Letting Go Near The End

                The medical field should offer the dying person a “good” death.  Since people are individually unique, this “good” death is relative.  The patient centered approach is best.  This approach considers the patient’s interests when making healthcare decisions.  It is contrary to the physician centered approach where decisions are made without patient contribution.  The dying person should have the option of changing their mind about anything, at any time.  For some, it may mean dying in the comfort of your home surrounded by family but for others dying in a hospital with twenty four hour care -hence the term “dying with dignity”.   No matter where the death takes place, an interdisciplinary approach is necessary to understand and satisfy the dying person’s unique needs.

            The medical field should encourage the person to have advanced directives.  Any questions should be answered by medical professionals.  Decisions cannot be made without specific, honest and professional advice.  In the reading, we learned it is probably less painful to be hungry than to have a protruded abdomen.  So, depending on the circumstances, we may decide to forgo food.

                The doctor (unlike Monopoli’s) should make known to the dying person their disease state.  This honesty will allow time to be budgeted for the social and emotional closure the person needs.   These needs vary.  Some people will want formal goodbyes and some will be happy knowing that they are remembered. 

A small party can be assembled to tell the person how much they are loved and will be remembered.  The medical community must yield private time to allow these social and psychological finalities.

            Another area the medical community needs to address is keeping the dying physically comfortable.  Foremost, the doctor should alleviate any suffering by prescribing medication.  An aide may offer comfort by turning a fan on or ensuring there are no bed sores forming.  A volunteer can lightly massage aching hands or feet.  A counselor can help the dying who become depressed or anxious over family strive arising from the death.   The medical field must become part of a team.

            To conclude, a “good” death is characterized by an interdisciplinary approach in which the dying person is allowed to make decisions about their own end of life choices.  The medical personnel should make the person aware of their end of life choices and the progression of the illness so that the person can make wise decisions.  The doctor should always give honest opinions and help alleviate pain.  The person should be allowed to have quality time with their lifelong connections and say their goodbyes.

The team should be able to connect the person to community professionals for spiritual closure, for mental health services, and for taking care of any unfinished business.  And, last, it is my opinion that life should not be prolonged beyond futility.  Still, in the context of this reading, the decision should always be that of the dying whose wishes are most important. 

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