Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

Tagore, from Stray Birds, CCXIX 
 
Society's Contributions to Defensiveness 
 
Until now we have looked at the individual human reaction to death and dying. If we now take a 
look at our society, we may want to ask ourselves what happens to man in a society bent on 
ignoring or avoiding death. What factors, if any, contribute to an increasing anxiety in relation to 
death? What happens in a changing field of medicine, where we have to ask ourselves whether 
medicine is to remain a humanitarian and respected profession or a new but depersonalized science 
in the service of prolonging life rather than diminishing human suffering? Where the medical 
students have a choice of dozens of lectures on RNA and DNA but less experience in the simple 
doctor-patient relationship that used to be the alphabet for every successful family physician? What 
happens in a society that puts more emphasis on IQ and class-standing than on simple matters of 
tact, sensitivity, perceptiveness, and good taste in the management of the suffering? In a 
professional society where the young medical student is admired for his research and laboratory 
work during the first years of medical school while he is at a loss for words when a patient asks him 
a simple question? If we could combine the teaching of the new scientific and technical 
achievements with equal emphasis on interpersonal human relationships 
 
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we would indeed make progress, but not if the new knowledge is conveyed to the student at the 
price of less and less interpersonal contact. What is going to become of a society which puts the 
emphasis on numbers and masses, rather than on the individual-where medical schools hope to 
enlarge their classes, where the trend is away from the teacher-student contact, which is replaced by 
closed-circuit television teaching, recordings, and movies, all of which can teach a greater number 
of students in a snore depersonalized manner? 
 
This change of focus from the individual to the masses has been more dramatic in other areas of 
human interaction. If we take a look at the changes that have taken place in the last decades, we can 
notice it everywhere. In the old days a man was able to face his enemy eye to eye. He had a fair 
chance in a personal encounter with a visible enemy. Now the soldier as well as the civilian has to 
anticipate weapons of mass destruction which offer no one a reasonable chance, often not even an 
awareness of their approach. Destruction can strike out of the blue skies and destroy thousands like 
the bomb at Hiroshima; it may come in the form of gases or other means of chemical warfare-
invisible crippling, killing. It is no longer the man who fights for his rights, his convictions, or the 
safety or honor of his family, it is the nation including its women and children who are in the war 
affected directly or indirectly without a chance of survival. This is how science and technology 
have contributed to an ever increasing fear of destruction and therefore fear of death. 
 
 Is it surprising, then, that man has to defend himself more? If his ability to defend himself 
physically is getting smaller and smaller, his psychological defenses have to increase manifoldly. 
He cannot  maintain denial forever. He cannot continuously and successfully pretend that he is safe. 
If we cannot deny death we may attempt to master it. We may join the race on the highways, we 
may read the death toll over national holidays and shudder, but also rejoice - "It was the other guy, 
not me, I made it." 
 

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Groups of people, from street gangs to nations, may use their group identity to express their fear of 
being destroyed by attacking and destroying others. Is war perhaps nothing else but a need to face 
death, to conquer and master it, to come out of it alive; a peculiar form of denial of our own 
mortality? One of our patients dying of leukaemia said in utter disbelief: "It is impossible for me to 
die now. It cannot be God's will, since he let me survive when I was hit by bullets just a few feet 
away during World War II." 
 
Another woman expressed her shock and sense of incredulity when she described the "unfair death" 
of a young man who was on leave from Vietnam and met his death in a car accident, as if his 
survival on the battlefield was supposed to have guaranteed immunity from death back home. 
 
A chance for peace may thus be found in studying the attitudes toward death in the leaders of the 
nations, in those who make the final decisions of war and peace between nations. If all of us would 
make an all-out effort to contemplate our own death, to deal with our anxieties surrounding the 
concept of our death, and to help others familiarize themselves with these thoughts, perhaps there 
could be less destructiveness around us. 
 
News agencies may be able to contribute their share in helping people face the reality of death by 
avoiding such depersonalized terms as the "solution of the Jewish question" to tell of the murder of 
millions of men, women, and children; or to use a more recent issue, the recovery of a hill in 
Vietnam through elimination of a machine gun nest and heavy loss of VC could be described in 
terms of human tragedies and loss of human beings on both sides. There are so many examples in 
all newspapers and other news media that it is unnecessary to add more here. 
 
In summary, then, I think that with rapid technical advancement and new scientific achievements 
men have been able to develop not only new skills but also new weapons of mass destruction which 
increase the fear of a violent, catastrophic death. Man has to defend himself psychologically in 
many ways against this increased fear of death and increased inability to foresee and protect 
himself against it. Psychologically he can deny the reality of his own death for a while. Since in our 
unconscious we cannot perceive our own death and do believe in our own immortality, but can 
conceive our neighbor's death, news of numbers of people killed in battle, in wars, on the highways 
only support our unconscious belief in our own immortality and allow us-in the privacy and secrecy 
of our unconscious mind-to rejoice that it is "the next guy, not me." 
 
If denial is no longer possible, we can attempt to master death by challenging it. If we can drive the 
highways at rapid speed, if we can come back home from Vietnam, we must indeed feel immune to 
death. We have killed ten times the number of enemies compared to our own losses-we hear on the 
news almost daily. Is this our wishful thinking, our projection of our infantile wish for omnipotence 
and immortality? If a whole nation, a whole society suffers from such a fear and denial of death, it 
has to use defenses which can only be destructive. Wars, riots, and increasing numbers of murders 
and other crimes may be indicators of our decreasing ability to face death with acceptance and 
dignity. Perhaps we have to come back to the individual human being and start from scratch, to 
attempt to conceive our own death and learn to face this tragic but inevitable happening with less 
irrationality and fear. 
 
What role has religion played in these changing times? In the old days more people seemed to 
believe in God unquestionably; they believed in a hereafter, which was to relieve people of their 

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