 n life, we are assured of only 2
things: taxes and death. The British Medical Journal
published an editorial on the end of life that is
interesting and thought provoking (1). Prudent people
carefully manage the financial implications of their
death before the event. However, few people make plans to
ensure that when the inevitable happens it is a
“good” death.
Most of us put off or even try
to defeat death, and enormous energies are devoted to
this task. Death is perceived of as a failure, as opposed
to a very important part of life. It is the one area of
life that is not openly discussed and planned for with
the same interest and vigor as good health. Yet death
will happen, and we should aim to control it as much as
possible.
Frequently, patients die in the hospital or the
intensive care unit when they would prefer to die at
home. We know statistically at what age we may die and
from what cause, but we still know very little about the
experience of death.
How do we define a “good” death? Several
excellent principles have been identified, which should
be incorporated into the mission of both individuals and
health care systems. These principles (Table)
include being able to retain control of events so that
you have time to say goodbye to friends and loved ones
and are able to leave when it is time to go and not have
life prolonged pointlessly.
Death should not be looked on as a failure of life but
as the celebration of life. We should embrace it when it
is time and understand that we have fulfilled one episode
of our existence. The inevitable should be planned for so
that, if at all possible, we can “die well.”
- Smith R. A good death. BMJ
2000;320:129-130.
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