DEATH AND DYINGbureaucratic efficiency are typically found to be at
odds (Sudnow 1967). A contrasting account of
hospital rules governing disposition of the body in
contemporary Ireland is even more sociological in
its emphasis (Prior 1989). In another hospital study
the ‘‘caring issue’’ has been seen as the main social
problem. The selfhood of the dying person is
found to be at risk since the hospital is essentially
dedicated to efficiency (Kalish 1985b). However,
studies suggest that an increasing proportion of
deaths may now be occurring at home or under
hospice care, which ‘‘mediates between the fami-
lies and formal institutions that constitute the
social organization of death and dying’’ (Marshall
and Levy 1990; see also Bass 1985).
The Funeral. The funeral as a social institu-
tion has long been of sociological concern (cf.
Habenstein 1968). For example, a massive cross-
cultural study attests to its worldwide function in
marking a major social transition (Habenstein and
Lamers 1963; Howarth 1996). Durkheim had em-
phasized its ceremonial role in facilitating social
regrouping. Later sociologists have shown that
elaborate and extravagant funeral rites may be
more reflective of commercial interests than of
human grief or mourning (Parsons and Lidz 1967).
The Bereaved Family. The now classic study
(Eliot 1932) of the economic consequences of
death on the family stimulated a large literature
that documents the general proposition that survi-
vors—particularly significant others—require vari-
ous types of social supports to ‘‘get through’’ the
period of intense personal grief and the more
publicly expressed mourning. In today’s societies,
the time devoted to bereavement activities is gen-
erally shorter (Pratt 1981). This is consistent with
Parsons’s (1963) position that in societies charac-
terized by an ‘‘active’’ orientation, the bereaved
are expected to carry out their grief work quickly
and privately.
Social Stressors as ‘‘Causes’’ of Death. Soci-
ologists and psychologists have investigated a range
of individually experienced ‘‘social stressors’’ as
causes of death, such as bereavement and retire-
ment. The hypothesis that a bereaved spouse is at
higher risk of death (the ‘‘broken heart’’ syndrome,
or ‘‘death causes death’’) has been widely investi-
gated but with no conclusive results. Similarly,
retirees in some longitudinal studies have been
shown to experience excess mortality, whereas
other investigations have reported opposite re-
sults. Retirement is a complex process, not a sim-
ple or single event, and the mortality impact of
retirement is moot.
In an era in which nursing homes play an
important role in the lives of many older people,
the mortality consequences of relocation have come
under critical scrutiny. Several studies have report-
ed that the ‘‘warehousing’’ of the frail elderly
results in increased mortality while in other stud-
ies feelings of security in the new ‘‘home’’ are
shown to enhance a sense of well-being resulting in
lower mortality. Similar caveats apply to macro-
level studies that attempt to relate such collectively
experienced stressors as economic depressions,
wars, and technological revolutions to trends in
mortality. Advances in mathematical modelling
and the increasing availability of large and relevant
data sets make this problem an attractive area for
continuing sociological research (see Riley 1983
for details and sources).
Self-Motivated Death. Durkheim’s studies of
suicide spawned a wide, diverse, and sometimes
confusing research literature. In most such studies
social integration is the operative concept. If the
theoretical relationship is believed to be unam-
biguous, the empirical relationship is far from
tidy. The literature is vast and well beyond the
reach of this review. Apart from suicide, it is a
sociological truism that individuals are often so-
cially motivated to influence the time of their own
deaths. It has long been noted, for example, that
both Thomas Jefferson and John Adams delayed
their dying in order to participate in Indepen-
dence Day celebrations. Several empirical studies
have explored this so-called ‘‘anniversary effect’’
in which social events of significance are preceded
by lower-than-expected mortality (Phillips and
Feldman 1973). Such studies rest on Durkheim’s
insight that if some people are so detached from
society that they commit suicide, others may be so
attached that they postpone their deaths in order
to participate in social events of great significance
(Phillips and Smith 1990). An example of the
mortality impact of personal and local events is
seen in studies of the ‘‘birthday dip.’’ One year-
long study, in a test area, coded all obituaries for
birthdates. The results were striking. Fewer than
10 percent of the deaths occurred during the three
months prior to the birth date, whereas nearly half