McGraw Hill/ Open University Press (2004)
ISBN: 0-335-21411-8 166 pages plus index
Audience: A Good Death: On the Value of Death and Dying is part of a series investigating death in late modern culture. The series editor identifies students of death, dying and bereavement and anyone with an involvement in palliative care research, service delivery and policy development as target audience. However, death occurs in all health care settings and it would be of interest for anyone caring for dying people.
Purpose: There are many ideas of what a good death constitutes; some of them play an important normative role in palliative care. This influences the attitude of carers’ and care provision towards dying people. Some of the ideas on how a good death can be achieved evolve around a certain mind-set, that one has to make certain preparations or that certain features are necessary in order to achieve a good death. Some examples of normative aspect are that a good death is consistent with patient’s former or present values and aims, death should be meaningful, patients should die with dignity and awareness is preferred to denial of death. Good death is also associated with ideas of acceptance, self-controlled death, death without suffering, rituals of death, completion of death, life review and a peaceful death. The fundamental question this books attempts to answer is: if we adopt these ideas, will they do good and benefit people?
Content: The text is an abridged and revised version of the author’s doctoral dissertation. It is well structured, includes six chapters, the first outlining the underpinning ethics and values. In further chapters the period of dying, global features of death and dying, facing death, preparation to die and the environment of dying and death are discussed.
Highlights: The book is academically written, but use of personal language allows for engagement in the detailed arguments and well defined ideas. The detailed attention to definitions and development of ideas provide clarity and depth to the text. In the general health and palliative care literature underpinning values are rarely subject to discussion and reading this book provides an opportunity to examine ones own values and norms about what a good death constitutes.
Limitations: The author acknowledges that the choice of ideas on good dying is limited to ideas from a modern Western palliative care context. Although consistent within the context, readers with a different cultural perspective might find some of the theoretical assumptions less convincing.
Comment: The central message of the book is that we need to be aware that professional framing of notions of a ‘good death’ should be carefully considered. Patient centred-ness and respect for autonomy can be eroded by applying professional frameworks without debate and analysis of these underpinning norms and values.