Encyclopedia of Sociology

DEATH AND DYING

were reported during the following three months.
Along similar lines, several sociological investiga-
tions have explored the proposition that some
people die socially before they die biologically.
These studies center on the notion of ‘‘levels of
awareness’’ of death (Glaser and Strauss 1965).
When both the dying person and his or her signifi-
cant others are cognizant of death as a soon-to-be-
experienced event, the ensuing ‘‘open’’ awareness
may enable them to negotiate various aspects of
the final phase of life. Other research on ‘‘dying
trajectories’’ involves certainties and uncertainties
as to the time of death (Glaser and Strauss 1968).

‘‘The Right to Die.’’ As a final and critical
example in this review of disparate empirical work, a
basic and far-reaching question is being asked:
Does the individual, in a society deeply committed
to the preservation of life, have a ‘‘right’’ to die?
This has become one of the most profound, com-
plex, and pressing issues of our time (Glick 1992).
It involves the ‘‘rights’’ and wishes of the dying
person, the ‘‘rights’’ and responsibilities of his or
her survivors, the ‘‘rights’’ and obligations of at-
tending physicians, and the ‘‘rights’’ and constraints
of the law. The human side of such issues is
producing a tidal wave of expressions of public
interest in television documentaries, opinion sur-
veys, editorials, pamphleteering, and radio talk
shows. The issue of euthanasia is openly debated
in leading medical journals, an unthinkable topic
only a few years ago. Hospital rules, in which do
not resuscitate (DNR) orders were written on black-
boards then quickly erased, are being changed.
Certain aspects of the issue have reached the
Supreme Court. A major book has proposed the
rationing of medical resources (Callahan 1987).
Radical movements have sprung up that advocate
active euthanasia and offer recipes for self-deliver-
ance. Final Exit, the Hemlock Society’s handbook,
was an instant best-seller (Humphry 1991). The
costs of the last days of life have been dramatized,
sometimes spoofed as a myth (Alliance for Ag-
ing Research 1996), and sometimes reported with
great care (Congressional Research Service). Jack
Kevorkian, often referred to as ‘‘Dr. Death,’’ has
become both hero and despised public enemy. In
short, the problems and dilemmas inherent in the
‘‘management’’ of death have captured both popu-
lar and scientific attention (see various issues of
the Hastings Center Reports). In both instances
doctors and lawyers play ambiguous but critical

roles. It is, however, the ‘‘negotiation’’ that is of

sociological interest. Norms designed to reduce

the perplexities in wrenching decisions or to reas-

sure the decision makers (including dying per-

sons) are generally lacking (Wetle 1994). The need

for relevant norms governing ‘‘the dying process’’

has been noted earlier (Riley and Riley 1986), and

the main considerations have been specified (Logue

1989). The U. S. Office of Technology Assessment

(1987) and the Hastings Center (1987) have issued

medical and ethical guidelines, respectively, on

the use of life-sustaining procedures. Many years

ago sociologists developed research models for

studying the social aspects of heroic operations

and the treatment of nonsalvageable terminal pa-

tients (Fox and Swazey 1974; Crane 1975). Yet

models necessary to the formation of norms capa-

ble of handling the ‘‘rights’’ and wishes of the

various parties to the process of dying are still

clearly needed. Furthermore, the conceptual prob-

lem of distinguishing between the two actors in the

dying process, which the Minnesota Conference

had emphasized, has not been resolved.

CURRENT ISSUES

With roots in these diverse studies, a set of three

issue-laden topics cry out for more research and

understanding: 1) dying individuals want a clearer

voice in how their last days are to be treated; 2)

policy questions are being raised that call attention

to potential conflicts between the rights of indi-

viduals and the imperatives of society; and 3)

programs and campaigns designed to reduce the

difficulties of dying are demanding wide social

action. These issues can be grouped under three

shorthand labels: the living will; assisted suicide;

and the quality of dying. While these issues are of

great sociological interest, they are only now be-

ginning to be framed in terms for sociological

inquiry. The following discussions, consequently,

rely largely on commission reports, conferences,

public forums, social commentary in the media,

brief reports in such journals as Omega, Issues in

Law and Medicine, Journal of the American Geriatrics

Society, Hospice Journal, and various unpublished

materials.

The Living Will. As noted above, one of the

most easily understood and practical developments

in response to the dilemmas of dying in America is

the ‘‘living will,’’ the so-called durable power of