The Death Positive Movement: Why Americans Are Talking About Death Again

For most of the last century, death in America happened behind closed doors. People died in hospitals, bodies were taken away quickly, and families met the funeral home for the first time at one of the hardest moments of their lives. Talking about death beforehand felt morbid, or even unlucky.

That is changing. A growing cultural shift, often called the death positive movement, encourages people to talk openly about dying, learn their options, and make plans before a crisis. You can see it in Death Cafés, celebrations of life, green burial, water cremation, end-of-life doulas, and the funeral directors explaining their work on YouTube and TikTok.

This guide explains what death positivity means, where it came from, why it is growing, and what it could mean for how you and your family plan for the end of life.

Key Takeaways

• “Death positive” does not mean being happy about death. It means being able to talk honestly about death, dying, and grief, and having the information to make your own choices.
• The term dates from 2013, but the ideas behind it go back to the hospice movement of the 1960s and to Jessica Mitford’s 1963 exposé of funeral industry pricing.
• Most Americans agree in principle. In 2025, 91% told the National Funeral Directors Association (NFDA) that talking about death is healthy.
• Far fewer act on it. Only about one in three US adults has an advance directive, and in a 2018 national survey just 32% had talked through their end-of-life wishes, although 92% said it was important.
• Your options are wider than ever: cremation, green burial, water cremation (legal in 26 states), human composting (legal in 14 states), home funerals, celebrants, end-of-life doulas, and, in 13 states and D.C., medical aid in dying.
• Planning ahead is the practical heart of the movement. Writing down your wishes protects your family from guesswork, conflict, and unnecessary costs.

What Does “Death Positive” Mean?

People who are death positive believe that it is not morbid or taboo to speak openly about death, and that honest conversations about dying make life better for everyone.

The term was coined by Los Angeles mortician and author Caitlin Doughty, who founded a group called The Order of the Good Death in 2011. In April 2013 she asked on Twitter why there was a “sex positive” movement but no “death positive” one. The phrase stuck.

The Order sets out eight beliefs, or “tenets.” In plain terms, they are:

1. Hiding death and dying does more harm than good.
2. The silence around death should be broken through conversation, art, and learning.
3. Being curious about death is natural, not morbid.
4. A dead body is not dangerous, and families should be able to care for their own dead if they wish.
5. End-of-life laws should honor a person’s wishes, whatever their identity or religion.
6. Death care should not do great harm to the environment.
7. Your family and friends should know your wishes, and you should have the paperwork to back them up.
8. Open, honest advocacy about death can change culture.

What death positivity is not

The phrase can sound jarring, especially if you are grieving. Supporters are clear that it does not mean:

• Feeling cheerful about death, or being told to “look on the bright side” of a loss.
• Rushing or skipping grief.
• Accepting deaths that are caused by violence, neglect, or lack of access to care.

Instead, it means making space for grief and giving people the knowledge to make choices that fit their values.

Where Did the Death Positive Movement Come From?

Death positivity has a short name but a long history. It brings together several reform movements that began decades earlier.

Challenging the funeral industry (1960s–1980s)

In 1963, British-born journalist Jessica Mitford published The American Way of Death, a bestselling exposé of funeral home pricing and sales pressure. Public outrage led to a Federal Trade Commission investigation and, in 1984, to the FTC Funeral Rule. The rule still gives you the right to itemized prices and to buy only the goods and services you want.

The hospice movement (1967 onward)

In 1967, Dame Cicely Saunders opened St Christopher’s Hospice in London, built around comfort, dignity, and honest conversation with dying patients. The first US hospice opened in Connecticut in 1974, and Medicare began covering hospice care in 1982. Around the same time, Elisabeth Kübler-Ross’s On Death and Dying (1969) and Ernest Becker’s Pulitzer Prize-winning The Denial of Death (1973) argued that modern society avoids death at a real cost.

Natural burial and home funerals (1990s)

In the 1990s, families began reviving older traditions: caring for loved ones at home after death and burying them simply, without embalming or concrete vaults. The first US conservation burial ground opened in 1998.

A new wave (2011 onward)

Around 2011, several projects launched almost at once:

• Death Café: Londoner Jon Underwood hosted the first Death Café in 2011, based on the Swiss “café mortel.” Strangers meet over tea and cake to talk about death. More than 24,000 have since been held in 100 countries.
• The Order of the Good Death and Caitlin Doughty’s Ask a Mortician videos, which now reach about 2.1 million YouTube subscribers.
• The Conversation Project (2012), a national campaign to help families talk about end-of-life care.
• End-of-life doulas, trained companions who give non-medical support to dying people and their families. The International End-of-Life Doula Association (INELDA) reports training more than 8,000 doulas. Learn more about death doulas.

Why Is Death Positivity Growing Now?

No single event explains the shift. Several forces are pushing in the same direction at once.

People want more say in how they die

Through much of the 20th century, dying moved from the home to the hospital. Many people now want less medical intervention at the end and more comfort and control. A landmark 2019 study in the New England Journal of Medicine found that by 2017, home had overtaken the hospital as the most common place of natural death in the US for the first time in roughly a century.

More choice at the very end of life

Medical aid in dying (MAID) allows a terminally ill, mentally capable adult with a prognosis of six months or less to request medication they take themselves to bring about a peaceful death. It is now authorized in 13 states and Washington, D.C., with New York (August 2026) and Illinois (September 2026) the most recent to take effect. MAID remains deeply debated, including over safeguards and disability rights, and many people who obtain the prescription never use it. For supporters, it reflects a principle at the heart of death positivity: that a dying person’s informed wishes should shape how their life ends. Our guide to medical aid in dying in the United States explains where it is legal and how it works.

Funeral costs and a demand for transparency

Families still often face confusing prices at the worst possible moment. Death positive advocates encourage people to compare providers and know their rights before they need them. Our guide to avoiding funeral scams explains what to watch for.

Fewer people follow one set tradition

As religious affiliation has declined, many families no longer inherit a ready-made funeral ritual. Instead, they design their own: a celebration of life, a ceremony led by a celebrant, or even a living funeral held while the person can still attend.

Concern for the environment

Embalming, metal caskets, and concrete vaults leave a lasting footprint. In NFDA’s 2025 consumer survey, 61.4% of respondents said they would be interested in exploring green funeral options, up from 55.7% in 2021.

The baby boom generation is aging

US deaths are projected to pass 3.6 million a year by 2037, about one million more than in 2015, according to the Census Bureau. More families will face these decisions, and many adult children are already caring for aging parents.

Social media opened the curtains

Funeral directors, embalmers, and doulas now explain their work directly to the public online. Mortuary schools report that some students first became interested in the field through TikTok videos.

The COVID-19 pandemic

The pandemic brought death into everyday conversation, often in its most isolated, hospital-bound form. Many people, including younger adults, wrote wills and advance directives for the first time.

The Gap Between Agreeing and Doing

Most Americans now agree that talking about death is healthy. Fewer have actually made plans.

Interestingly, younger people are not automatically more comfortable. NFDA’s 2025 generational study found that Gen Z adults were the least comfortable talking about death (63%, compared with 77% of Baby Boomers) and the least likely to have shared their funeral wishes, even though they were the most likely to say a funeral or memorial matters.

The lesson is simple: being open to the idea is a start, but the benefits only arrive when wishes are discussed and written down.

How the Movement Is Changing End-of-Life Care and Planning

Death positivity is already reshaping the choices families make. Here is what that looks like in practice, and what is likely to grow.

Planning earlier, and revisiting it

Instead of waiting for a diagnosis, more people are documenting their wishes in midlife and updating them over time. A plan can be as simple as a written list of preferences. You do not have to pay in advance. Our funeral pre-planning guide walks you through the decisions step by step.

More ways to care for the body

Families now have far more choices than burial or flame cremation:

• Cremation, now chosen by most American families. NFDA projects a 63.4% national cremation rate for 2025, rising to 82.3% by 2045.
• Green or natural burial, without embalming or a vault. The Green Burial Council estimates about 470 green burial cemeteries in the US and Canada. Find a green burial site.
• Water cremation (aquamation), legal in 26 states according to the Cremation Association of North America. Read our aquamation guide.
• Human composting (natural organic reduction), legal in 14 states. Read our human composting guide.

Availability varies widely by state, and a method can be legal where no provider yet operates, so check local options before you plan around one.

Families taking part

Home funerals are legal in every state, though nine states (Connecticut, Illinois, Indiana, Iowa, Louisiana, Michigan, Nebraska, New Jersey, and New York) require a funeral director for certain steps. Even when a funeral home handles everything, many families now choose to sit with their loved one, help wash or dress them, or hold a vigil. Our guide to family-directed funerals explains what is involved.

Ceremonies that reflect a life

Celebrations of life, non-religious celebrants, and gatherings in parks, homes, or favorite venues are increasingly common. In NFDA’s 2025 survey, 58.3% of respondents had attended a funeral at a non-traditional location.

A wider support team

End-of-life doulas increasingly work alongside hospice teams, helping with legacy projects, vigil planning, and emotional support. The field is growing quickly, but it is not licensed, so ask about training and experience. Find a death doula in your state, or read what’s driving the rise of death doulas.

Price shopping before the need

Consumers who have learned their rights are more likely to compare providers in advance and to choose funeral homes that are open about pricing. Under the FTC Funeral Rule, any funeral home must give you an itemized General Price List on request. Compare funeral homes in your state.

Common Criticisms of the Death Positive Movement

The movement has thoughtful critics, and their concerns are worth knowing:

• A “good death” is not equally available. Access to hospice, home care, and planning tools still varies by income, race, and where you live.
• The tone can feel wrong to grieving people. Humor and the word “positive” can sound dismissive when a loss is fresh.
• Commercialization. As “death wellness” grows, so do products and services that families may not need.
• Home death is not always easier. Caring for someone at home can be physically and emotionally demanding for untrained family members, and a hospital or hospice facility is sometimes the better choice.

The most useful parts of the movement are practical: knowing your options, sharing your wishes, and asking for help.

How to Start: Five Simple Steps

1. Start one conversation. Tell someone you trust what matters most to you at the end of life. The Conversation Project offers free starter kits.
2. Complete an advance directive. Name a health care agent and record your medical wishes. Forms are free in every state.
3. Write down your funeral wishes. Burial, cremation, or a greener option? A service, a celebration of life, or nothing formal? Use our pre-planning checklist.
4. Learn the costs and your rights. Request General Price Lists from two or three local providers before you need them.
5. Tell people where your plans are kept. A plan nobody can find cannot help your family.

Frequently Asked Questions

What is the death positive movement?

The death positive movement is a social movement that encourages open, honest conversation about death, dying, and grief. It promotes informed end-of-life choices, family involvement, environmentally responsible death care, and planning ahead so that a person’s wishes are known and honored.

Who started the death positive movement?

Mortician and author Caitlin Doughty coined the term “death positive” in 2013 and founded The Order of the Good Death in 2011. The ideas behind it draw on earlier work, including the hospice movement, Jessica Mitford’s The American Way of Death (1963), and Ernest Becker’s The Denial of Death (1973).

Does death positive mean being happy about death?

No. Death positivity means being able to speak freely about death and grief and having the information to make your own choices. It does not ask anyone to feel positive about a loss.

What is a Death Café?

A Death Café is an informal, free gathering where people drink tea, eat cake, and talk about death. It is not a grief support group and has no set agenda. The first was held in London in 2011, and thousands have since taken place around the world, both in person and online.

How is the death positive movement changing funerals?

It is encouraging more personalized ceremonies, celebrations of life, green burial, water cremation, human composting, home funerals, and the use of end-of-life doulas. It is also pushing families to plan ahead and compare prices before a death occurs.

Is medical aid in dying part of the death positive movement?

Many advocates see the two as closely connected, because both emphasize informed choice and honest conversation about how life ends. Death positivity does not require anyone to support medical aid in dying, though. The movement is about being able to discuss every end-of-life option openly, including ones people disagree on. MAID is currently authorized in 13 states and Washington, D.C.

How do I start talking about death with my family?

Choose a calm moment, explain why it matters to you, and start with one question, such as “What would a good last chapter look like for you?” Free guides from The Conversation Project and Death Over Dinner can help.

Sources: The Order of the Good Death; Death Café; The Conversation Project National Survey (2018); National Funeral Directors Association Consumer Awareness and Preferences Study (2025) and generational report (2025); Yadav et al., Health Affairs (2017); Cross & Warraich, New England Journal of Medicine (2019); US Census Bureau; Cremation Association of North America (March 2026); Compassion & Choices; New York State Department of Health (2026); Green Burial Council; Funeral Consumers Alliance; International End-of-Life Doula Association.