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.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Is it really true that this attitude is in all of society? I assume this article was written in response to a recent, highly-publicized case, and I'm sure that case and others like it are very distressing to health care professionals. I also assume there is a big difference in issues involving younger people -- my experiences as described above involved people in their 70s and 80s.
I wrote the first installment of Our Death-Defying, Death Denying Society in 2012, more than a year before Jahi McMath met her unfortunate demise. Our cultural attitude of death avoidance has been prevalent for a long time.

https://allnurses.com/nursing-activism-healthcare/our-death-defying-773839.html

Specializes in adult psych, LTC/SNF, child psych.
Physician assisted suicide is, in my opinion, 100% "right."

This has even been part of discussion with my husband as we're planning our advanced directives and MOLSTs at 26 and 29 respectively. Now of course, I have bipolar disorder, but that's even more the reason that I want things like this to be talked about now, when I'm in mentally stable place. I know it's likely that we won't have to deal with these things until much later in our lives, but I want things to be in place if I'm in a traumatic car accident tomorrow! Anything can happen and I want as much say into what happens to me when I can't speak for myself when the time comes.

Specializes in adult psych, LTC/SNF, child psych.
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.

What is NODA?

Specializes in adult psych, LTC/SNF, child psych.

In Maryland, we have a MOLST that does carry over to the hospital upon transfer. It's a bit more extensive than a DNR - including things like artificial fluids and blood products.

Specializes in Pediatrics.

think of how many bodies are pulled out of the East and Hudson Rivers. It's a common thing to see in a densely populated area. Always sad, but not shocking if you've lived here a while. It's VERY, VERY, VERY unlikely that someone else had similar clothing, but not impossible.

I would not criticize any family member for wanting DNA evidence in a situation like this -- I don't know if DNA testing is always done, but I have heard of it in similar cases. I can't imagine expecting a family to accept ID based exclusively on clothing. It's not explicitly stated, but the NYT story suggests that DNA testing was at the behest of the police -- not something the family insisted on.

Here's the Daily News story:

Avonte Oquendo's family cling to hope, await DNA tests as cops find second arm in Queens - NY Daily News

And from the NYT:

http://www.nytimes.com/2014/01/18/nyregion/police-investigating-remains-found-in-queens-for-link-to-missing-autistic-boy.html?_r=0

thanks for the links!

I completely understand what you are saying. I'd want proof too. Some parents never get any sort of proof/evidence, this leaving them with absolutely no closure. It's not the ending they want, especially since it may be difficult to determine cause of death. I know I'd make a terrible lawyer, judge (or even a juror, lol), but I feel like that if it looks like, smells like and talks like a duck, then it is most likely not a pelican. Fortunately, the technology exists that they can trace the DNA back to him (assuming it is him).

And yes, there are many many body parts and other things floating around these parts (sadly). I will reiterate: I HOPE it doesn't turn into a similar situation as this, and that this "death-denying phenomenon" is not becoming a trend.

What is NODA?

Sorry I'm totally jumping in here. I love this program and will take any opportunity I can to sing its praises. :) NODA = No One Dies Alone. Volunteers of all backgrounds, medical or otherwise, sit vigil with patients who don't have loved ones nearby. It sounds simple enough, but it means so much.

This page has a really beautiful article written by the RN who started the program:

No One Dies Alone

Specializes in Emergency Nursing.

I was shocked to discover a few months ago how inexperienced my co-workers were with death. One had never seen a dead body prior to working in the ED. None had been to funerals as a child. These are people who purposefully work in healthcare, and get upset about CPR on a 90-year-old, or revoking a DNR. If my co-workers are evolving and processing their beliefs as they actively work with dying people, I can only imagine how difficult it is for the general public to understand and make choices about something they have been shielded from their entire lives.