An article in the Journal of the American Medical Association found that there is no one definition of a good death; quality end-of-life care is a dynamic process that is negotiated and renegotiated among patients, families, and health care professionals.
What is a good death?
What is a good death?
What is a good death?
In a Gallup poll in America, more than 70% of individuals surveyed feared dying in pain or alone without the chance to say good-bye.
Twelve principles
The authors of The future of health and care of older people: the best is yet to come [London: Age Concern, 1999] set down 12 principles of a good death:
- to know when death is coming, and to understand what can be expected
- to be able to retain control of what happens
- to be afforded dignity and privacy
- to have control over pain relief and other symptom control
- to have choice and control over where death occurs (at home or elsewhere)
- to have access to information and expertise of whatever kind is necessary
- to have access to any spiritual or emotional support required
- to have access to hospice care in any location, not only in hospital
- to have control over who is present and who shares the end
- to be able to issue advance directives which ensure wishes are respected
- to have time to say goodbye, and control over other aspects of timing
- to be able to leave when it is time to go, and not to have life prolonged pointlessly
Nine key issues
An article in the Journal of the American Medical Association (Vol. 284 No. 19, November 15, 2000) found that there is no one definition of a good death; quality end-of-life care is a dynamic process that is negotiated and renegotiated among patients, families, and health care professionals.
The article ranked the key issues for patients like this (most important at the top):
- freedom from pain
- at peace with God
- presence of family
- mentally aware
- treatment choices followed
- finances in order
- feel life was meaningful
- resolve conflicts
- die at home
The article showed that patients highly valued attention to spirituality; in particular, the importance of coming to peace with God and praying.
Achieving peace with God and pain control were nearly identical in importance for patients and bereaved family members. However the survey found that for some patients it was more important to resolve faith issues with themselves rather than to take part in social or interpersonal expressions of spirituality.
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