"Good night, sweet prince,
And flights of angels sing thee to thy rest!" Hamlet, William Shakespeare
Just when you think you've heard everything about death and dying someone pulls on a harp string and there's a new topic: Music Thanatology which, according to the Music-Thanatology Association International is:
"...a professional field within the broader sub-specialty of palliative care. It is a musical/clinical modality that unites music and medicine in end of life care. The music-thanatologist utilizes harp and voice at the bedside to lovingly serve the physical, emotional and spiritual needs of the dying..."
The idea of playing music as part of palliative care feels, intuitively, like a good idea. However there seems to be little scientific evidence to support the concept. One study is simply a survey of 65 cases where music thanatologists applied prescriptive sessions and found that:
"Data collected included vital signs and observational indicators before... and after...the vigil. Patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil. Results from this study suggest that a prescriptive vigil conducted by a trained music thanatologist could provide an effective form ofpalliative care for dying patients."
What's curious is the particular approach that "certified" music thanatologists take. While actual practice might vary, the official stance is to use voice and/or harp only. It's unclear how this limitation was derived, but the belief, according to the MTAI is that the harp is the instrument of choice because:
"The harp is portable and polyphonic. It is mostly wood and has live, vibrating strings. Those strings are allowed to ring, creating an audible sense of blossoming forth into life, followed by resonance and duration, and ending with a gentle taper towards restful silence."
Why these qualities are particularly effective is unclear. One might think a cello could be equally effective.
Another curious feature emphasized by music thanatologists is that they don't usually perform recognizable songs, but collections of musical phrases that they feel are appropriate to the individual case. In an interview with practitioner Keiran Schanble he said:
"...we generally use unfamiliar music..we’re offering support without asking the person something in return. We don’t necessarily want to grab their attention. It isn’t a performance."
Music can have powerful and soothing effects on the living and the dying. Further investigation of the particular applications of music and its use in palliative care would be welcome.