What Is A “Good Death”?

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http://www.thebrittanyfund.org

 

It’s still November 1 as I begin to write this.

A  very brave soul left us today, although she will, hopefully, be remembered for a long while.

A woman who chose to die on her own terms.

A woman who died with dignity and with compassion, the kind of death we should all be able to experience if we need to.

A “good death”, or at least as good as it can be.

I love what she said….

 

“My glioblastoma is going to kill me and that’s out of my control.  I’ve discussed with many experts how I would die from it and it’s a terrible, terrible way to die. So being able to choose to go with dignity is less terrifying.”

On Oct. 6, she launched an online video campaign with Compassion & Choices, an end-of-life choice advocacy organization, to fight for expanding death-with-dignity laws nationwide.

“For people to argue against this choice for sick people really seems evil to me. They try to mix it up with suicide and that’s really unfair, because there’s not a single part of me that wants to die. But I am dying.”

 

Brittany  Maynard chose quality of life over length of life. She chose acceptance, and yet did not go down without a fight, a fight for others in her situation to be able to choose their own “good death”.

There is so much attention around this notion right now.  Dr. Atul Gawande’s book, “Being Mortal. Medicine And What Matters In The End” talks about telling the truth to patients and allowing them an informed choice about what their end of life options look like. Often, when faced with the truth, patients choose palliative care, rather than staying alive well past the time they could have a good death. In “Smoke Gets In Your Eyes. And Other Lessons From The Crematory,” Caitlin Doughty examines death and dying from a  morticians view and talks about the importance of a plan for our death and more about the acceptance of it. Both of these books are on my next Amazon purchase list, and in the short blurb I have written here I have down them both a great disservice. These are works of great importance, just as Brittany Maynard’s death was an important and meaningful entry into our idea of the meaning of life and death, and what a good death is comprised of.

People are arranging green funerals. More and more people are choosing cremation and to not be embalmed, often because of the ridiculous cost of a modern American funeral, but also because of the absurdity of it. It’s a body we leave behind, a vestment we wear daily that has nothing to do with who we are.

There is a Death Cafe movement, where people get together and talk openly about this notion that we are all going to die, that it’s inevitable, and how to make those end of life decisions that work for us. How to get our affairs in order and our funerals planned before we die, and how to make clear choices while we still can. How to accept the inevitability of our own death and that of those we love.

The discourse in this country needs to change. We can change it, one person at a time. We can, we have more power than we think. We certainly have power over OUR death in terms of preparing for it. We deserve “good death”, whatever that means to us. To some it will mean fighting to the last breathe, trying every option, ever “giving up”.  Others will choose palliative care, pain maintenance and as much quality time as possible with their loved ones. Often, according to Dr. Gawande, stopping treatment actually prolongs the life of the dying. Acceptance adds, rather than subtracts time, but it certainly adds quality time.

Brittany  chose something else, something that very few people can legally do in this country. She took control of the inevitability of her own death, and was able to die before the suffering became too much for her and her family. And then she shared it, with all of us. She has given us  a great gift and she knew it. She didn’t squander her death, she opened up, shared with all of us her last days here on this earth so that people would talk, would think about these issues. She’s going to be in People magazine for god’s sake…she was willing to ruffle feathers and stand for something she strongly believed in, even as she moved into an experience that certainly seems unfair and held no joy for her.

I for one am listening, and, more importantly, am involved in the discourse. I have been involved with grief work for a few years now, and see the  incredible importance of that. But Death work is also important,  maybe more so.

In working with people who are grieving I see the turmoil, the guilt, the bewilderment, the anger that those left behind often feel because they “never talked about it”, or “the doctors gave us hope until the last second”. I can only imagine how frightening death must have seemed to some of these people who died in denial, not prepared. I am talking about people who died of a disease, maybe having it for years, not a sudden death. However talking about death, clarity in planning for what WILL happen to us all would be an incredible gift in case of sudden death too. I know how it might have helped me.

I have also listened to people talk about a better kind of death. where their person was not in pain, where all affairs were in order, where everything that needed to be said was said and where the inevitable end was openly discussed and prepared for on every level.  A better death in every way.

 

I’m not sure how to end this because this really isn’t an end. It’s a beginning. I am planning on becoming more involved in this movement, and I imagine it will show up again in what I write. Brittany Maynard’s death was, in a way, a call to action. One whichI am heeding and that I hope furthers a growing national discourse on all issues surrounding death.

 

 

 

 

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3 Comments

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  1. Very well put. My son knows my wishes, but I also know that when the time comes he may need to do something else for his own closure, which I can understand.

  2. My mother has two terminal cancers. When the oncologist told us about her non-small cell Stage IV lung cancer, she said it was untreatable and my Mom had roughly two months to live. She said hospice would be good fit for her. That was about a month ago.
    Enter the pulmonologist. He sold Mom an a procedure, like the traveling salesman sells magical elixir. It was an “easy” procedure, with a 3 possibly 4 day hospital stay. My Mom bought that, hook, line and sinker. Especially after he said she would have 4-6 months of good breathing.
    7 days in the hospital, daily chest x-rays, CT Scans, and episode of atrial fibrillation, and countless resources went into this stay.
    I may sound crass here, but the medical man hours, and time and effort put into a person who is not going to live, NO MATTER what they do, is insanity. It shows a broken healthcare system. One gets into the cog of the big hospital machine, and it is hard to get out.
    My mother is still in charge of her faculties and therefore can make her own decisions, but I see this as wasteful.
    I wish my mother would take the oncologists advice and go on hospice. I see it as a more dignified way to die. I also wish she lived in a state where she could get that prescription and when the time comes, make her own choice.
    Lung cancer is ugly and fast, but it will steal her dignity. Not only will she suffer, but we, her family will also.
    I understand, when given a choice, most people will choose life. But it would be nice to live in a world where you can choose a swift death when the time comes. also. Dr. Kevorkian had a lot of this right.
    That “easy” or

  3. oh sweetie…
    so hard.
    This situation with your mom is what Atul Gawande’s book is about. the excerpts i have read are fascinating and i can’t wait to read the whole thing. but it’s that doctors selling patients on last gasp efforts when the outcome cannot possibly change that makes me the maddest too. palliative /hospice care is the very least we should be able to have.
    I am so sorry that you and your family are going through this.

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