Sarah Grace
Chapter Introduction
As discussed in other chapters, death is a taboo topic of discussion and western societies have become death-denying or death-phobic, often resulting in a lack of death-related conversations. Although we may wish to avoid it, death is certain, whether it be our death or that of a loved one. Avoiding death-related discussions ultimately contributes to uncertainty, discomfort, and suffering at the end-of-life. When people do talk about death, it tends to be constructed as something to be feared, fought, and conquered. Conventional perspectives of death construct ideas about “proper” end-of-life care and experiences. These often fail to take individual wishes into account and can infringe on a person’s right to choose how they want to die. This chapter examines several types of end-of-life care: palliative and hospice, including the role of death doulas. It also explores the option of medical aid in dying (MAiD).
After completing the chapter materials, you should have an understanding of:
- The complexity of dying with dignity, including its psychological, cultural, and social dimensions.
- The diverse options at the end of life, including palliative care, hospice care, medical aid in dying (MAiD), and the role of death doulas, as well as the differences between them.
- Key terminology, attitudes, and perspectives related to end-of-life care, along with laws and policies governing practices such as MAiD in the United States, Canada, and other countries.
- The psychological theories underpinning end-of-life care, such as Erikson’s Psychosocial Development Theory, Self-Determination Theory, and Terror Management Theory, and how these theories inform compassionate care practices.
- How social, cultural, and religious constructions of death influence end-of-life experiences, patient preferences, and the support provided by caregivers.
- The multidisciplinary nature of end-of-life care, including the roles of healthcare providers, spiritual counselors, and death doulas in supporting dignity and autonomy.
- Ethical considerations surrounding medical aid in dying (MAiD) and its legal, cultural, and practical implications across different countries.
QUESTIONS TO THINK ABOUT WHEN COMPLETING CHAPTER MATERIALS
- What does death with dignity, or a dignified death, mean to you? How do cultural, social, and personal values shape this definition?
- How do palliative care, hospice care, and medical aid in dying (MAiD) contribute to helping a person die with dignity? How does each align with the principles of autonomy, compassion, and holistic care?
- What are your rights under the laws governing medical aid in dying (MAiD) in the United States or Canada? What restrictions or barriers might prevent a person from accessing MAiD, and how could these laws be improved to better serve patients?
- Compare and contrast two examples of assisted dying laws from other countries. What similarities and differences stand out, and what can be learned from these approaches?
- What role do death doulas play in the end-of-life care process? How do their contributions complement or differ from those of palliative and hospice care teams?
- How can psychological theories like Erikson’s Psychosocial Development Theory or Self-Determination Theory provide insight into the emotional and spiritual needs of terminally ill individuals and their families?
- How might social and cultural attitudes toward death influence a person’s experience of end-of-life care or the support they receive from caregivers?
