Designing a Better Death

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Cold, antiseptic hospitals; rooms filled with beeping machines; warehouses of people nearing their ends. Why on earth must we die in such ugly places? That’s the big question that Rotterdam-based architect Alison Killing asked at TED Global in Rio de Janeiro last year. Plugging into a big, timely conversation about what it means to approach death, Killing threw her discipline’s hat into the ring: Architects, she says, can help people die better. She talked to OZY about the birth, growth and future of her big idea.

Killing tells us she didn’t have a single guiding idea telescoping her work in the beginning. “I liked to make things,” she says — apt enough for an architect. Most of her colleagues, Killing says, aspire to build gleaming galleries or gorgeous libraries, but they don’t “generally graduate wanting to build hospitals,” she concedes. So she was doing her project-by-project thing, making Europe prettier, thinking about cities and built environments. But budding all around her was a conversation about death across all fields. Pew Research Center tells us the number of people older than 65 will triple by around 2050. And while people in some disciplines — like urban design and health policy — have been thinking about our aging population for a while, architects like Killing were just starting to figure out their place in things.

Take, for instance, Maggie’s Centres, designed with the motto “People with cancer need places like these.” Maggie’s Centres was founded 20 years ago in memory of Maggie Keswick Jencks, a landscape designer whose husband was an architecture critic. The U.K. buildings are sweet, warm and designed by fancy architects like Frank Gehry. What of hospices and hospitals — where more and more patients are dying? Some 1.5 million Americans entered hospice in 2013 in the U.S., according to the National Hospice and Palliative Care Organization. Those aren’t as nice as they could be. Christopher Shaw, director of the U.K.-based firm Medical Architecture, calls them, in fact, “fairly ignominious” places to pass away.

Death in Venice

“Death in Venice” showed the evolution of the relationship between modern architecture and our understanding of, and approach to, death over the last century.

Source Killing Architecture

But it wasn’t always like that. This is what Killing discovered when two friends called her up to suggest entering a contest in the Venice Biennale, the every-other-year arts-and-design extravaganza. One of the friends had just finished designing a crematorium, and the other had studied public mourning after Princess Diana’s death. Together, they gathered a team and began some serious research — desk and primary, including interviewing undertakers and hospice workers. What they uncovered: a long, nuanced history of death rituals, many of which were not cold and antiseptic affairs. For one, in 1960s Britain, funeral services were often collective, with the same sermon applied to six coffins at once. Hardly anyone attended, because they weren’t allowed time off during the week, she recounts. Shaw had some notes to add: During the Victorian era, people lived in closer proximity to death, which meant it received greater consideration. Today, ironically enough, thanks to medical advances, we talk about it less.

Digging through archives, Killing and Co. discovered some gorgeous images of hospitals with intricate trimmings around arches and colorful paint and courtyards and gardens. Studies had been done on these topics for a few decades — architect Robert Ulrich had a landmark finding in 1984, showing that over nine years, patients in a Pennsylvania hospital recovered from surgery faster when they had a lovely view out the window; and a small community of architects like Shaw had built on that legacy. But Killing saw a gap — an area that was “massively understudied” — in architects tackling the rather gloomy specialty of death.

The team kicked into high gear before Venice. The themes for the 2014 Architecture Biennale were “The Fundamentals” and “Absorbing Modernity” — and they discovered the research was exactly on track to tell a story of a uniquely modern problem. With sweaty, start-uppy brows, they pulled off the entry, and landed in Italy with the appropriately-titled “Death in Venice.”

Killing’s big idea is out in the world — but what now? It needs some legs, to start, and Killing figures Europe, particularly the Netherlands and the U.K., surprise, are the best places to get some traction. It’s tough — docs and other medical professionals “need to be onboard,” she says. It’s difficult to convince hospitals that “there’s any value in spending money on bigger windows and daylighting and stuff like that, rather than on medicine. There’s still a discussion about whether that’s worthwhile.”

And the actual designs? They’ll change as the rapidly growing and massive mortality economy keeps evolving. For now, there are hospital paint jobs and quiet places for palliative care. And of course, it’s not all about the space, but the people too; Shaw points out that with death comes, sadly, all the drama of Tolstoy’s unhappy families, “coercive groups” who want to talk inheritance or, on the softer side, parents and children who’d like to be around at the end. That last part? It’s uncontroversial enough, just like a garden.

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