Good Death

The good death is a difficult concept that has proven difficult to ignore. Would the wrong kind of death expose us to vengeance from the deceased spirit? Is self-termination the worst or the best kind of death? Should the health care system be expected to foster a good death for the nonresponsive person whose organs will soon be donated? Still haunted by ancient fears and hopes, the 21st century is adding its own technologyinfused puzzlements. Both then and now, visions of the good death reveal much about the societies in which they have been constructed. The profusion and confusion of ways in which good death has been conceived are sorted out in this entry.

Good Dying or Good Death?

Often good death actually refers to good dying. Emphasis is on how a life ends, not on what might come thereafter. This orientation is at the core of the hospice/palliative care movement. People have varying beliefs about death and afterlife, but relief from pain and other symptoms would be welcomed by everybody. “Death with dignity” soon became a catchphrase, though the issue was quality of life during the final passage. Blurring the distinction can lead to miscommunication, when one person is focused on end-of-life experiences, and another on the nature and meaning of death.

Sometimes death does mean death. Devout people have suffered intense deathbed anxiety at the prospect of being judged unworthy. The memento mori (“Remember, you must die!”) tradition that flourished in Europe from the 13th through the 16th centuries made the moment of death the final exam that determined the fate of one's soul. The outcome was uncertain. God's mercy might redeem a sinner, but a person regarded as pious and upright might be consigned to eternal damnation. The God-fearing person therefore prepared for divine judgment throughout life. The judgment of the dead had also been prominent in the dynastic Egyptian belief system, among others. Good death was the guiding vision in societies that envisioned the radically different outcomes of a blessed or tormented afterlife.

The distinction between dying and death would seem to parallel “alive” and “dead,” but the increased use of life support systems has raised questions with medical, ethical, legal, and economic implications. Is the person in a persistent vegetative state dying, already dead, or suspended somewhere in between? Should termination be regarded as a good death that ends a bad dying? Or is this person's status now beyond dying-anddeath, alive-or-dead, and good-and-bad? And perhaps beyond our ability to comprehend?

Euthanasia is a term frequently invoked in such a context. It is, laden, however, with ambiguity and emotional connotations. Euthanasia originally referred to an easy passage from life. The term can also be translated optimistically as “happy” or “pleasant.” A person could be comforted by loved ones, priests, medications, and music, for example. The comfort theme has continued to the present day, but it was not long before euthanasia had morphed into mercy killing. On battlefields ancient and modern, a wounded warrior would be found in a desperate situation: helpless, mutilated beyond survival. His eyes, if not his voice, would speak for him. The warrior who found him—friend or foe—would end his suffering with a decisive blow.

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