The term ‘good death’ refers to an individual’s preference for how a person wants to die. For a majority of people, some of the factors that comprise a ‘good life’ include dying a peaceful death at home surrounded by friends and family, without worrying about complications. This article discusses about the definition of good death.
Definition of a ‘Good Death’
Here we try to understand the definition of a good death and the principles of good death. However, there are complex and frequent ethical dilemmas that are presented at the end of life. There are two important factors that contribute to this dilemma:
The rapid development of medicine in the last three decades has exponentially reduced the number of sudden deaths in developed countries. The United States has a 911 system which is ready to alert advanced life support ambulances in case of an emergency. These ambulances come with trained medical teams as well as portable defibrillators. They help transport patients to emergency centers. The result: people who would have died on the spot may now die of diseases at a later age. In the case of a sudden death, one avoids ethical ambiguities. Gradual death makes a case for more ethical challenges. When considering the definition of a good death
What are the Principles of a ‘Good Death’?
The definition of a good death involves the following principles.
- Knowledge of when death comes knocking and also knowing what to expect
- Ability to regain control of what takes place
- To be given privacy and dignity
- Ability to control pain relief and as well as other symptoms
- Decision on where death occurs (at home or somewhere else)
- Access to expertise and information of different kinds
- Ability to get spiritual or emotional support when required
- Ability to get hospice care anywhere, not just in a hospital
- Control over who will share in the later moments of life
- Ability to issue directives in advance to ensure wishes are respected
- Opportunity to say goodbye whenever and control other aspects of life
- Ability to leave the world when It comes to saying goodbye without having it being prolonged
Importance of Choice for a ‘Good Death’
When discussing about the definition of a good death, it is necessary to understand the importance of choice for good death. According to a report published in 1999, a principle necessary for a good death is to be able to have control over pain relief as well as other symptom control. However, it is not about taking care of all symptoms taken but being able to have control over the amount of pain relief and treatments provided during the later stages of life.
This is an important point to note as most people do not want to be ‘cozied’ into death. Some people would rather be awake and alert when death comes knocking.
Therefore, choosing how you want to ‘welcome’ death is something most people want to have control over.
Let us take the example of someone suffering from respiratory problems. Let us call him Michael. Michael is diagnosed with aggressive secondary tumor which grows out of the mastoid bone right behind the ear. When diagnosed with this condition, the tumor has a high chance of pressing against the brain stem. In Michael’s case, the tumor is inoperable.
Michael believes that if an operation is essential, he wants to do it. He wants to do it properly, according to his terms and conditions. Michael, therefore, makes a choice.
However, adhering to one’s wishes is a role the caregiver has to play to make a ‘good death’ successful. While the doctors and nurses wanted what was best for him, he wanted to go through the motions to ensure he had control over death.
What are the Seven Keys to a Good Death?
The definition of a good death also comprise the important keys of a good death.
Experience Little Pain – The definition of a good death would include having little or no pain at the time of death. Here, being pain-free would mean being physically and spiritually pain-free. While there is medication for physical pain, how does one heal spiritual pain? It can be achieved by giving person hope through sacred texts and prayers. It could also involve being engaged in spiritual questioning. Spiritual issues need closure at the end.
Resolving Conflicts – Unrecognized and unresolved conflicts with people need to be addressed, says the definition of a good death. They include past issues with family and sometimes close friends. When you ask for forgiveness from people who you severed ties with in the past, you can be assured of a good death.
Fulfilling Wishes – Some people want to live long to see certain wishes come true. It should be noted that there is a difference between a good death and appropriated death—one where the dying wishes of a person are stolen by other forces, including family members who have their own agenda.
Reviewing Life – There are two ways people who are nearing the end find meaning: through recognition of the people they have loved and who loved them, and through the work they have done. In order to have a good death, the dying person should be able to speak about what brought meaning to their lives. This will ensure a peaceful death, hence this too is a part of the definition of a good death.
Handing Over Control – This is where deathbed conversations come into play. One must ask a dying person what they need and want. One must be willing to make last wishes come true, although some dying wishes may not be reasonable. Sometimes, all a dying person wants is someone to take care of their work or their loved on when life comes to an end.
Deciding Who Spends The Final Moments – A person nearing the end of life longs for solitude. They want family and friends to be around. It should be the dying person’s decision to have who he wants surrounding him. The person should also be allowed to decide the amount of consciousness they want. While some people want to sleep, others prefer being alert. These wishes can come true.
There is room for growing through dying. In order to ensure a good death, we should foster peace and love. If we are aware of the definition of a good death and know what constitutes a good death, we can prepare ourselves and our loved ones to die on pre-determined terms. We realize that death may not always happen on our own terms and sometimes can be sudden and surprising. But, we can hope to exercise little control to ensure it goes according to our wish.
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