Western Attitudes Toward Death from the Middle Ages to the Present was French historian Philippe Ariès's first major publication on the subject of death, it was published in 1974. Ariès was well known for his work as a medievalist and a historian of the family, but the history of death was the subject of his work in his last decade of scholarly life. Ariès wrote several major books and articles on death mentalities and is credited with introducing death as a topic for historical inquiry. Western Attitudes Toward Death began as a series of lectures presented to Johns Hopkins University, which he gave for the express purpose of translation and publication. Because Ariès saw America as influential in changing the way the western world viewed death, he felt it was important to have his ideas circulating on both sides of the Atlantic.Philippe Ariès, Western Attitudes Toward Death from the Middle Ages to the Present (Baltimore: Johns Hopkins University Press, 1974), x. Covering over a millennium of history, Ariès divided Western Attitudes Toward Death into four separate periods, which make up the four major sections of the book: Tamed Death, One’s Own Death, Thy Death, and Forbidden Death.

Tamed Death

In his first chapter, he discusses the first period, "Tamed Death", using a number of ancient texts and medieval romances. He argues that prior to the seventeenth century, people were acutely aware of their own imminent death, prepared for it, and accepted it. True to his roots as a medieval historian, he cites examples such as of King Ban, Tristan, and Lancelot—these characters are shown facing death while knowing that 'their time has come' and prepare themselves by following prescribed rituals. These rituals were often religious such as Lancelot positioning the body to be facing Jerusalem.Ariès, 8. The dying man readied his body and soul for death and waited.

There were four general characteristics: first, the dying person would usually be lying in bed, or at least in a recumbent position. In the Christian tradition the dying person would lie on his or her back, facing the heavens. Second, the dying person in this period always presided over his death and understood its accompanying religious rituals and protocol. The priest was not brought until he was called for, and loved ones did not say goodbye until the dying person consented. Third, death was a public ceremony and parents, spouses, family, neighbors and even children were present at the bedside. Death was seen as normal and it was customary for loved ones to witness the occasion. Finally, while accepted and witnessed, it lacked "theatrics" and a "great show of emotions".Ariès, 13. Ariès explains his choice of "Tamed Death" as a title is meant to contrast with the "wild" death of the twentieth century, in which people fear and avoid death.Ariès, 14.

In this early medieval period people were not concerned with what would happen to their bodies after death. For superstitious reasons they did not want the dead to be buried in cities or near the houses of the living, but if the body was buried in a churchyard and remained under the church's protection, little else mattered. People did not believe that the grave should be permanent (especially the graves of the poor) and ossuaries were very common.Ariès, 22. Moreover, the burial grounds were common meeting places where dancing, gambling, and even commerce took place.Ariès, 23.

One's Own Death

Subtle changes in western people's attitudes toward death occurred around the eleventh and twelfth centuries. Ariès titled this mentality shift: "One's Own Death". The defining feature of this era was a new personalization of death, in which the individual rather than the act of death itself came to the forefront. Ariès notes four major indicators that signify this change.

He explains that in the previous era, the Christian tradition of Last Judgment separated believers and non-believers after death. Christians alleged that during the second coming of Christ believers would be resurrected in Paradise, while non-believers would cease to exist. However, by the twelfth century Ariès observes that Last Judgment had taken on new meaning. It came to signify judgment passed on one's soul after the moment of death. In the new Christian tradition, people believed that after death their good and bad deeds would be weighed against each other, and based on those deeds they would be either damned or admitted immediately into heaven. This made death more personal and individual.Ariès, 31. Ariès notes that the actual moment of death began to gain greater significance, as Christians believed that a person's deathbed behavior and personal reflection on their own deeds, at the moment of death, could influence heavenly judgment. As in the previous era friends and family were often present, but their presence became more closely tied to witnessing the moment before judgment rather than simply witnessing death.Ariès, 37.

Finally, in this era, depictions of corpses and skeletons became more prevalent, and individual tombs with inscriptions grew in popularity. Although religious artwork had featured macabre themes in the past, by the seventeenth century there was an influx of artwork that featured decaying cadavers and the physical body after death. Ariès argues that this artwork was meant to warn against moral corruption and also express love of life. He states that men of that era felt a "love of life which we today can scarcely understand", due to our increased longevity.Ariès, 45. Ariès also notes that by the thirteenth century individual tombs with inscriptions were becoming more typical, especially for the religious elite and royalty. Although during the Roman period individual graves had not been uncommon, this practice had faded during the Middle Ages. By the eighteenth century, the middle and lower classes were also likely to have tombs, or at least plaques, marked with individual inscriptions. As people became more conscious of their individual place in the world, their death reflected that awareness Ariès, 46–49.

Thy Death

By the early eighteenth century, Ariès observed an abrupt change in the western person's attitude toward death. Death was dramatized, exalted, feared, and in some cases worshipped.Ariès, 56. Looking to themes in artwork from the sixteenth to eighteenth centuries, Ariès argues that death became categorically similar to sex, and was seen as a break from the ordinary. Although the erotic associations with death did not last beyond that short period, he maintains that death was no longer normalized. People did not look at death as a familiar occasion that was part of life, as they had in the past. Although people continued to participate socially and ritualistically in death, and crowds still flocked to the bedside of a dying person, their purpose had changed. Instead of witnessing death, they mourned it.Ariès, 59.

Although mourning was not completely new in the eighteenth and nineteenth centuries, Ariès argues that it became unregulated. It was less of a ritualized social obligation, and more of a spontaneous and often excessive display of emotions. Ariès maintains that survivors no longer accepted the death of friends and loved ones. He states that people of this period lamented that death was a complete rupture from life and were consoled by preserving the memory of the deceased. Memorializing the dead became an important feature of the period of "thy death".Ariès, 67–68.

There was also a renewed interest in burial grounds and grave markers. In the past Christians had been content to relinquish bodies to the care of the church. Even when gravestones became more prevalent, Ariès argues that they were predominantly an expression of individuality or representative of individual donations to the church. However, by the eighteenth century, bodies were buried away from the church in individual cemetery plots, where people felt they could commiserate with the dead and cultivate their memory.Ariès, 70–75. Ariès also observes that while all western people celebrated cemeteries and their new role in society, France, Italy, and Germany are known for more elaborate tombs and burial sites when compared to the simple style of North America, the UK, and Northwestern Europe. He suggests that this trend is due to economic inequalities; poorer nations were more inclined to build elaborate tombs as a statement against the elegant simplicity that wealthier nations promoted. Ariès also notes that because the countries that favored more ornate tombs were also Catholic, it later became indicative of religion.Ariès, 81.

Forbidden Death

The final period Ariès demarcates in the evolution of western attitudes toward death is the era of "forbidden death". Beginning in the very late nineteenth and early twentieth centuries, Ariès argues that a "brutal revolution" occurred in western attitudes toward death, in which death became both shameful and forbidden. While this trend began in the United States – spreading to Britain, Northwestern Europe, and eventually the whole of the continent – the bulk of his analysis in this section deals primarily with Britain and Europe. Growing out of the sentimental era of "thy death" in which survivors mourned the death of loved ones openly, spontaneously, and with heightened displays of emotion, it soon became common practice to shield the people actually dying from the reality of their condition. The mourner, so moved by the gravity of death, wished to spare their dying loved one any emotional turmoil. Thus in the era of "forbidden death" the dying man no longer presided over his own death. Soon the extreme emotions that survivors expressed in the previous period were replaced with an equally extreme avoidance of death and suppression of emotion that became dominant in the twentieth century. Ariès names two societal trends that he believes were very influential on shifting attitudes toward death: the advent of the hospital as a place of dying, and a growing sentiment that life should be, above all, happy.

Citing trends in literature, such as the work of Tolstoy, Ariès argues that the feeling surrounding death changed before its actual rituals did. By 1930–1950, he states that the displacement of the site of death from the home to the hospital accelerated changes in attitude. While for most of history the dying person took his or her last breath in bed, surrounded by loved ones, now, in era of "forbidden death" people are more likely to end their lives alone in a hospital bed.Ariès, 88. Ariès writes that death in the hospital is often a "technical cession" that is predetermined by a hospital team, frequently occurring after the dying person has already lost consciousness. He argues that the moment of death is difficult to distinguish for most survivors because they have already witnessed many "silent deaths" as the dying person loses different abilities – from breathing and eating on their own, to verbal communication and eventually consciousness. He states that in this current period there is no great and dramatic act of death, which was what family, friends, and neighbors used to gather together to witness. Ariès writes: "No one any longer has the strength or patience to wait over a period of weeks for a moment which has lost its meaning." Instead, doctors battle against death and when death finally comes it is usually considered a failure of medicine rather than a normal occurrence.