I've Been Told That There Are "Good" And "Bad" Deaths. How Can Any Death Be "Good"?

I’ve been told there are ‘good’ and ‘bad deaths.  How can any death be ‘good’?

There definitely are “good” deaths and “bad” deaths and hopefully you can avoid the latter with the help of palliative care and hospice.   The Institute of Medicine just released a report—Dying in America—describing how frequently Americans are suffering at the end of life!

What is a “bad” death? It’s when someone is suffering at the end of life, as evidenced by any of the following:  inadequately treated pain (or any other symptom); delirium [confusion]; restrained in bed; not being bathed or turned to prevent bed sores [which can occur in less than 24hrs if we don’t turn a patient].  If you’ve ever watched a loved one having a “bad death”, you’ll know exactly what I’m describing.

b It’s unrealistic to say any death is ‘bad’:  every one of us will eventually die and the only real choice we have is ‘how’—how peaceful and dignified do we want it to be.

 

A helpful perspective comes from Buddhism which describes the four core qualities of a peaceful death:  having a peaceful mind, not to suffer, not being alone, and a family’s acceptance of the patient’s death.

Critical to this is family acceptance.   ‘Modern medicine’ with its multiple sub-specialties, each focused on only one organ system and complicated technology, has evolved to where it treats death as a ‘failure’.  The dying process has become ‘medicalized’ in hospitals; and families, not knowing what to do during the final few weeks, are naturally uncomfortable and afraid.

Death is a natural part of life.  But, because doctors have been taught to ‘rescue’ all patients and not how to talk about end-of-life issues, they are often just as ‘death anxious’ as families, leading to unrealistic expectations which in turn often results in increased, rather than reduced, suffering.  It is distressful to watch what many patients endure due to the well-intentioned but ill informed efforts of relatives and doctors who can’t ‘let go’!

Thus, a ‘good’ death should be where the patient is cared for by family assisted by hospice staff, on clean sheets in their home, bathed daily, with minimal pain or other symptom distress; enabling family to say ‘goodbye’ while their loved one dies peacefully with dignity.

That’s the lasting image we would hope to have.