What Is Death Positivity?

What is the Death Positivity Movement?

The Death Positivity Movement was coined in 2011 by funeral director Caitlin Doughty, but the sentiment existed long before — the movement’s origins date back to the 1970s, drawing on the hospice movement.

The first U.S. hospice opened in 1974, and hospice care gained federal funding in 1978.

In the 1980s, palliative care became more widespread in the U.S. This allowed for more open discussions surrounding the care of people in hospice care and individuals with end stage illnesses.

The discourse around palliative care at this time also involved helping families and loved ones come to terms with their loved one’s end of life. This helped shift focus from potentially uncomfortable and unwanted medical interventions to enhanced care and quality of life.

However, death positivity was not necessarily a well-known concept, even in recent years.

Elizabeth Grady, DO, is the Medical Director of the Palliative Medicine Department at the University of Maryland Baltimore Washington Medical Center. Dr. Grady is fellowship-trained and board certified in internal medicine and hospice and palliative medicine by the American Board of Internal Medicine.

She has been providing palliative care at UM BWMC since 2016. But she says that even in 2014, death positivity was not something that was mentioned.

“Since I started this job, I kind of had to explain what palliative and end-of-life care was and why it matters to everybody in the hospital,” she says. “Fast forward to now, and we could not be more supported.”

Today, many forums openly discuss death, including books, activism, and museums.

Is it beneficial?

Dr. Adeel M. Khan is a hematologist/oncologist and epidemiologist at the University of Texas Southwestern Medical Center, where he serves as the Director of Myeloma Epidemiology Research and Clinical Director of its Monoclonal Gammopathy Precursor Clinic.

“In my own field of cancer care, the acceptance of death reduces anxiety, the sense of burden, and overall anguish that people confront in the dying process,” he says.

He notes that research also reflects that acceptance of death is beneficial. A 2019 study involving 307 individuals with cancer found that death acceptance decreased existential distress and anxiety after a year.

Additionally, a 2025 study involving nine inpatient hospice care units in Korea found that death acceptance was associated with decreased symptom severity and increased quality of life perceived by caregivers.

It is important to note that while acceptance of death is a part of the Death Positivity Movement, and there is research on death acceptance, more studies on death positivity specifically are needed.

Grady says that even though you may feel scared, the best thing to do is talk about it openly.

“We’re the experts, and we know how to make this go as smoothly as possible and keep you in the driver’s seat over your own healthcare for as long as we can.”

What does it look like?

Grady says it is important to get to know someone outside of their illness. She also emphasizes communicating respectfully and honoring one’s wishes.

“In my opinion, the most important first step is asking the patient, ‘Who do you want to be knowing your medical conditions?'” she says. “If you’re going to get news about test results or what options you have left, who do you trust to be in the room? Who would support you?”

She says it is important to meet people where they are and not force them too quickly too soon.

“We use a method called ‘ask, tell, ask’ a lot,” she says. “‘Is it OK if I tell you; do you want to know the prognosis?’ And if someone says ‘no,’ then we don’t tell them, and then we can say, is there anybody else you’d want us to tell?'”

Khan says that peace at the end of life can mean different things to different individuals. However, he says that human connection through kind words can be comforting.

“For instance, in accepting a hospice option with no further cancer treatment, both patients and family worry if it is the ‘right’ option,” he says. “In those circumstances, it is my task as the physician to walk them through this and comfort them as best as possible.”

He says that he tries to steer the individual and their family to understand their particular situation and its implications on their lives. He says that from understanding can then come acceptance.

“My goal is to ease their pain to a point of peace as best as I can.”

Planning

Advanced care planning is an important tenant of the death positivity movement.

Grady says advanced care directives involve:

• designating a person you trust to make medical decisions on your behalf
• creating a living will
• completing a Medical Orders for Life-Sustaining Treatment (MOLST) form

“You can give flexibility to the people that you designated to change that, or you can say, ‘no, I want this followed exactly as written,'” she says.

She recommends revisiting the MOLST form to ensure that what is listed is still what you want, especially as your disease progresses.

“That paper should be on your refrigerator or nightstand so that if 911 is ever called to your house, they know what your wishes are,” she says.

This can feel like a daunting or uncomfortable task. However, Grady reassures that you will not be abandoned throughout this process, no matter what medical procedures you choose or don’t choose.

“Through the work of palliative care and sometimes even hospice care, you get an even bigger team of people who know exactly how to navigate this with you, and you’re not alone.”

Takeaway

Death positivity does not involve celebrating one’s death or feeling happy about it but rather accepting death as an inevitable part of life.

Research shows that death acceptance is beneficial to individuals in the end stages of illness, as well as their caretakers. However, more research on death positivity specifically needs to be done.

While arriving at this acceptance may not be easy or linear, you may find that having open and candid conversations with your palliative care team and your loved ones can be beneficial. Start slowly and only proceed with what you are comfortable engaging in. Death positivity can look different for different people, and that’s perfectly OK.