In Search of a Good Death

In Search of a Good Death - In Search of a Good Death David...

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In Search of a Good Death David P. Schenck & Lori A. Roscoe Published online: 18 October 2008 # Springer Science + Business Media, LLC 2008 Abstract Spirituality and storytelling can be resources in aging successfully and in dying well given the constraints of modern day Western culture. This paper explores the relationship of aging to time and the dynamic process of the life course and discusses issues related to confronting mortality, including suffering, finitude, spirituality, and spiritual closure in regard to death. And, finally, the role of narrative in this process is taken up. Keywords Aging . End-of-Life . Spirituality . Closure . Narrative Introduction The transformation of diseases like cancer, HIV/AIDS, and heart disease from death sentences into manageable chronic conditions has likewise transformed the process of dying and perhaps even the meaning of death itself. Rather than dying at home from the uncontrollable ravages of disease, many of us will die in hospitals or other institutional settings, and as many as 70% of those who die in an institutional setting will do so after a decision is made to withhold or withdraw treatment.1 Rather than the inevitable end of biological human life, dying has become a series of difficult decisions for patients and their families to navigate and opportunities to reflect on the spiritual aspects of life’s end have been eroded in the process. The accelerating pace of the aging of the world’s population, attributed to reductions in infant mortality and medical/technological advances that prolong life, adds urgency to the desire to find meaning in aging and dying. Questions such as what it means to age successfully and what is required to do so, and what it means to die well and how that might be accomplished, occupy an increasingly prominent place in both private
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conversations and those about health policy and medical care. We all may wish for a long life and a good death. However, the goal of dying a good death may be beyond our reach if what we mean by that is having control over the circumstances of our deaths or the deaths of those we love.2 While long life and a good death are certainly aided by increasingly sophisticated knowledge about aging and biology as well as by access to good medical, hospice, and palliative care, science and technology can neither answer questions about the meaning of life and old age nor about how best to approach its end. Despite the present reality that most people die as patients in a health care environment as the result of a deliberate decision to limit treatment, aging and dying are fated aspects of individual life and social existence, not merely one of “life’s problems that can be solved through will power, aided by science and expertise.”3 Many improvements have been realized both in prolonging life and in improving the quality-of-life of patients with life-limiting illnesses. Along with these improvements in medicine and technology, the field of biomedical ethics has enhanced
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In Search of a Good Death - In Search of a Good Death David...

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