In search of a good death

Editor—Clarke warns against the medicalisation of dying when medicine and technology overstep the boundaries of the body or when palliative care focuses on symptom management.¹ This can be a reality but depends on the healthcare provider, such as when death is resisted—when it is inevitable or when technology is lengthening the dying process as opposed to providing a good death.

Figure 1.

The Death of Socrates by Jacques-Louis David, 1787

Credit: WOLFE COLLECTION, METROPOLITAN MUSEUM OF ART, NY

Healthcare providers need to be cognisant of the importance of caring for the body holistically, and not just focusing on the corporeal needs. Symptom management is an essential part of palliative care, but the heart of palliative care is the dying person.

Innovations have greatly affected the dying process—providing the dying person with options and control. Nevertheless, healthcare providers do impart a technological realism. They are the experts on medicine and technology, playing a key part in how patients perceive and embody technology. In addition, to what extent a dying person embodies the technology is unique and remains a comparatively uncharted matter.

Clarke notes that palliative medicine “lacks a specific disease, bodily organ, or life stage to call its own.” On the contrary, palliative medicine embraces Clarke's quotation. The beauty of palliative care is that it does not marginalise a disease or life stage but embodies any dying person with any disease at any life stage.

To find a balance between humanism and technology, healthcare providers need to embrace the theory of patient centred care. Then technology will inadvertently and fortunately slide into the background. The positive or negative outcome of the medicalisation of the dying process is unique and contingent on not only the dying person but also the healthcare provider. Medicalisation and technology do not have to be polarised against a good death but can enhance the dying process in the interests of the patient.