Table 3.
Summary of Primary Themes and Key Determinants Affecting the Quality of the Death Experiencea
| Good death Primary theme: Wholeness and certainty | Poor death Primary theme: Separation, doubt, isolation | |
|---|---|---|
| Dignity |
I think what is important in dying is that a person is able to die with dignity. … Being able to carry out some of the wishes of the dying, so if that person says, ‘I would like to die at home, I want to be at home’—giving them that opportunity to do so is very important—dying with that dignity. (MJB1030FG-E) I think to me a good death is a death with dignity. And also at peace in the person's own heart. (TC1030) A good death is one in which a person's wishes were honored. (MJB1030FG-B) I said, ‘Do you want to accept Him [Jesus]?’ He [the patient] said, ‘Yes.’ I said, ‘Okay, let me call your family. … I'm not going to do anything if you personally don't feel a desire that you want to do it.’ (MB1021) |
[A poor death] is the pain and the deterioration of the health makes the person feel like subhuman or even look like subhuman because of the sickness … the clothing poorly changed and smell. (TC1030) I knew of a patient who did not want to be resuscitated but the family wanted him to be resuscitated. It was not a good sight. For me a poor death is one who dies and his or her wishes are not honored. (MJB1030FG-B) A poor death would be a death in which a person's freedom of choice and self-determination has been removed. (RT0819) But if a dying patient feels out of control, his life is in the hands of physicians, nurses, other people, hospital administrator, then it is not a good death. (TC1030) |
| Preparedness |
[A good death is] where the person is absolutely confident of what's happening on the other side, where there's no doubts, no uncertainty, where they are sure where they're going. (MB107) When they put in the balance the things that they did and on the other side the things that they could not accomplish or even the wrong things, at the end they are satisfied. (JP414) For me the difference is a good death is when you are prepared; a poor death is when you are unprepared. (MJB1030FG-K) They recognize that this is just another stage, a portal, to something else that God has prepared for us theologically. (MB129) I would characterize a good death … when people have an opportunity to perhaps reconcile relationships. (MJB1030FG-D) A good death is also [when] they prepare themselves to leave their legacy behind. (MB129) A “good death” is when the person, at various stages in his or her life, put their house in order; they decided who is going to get what; not making that decision at the time when that transition occurs. (MJB1030FG-G) I would say a good death is one that helps you to be reconciled and at peace with yourself, with your past life, with God and with others; so to be at peace in those three areas, with your own life, with God and with others. (CM1217) Then after explaining [to] them some principles and truths about scripture most of them enter into this sphere of peace. Then I ask them again, ‘How do you feel now?’ And many times I have heard something like, ‘I am ready. I am ready.’ (JP414) I've witnessed people who have had a good death when they have understood … that there was definitely going to be closure to life and had an understanding that they need to be prepared for that end. (MB129) |
There's another one … which I considered a bad death, was someone who would not accept it under any circumstances—‘I will not die’—even though it was inevitable. And fought the system … irritated physicians by more and more demands. ‘I want alternative treatment and if you can't get me alternative treatment I'll find someone who will.’ And ended up going to other places around the world for alternative medicine. … There's a lot of self-created angst and anxiety by the absolute refusal to accept the death. (MB107) Dying unrepented or not reconciled with God and angry or hating, that would be a terrible and very poor death. (CM1217) There was this Mexican dancer—he was dancing with his dance team … and a pole fell and hit him dead. And now his family is devastated. ‘Our young son is dead and he is twenty-something years old.’ I don't know if I would call it a bad death, but it is something that feels abrupt; it feels sad in a different kind of way. (MJB1030FG-A) I would say that the opposite would be reflected for a bad death which is fear. Disorientated, in a way, they don't know where they are going. Many questions, many, many questions to themselves; to God. (JP414) A bad death would be without Jesus. It's a bad one because you're distancing, because you can be saved by accepting Jesus as your savior, so if you do not accept Jesus and you die, according to the Bible, you're lost. (MB1021) Poor death is a lot of fear. Anxiety about what is happening after death, the final destiny. (TC1030) They had a stroke and lasted about a week, but they died with a lot of unresolved issues. I don't think that is the way it should happen. (MB129) It really depends on whether you believe this or not. If you don't believe in this afterlife you are actually going to the termination of your life. It is a terrible process and you will be scared to death. (TC115) |
| Physical suffering |
A ‘good one’ is one where there's no pain. There are certain people who have cancer and because of the location of it there just isn't any discomfort at all. (MB107) A good death is one in which … pain is minimized to the degree that is possible. (CG124) In the physical part, if you have your medicine that helps you with the pain, that is part of it [a good death] as well. (CM1217) A good death would be one in which there was a minimum of physical suffering. (RT0819) |
The pain was awful. His heart was good; his soul was good, but physically it was very, very difficult. So that's a bad death. (MB107) A poor death is one who suffers physically with cancer and morphine or whatever drugs are used that do not ease the situation. (MJB1030FG-C) A poor death would be one that is in constant pain and the pain cannot be eradicated and the quality of life is awful. (MJG1030FG-I) Let's begin with the physical part—if you are really suffering a lot and that could be avoided, that could be a poor death. (CM1217) |
| Community |
A good death is certainly having those who you love most around you. (MB1030) I firmly believe that we are born into a community and we die in a community. … We ought to be able to really celebrate a person's life … and we do that in community as well. (MJB1030FG-H) Comfortable, cared for, loved, family and friends, community around together. (CM1219) A good death, I say a ‘holy death’ will be surrounded by family and friends. (CM1217) |
[A bad death is] one in which the individual dies alone and isolated, filled with regret or bitterness. That death is often characterized by anger or fear. There is a clinging to the anger. (CG124) She pretty much locked herself in hospital room. … She'd been on staff at this church for 30 years, and wouldn't allow anyone else to come in to see her and spent most of her time weeping. That was a poor death. (MB107) [I have seen] people that are very isolated because of some of the choices they've lived. They have basically broken ties. … I think that is probably the worst. (CG124) So a poor death would be one … where the support around the individual is not there in any which way, whether it is hospice or family or friends or whatever. (MJB1030FG-I) |
a
Participant identifiers that include “FG” indicate that the quote is from a focus group; the letter afterwards indicates the specific speaker.