Study Tries to Define Good Death

ByABC News
November 14, 2000, 10:45 AM

N E W   Y O R K, Nov. 14 -- A good death is defined differently by doctors and patients, which means some physicians may be ignoring spiritual issues patients consider important, a new study finds.

Responding to a questionnaire about the 44 attributes important in defining a good death, more than 70 percent of 1,426 physicians, care providers, seriously ill patients and recently bereaved family members across the country agreed being treated as a whole person was essential to a good death.

The definition, however, of treating the whole person varied widely, with patients placing more importance on spiritual and psychological issues than physicians. Patients consistently said mental awareness, not being a burden and coming to peace with God were critical to them issues that did not register as much with doctors.

The study is being published in the Nov. 15 issue of the Journal of the American Medical Association, which focuses on end-of-life care.

Concerned that physicians focus only on the medical aspects of care without acknowledging the emotional and spiritual needs of dying patients and their families, Dr. Karen Steinhauser a health scientist at the Veterans Administration Medical Center and assistant research professor at Duke University Medical Center, in Durham, N.C. conducted the study to reveal what people want when they die.

If we want to help people die better, we have to know what better is, Steinhauser said.

Besides stressing a sense of psychological awareness while dying, study participants said pain management, preparation for death and having a sense of completion were important to them.

Dr. Timothy Daaleman, an associate professor at the Center on Aging at the University of Kansas Medical Center in Kansas City, whose commentary on spirituality as part of end-of-life treatment also appears in the issue, agrees with Steinhauser that American physicians over-medicalize death, saying, Physicians have an important role beyond dispensing medical information.