5 thoughts on “A ‘good death’?

  1. Thanks for this thoughtful piece that adds to the conversation around end of life choices. I think Laura is right in saying that we can’t decide what is a good death for all people, all of the time. Continuing to ask what matters as the journey unfolds is paramount.

    However, for some that may also include taking active steps to end their life, no matter how helpful medical professionals feel they are being with pain relief and so on.

    It seems that Kiwis are overwhelmingly in favour of having this choice according to a new paper from Phillipa Malpas et al in the Journal of Palliative Medicine.

    As Phillipa says, we need to keep talking about this, with respect for one another’s views about dignity and suffering.

    • Thanks Sande, I saw Phillipa’s paper – a good and interesting study. Most Doctor’s organisations, at a policy level, are not in favour of PAS/euthanasia, like Hospice NZ, and the Nurses Org’s. There was another study out this year by the Association for Palliative Medicine (UK) that was overwhelmingly against PAS (see http://www.ehospice.com/uk/articleview/tabid/10697/articleid/13677/language/en-gb/apm-assisted-suicide-would-have-an-adverse-effect-on-hospice-and-palliative-care.aspx). Of course we can’t make generalisations about doctors, but it’s interesting to note what those who deal with the dying daily think – does it have anymore weight? I’m sure this issue will continue to develop. My hope is the debate will include spiritual considerations not just the physical individualistic concerns.


      • Mm, that article you link to has a very interesting headline saying PAS would have an adverse effect on palliative care. I don’t think there’s any substance to that and quite possibly the headline was the preserve of the sub editor so best not to get too hooked on that one!

        However, if we are to move into the area of spirituality then I suspect we’re talking about that which makes significant or ultimate meaning for a human person. As an embodied person I do have to speak about that, in part from a physical, individualistic perspective, as well as acknowledging my family/friends and to a lesser extent my community. Other from varying worldviews and backgrounds may weight that differently.

        For me, taking seriously how I make meaning is to accept that I may choose a different path at the end than you might, or the doctor with some involvement in my care might. Even although a doctor may feel differently, I would expect that the doctor caring for me would take what mattered to me to be central. To treat me as a whole person, whose meaning making is constructed through the hard slog of chronological years, experience and intellectual enquiry.

        Taking me seriously is one way in which spiritual care could be exercised. I would see that this is true in The Netherlands and some other countries that have accepted end of life choices. This may well be a good question to pose to Dr Rob Rob Jonquiere when he visits New Zealand in February.

  2. “This helplessness (in the face of disease) can make it more difficult for doctors to rely on the phronesis (or prudence) that constitutes virtue-based medical practice. It is just as important a skill for a physician to be able to explore and understand the priorities for an individual person around the end of their life, as it is for them to investigate and treat disease ad infinitum.”
    This seems an important piece in terms of the training of medical students. And maybe it’s more than that – something about the very essence of the doctor’s view of him/herself and his/her role in life.

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