After Dying Matters Awareness Week 2014, The Marie Curie Institute undertook an analysis of our display at The Walker Art Gallery. Members of the public were invited to ‘Write or draw what symbolises ‘Life’ and ‘Death’ to you on our Hollywood style lettering’. The aim of the analysis was to gain an insight into peoples’ perceptions of death (and life) in order to inform public engagement techniques to normalise the topic of ‘death’.
Here are some excerpts from the findings:
Background
Within the context of Western Society, advances in medical science have simultaneously reduced the incidence of childhood and early adult deaths and extended life expectancy. One result of such advances has therefore been to delay personal experiences of death and dying into midlife (House of Commons Health Committee, 2015). Further, since the foundation of the National Health Service (NHS) in the United Kingdom (UK) in 1948, an increasingly paternal, medicalisation of death and dying has resulted in more deaths now commonly occurring in a hospital setting, which has further removed ‘death’ and ‘dying’ from general society (House of Commons Health Committee, 2015; Mellor and Shilling, 1993).
The philosophical underpinnings of the meaning of 'life' and 'death' have been much debated over time. 'Meaning of life' seeks to understand the purpose of human existence within a broader metaphysical context over and above individual human contributions (Horne, 2013). Given the shift towards an individualistic focus this makes ‘meaning of life’ contemplations difficult in a traditionalist/religious vacuum. ‘Meaning in life’ on the other hand could be expressed in terms of subjective views that individuals' lives have purpose through the activities undertaken, which may provide pleasure and happiness (Wolf, 1982; Sigrist, 2015).
In May 2014, the National Museums Liverpool (NML) hosted an interactive, public exhibition, consisting of individual lettering, spelling ‘LIFE’ and ‘DEATH’. Members of the public were invited to write comments directly on to the lettering and these comments and illustrations were recorded verbatim and made available to the Marie Curie Palliative Care Institute Liverpool (MCPCIL) at the University of Liverpool to enable a form of qualitative Content Analysis of these public contributions to be undertaken.
The aim of this report is to provide a qualitative analysis of these contributions (written and illustration) in order to gain an insight into peoples’ perceptions of death (and life) with the purpose of informing future public engagement techniques to ‘normalise’ the topic of ‘death’. As previously discussed, it is envisaged that contributions will be more focused on ‘meaning in life’ than ‘meaning of life’. Further, those contributions to ‘what symbolises ‘life’’ will include but may not be limited to: purposefulness; happiness; self-actualisation; youthfulness; and health. Similarly, it is envisaged those contributions to ‘what symbolises ‘death’’ will include but may not be limited to: ambiguity; fear; frailty/old age.
Engaging the public
The Bucket Project representatives were present for an hour or more each day that the exhibition was active and they engaged in conversations with the public about the Bucket Project, Dying Matters and the lettering display. They gave a background to the project and inquired whether people would like to contribute. Other people also contributed to the display without personally talking to the representatives, though they may have taken leaflets/newsletters from the display stand.
The results of this content analysis concur with the hypothesis in that the written contributions largely related to ‘meaning in life’ over ‘meaning of life’ reflecting a priority of purpose for individuals over broader human existence perspectives. This focus on the ‘self’ was evident by the significant proportion of written contributions which reflected individuals’ names. Whilst these were reflected on both ‘life’ and ‘death’ lettering they were more frequently noted on the latter, which may support the individualistic ‘meaning in life’ perceptions in a reduced traditionalist/religious framework.
Similarly the frequency of the acronyms ‘YOLO’ (i.e. You Only Live Once) on both lettering and ‘YODO’ (i.e. You Only Die Once) on ‘death’ lettering could provide additional support for a shift of focus to ‘meaning in life’, prioritising ‘life’ over ‘death’. These acronyms are examples of the type of language adopted largely within more recent technological communication, and are arguably more synonymous with younger individuals.
A proposed youthful demographic of a proportion of the participants to this exhibition is also supported via the use of ‘emoji’ and ‘hashtag’ punctuation across both ‘life’ and ‘death’ lettering which again reflect more recent language style adopted largely within technological communications.
The hypothesis that written contributions to ‘life’ lettering would incorporate purposefulness, happiness, and self-actualisation comments is also supported by this data analysis. Those written contributions relating to ‘happiness’ were the most frequently reported category within this lettering. ‘Purposefulness’ and ‘self-actualisation’ were largely reflected within the category entitled, ‘purpose to life’. Examples include: ‘Be, all, you can possibly, be’; ‘Fullfill your life to the fullest’; ‘Life is all about people - you are who you spend time with’. The remaining significant category within the ‘life’ lettering related to ‘Friends/Family’. Within the literature connectedness to others is subsumed within descriptions of potential purposeful activities that may provide happiness. Therefore this category provides additional support that the current focus is towards individualist ‘meaning in life’ perspectives incorporating purposefulness, happiness, and self-actualisation ideologies.
Contrary to our earlier hypothesis, however, neither ‘youthfulness’ nor ‘health’ were represented within the written contributions provided for the ‘life’ lettering. However, given that the demographic of the visitors to this exhibition may have included a significant proportion of young people this may explain why these categories did not feature, as the young are synonymous with ‘youthfulness’ and ‘health’, the mindfulness of which may only be encountered when these natural qualities start to ebb.
Whilst the category representing ‘unclassified’ written contributions was reflected within both the ‘life’ and ‘death’ lettering, it was significantly represented in the latter (i.e. 10% - 3 times greater representation within ‘death’ than ‘life’ lettering). Examples of these written contributions include: ‘Look out for drowning people! Lol’; ‘Pomegranete Izzy’; ‘To enjoy your death... After all they have cookies! Eve S THS’. As these examples show, these comments are diverse and ambiguous in meaning. It could be argued that the greater frequency of this category of comments within the ‘death’ lettering reflects public ambiguity about death and dying, in line with aforementioned literature, and is therefore supportive of the hypothesis that ambiguity will be a feature within the written contributions reflecting perceptions about ‘death’.
Interestingly, however, the illustrations accompanying some of the written contributions followed more traditional categorisation, whereby ‘life’ was depicted by ‘positivity’ (i.e. chick, happy face, smile, the sun) and ‘love’ (i.e. heart, kiss, people) whilst ‘death’ illustrations represented traditional death imagery (i.e. skull, bomb, flower, ghost), love (i.e. broken heart, heart, people) and sadness (i.e. sad face). Whilst imagery can promote universal messages and meaning, specific detail regarding such meaning can be compromised and limited by the artists’ abilities, which may explain the basic illustrations and their more traditional nature in relative comparison to the written contributions.
Conclusions
In support of the aforementioned literature, the analyses concur that the written contributions focused more so upon ‘meaning in life’ over ‘meaning of life’, suggestive of a reduced focus upon traditional/religious frameworks to support existential meaning. Further, those contributions to ‘what symbolises ‘life’’ included expected categories of: purposefulness; happiness; and self-actualisation. Similarly, those contributions to ‘what symbolises ‘death’’ included ‘ambiguity’. Contrary to our earlier hypothesis neither ‘fear’ nor ‘frailty/old age’ were representative categories within the contributions provided for the ‘death’ lettering. However, comments with more negative connotations were recorded within these contributions.
These results suggest support for the previously argued theory regarding the privatisation of death and dying and ensuing individualist perception and experience afforded death and dying. Future public engagement exercises should aim to reduce the ambiguity regarding death and dying and to find ways to initiate social discourse.