Explainer
Change
Death & life
6 min read

Dealing with death – why the fuss?

“No fuss” cremations are getting more popular. Not giving a formal space or process to say goodbye feels like a seismic cultural shift to Jane Cacouris. Part of the How To Die Well series.

Jane Cacouris is a writer and consultant working in international development on environment, poverty and livelihood issues.

A sculpture shows mourning women raising hands and fists to the sky.
The Tragedy of the Sea memorial in Matosinhos, a Portuguese port.
Prilfish, CC BY 2.0, via Wikimedia Commons.

Widow’s Rip is a notorious swirl of ocean just offshore from Nazaré, a centuries-old fishing village on Portugal’s windy and unpredictable Atlantic coast. Decades ago fishermen used oxen to pull brightly painted boats onto the beach and then rowed into the giant waves. Many lost their lives when the seas were rough. I first visited Nazaré with my Portuguese grandmother as a child and stayed in a fisherwoman’s house with an orange-tiled roof just off the central square. My eyes had to adjust to the gloom every time we went inside as she kept all of the shutters drawn. Even though it was thirty degrees outside, I remember her tanned, crumpled face shrouded in a black shawl that covered her head and shoulders. She wore a black knee length skirt with an array of petticoats and black shoes. As a ten-year-old, I was a little scared. I asked my grandmother when the fisherwoman’s husband had died. “About twenty-five years ago at sea”, she said. She explained it would be a sign that you didn’t love your late husband if you didn’t wear black for the rest of your life.  

Nowadays, although fishing is still a livelihood for some who live there, Nazaré is known for its sweeping beach and touristy promenade of restaurants, bars and stalls selling Portuguese wares. But the widows, now very old ladies, who lost their husbands to the sea all those years ago still potter around the town dressed head to toe in black. An ingrained tradition of how to grieve.

No other event in our life brings us closer to facing questions of mortality and eternity than the death of a loved one.

Grief and how we deal with the loss of a loved one is of course deeply personal and expressed differently depending on so many things; culture, beliefs, personality, life experience, to name a few. But in recent years, there has been a defined shift in British society away from some of the traditions that have historically accompanied death.  

The growing trend for direct or “no fuss” cremations is an example of this shift, with a rise from 3 per cent of all cremations in 2019 to 18 per cent in 2022 according to a life insurance company’s recent report. A traditional cremation includes a service at the crematorium or place of worship beforehand, whereas a direct cremation does not have a service. Instead, the deceased is taken directly to be cremated with no one in attendance, unless witnesses ask to be present. A simple coffin is used, and the timing of the cremation is determined by the funeral director, usually according to availability.  

Why are families choosing to cut out the funeral?  

Sources point to a range of reasons. A matter of choice – perhaps a statement of faith that the afterlife is not about funeral rituals, or conversely, that there is no afterlife, and the body will just decompose organically and be subsumed back into the Earth so why make a fuss? It can be for practical reasons such as cost; traditional funeral services are much more expensive than a simple cremation, estimated to be approximately £2,500 cheaper. A “no fuss” cremation can also reduce the likelihood of family division or arguments over the type of ceremony. Or family living in different locations geographically means a memorial service scheduled for a more convenient time can be organised.  

All these reasons seem perfectly valid. But not giving a formal space or process to say goodbye does feel like a seismic cultural shift, even for the British, known for our ability to keep our feelings under wraps. Practical reasons aside, are we ducking the emotion that inevitably hits us when we lose someone we love? Or perhaps avoiding the difficult questions that come with death? No other event in our life brings us closer to facing questions of mortality and eternity than the death of a loved one.  

On holiday in Nazaré in his youth, my father remembers a fisherman’s death in the house where he was staying. The night before the funeral - with the deceased laid out in the dining room - each of the women in the family took it in turns to sit in the corridor outside, the top skirt of their seven petticoats over their head, wailing in an outpouring of grief so raw that they couldn’t continue for more than a couple of hours. The “wailing process” carried on throughout the night, the role passing from woman to woman until sunrise. Not only was the loss of the fisherman the loss of their beloved, it was also the loss of a working partnership - the women sold the fish that the men brought home – and the loss of the family’s livelihood and income. The wailing was a necessary part of expressing this agony ahead of the funeral service when the rest of the family would come together to support each other.  

There are also intensely reverent traditions observed with death in Portugal, particularly within the Catholic church. The burial or cremation is usually no more than three days after the person has died. When my grandmother passed away a few years ago, her body was laid in an open casket in a room of the Catholic church in the mountain village in rural Portugal where she had lived most of her life. The night before the funeral, a procession of people visited her to pay their last respects, including distant family members, whilst my immediate family sat with her all night. People touched her arm or hand, and sat and chatted to one another. After Mass the following day, her coffin lined with lead was sealed and she was taken to the family Mausoleum to be laid beside my grandfather, along with the remains of around thirty of our relatives dating back to the early 1900s.  

Brazil, where we lived for several years, has many similarities to Portugal in dealing with death. The time between death and burial or cremation is even faster, usually within twenty-four hours. Family and friends rapidly gather, usually together with the body of the loved one in an open casket. Touching and kissing the body and wailing over it is not uncommon. According to a Brazilian friend, “Bebendo do morto” which means “drinking to the dead” is an old custom where family members raise a final glass of Cachaça, a traditional drink, to the deceased in the presence of their body.  

A funeral service is partly about taking a look back at our loved one’s jigsaw of life, at all the pieces that have slotted together to make up their precious and unique time on Earth.

In all these traditions, the funeral service acts as the closure to the first “phase” of grief, and the passing of the deceased into God’s care. The next phase is then the more private continuation of grief for months or years to come.  

Christians believe in life after death based on a conviction that as Jesus rose from the dead, so will we. A funeral service is partly about taking a look back at our loved one’s jigsaw of life, at all the pieces that have slotted together to make up their precious and unique time on Earth. Of course, there are damaged and missing pieces, but Christians believe that the jigsaw will be made whole and perfect in Heaven with Jesus. It is also a chance to give thanks for the the life of a human being wonderfully and fearfully made in the image of God. 

Regardless of the country, the culture or the tradition, the death of someone we love means that our world will never be the same again. It will continue spinning without them and we have to get used to that. The Book of Ecclesiastes in the Bible says: 

 “There is a time for everything, and a season for every activity under the heavens: a time to be born and a time to die”.  

Death is an entire season; not only the end of the existence of a human on Earth who was created and loved by God, but a prolonged period of growth and change for those of us left behind.  

Death deserves us to make a fuss.  

  

Article
Assisted dying
Care
Comment
Death & life
Suffering
5 min read

Why end of life agony is not a good reason to allow death on demand

Assisted dying and the unintended consequences of compassion.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A open hand hold a pill.
Towfiqu Barbhuiya on Unsplash.

Those advocating Assisted Dying really have only one strong argument on their side – the argument from compassion. People who have seen relatives dying in extreme pain and discomfort understandably want to avoid that scenario. Surely the best way is to allow assisted dying as an early way out for such people to avoid the agony that such a death involves?  

Now it’s a powerful argument. To be honest I can’t say what I would feel if I faced such a death, or if I had to watch a loved one go through such an ordeal. All the same, there are good reasons to hold back from legalising assisted dying even in the face of distress at the prospect of enduring or having to watch a painful and agonising death.  

In any legislation, you have to bear in mind unintended consequences. A law may benefit one particular group, but have knock-on effects for another group, or wider social implications that are profoundly harmful. Few laws benefit everyone, so lawmakers have to make difficult decisions balancing the rights and benefits of different groups of people. 

It feels odd to be citing percentages and numbers faced with something so elemental and personal and death and suffering, but it is estimated that around two per cent of us will die in extreme pain and discomfort. Add in the 'safeguards' this bill proposes (a person must be suffering from a terminal disease with fewer than six months to live, capable of making such a decision, with two doctors and a judge to approve it) and the number of people this directly affects becomes really quite small. Much as we all sympathise and feel the force of stories of agonising suffering - and of course, every individual matters - to put it bluntly, is it right to entertain the knock-on effects on other groups in society and to make such a fundamental shift in our moral landscape, for the sake of the small number of us who will face this dreadful prospect? Reading the personal stories of those who have endured extreme pain as they approached death, or those who have to watch over ones do so is heart-rending - yet are they enough on their own to sanction a change to the law? 

Much has been made of the subtle pressure put upon elderly or disabled people to end it all, to stop being a burden on others. I have argued elsewhere on Seen and Unseen that that numerous elderly people will feel a moral obligation to safeguard the family inheritance by choosing an early death rather than spend the family fortune on end of life care, or turning their kids into carers for their elderly parents. Individual choice for those who face end of life pain unintentionally  lands an unenviable and unfair choice on many more vulnerable people in our society. Giles Fraser describes the indirect pressure well: 

“You can say “think of the children” with the tiniest inflection of the voice, make the subtlest of reference to money worries. We communicate with each other, often most powerfully, through almost imperceptible gestures of body language and facial expression. No legal safeguard on earth can detect such subliminal messaging.” 

There is also plenty of testimony that suggests that even with constant pain, life is still worth living. Michelle Anna-Moffatt writes movingly  of her brush with assisted suicide and why she pulled back from it, despite living life in constant pain.  

Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder. 

Despite the safeguards mentioned above, the move towards death on the NHS is bound to lead to a slippery slope – extending the right to die to wider groups with lesser obvious needs. As I wrote in The Times recently, given the grounds on which the case for change is being made – the priority of individual choice – there are no logical grounds for denying the right to die of anyone who chooses that option, regardless of their reasons. If a teenager going through a bout of depression, or a homeless person who cannot see a way out of their situation chooses to end it all, and their choice is absolute, on what grounds could we stop them? Once we have based our ethics on this territory, the slippery slope is not just likely, it is inevitable.  

Then there is the radical shift to our moral landscape. A disabled campaigner argues that asking for someone to help her to die “is no different for me than asking my caregiver to help me on the toilet, or to give me a shower, or a drink, or to help me to eat.” Sorry - but it is different, and we know it. Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.  

In Canada, many doctors refuse, or don’t have time to administer the fatal dose so companies have sprung up, offering ‘medical professionals’ to come round with the syringe to finish you off. In other words, companies make money out of killing people. It is the commodification of death. When we have got to that point, you know we have wandered from the path somewhere.  

You would have to be stony-hearted indeed not to feel the force of the argument to avoid pain-filled deaths. Yet is a change to benefit such people worth the radical shift of moral value, the knock-on effects on vulnerable people who will come under pressure to die before their time, the move towards death on demand?  

Surely there are better ways to approach this? Doctors can decide to cease treatment to enable a natural death to take its course, or increase painkillers that will may hasten death - that is humane and falls on the right side of the line of treatment as it is done primarily to relieve pain, not to kill. Christian faith does not argue that life is to be preserved at any cost – our belief in martyrdom gives the lie to that. More importantly, a renewed effort to invest in palliative care and improved anaesthetics will surely reduce such deaths in the longer term. These approaches are surely much wiser and less impactful on the large numbers of vulnerable people in our society than the drastic step of legalising killing on the NHS.