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One of the main differences between human beings and animals is the former's awareness of the inevitability of death. Existentially, this is of course both a tragedy and a triumph—a tragedy because it lends an undercurrent of fear to many of our waking, as well as sleeping, moments; a triumph because it gives a sharper edge of pleasure and meaning to those moments.
Cultural history is replete with a variety of attitudes towards death, ranging from complete denial, through highly ritualized acceptance, to a kind of “thanatocracy,” in which life itself is regarded as a delusional moment in the greater reality of death. The picture is never clear, of course, for it could be argued that a seemingly death obsessed culture like that of ancient Egypt was really a death denying one, since its images and artifacts relating to death are those of life's continuance rather than of life's end. Our own dreams of heavenly paradise and rewards can be similarly interpreted.
In our American culture it is only very recently that a psychology and philosophy known as “thanatology” has sprung up, initiated most likely in 1969 by the publication of Elizabeth Kubler-Ross's now classic book, On Death and Dying.
Jo Roman, a painter, sculptress, and psychotherapist, had for many years been thinking about how to arrange her life so that she might assure herself a death with dignity, a death without the humiliation of pain and helplessness. She had vaguely speculated that her productive years would be drawing to a close sometime in her seventies and that she would plan to end her life before control of her body was taken out of her hands by the debilitating effects of senility or illness or by the doctors and technicians in charge of her final hours, months, or years. This was not a position arrived at easily, and in fact as she thought and felt more deeply about the matter, a book began to take shape in her mind, which she planned to call Exit House, a plea for socially sanctioned institutions wh