The Madness of Joanna of Castile (1866) by Lorenzo Vallés. Courtesy of the Museo del Prado, Madrid


Final thoughts

Do deathbed regrets give us a special insight into what really matters in life? There are good reasons to be sceptical

by Neil Levy + BIO

The Madness of Joanna of Castile (1866) by Lorenzo Vallés. Courtesy of the Museo del Prado, Madrid

How do we find out what really matters in life? One way might be to ask those who are dying. They might occupy a perspective that allows them to see better what’s trivial and what’s truly significant. The prospect of imminent death might carry them above petty squabbles and the pursuit of money and status, and allow them a clear view of the goods that make our lives worthwhile.

What really matters, it turns out, is family and relationships and authenticity. At least, that’s what people apparently report from the deathbed. There’s very little systematic research on this question, but there’s some unsystematic research. Search the internet for ‘regrets of the dying’ and chances are you’ll quickly hit upon a website or a newspaper article reporting the work of Bronnie Ware, an Australian former nurse whose blog recording bedside conversations became the basis for a bestselling book. According to her, the dying expressed five common regrets:

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I hadn’t worked so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

Broadly, people seem to wish for a more meaningful life. They wished they’d been more authentic in their activities (1; 3). They wished they’d prioritised friends and themselves, rather than work (2; 4; 5). They wished, in short, that they’d stopped and smelled the roses.

Along with almost everyone else, I find it plausible that these things are very valuable, and that they’re components (though far from the only ones) of a meaningful life. But I’m not convinced that the reported regrets of the dying provide us with reasons to think them valuable. I’m sceptical, first, of the reports themselves. There are various cultural pressures that might lead people to report such regrets, whether they feel them or not, and might lead us to attribute them to the dying, whether they report them or not. Second and more importantly, I doubt that the perspective of the dying gives them a clearer view on what really matters. There are reasons to think that the view from the deathbed is worse, not better, than the view from the midst of life. Their lack of engagement in ongoing projects might leave them with an impoverished sense of their value.

I’m not the first person to wonder whether deathbed regrets are epistemically privileged. The American philosopher Eric Schwitzgebel gives two reasons why we should be cautious in giving them significant weight. First, the dying might be subject to hindsight bias, in the form of a tendency to assume that their current epistemic perspective looking back on the past is identical to the perspective they should have adopted at the time. Take the advice that people should prioritise fulfilment over money. That advice is easier to find compelling from the perspective of the financially comfortable present self than it is from the perspective of the worried past self, struggling to make ends meet. Even if the person who offers the advice was herself once poor, she might easily romanticise the past, in part because memories of day-to-day life tend to be crowded out by memories of peak moments. Perhaps I recall my time of relative poverty as better than it really was, because I remember dancing to the radio in the kitchen and not struggling to pay the bills. My biased recollection could easily lead me to underestimate how much money really mattered to a decent life.

Schwitzgebel’s second reason for wariness about deathbed regrets arises from the fact that the dying escape the consequences of their advice. They don’t risk accusations of hypocrisy if they fail to live up to it, because they can’t be expected to try. This lack of a stake in their advice might free them to fantasise, in a way that those of us who are called to live up to our own advice can’t. For that reason, Schwitzgebel suggests that we might do better to prefer the wisdom of 40-somethings: those who have experienced enough to have a broad perspective on life, but who still have a stake in living.

While these concerns are significant, they don’t seem sufficient to eliminate any sense that the view from the deathbed is epistemically privileged. For one thing, the status of the (so-called) hindsight bias is contested: as the Australian philosopher Brian Hedden has argued, in hindsight we often have a better grasp of what our total evidence at the time actually was, and what propositions it actually supported. The objection that the dying are suspiciously free of the need to abide by their own advice seems to generalise too broadly: we often, and apparently appropriately, seek advice from people who we know won’t follow it themselves, because they won’t face the problems we face (we go to celibate priests for advice on marriage problems, for example). Together these concerns could give us reason for downgrading deathbed advice to some degree, but they’re compatible with thinking that it nevertheless has special epistemic weight.

We can reinforce Schwitzgebel’s scepticism with a third worry. The regrets of the dying are platitudes, taken-for-granted pieces of folk wisdom, and that very fact is grounds for wondering about their sincerity and about their representativeness.

The dying person knows that if they say they regret not making more money, they’ll be seen as shallow

Ware’s The Top Five Regrets of the Dying (2012) gives us ‘anecdata’, not carefully collected evidence. We don’t know how broad a range of patients she saw in her ‘several years’ in palliative care. It probably wasn’t especially broad, since she worked for an agency that provided help in the homes of those who could afford such services. Nor do we know how systematically she has reported the regrets she heard. Perhaps certain things struck her more forcefully than others, and she was more likely to remember them. Beyond these considerations, there are reasons to worry that both what was actually said to her and what she recalls being said were shaped by expectations and cultural pressures of various sorts.

The top regrets of the dying are suspiciously familiar. It turns out that the dying value exactly the things that our culture tells us all to value: the themes that fill our advertising and magazines. The variously attributed saying ‘No one ever said on their deathbed I wish I’d spent more time at the office’ and close variations thereof return close to 40,000 hits on Google, indicating how deeply such sentiments resonate with us. That friendship and family and feelings are valuable is surely part of the reason why we value them. But the everyday banality of the advice gives us reason for suspicion.

The ubiquity of the advice suggests that there’s a cultural script in play here: a set of expectations that shapes what’s said and what’s heard. Perhaps our expectations lead us to fit what the dying say into the established script; perhaps Ware (for instance) turned more ambiguous or noncommittal statements into those she reports, or perhaps she recalls and reports only those that fit the script and ignores (who knows how many?) others that don’t fit. On the other hand, perhaps the script shapes what’s actually said: perhaps her reports are accurate and representative, but they were expressed because these are the kinds of things that one’s supposed to say in this kind of situation. The dying person knows full well that if they say they regret not making more money or not spending more time at the office, they’ll be seen as shallow.

If cultural scripts are responsible for what’s reported or what’s remembered, it might well be that these nuggets of wisdom circulate so widely and are repeated so often not because they come from the dying (if they come from the dying at all): rather, it might be because they’re truisms that are attributed to the dying. If that’s right, the idea that we should give these regrets special weight because they’re expressed by the dying gets things backwards: we attribute these things to the dying because we give them special weight.

What if further research indicates that the dying really do express such regrets, and we found out (somehow) that they genuinely express what really mattered to them at the time that they expressed them? Should we give them special weight under those conditions? I’m still sceptical.

The idea that the perspective from death is epistemically privileged is one with a distinguished philosophical pedigree. Existentialists, in particular, are associated with the idea that holding the fact of our inevitable deaths in mind can help in achieving authenticity. In Being and Time (1927), Martin Heidegger argues that death individualises us, because at death we cease to be in social relations with others. This, for him, entails that awareness of my death enables me to grasp my authentic being, while evading contemplation of my death (by assimilating it to the empirical fact of the death of everyone) allows escape into inauthenticity. Other existentialists (eg, Karl Jaspers) developed this kind of thought in slightly different ways.

Authenticity consists, more or less, in being true to oneself and to what is distinctive about each of us. It’s an ideal that many of us value. If Heidegger’s right, contemplation of death can give us a route to authenticity. When I’m absorbed by day-to-day concerns, I’m unable to glimpse my authentic self and what matters to me. If I manage to still the clamour without, perhaps I will better hear the voice within, and perhaps contemplation of death will enable me to hear better. The dying person, no longer distracted by these minutiae, might be in a better position to hear that authentic voice.

But the appeal to authenticity, in its standard form, won’t vindicate the thought that the dying have special insight to offer to us. Authenticity is about hearing one’s own inner voice. Perhaps the dying person is in a better position to see what really matters for her. Yet there’s no reason to think that her wisdom indicates what matters most for me. Perhaps, though, the Heideggerian manoeuvre works for values other than authenticity. Perhaps there is a set of goods that are valuable for all – or almost all – of us, and the view from the deathbed helps us grasp them for the same reason it (supposedly) enables us to grasp what matters distinctively for each of us: because we’re no longer distracted by everyday matters.

I want to suggest that this thought might have it backwards. The view from the deathbed might be impoverished, not enriched, because it’s outside of everyday concerns.

Heidegger claims that, when we contemplate our individual death, we emerge from absorption in the everyday. The view from outside everyday life is very different from the view within it, he suggests. That’s plausible, but it doesn’t follow that the view from outside the everyday is more reliable. There are grounds for thinking it’s less reliable.

You’re not going to start reading War and Peace if you know you have just 24 hours to live

From within an ongoing project or enterprise, the stakes not only look different to how they appear from outside it; they are different. In an influential article on the absurd, the American philosopher Thomas Nagel notes that, when we exercise the distinctively human capacity to step back from the life in which we’re immersed and survey that life and ourselves ‘with that detached amazement which comes from watching an ant struggle up a heap of sand’, all justifications for our struggles seem to drop away. Meaning seeps away because taking this crucial step backwards entails stepping back from the kinds of concerns that constitute reasons for us. It is only from within our life projects that questions about justification can be answered at all because, in the absence of the commitments that give our struggles meaning, nothing is justified. The view from the deathbed might be the closest we can get to seeing life and its concerns from outside. From outside, we can’t grasp the significance of those concerns, not because they’re not real, but because they’re graspable only from within.

Most plans and projects have a significance only for the person who’s confident she’ll live for some time to come. Saving money often makes sense only because there’ll be a later, at which I might need the money. Learning French might make sense only in view of the possibility of a visit to Paris. Planting roses might make sense only if I’ll be around to see them bloom (of course, people plant things for their children or even for strangers – trees are a storied example – but even this sort of planting often depends on having some kind of personal future, because the sapling might need care before it can survive on its own). Even starting a book, or a box set, is an enterprise that could require confidence in a personal future to make sense. You’re not going to start reading Leo Tolstoy’s 1,392-page novel War and Peace (1867) if you know you have just 24 hours to live. You won’t even start watching Game of Thrones.

Once you know your death is imminent, extended plans and projects cease to have a grip on you as valuable activities; valuable for you. On the deathbed, only a narrower, more immediate, set of commitments continues to have significance. When we know that we lack a personal future, we find ourselves external to the system of justification that underwrites longer-term projects. We still understand them, but now we see them from the outside. Finding ourselves on the outside of the frames of justification that underwrite these projects, the passionate commitment of others to them seems absurd, like the ant’s struggle does to Nagel. The view from the deathbed is a perspective that has shed important sources of meaning.

If that’s right, the view from the deathbed is epistemically distinctive. It’s the perspective of someone who is embedded in a simpler set of commitments: for whom simpler pleasures – those that can be realised immediately, or come to fruition relatively quickly – retain their grip, but for whom broader commitments are absurd. The view from the deathbed comes as close as is humanly possible (for those who aren’t deeply depressed) to abandoning the sets of commitments that give more extended projects meaning. It’s not because the deathbed is epistemically privileged that diachronic projects look meaningless. It’s because the perspective lacks the temporal horizon that makes sense of them. These projects lack meaning because their meaning is graspable only from within. They’re still meaningful, even if those who lack a future can’t sympathise with them.

In his recent book on the midlife crisis, the American philosopher Kieran Setiya argues that these crises can arise because, as we complete our projects, they lose their meaning for us. These projects are telic: they have a goal, and it’s our commitment to this goal that makes them meaningful to us. Once we’ve achieved that goal, they come to seem absurd. Setiya counsels us to ward off the midlife crisis by finding value in the atelic: in activities that don’t have a goal beyond themselves (going for a walk for the sake of it, rather than to get somewhere, for example). Whatever the merits of his solution to the problem that he sees midlife as posing, Setiya’s distinction is a helpful one. Telic pursuits are diachronic; atelic are not, or not necessarily. From midlife, when those of us who are lucky have achieved some of our goals, these telic pursuits seem pointless and absurd. But we remain in the midst of life and have to find a way to recommit to ongoing projects (Setiya recommends finding value in the moment, in the atelic aspects of our telic activities).

At each life stage, we face a different mix of telic and atelic activities. These activities are meaning-conferring for us; they constitute what’s valuable. Perhaps the perspective from the deathbed authentically reflects what matters for those who are forced to withdraw from ongoing activities, in view of their foreshortened temporal horizon, and what has value for them. But their wisdom doesn’t illuminate what has value for those lucky enough to be able to continue to engage in worthwhile telic activities. From outside the telic, only the atelic (or the pursuit of very short-term goals) retains meaning. Companionship, contemplation, beauty… they remain available to the dying and take on extra force. But their perspective is partial. Perhaps from the deathbed certain goods are grasped especially forcefully, but others slip away entirely. It’s not because these commitments lack value that they’re seen as pallid or pointless; it’s because their value can be fully grasped only from the inside.

To read more on life, death and meaning, visit Psyche, a digital magazine from Aeon that illuminates the human condition through psychological knowhow, philosophical understanding and artistic insight.