ABSTRACT
The dying trajectory for most people has become prolonged due to demographic and epidemiological changes, with more people dying in older age with multi-morbidities, including dementia (Murray, Kendall, Boyd, & Sheikh, 2005). Sociological and anthropological work around ageing, dementia and dying has suggested that the asynchronous decline of bodily and cognitive functions, often attributed to these demographic and epidemiological changes, and the current care practices used to manage this decline, may result in a form of social death, whereby people are treated as if they are already or nearly dead (e.g. Froggatt, 2001). Research on social death suggests that when it occurs before physiological death (i.e. the death of the body), it marks a loss of personhood (Lawton, 2000). These experiences of ‘prolonged dying’, loss of personhood and the corresponding culturally constructed sensitivities around this have ignited and united public and professional interest in death (Spiro, 1996). Consequently, within England there has been a search for normalising ‘good death’ that controls this decline, both in terms of euthanasia and assisted dying (N. Richards, 2014), and in extending hospice and palliative care to general end-of-life care (Clark, 2002). In this article, I outline how policy-makers have engaged with different notions of social death in constructing and justifying end-of-life care policy, as they seek to address and improve the quality of care when dying and the experience of death.
