Abstract
BACKGROUND: Death is a difficult topic to discuss for many. Notwithstanding, there is much to learn regarding the contemporary Japanese people's views on a good (peaceful) death. Particularly, shifts in public perceptions of death following the beginning of the COVID-19 pandemic should be considered by health care staff who deliver end-of-life care. OBJECTIVE: This study examined the recent representations of peaceful death in Japanese YouTube videos to understand related narratives and family structures. METHODS: We examined 457 YouTube videos about peaceful death using content and family network analyses. The videos were classified into 3 groups: ordinary people, celebrities, and fictional characters. RESULTS: We identified emerging medical actors who discussed end-of-life with the public. Death portrayed or discussed in the videos mostly involved adults aged 18 to 59 years (179/501, 36% ages), and the most common narrative was illness (101/839, 12% narratives). Although the most common religious stance was nonreligious (304/532, 57.14% religious stances), videos of regular people tended to mention or show a religious practice or symbol (154/272, 56.61% religious stances). There were significant differences (F2, 454=22.81, P<.001) in terms of gender between celebrity and regular videos (P<.001, 95% CI 0.23-0.49), celebrity and fiction videos (P=.005, 95% CI 0.05-0.34), and fiction and regular videos (P=.008, 95% CI 0.03-0.29). This suggests a bias towards male representations of death among celebrities and fictional characters. Male family members were also overrepresented in videos about celebrities and fictional characters as per the visualization of family networks. The networks also suggested that common people's families were more complex than celebrity and fictional people's families. Furthermore, in common people's families, women and men were equally important when reaching out to other family members quickly and in terms of trust. CONCLUSIONS: The current image of Japan as a nonreligious nation, and the gender bias in Japanese social media should be challenged. Furthermore, health care and research protocols related to end-of-life care for patients beyond older adults should be developed.