Our minds love neat categories, and a popular one is the ‘good’ vs. ‘bad’ death. After speaking with 67 death doulas, I found that this binary doesn’t fit the complexity of dying. As a matter of fact, this type of framing invites judgement and can create unrealistic expectations that make the dying process harder than it needs to be. Dying is deeply personal and cannot be universalized. Let’s explore why dismantling the ‘good’ vs. ‘bad’ death concept is important, and why our society at large must shift our framing of death and dying.
About our Guest Author, Jenna Yeam
Jenna Yeam is a student-researcher at Duke University exploring what it means to die well and how to help people die better. As part of her research, she interviewed 67 Death Doulas to help shape her thesis and create public-facing resources such as this one. Jenna also hosts student-led Death Cafes on Duke’s campus where she leads important conversations about Living Well by talking about Dying Well.
Why should we move away from “Good Death?”
Labeling a death as “good” implies that there is a “bad” death. However, death is just death. The good-bad dichotomy can be harmful because it dismisses death as a natural part of life. Death is a human equalizer, part of the human condition, and a reality we should be aiming to accept rather than stigmatize. As such, we should not be labeling our inevitable fate as “bad.”
According to one of the death doulas I interviewed, “Death is just a part of life. It is just death and to say that it has to be good means that somebody is saying that death is bad.”
Why can’t death be universalized? Because each death is unique.
Why Context Matters
The experience of dying, for the dying person and their witnesses, is highly contextual, meaning that the quality of the experience is dependent on the physical setting, circumstances, and people surrounding the dying person. When thinking about death, circumstances may mean:
- The dying person needs a certain care setting such as a hospital or nursing home due to financial or familial strains.
- The family may not be able to be in person with their loved one due to limitations on their ability to travel long distances, at all or as much as they would like.
- Loved ones may need to call on caretakers and additional support to address all sides of the dying person’s wellbeing, whether it be family, a chaplain or a Buddhist priest. Dying is a team effort.
Life is unpredictable and for those involved in the end of life, each of these decisions are rights the individuals should have.
Individual preferences
Ideally, each person’s preferences and needs inform what their death will look like. It “is often determined by societal structures, cultural background, [and] tradition,” according to one death doula. With an individualized approach, dying for one person will look entirely different from another. It’s important that the dying person can communicate their wishes to any part of their team, if they are able.
A personalized approach recognizes the uniqueness of every individual’s end-of-life preferences. As another death doula shared, “Some people want to be with family while others want to be alone.”
Thinking death is “good” or “bad” can set unrealistic expectations
The idealized concept of a “good” death can set unattainable goals for the end-of-life process.
According to the death doula community, when people hear of a “good” death, they think of a death “without pain, with all the family, something glamorous.” It can lead to disappointment and more suffering if the dying journey doesn’t match these expectations. “It doesn’t always go this way.”
There are many things in the dying process that cannot be controlled, and there is no way to “wave a magic wand and say, boom, the picture-perfect Hollywood death,” doulas added. “There [are] a lot of things that are not within the control of individuals” such as:
- The physical decline of the dying person,
- The ongoing responsibilities of visiting family members,
- The timeline and trajectory of the individual’s end-of-life.
We should all be ready to adjust plans at any point.
The term “good death” dismisses suffering
“I don’t use the term [good death] because it dismisses the inevitable pain of death,” said one death doula. Using the term good death can inadvertently minimize the pain and struggles that may come with dying, as dying is never an “easy or fully happy experience, because it is death.” In the same way that life is intrinsically characterized by challenges and struggle, the dying process may not be entirely free of suffering, for the dying person or their loved ones.
Being Present to Death
If possible, it is helpful to be present to the full range of emotions and experiences that accompany the end of life. “We acknowledge the emotions and then do not label them as good or bad.” When loved ones and care team members are emotionally and psychologically present in the dying space, both the bereaved and the dying person’s human essences are respected.
It can be helpful for the dying and their loved ones to seek end-of-life resources so they can navigate the dying and post-death process with awareness of what to expect and knowledge of their rights. This ranges from the death rattle to physical body changes to one‘s rights regarding funeral services.
Being present and informed encourages us to embrace the complexity and individuality of the dying process. By reframing how we talk about dying, we can establish more humane and accepting mindsets, as well as realistic expectations, before and while navigating an end-of-life journey.
“The Death Rattle sounds scary, but…it is a natural part of the dying process.”
The more people that can learn about what to expect physically, their rights regarding hospice and funeral services, and exploring important considerations that doctors may not always address, the more they can guide and be present in the dying experience. The dying, if able, can also take steps to be more ‘present’ or ‘conscious’ during this time, whether through mindfulness exercises, guided rituals, legacy projects, obituary writing, or other meaningful acts that foster closure.
By acknowledging the full spectrum of the dying journey, we can better support those at the end of life and their families, ensuring their dignity is honored and upheld.
