Good Death

     Every living person ponders about the question on what constitute to good death. Various answers have been given by many people. Some see good death as that of dieing a delayed death. This is after being allowed enough time to prepare one. Others see good death as sudden death from accidents, heart attack, and shooting oneself with a gun among others. These are the various opinions which physicians have made an attempt to understand and provide a definition of good death in when dealing with patients. It is the professional obligation of physicians to provide their patients with good death. The question that we can ask ourselves is who between the patient and the physicians has the right of bringing up the issue of good death.


Attitude towards death has changed in the past fifty years. During the old times, people saw death as being constantly beside them and people were ready to die at any time of their lives. Modern medicine has made an implication to people that death can be defeated. Therefore, many of us fear death. Death is seen as a failure and not an important stage of life. The modern medicine does not, however, give an assurance of helping man to die a death that is comfortable. Neither does it prepare one for good death. Modern death has therefore, become medicals, sanitized, and professionalized.  This has made death become a very foreign subject to the people.  This perspective has to be changed (Debate of the Age Health and Care Study Group, 1999, pp 64).


The medical model sees death as something to be controlled through a heroic struggle (Green, 2008, pp 17). Since death becomes the eventual winner of our lives, we have to be a little savvy and hope that we can manage the manner and prolong the time of death. The medical model has the determination of controlling death as a way of wining temporal victories before death. This claim is featured in the PBS series of Bill Moyer’s called On Our Own Terms and Meyers on Dying. This program was first aired   in September 2000.


Moyer’s programs talks of the prognosis of death.  He deals with the issue of making hard choices, palliative care, and services at the end of life. The series have personal stories from families on their failure, struggles, and the salient heroism. What is common about Moyer’s series is managing death efficiently to form good death.


Death, according to an interviewed middle aged pedestrian suffering from cancer, is like being caged in a plane by a pilot who is an enemy. He watches you but you have no alternative.  This is not good death, what is important is to help patients learn how to die. The struggle with death is to find something to narrate about what death means. The lesson leant from the individual stories are the frustrations of getting death as well as its ambiguities.


In Moyer’s third program series known as A Death of One’s Own, he states that a good death is that which is controlled and to be in charge of the final days we have on earth. Well death according to Moyer’s is not of voting it down or up in a Kevorkian manner but making choices that is well considered.  Jim in one of the episode sees good death as going to sleep. He suffers from ALS and has five years to live. Meanwhile his health is slowly deteriorating as the expenses of care taking and medical treatments are rising yet, is not soon that he will go to sleep. Jim considers taking suicide but the doctors and his wife are not for it. And the option he has is to starve to death.


Kitty also faces the same dilemma.  She wants to be assisted to commit suicide but this is against the law.  She has been told that she will die in four months time from the ovarian cancer. She desperately wants a means of controlling the circumstance and time of dying. Good death is based on various principles. This is when a person is made to understand what to expect and when death is coming. Good death involves being accorded, privacy and dignity, taking control of what happens, and controlling over symptoms and pain associated with a fatal disease. Good death involves making decisions of where death should happen .It is about gaining access to different kind of expertise and to information (Picardie 1998, 14).


There is also the need for emotional and spiritual support as a principle of good death. Other principals of good death involve having access to hospice and hospital, having control over who shares and who is present at the time of death. The wishes should be respected and there should be   time to give directives in advance.  Good death is being able to say goodbye and not having life to be pointlessly prolonged (Neuberger, 1999, 125).


Moyer’s narratives of death have been simplified, edited, and have idealized constructs of the threatening and chaotic event of death. Today’s realities of death are faced with death management which involves law, medicine, and ethics which contradicts with the old rhetoric of cultural expectations and religious faith. Various decisions have to be made by the caregivers from the family and doctors on ways of achieving good death.


Reference

Green J(2008)Beyond the good death: the anthropology of modern dying, Publisher University of Pennsylvania Press, p 17

Neuberger J. (1999) Dying well: a guide to enabling a good death. Hale, Cheshire: Hochland and Hochland;

Picardie R (1998) before I say goodbye. London: Penguin,





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