A Good Death? Finding a Balance Between the Interests of Patients and Caregivers

Uses two case examples to explore the meaning of a "good death," focusing on problems created by culturally approved conceptualizations of death/dying. The values of autonomy, independence, & self-control can often overshadow the reality of negative consequences for family members & health care workers. It is argued that more realistic expectations about death must be developed to protect the health/welfare of family & caregivers & to prevent undermining the collective basis of care. One or more of the four guiding principles of autonomy, justice, doing no harm, & beneficence are often challenged by impending death, requiring practitioners to engage in a balancing act between these values. An alternative ethic of terminal care is outlined, weighing the do no harm dictum with justice & beneficence, & encompassing protection for the larger community. It is maintained that a more collectivist orientation toward care of the dying eases some of the moral dilemmas faced by caregivers & frees them from the constraints of good death assumptions. 10 References. J. Lindroth