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The Good Death

The Good Death

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by Jennifer Kearney. Originally submitted for Social Science at University College Cork, with lecturer Kathy Glavanis in the category of Social Studies
An essay for the 2011 Undergraduate Awards (Ireland) Competition by Jennifer Kearney. Originally submitted for Social Science at University College Cork, with lecturer Kathy Glavanis in the category of Social Studies

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Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial

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04/26/2014

 
The Good Death
Abstract:
The purpose of this essay is to examine whether there is a
good death
incontemporary Western societies, and if so, what form this might take. First of all, the conceptof what constitutes a bad death is examined using examples from popular media which haveserved to influence this view. The good death is then contextualised as a death which doesnot have any of the characteristics of a bad death. The evolution of death has seen dying
 – 
 which was once an experience shared by entire communities
 – 
become privatised, hospital-based occurrences, removed from all but immediate family.
Keywords:
Bad death, dying, good death, medicine, sickness.Death is what defines life. Life and Death are intricately woven together to create a tapestryof light and dark, of knowledge and ignorance, of wondering and fear. Life and living do notalways carry the same meaning, but death and dying almost always do; in every language andin every culture death means the biological end of life, or at least the end of this life. Death isinevitable; from the moment of conception a person begins the process of dying. For someindividuals, death does not occur for eighty years or more, for others it may happen beforethey are even born. However, regardless of the timing of death, it is the culture, religiouspractices and location of a society which determines whether a certain death has been good orbad. If we assume that such a thing does exist, then what are the factors which constitute a
„good death‟? Furthermore, if we
are to assume that the good death is conceivable, then there
must also exist a „bad death‟, because otherwise there would only be the fact of death, neither 
positive nor negative. It is clear that death is not merely another fact of life because ashumans, we seek the meaning behind death through burial rituals, grieving, and religiouscustoms. To contextualise the concept of the good death, first we must examine what ismeant by a bad death.
According to Howarth (2007, pp 23) a bad death is an “untimely or premature end”. In the
modern Western world, thanks to the progress of medicine and increasing life expectancy,death has become more and more associated with old age. Howarth goes on to explain howmedical science has developed techniques which have drastically reduced the incidence of mortality as well as the accompanying pain. In this explanation, Howarth draws on
Simpson‟s (1972) view that the rate of medical advancement in curing previously life
-
 
threatening illnesses has lead society toward the hope that death will someday be avoidable.The portrayal of the eternal struggle of medical professionals against death and thecontinuous fight to save the lives of patients has caused death to be cast as a feared enemywho may strike at will. This is evident in television series such as
Grey’s Anatomy
or
PrivatePractice
, where doctors triumph against death on a daily basis, and where patients are willingto take any risk to ensure their own survival against the unknowing darkness that is death. Asa result, modern Western society has become increasingly dependent on medicalprofessionals to protect them from this invisible enemy, and accordingly many occurrences of death take place in a hospital setting. Within the hospital, it is expected that the curativenature of medicine will force death to retreat. In some cases, patients enter the hospital andare pronounced
dead
on arrival‟
or at least very close to death. This may be as a result of anattack, a road or work accident, suicide or perhaps an illness left untreated. In cases such asthese, where death occurs suddenly and sometimes violently, neither the individual nor theirfamily have had
time to prepare for death‟s arrival.
The sudden nature of unanticipated deathexacerbates the trauma for bereaved families, and in this sense can be seen as a bad death forboth the individual who has died as well as for their family. There has been no time forpreparation or for farewells; this undermines the Western concept of regulation and controlwhich are apparent in almost all areas of life. It also contradicts the notion to which manypeople subconsciously prescribe which suggests that death comes naturally with old age,after a long life.Perceptions of death in the Western world have been largely moulded by theinstitutionalisation and medicalisation of dying. Where hospitals were once institutions whichcared for the poor and the destitute, the nineteenth century saw a move toward providing carefor the sick. Significant advances in medical technology has meant that people suffering fromboth acute and chronic illnesses seek hospital-based care and treatment to the extent thatapproximately 60 percent of people in modern society die in a hospital setting (Howarth,2007). Howarth (2007) notes that Aries (1981), Elias (1985), Illich (1976) and Becker (1973)have all drawn the conclusion that the institutionalisation of sickness and dying has removeddying from the wider community, and in doing so has caused unfamiliarity with death whichhas negative consequences for the dying individual. In this way, before actual death occurs,
the dying individual must first endure “social death”, in which they are separated from
mainstream society and removed to a hospital/hospice setting.The hospice movement has become increasingly popular since the late 1960s, and wasdeveloped to create an alternative to medical end of life care. Hospice care is based on the
 
ethos of providing more holistic care which includes caring for psychological and spiritualpain as well as physical. Hospice care is not curative
 – 
people who avail of such care havealready been diagnosed as terminally ill, mostly such individuals suffer from cancer, althoughin recent years hospice care has been available for people suffering with AIDS
, Alzheimer‟s
 and other diseases (Howarth, 2007). In addition to providing care for the dying person, thehospice also offers additional services to the families of the dying person. The ethos of hospice care is intended to facilitate a good death for dying people, and as such individualsavailing of such care are encouraged to live as much as is possible until they die, and whenthis moment does arrive, to be secure in the knowledge that they will not die in pain, nor diealone (Morgan, 2001). Whil
e the hospice movement‟s roots lie in providing an alternative to
medical care, it has been criticised as becoming increasingly incorporated into mainstreamhealthcare provision through increased regulations and involvement of medical professionals.While the hospice movement was set up to promote and facilitate a good death for patientsand their families, in some cases their death can be drawn out and physically and emotionallyexhausting for all involved. People can be kept alive against their wishes or in states of painand other forms of suffering (e.g., loss of control, fatigue, depression, and hopelessness). It isalso possible to keep people alive who are in a coma or a persistent vegetative state. In casessuch as these, some people have considered death to be a welcome release, and so expresstheir wish for death to be hastened in order to alleviate their suffering (Howarth, 2007). Inmost countries, euthanasia and assisted suicide are seen as the wrongful killing of anotherhuman being, and as such are illegal in most cases. The difference between the two lies inwho commits the fatal action: assisted suicide involves the physician assisting a person to die,but it is the patient who undertakes the final action; while euthanasia involves a person dyingas a result of the actions of the physician (Howarth, 2007).The word "euthanasia" comes from the Greek words
eu
and
thanatos
and means "happydeath" or "good death." Roughly speaking, there are two major views about euthanasia. Thetraditional view holds that it is always wrong to intentionally kill an innocent human being,but that given certain circumstances it is permissible to withhold or withdraw treatment andallow a patient to die. A more recent, radical view is embraced by groups who express theirviews on the right to die. It denies that there is a morally significant distinction betweenpassive and active euthanasia that allows the former and forbids the latter. Accordingly, thisview argues that mercy killing or assisted suicide is permissible (Moreland, 1992).The issues surrounding the euthanasia debate are tips of a much larger iceberg. At stake arecrucial world view considerations regarding what it is to be human, what the purpose of life,

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