Abstract
Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer a compelling movement towards individuals seeking control of their dying trajectory to actualise the notion of individual choice. With this shifting landscape there is an opportunity to be grasped to change how we manage our dying trajectory away from the biomedical patterns of behaviour when dying, in order to balance life decisions. To achieve this prospect, we need to engage with a framework upon which to pin the changes. This paper offers a re-framing and re-presenting approach, using illustrative examples that draw upon British and New Zealand literature, together with over 50 years of professional nursing, and the Ars Moriendi to reflect upon the self-centricity of the contemporary Western individual to access a ‘good death’ of choice.
Highlights
The construction of a ‘good death’ has transcended the religious prescription of how dying occurs, with the contemporary notion of a medicalised death meeting this criterion across many Western countries. This move has witnessed the religious framework of the Ars Moriendi as being no longer relevant to the contemporary death, as medicine is portrayed as being able to meet the needs of the dying patient today
That clinicians may not be able to meet the needs of the dying, or those experiencing intolerable suffering, produces a reflexive abhorrence in that their expertise as gatekeepers of the dying is insufficient to quell the rising storm of those seeking control as individuals move towards death through methods that do not align with traditional medical care
To consider death as preferable to that of life produces a subtext of “otherness” for the individual involved.4. It locates the self-determined individual outside the boundaries of the contemporary medicalised ‘good death’. Does not quell those seeking the right to choice and the right-to-die, as such individuals remain resolute to their belief that control of the self should be attainable in death as it is in many other spheres of life, and that the right to choose one’s dying trajectory, whether medicalised or not, should not be contained and constrained by the powerful expert [1], but be attained in a similar manner to lives led, through the actualisation of the perceived freedom to make choices
Summary
This move has witnessed the religious framework of the Ars Moriendi as being no longer relevant to the contemporary death, as medicine is portrayed as being able to meet the needs of the dying patient today.2 This is evident in the construction of specialist medical practices to care for the dying, under the global umbrella of palliation and the subsequent development of specific medical models of care to provide symptom relief for the dying individual.. That clinicians may not be able to meet the needs of the dying, or those experiencing intolerable suffering, produces a reflexive abhorrence in that their expertise as gatekeepers of the dying is insufficient to quell the rising storm of those seeking control as individuals move towards death through methods that do not align with traditional medical care It is, this contemporary desire for control of the self at end-of-life that is proving problematic within the context of the medical narrative of care. Does not quell those seeking the right to choice and the right-to-die, as such individuals remain resolute to their belief that control of the self should be attainable in death as it is in many other spheres of life, and that the right to choose one’s dying trajectory, whether medicalised or not, should not be contained and constrained by the powerful expert [1], but be attained in a similar manner to lives led, through the actualisation of the perceived freedom to make choices
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