for education about death and bereavement?” The answer, unsurprisingly, is that there is.
The argument against filming a person's death is that this is the most private moment. Among those who take that view, some want death depicted as calm, gentle, and easy, without the reality of times when it can be frightening, disturbing, or just messy. But that is much less strongly felt than the view of those still embarrassed about death. That embarrassment, and the silence that went with it, characterised our society until the late 1970s, before the work of Dame Cicely Saunders and the hospice movement became widely known.
For, despite the publication of Elisabeth Kubler-Ross's seminal work On Death and Dying in 1970 and Geoffrey Gorer's even earlier Death, Grief and Mourning in Contemporary Britain in 1965, people did not talk about death. Death was clinical, in hospital. It did not take place in your own home, in your own bed, lying beside a loved one. It certainly was not screened on television in your own sitting room.
The change in culture has been remarkable in the intervening years. The media have reflected that. Locally, newspapers have often campaigned for neighbourhood hospices. Yet the screening of Fighting for Dignity (ITV, 24 March), depicting Annie Lindsell, a young woman with motor neurone disease, fighting to die as she desired, suggests that all is not yet well with how we think about death and how we allow or deny people the right to die as they wish. It suggested a medical establishment still too keen to control what ordinary mortals are allowed to do.
Meanwhile, journals with articles about death and dying proliferate. There is the aptly named Mortality, a journal title that would have been impossible 20 years ago. Sociological and anthropological journals give death much attention. Nothing, however, compares with what happened after Princess Diana's death. The nation, in mourning, invented rituals for grieving that had not existed before. The media depicted them, firstly, as a sign of respect, and then, almost universally with amazement, as the crowds flooded towards the gardens of Kensington Palace and sat in small groups, often around candles, talking quietly, thinking, grieving.
Princess Diana's death and the national reaction to it, with the search for a ritual, may have been the turning point for the depiction of death in our society. Despite voices raised against it, Lord Winston's series depicting a man's death will almost certainly be screened by the BBC. Despite disquiet in much of the medical establishment, television and radio programmes about individuals wishing to die in a manner of their choosing will proliferate, and public support for them is growing. The debate about advance directives is hotting up, and what was once the academic concern of medical ethicists and lawyers has become the subject of discussion in pubs and taxis.
And now, as was reported on Radio 4's news two weeks ago, Tony Walter, reader in sociology at the University of Reading, is setting up a cross disciplinary masters degree in death and society. Academic interest in death and dying goes back some decades, but it was never the subject of a news story before. Death has become fashionable and is no longer the great unmentionable. The challenge for the medical profession will be to keep up with the trend and join the debate about how we die, without wishing to medicalise that event, control it, or even sanitise it.