From an American perspective the current state of death care appears bleak: a mismanaged pandemic has exacted a worldwide toll well exceeding 2 million (as of February 2021), with Belgium, the UK, Italy and the US having among the highest Covid-19 per capita death rates at over 1,000 deaths per million. Countless families are bereft, many never having been able to say goodbye to their hospitalised loved ones or memorialise them as they would have wished. Overworked, under-equipped hospital staff have been stretched to their limit caring for the infected and the dying. But death care deficiencies did not arrive with the pandemic. Millions of frail, elderly individuals have passed their final years isolated in institutional settings, often without a hand to hold when taking their last breath. While a smaller number of Americans die in hospitals than 20 years ago, deaths in nursing facilities remain at around 20 per cent, the vast majority of whom would have preferred to die at home. Antiquated funeral laws, local cemetery regulations, and funeral home policies compel families to spend excessively on final arrangements. Under-regulated crematoria spew carbon fumes, each incineration comparable in carbon emissions to the energy consumption of the average American home for one month. Many cemeteries in dense urban areas around the world face dire limits on burial space. In New York City, for example, cemetery lots are expected to be depleted by 2025.
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