Our Death-Denying Society (Revisited)

Americans are totally immersed in a death-defying, death-denying culture where the final outcome is often delayed by employing futile treatments and heroic measures. A cultural change needs to take place regarding issues surrounding death and dying because, even in the face of advanced medical technology and skilled interventions, every person in existence will die. Nurses Announcements Archive Article

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Death is not the worst thing that can happen to a man.

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Funny how you'll plan every aspect of every trip except the most important one you'll ever take.

Several high-profile instances of brain death have entered the public's awareness in recent weeks, including the painstakingly tragic demise of 13-year-old student Jahi McMath. Hence, now is the time to provide some basic education on brain death, and at the same time, scrutinize some commonly-held attitudes regarding the issues surrounding death and dying.

Simply put, the people of the United States are deeply engrossed in a death-defying, death-denying culture. Characteristics of this culture include an attitude of outright denial, the inability to openly discuss the topic of death, and misguided reliance on futile measures in spite of a terminal prognosis. However, the populace of this country was not always bathed in a collective state of denial.

In past times, death resulted in a sorrowful time for individuals whose loved ones succumbed. Dying was visible, expected, natural, out in the open, and an acceptable outcome. Death was a powerful affair that frequently involved the entire family: a person would die at home in the company of loving relatives who paid their final respects. The surviving family members would even give the post mortem care on the death bed.

In the present day, most deaths now take place in hospitals, nursing homes and other types of healthcare facilities. In the span of a few generations, the business of dying has been extricated from the home and conveniently transferred to institutionalized healthcare settings. American society has been doing a remarkable job of removing death from public view in the 21st century. Many people fear what they have not seen, so the invisibility of death makes it frightening in today's society.

The process of dying is a uniquely personal, unavoidable, intricate journey that every individual in existence will make when end of life approaches.

In a nutshell, brain death is the complete and permanent cessation of all brain function. It is important for the general public to understand that once the brain has died it will never, ever regain any function. Brain death is utterly irreversible; therefore, a patient who has been declared 'brain-dead' will not improve because he is dead. Contrary to misleading notions, brain death is not the same as a persistent vegetative state or a comatose state because the patient who is in a coma or PVS has some brain function, whereas the brain-dead patient has absolutely no brain function whatsoever (and never will).

No one has ever recovered from brain death. Ever. A brain-dead body might appear 'alive,' feel warm and appear to be resting, but these effects are the result of warming blankets, a ventilator, and medications to maintain the blood pressure. There is no medical treatment or intervention in existence that can reverse brain death. There is no miracle in existence that will restore cerebral function once a declaration of brain death is made. A brain-dead person is very much dead.

It is imperative that Americans have a national conversation about issues surrounding death and dying to clear up common misconceptions. However, in these bitterly politicized times, I doubt this conversation will take place anytime soon. Furthermore, a change needs to occur regarding our largely unrealistic views on death. Until Americans grasp that death is a natural and acceptable end to the circle of life, there will always be people who do everything humanly and technologically possible to evade the final outcome that every living individual will face.

Sorry I did not mean to promote euthanasia(thats a whole other topic!!). I simply meant that we have a much harder time excepting death in humans and sometimes prolong the inevitable unnecessarily.

Specializes in CRNA, Finally retired.

Of course we are animals. Upright primates with a large forebrain.....monkeys with keys. The more science studies the other species, the more understanding we have of their complex emotional lives.

I would hate to be denied the kindness of a peaceful, pain-free death because I'm "too good" for it.

Specializes in Cardiology, Cardiothoracic Surgical.

An end-of-life debate aside...I do question the wisdom of keeping a chronically ill, very elderly patient (85+) a full code. One of my greatest fears is starting CPR on someone's frail grandmother and hearing and feeling their ribs crack, seeing them survive, only

to die later of related illnesses (pneumonia, broken bones, etc.)

Specializes in Pediatrics.

Human life has an intrinsic value much higher than that of animals.

I know many that would argue this point. Animals play an incredibly important role in many peoples lives. Just sayin'.

Anyway, this is a great post. I am so tired of reading ignorant peoples comments about the thousands of brain dead people who came back to life. I seriously hope that others reading these comments do not believe such a thing.

I know this would never be possible, but, maybe if the general public actually saw pictures or video of this poor dead child, they could see what brain dead really means. Back when the Shiavo case was in the media, we saw videos of her. We could see she was not brain dead, but could clearly see her level of function.

I am both a chaplain and a nurse; I feel awkward sometime as a chaplain when asked to pray for patients that seem "dead" to me. I have learned to pray: "God, the family asks....." - I feel this honors the family's requests and seems comforting as well.

I have also observed that sometimes it is not the family wanting to prolong the inevitable, but the physician. I have had families assume I am coming to talk them into more interventions when that is not my intention. Sometimes I have been a mediator between the medical staff and the family.

I've been a hospice rn, admission nurse for many years. Often times, I am one of the first to actually to sit and talk to a family at length about a terminal process. Reactions do run across the board, I have those that are very ready to have the conversation, "Let's get the show on the road. I am ready to meet the Lord, and those that believe that I am there to personally end their lives because, "your just going to sit there and let me die." I have had to witness a family not be able to stop artificial feeding on a loved one that was also a ventilator patient because the state forced the nursing home to continue to feed him due to him not completing a living will. It was heartbreaking to all of us involved. Politicians who never laid eyes on this man were able to make decisions for him over that of his extended family and medical advice. I have also witness family wanting everything done on the multiple metastatic cancer patient who was actively dying. I have had to call 911 for the actively dying to be taken to the hospital due to non-acceptance and unwillingness to sign a DNR. This particular family were doing there own treatments via feeding tube because they saw something on Oprah.

There are many problems due to death denying in the American society. In part, stories such as Jahi McMath, the media gives only partial information, they want sensationalism over giving true hard facts of a story. We now survive many things that would have taken our lives 50 years ago, a century ago. We think if we can hold out long enough there will be a new pill, a cure or procedure that will save us. We have a large religious society that believes that God will step in and save us. They see medical professionals are "acting like God" when we say there is no more that can be done or recommend stop life sustaining measures. However, they do see us "acting like God" when we bring the dead back to life and the following consequences, ie: Terri Shiavo and Jahi McMath.

It is something that needs to be changed in our society. We all face death. We just don't know when and where. I have told patient's I can't tell them when they will die, but I will do my best with the help of our doctors and staff to make it as peaceful as possible. I tell them we never know when our time will be and they could even outlive me. Life is fickle but precious. Death is a part of life and can be a very spiritual journey for those involved, the pt, their family and those that care for them.

Specializes in NICU, ICU, PICU, Academia.

I think we touch a larger issue than the end of life discussion. Our society, as a whole, seems not to be able to accept 'no' for an answer.

You're 60 years old and post-menopausal. No, you can no longer have children.

But I want to - so I'll find a doctor to manipulate my hormones, wave their magic wand over a petri dish and - voila' - the stuff of which headlines are made.

I'm a 2.89 GPA student, and the minimum GPA for entry into 'X' program is 3.0.

But, I really want to study 'X' , so instead of studying harder and raising my GPA to the entry standard, I'll sue and deprive a qualified candidate a seat in the 'X' program.

I make $35,000 a year but want to live in a $200,000 home.

No, you cannot purchase such a house because you don't have a down payment or qualify for a mortgage.

But I really want it, so I'll beg my parents to mortgage THEIR home for my down payment and get a sub-prime.....

See, I just see this as a symptom of a larger problem.

An end-of-life debate aside...I do question the wisdom of keeping a chronically ill, very elderly patient (85+) a full code. One of my greatest fears is starting CPR on someone's frail grandmother and hearing and feeling their ribs crack, seeing them survive, only

to die later of related illnesses (pneumonia, broken bones, etc.)

I worked as a charge nurse in a LTC facility where ALL the residents were designated "FULL CODE'. I will never, ever forget the feel and the sound of ribs cracking on an 85+ year old lady during a code. Of course, she did not survive, despite my efforts and the EMS service that relieved me of CPR.

A prime example of the politicizing of death. This comment could cause a poopie storm, the likes of which you've never seen.

It's not politicizing death. If someone wants to end their life they should be able to without it being a crime.

I have done CPR twice in my short career in medicine, both patients made it.

However seeing the suffering and agony of living after a severe stroke is a fate worse than death if you ask me.

I'm a NODA volunteer.

Specializes in Pediatrics.
I think we touch a larger issue than the end of life discussion. Our society as a whole, seems not to be able to accept 'no' for an answer. You're 60 years old and post-menopausal. No, you can no longer have children. But I want to - so I'll find a doctor to manipulate my hormones, wave their magic wand over a petri dish and - voila' - the stuff of which headlines are made. I'm a 2.89 GPA student, and the minimum GPA for entry into 'X' program is 3.0. But, I really want to study 'X' , so instead of studying harder and raising my GPA to the entry standard, I'll sue and deprive a qualified candidate a seat in the 'X' program. I make $35,000 a year but want to live in a $200,000 home. No, you cannot purchase such a house because you don't have a down payment or qualify for a mortgage. But I really want it, so I'll beg my parents to mortgage THEIR home for my down payment and get a sub-prime..... See, I just see this as a symptom of a larger problem.[/quote']

Love this post. Love it, love it, love it. This says it all.

You forgot to add the part about the 8 year olds wanting iPhones, and getting them. Even though they are never away from their overprotective parents (not to mention a job or any sense of responsibility or independence).

In my religion,I'm taught death isn't natural.

It wasn't apart of the first human condition(Adam and Eve didn't even know what it was before eating the fruit).

Probably has nothing to do with the conversation though.