People have thought about life and death since Neanderthal times. The fact that “Living with Death’ was a cover story of Newsweek (May 1, 1978) and that Time June 5, 1978) did a feature story on “A Better Way of Dying” indicates the extent to which dying and death have become concerns to the lay public as well as the health professionals-a surprising development for a culture so often described as death denying. There are a number of reasons for this increasing awareness. Recent advances in innovative medical technology are significantly altering the nature of dying, often compelling the terminally ill to confront years of chronic illness before the actual moment of death. In addition, many postindustrial Americans are alienated from traditional family, religious, and community supports. The results are increased loneliness, anxiety, and self-doubt. Feifel (1977) observes that it is a historic phenomenon that consciousness of death becomes more acute during periods of social disorganization, when individual choice tends to replace automatic conformity to consensual social values. He states:

With the advent of the H-bomb, physical science has presently made it possible for us all to share a common epitaph. Not only descendance in social immortality but history as well is being menaced. Time along with space can now be annihilated. Even celebration of the tragic will be beyond our power. Death is becoming a wall.