Over the past century, the viewpoints of death have had a definite shift within society. This can be attributed to the shift in medical care from family settings to a more institutionalized setting. As a result, what used to be considered a natural part of life is now viewed as a failure in medical technology. Today, we tend to think as a society that the ideal death would be in our sleep without suffering. In contrast, the medieval era believed that death should be by noble cause, and it’s said that people of that time actually prayed to not die in their sleep. Understandably, the various viewpoints of “the good death” can make providing comfort for hospice patients a challenge.
In addition to the various cultural differences in the perception of a good death, there also tends to be a difference among healthcare professionals, families, and patients.
The Influence of Cultural Backgrounds
To better understand what a good death means for a patient and establish appropriate goals, one must have an idea of the patient’s cultural background. Recent data suggests that Latino and African Americans are more likely to ask for more life-sustaining therapies versus Caucasians. However, more recent data suggests that African Americans are less likely to want to be “connected to machines” versus other ethnicities. Additionally, a study including Hispanic cultures found that mortality was highest around Christmas and All Saints Day. This study suggests a better quality of death around religious holidays, whereas other cultures view death around holidays a more traumatic loss.
Other Influences and Considerations
In addition to the various cultural differences in the perception of a good death, there also tends to be a difference among healthcare professionals, families, and patients. Data shows that a healthcare professional’s idea of a good death tends to be more biomedically related. Family members of the patient tend to stress the importance of meeting with clergy members, and lastly, the most important attribute of a good death from the patient perspective was coming to peace with their terminal illness.
As mentioned, understanding what a good death is can pose a challenge when providing comfort care for patients, hence providing goals of care for hospice patients can be even more challenging. However, as healthcare professionals, it is crucial that we take the patient’s beliefs and wishes into the utmost consideration when we are establishing comfort goals for them.
By: Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care, Hospice of Southern Illinois
October is American Pharmacists Month and we present to you a series of end-of-life topics throughout the month by our very own, Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care! Our series will help expand your understanding of the field and debunk some myths in the field of pharmacy.
Topic 3: The Good Death
Read last week’s topic 2, End of Life Care Agents for Parkinson’s.
Our first post of the series, topic 1, click here, What is the difference in Palliative Care and Hospice?
Learn more about our pharmacy residency program here.