William Osler's Study of the Act of Dying: an analysis of the original data

Because of popular fears about death and dying, his personal interest in the subject and a lack of empirical data regarding the dying process, William Osler conducted a novel 'Study of the Act of Dying' of 486 patients at the Johns Hopkins Hospital between 1900 and 1904. Osler never wrote a manuscript describing the results of this study. However, in his lecture 'Science and Immortality' Osler mentioned the study briefly and reported that 104 patients (21%) experienced physical, mental or spiritual discomforts. He concluded that for most patients 'death was a sleep and a forgetting'. To better understand the results of Osler's study, the original data collection cards and a spreadsheet of the study data used by Osler were carefully examined. One hundred and eighty-six unique patients (38%) experienced discomforts, 79% higher than Osler reported in 'Science and Immortality'. Overall, 76 cards contained data discrepant with Osler's spreadsheet (McNemar's test, P<0.05). A number of factors, including haste, may account for the discrepant results. Nevertheless, the results shed light on the dying process during Osler's time. Furthermore, the results suggest that many dying patients during Osler's time experienced discomforts.