The article is typical of academic journals. It portrays dying process as a series of biological or pathophysiologic phenomena with interventions being overwhelmingly pharmacological in nature. Reading it one might logically assume that hospice nurses could well be replaced by pharmacists. In many areas the article is elementary and redundant to the point of tedious. I would recommend it for first year nursing students.
The article begins with the question: “WHAT'S A GOOD DEATH?” Then answers that question with, “Most patients facing the end of life say it means freedom from pain and other distressing symptoms.” The author then proceeds on the assumption that this simplistic view has merit.
The assumption that a “good death” is dying “free of pain and other distressing symptoms” is the equivalent of the philosophical point of view that a “good life” is one “free of pain and other distressing symptoms.” This is sheer and utter nonsense.
Good symptom control in dying process is NOT the goal, it is a means to the goal. The ultimate goal in dying is the same as the ultimate goal in living; i.e. to do it consciously.
When your son asks if he can play football do you say, “Oh goodness gracious sakes alive! No, no, no Sweetheart. You can’t do that. You might feel some pain or other distressing symptom… and of course that would not constitute a good life.”
Dying consciously seems to be a concept that lies beyond the capacity of hospice’s academic elite to grasp… which is incredibly disheartening. They seem to think there is a fundamental difference between living and dying, which I assume stems from their definition that death “ends” life.
One endures some pain and distress in life because it is widely recognized that some form of learning may result. But when one assumes that death ends life, nothing results… so there is no point to dying. And if that is true, then there is no point to living either.
The current philosophy endorsed by hospice hierarchy is the same as that expressed in Aldous Huxley’s, Brave New World. (Perhaps that would be an appropriate book in the “recommended reading” thread.)
It is not that symptom control is not important… it IS important. But I repeat, it’s importance is measured by the degree to which it accomplishes the real goal.
There may even be times (banish the thought) when feeling pain is appropriate and beneficial. Of course that could only happen if death does not end life and the individual continues to learn and grow beyond the grave.
For hospice to assume that death ends life is a religious doctrine in itself. Hospice bends so far over backwards trying to avoid endorsing a religious doctrine that it adopts a religious doctrine in reverse. In so doing it seriously damages its own credibility in being the public’s guardian or guide to dying process. Not to mention the fact that it is out of step with roughly 90% of the world’s population, all of history’s great spiritual teachers and now with leading thinkers in the fields of quantum physics and the study of consciousness.
Other than that, it was a pretty good article… rather self-congratulatory in tone and the author completely missed the point of Mrs. Brown’s question about how she would die (she sent in a social worker to address a medical question.) But all in all it wasn’t bad… for first year nursing students.