A "Good Death" Requires More Than Medical Care.

• Position: Social, spiritual and psychological needs of the dying - Brief Article

Top-notch biomedical care is critical at the end of life, but Duke University Medical Center and Durham (N.C.) Veterans Administration Medical Center researchers say addressing dying patients spiritual, psychological, and social concerns is just as important for promoting a good death. Funded by the U.S. Department of Veterans Affairs, they sampled 75 local patients, families, physicians, nurses, social workers, chaplains, and volunteers. The participants, ranging in age from 26 to 77, were separated by role and convened into focus groups to discuss their experiences with end-of-life care and to reflect on what made those deaths good or bad.

The focus groups repeatedly stated the importance of affirming the patient as a unique and whole person. Patients said they appreciated health care providers who showed empathy, and family members noted that they had been comforted by those who treated their relatives as real people--complete with individual lives, values, and preferences--rather than as "diseases."

"There has been a national priority placed on end-of-life care in recent years," indicates lead investigator Karen Steinhauser, a health scientist at the Durham Veterans Administration Medical Center and senior fellow with the Duke Center for the Study of Aging and Human Development. "While we know there is no `right way' to die, we are still trying to understand what constitutes a good death." Findings from those discussions offer a framework for clinicians, educators, and researchers to consider as they work with dying...