Scrooge forms a deep emotional bond with the Ghost of Christmas Present and his death at midnight of December 25th is an emotional turning point.
It's also this ghost who hits Scrooge with his own words about the "surplus population", and the old man is clearly ashamed of himself.
Bob Cratchit goes up to Tim's bed, and his body is still there, and he kisses his face.
The scene with the young future debtors has them celebrate Scrooge's death, relieved that they'll have an extension to pay off the large sum they owe.
The saddest thing about Jacob Marley is that he, unlike Scrooge, can't get a second chance to change. He's already dead at the start of the story, and is doomed to an eternity of regret.
He does, though, get to influence the fate of his old business partner — which must be some comfort given that the tormented ghosts, for the most part, have learned to feel remorse for their selfishness but can no longer help anyone on Earth.
The final vision of the past, on the night Jacob Marley died, shows Belle happy with the man she eventually did settle down with. She has a large family, and they're enjoying Christmas Eve together. Scrooge realizes at that point that he well and truly missed his chance to be the man in that vision rather than looking in from the outside, and is further saddened with the revelation that Belle still cares about him, feeling pity that he's shut himself up and won't visit his dying partner.
"And now Scrooge looked on more attentively than ever, when the master of the house, having his daughter leaning fondly on him, sat down with her and her mother at his own fireside; and when he thought that such another creature, quite as graceful and as full of promise, might have called him father, and been a spring-time in the haggard winter of his life, his sight grew very dim indeed."
The passage of the spirits outside after Marley's ghost departs is scary, but also includes a tearjerking moment.
The air was filled with phantoms, wandering hither and thither in restless haste, and moaning as they went. Every one of them wore chains like Marley's Ghost... Many had been personally known to Scrooge in their lives. He had been quite familiar with one old ghost, in a white waistcoat, with a monstrous iron safe attached to its ankle, who cried piteously at being unable to assist a wretched woman with an infant, whom it saw below, upon a door-step. The misery with them all was, clearly, that they sought to interfere, for good, in human matters, and had lost the power for ever.
Some film adaptations show Tiny Tim's body as the Cratchits grieve.
The 1954 "Shower of Stars" version has Scrooge go further in disbelieving Jacob Marley than most versions, using the "I'd heard you had no bowels" line and saying his appearance means nothing to him. Marley is despondent that he'd come all this way only to not be believed.
Marley: Oh, God! Oh, God. These are hard hearts of this world, and the torment of years to come. I come out of torment, I come to help a soul avoid eternal misery, and I am not believed!
During one year's production for a Christmas Concert, the scene of Tiny Tim's death was scored with an orchestral version of "Asis' Death" from Edvard Grieg's Peer Gynt suite.
Some adaptations show Jacob Marley's death, with Scrooge either not caring at all or deeply caring, with his death being the last straw that fully hardened his heart. It's even worse in versions where Marley realizes where they went wrong on his deathbed, tries to appeal to Scrooge to change, and he doesn't listen.
In one musical theater adaptation of A Christmas Carol, the story is narrated by a young gentleman who walks with a limp, who retells the story that Scrooge himself told him years ago. During the scene with Christmas Yet To Come, there's the expected tear jerker scene with the Cratchit family mourning Tiny Tim's death. They sing the appropriately-tear jerking "The Little Child" until they are too choked up to continue, at which point the song is finished by a verse sung by the narrator, which is the only time the narrator sings outside the opening and closing musical numbers. This verse becomes extra chilling in hindsight when, at the end of the story, it is revealed that the narrator is Tiny Tim, all grown up and healthy thanks to Scrooge. Not only is Scrooge in-story witnessing the possible future of the death of a poor child, but also out-of-story the narrator is watching his own family's reaction to his death in an alternate timeline and, much like Scrooge, he cannot comfort them. Chilling.
In any version, when Scrooge's fiancée leaves him after seeing he values money more than he values her. Especially in the 1970 musical, the 1999 Patrick Stewart version and 2004 musical, when old Scrooge is shouting at his younger self to go after her. It's sadder when you realize that he's spent years regretting the choice of letting her go.
Special mention goes to how the actors in the 1999 Patrick Stewart are able to convey emotions and thoughts of their characters with simple facial expressions. Young Scrooge in particular was well done, the shock and fear he feels when his fiancée releases him from the engagement is evident on his face with the prospect of losing someone he still cares deeply for. And the when his fiancée leaves, he almost gets up to go after her, but you can see from his face how his thoughts are calculating the hard numbers of the decision before him, and the slowly hardening expression he makes when his choice is made is absolutely phenomenal acting. The fiancée also shows great emotion, especially how she looks back not only once but twice as she walks away; despite her words, it's clear she's very much hoping she's wrong. And the whole time, Patrick Stewart is being Patrick Stewart, portraying Scrooge's despair over what happened and begging his younger self to make the right choice, even though it's impossible.
Old Scrooge: Go after her! (tearfully) GO AFTER HER!
The BKN version changes it so the Ghost of Christmas Yet to Come doesn't take Scrooge to a future where Tiny Tim died from his illness; rather he takes him to a future where Tim became exactly like Scrooge. Scrooge is utterly horrified.
The novel The Life and Times of Bob Cratchit goes into extravagant detail about how much Bob's life sucks, but he knows others suffer worse, and he eventually forms an odd friendship with Jacob Marley that turns tragic when Marley promptly dies. His ghost begins to haunt him and make him perform good works in his stead as a form of release. Eventually Bob tells him that he was responsible for what he did in life, and Marley collects himself before calmly saying how much his punishment hurts.