Humans in Search of a “Good Death”

Posted on February 5, 2021 by Martin Oaks under Uncategorized
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As prominent psychologist Edwin Shneidman noted, you don’t have to die, it will be done for you.

Shneidman also theorized that a person doesn’t experience death.  Ironically, it is the living loved ones who experience the death.

For well over 50 years, Shneidman studied loss of life, a subject which does not appeal to many, even in the academic world.

“I think in America, we live in a very youth-centered culture, a very kind of anti-aging culture,” said Sarah Farr, founder of Death Positive DC.  “There’s a lot of denial of death.”

Researchers have labeled our culture “death phobic,” i.e., ignore the inevitable until it is no longer possible.

Shneidman had no fear about directly exploring every facet of the finitude of human life.  When he passed away at the age 91 in 2009, he had published 20 works on the subject.  As a clinical psychologist, he was especially intrigued by the concept of a “good death.”

This is another taboo subject: according to a paper in the American Journal of Geriatric Psychiatry, “There is a dearth of research examining the psychological aspects of a good death, particularly from a patient perspective.”

What actually is a “good death?”  The Institute of Medicine, in the late 1990’s offered a definition which is still generally accepted: a death “free from avoidable distress and suffering for patient, family, and caregivers, in general accord with the patient’s and the family’s wishes, and reasonably consistent with clinical, cultural, and ethical standards.”

Peaceful, painless, the patient making choices with relative emotional wellbeing — that’s about as an ideal cessation humans can hope for.

Shneidman hypothesized that there is no “best” way to die.  Everyone dies differently.  But he did identify ten conditions that lend themselves to an easier passing:  natural; mature; expected; honorable; prepared; accepted; civilized; generative; rueful; and peaceable.

Fundamentally, Shneidman believed that a natural death is preferable — not a violent or traumatic passing, but one where the body simply fails.

Next, Shneidman posited that death at a mature age is most desirable.  It is deeply troubling for all concerned when a passing is premature.

Sudden or unexpected deaths are similarly painful:  Shneidman said an expected death, when everyone knows the end is near, allows all to come to better terms with the event.

An honorable death is equally important.  This means the loved one has a passing in which there is a sense of a life well lived.

prepared death, where there is no unfinished personal or professional business, goodbyes have been said, and final disposition arrangements have been made qualify as prepared.

While no one wishes for death, it is best when all have accepted the fate. This is not to say that one shouldn’t fight for one’s life, do all the medical procedures required — but when the time comes, it is recognized for what it is.

The dying scene, as Shneidman termed it, ought to be civilized.  No matter if it happens at home or in a facility, the surroundings should not be chaotic.

If the loved one has a generative sense, death is more tolerable. This translates into leaving a legacy — the spirit of the person is passed on to the family, or in some cases, a business, a charity, or even a group of friends.

The next condition Shneidman listed is ruefulness — the passing and any memorials should be conducted with a balance of true sadness and a recognition that the process is unavoidable.

The tenth condition is the peaceable nature of the death, where physical pain is managed to the fullest extent.

These ten criteria are optimal.  Through no one’s fault, they are not always attainable.

For those left behind, Shneidman offered this:  “Mourning is one of the most profound human experiences that is possible to have.  The deep capacity to weep for the loss of a love one…is one our noblest human traits.”

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