The words “good” and “death” are not often used in the same sentence, at least not in general conversation. When we discuss death, if we do at all, it is usually in the context of tragedy or grief; most of the news reports we see of death and dying don't depict death in a way that could be considered 'good' under any circumstances. Yet our population is aging, and more and more people are witnessing their elders' last years and wishing to approach their own deaths more intentionally. Many people feel drawn towards advance planning because they have experienced "bad" deaths and want to avoid putting their survivors into a similarly emotionally fraught situation. Because of this, and in hopes of changing our experience of death and dying, more and more books and other resources are cropping up to try to guide us through legal and medical matters we and our families will experience as we approach death. Yet the concept of a "good death" is nothing new – efforts to curate our deaths have been under consideration for centuries.
A ‘Good Death’ Through the Years
Throughout history, the concept of a 'good death' has evolved, each era shaping its own interpretation. In early medieval times, dying the 'good death' was of supreme importance, as it would assure passage into heaven. This era's vision of dying well meant dying surrounded by family, friends, and priests or other religious persons. On one's deathbed, renunciation of all sins and administration of the sacrament were thought to assure acceptance into the grace of God; bonus points were given for offering ethical direction to those surrounding as one lay dying, such as instructing surviving children to be pious. A bequest to help people experiencing poverty in one's will, if financially possible, was also considered necessary to dying well. A good death was considered so important that books, such as Christopher Sutton's book Learne to Dye (sic) (1601), endeavored to guide people through the end-of-life steps necessary for a ‘good death.’ Dying suddenly, without time to prepare and assemble the required sacraments, was considered very bad for one's chances of going into the afterlife.
By the 1700s, however, people began to consider the person's entire lifespan more critical to their afterlife experience than the hours immediately before death. Dying suddenly came to be regarded as a blessing since it precluded protracted suffering. A person's moral character throughout their life counted more towards their 'good death' than whatever happened during the days and moments around their dying. This reflected a shift towards more consequential thinking, drawn from a puritanical value system.
A Good Death in the 20th Century and Beyond
As people began living longer due to better nutrition and healthcare, and the population began dying later in life, different criteria began to define dying well. With less focus on piety, dying well began to mean a 'well-managed' death. In 2007, Dr. Edwin Schneidman (now considered the father of modern thanatology) put forward new, specific criteria for a "good death," defined as "a death that one might choose it if were realistically possible for one to choose one's own death.' The criteria were that the death be:
- Natural, as opposed to accidental or suicide/homicide.
- Mature: after the age of 70
- Expected: not sudden or completely unexpected
- Honorable: the deceased will be remembered and spoken of well
- Prepared: legal paperwork mostly or wholly finished, funeral wishes known and perhaps prepaid.
- Accepted: the person was not in denial that they would die
- Civilized: not dying alone or in dire straits; some beauty in the environment, such as flowers or music.
- Generative: to have fostered relationships with younger generations; shared wisdom
- Rueful: survivors are left with bittersweet feelings: sadness at the loss but happiness for a life well lived
- Peaceable: freed from emotional and physical pain at the moment of death.
As we've entered the 21st century, more ways to "die well" are entering the mainstream. Green burial (reflecting concern for the environment), home funerals (expressing a wish to be more hands-on with our loved ones), and even human composting are gaining popularity. We are starting to consider how our dying and death impact the larger world around us in the same way we consider how our time on earth does.
Whether we look at Schneidman's criteria or the mandates of the medieval good death, there will be some factors we can control and some we can't. No matter how hard we try, we cannot always control whether we are diagnosed with a serious illness or whether we become the victim of an unfortunate accident. We can't necessarily control the age at which we die. We can't control whether our death is expected or unexpected. However, in both Schneidman's model and the medieval good death ideal, we can make choices that will impact the overall experience. This realization can empower us to take charge of our end-of-life journey, making decisions that ultimately will shape how we die to the extent it is possible to do so.
In this series, A Good Death, we'll go step by step through different areas and guide you toward making plans and decisions that align with your values rather than a one-size-fits-all mandate. The worksheet below gets you started on identifying what is important to you when you consider 'dying well.' This is deeply individual, and there are no right or wrong answers. While going through these different modules, you can reflect on what is most important to you and plan accordingly. Each subsequent module will also be accompanied by a worksheet to help you assess where you are and where you'd like to be, identifying steps to take along the way.
Death is unknown and frightening, but we can put our own personal stamp on how we end our lives, even in small ways. In doing so, we empower ourselves and give a gift to those who survive us, lessening the choices and decisions they will have to make in the stress of the moment and offering them an opportunity to feel the satisfaction of helping us carry out our wishes. Please join us on this seven-part journey.
Worksheet
Module One Worksheet: Assessing Your Values, Current Status and Where You'd Like to Be
