Elizabeth CartwrightHSC4658June 22, 2013Session 10Dignity and DeathThe main thing I learned through reading Ira Byock’s Dying Well: Peace andPossibilities at the End of Life is that there is no dignity in death. I know this will be acontroversial opinion of mine. It is my own though and just a personal opinion. When myboyfriend asked me if I thought a soldier dying for his country died with dignity, I told him Ithought a soldier could die honorably but not with dignity. I think people can die well, die withhonor, die with personal pride and die in various degrees of emotional and physical pain, but Idon’t believe death is dignified and therefore in my mind, you cannot die with dignity.One important lesson I felt the author tried to portray in the book was the importance ofpain management in dying well. Pain is a large contributing factor in the loss of dignity from mypersonal perspective. Chapter four and ten were great examples of how pain and dignitycorrelated. Chapter four told the story of Douglas Kearney who was diagnosed with “nonsmallcell adenocarcinoma of the lung” or lung cancer. He’s continual degenerated state takes a toll onhim emotionally as well as physically until one day he started exhibiting behavior that wasabnormal. Byock (1997) stated about the situation:Dying is important to everyone, but especially to someone who is dying and has already begunlosing control over much if his life. And while many people think of dignity in terms ofappearance, independence, and personal embarrassment, people close to a dying patient seem toknow intuitively that their loved one’s dignity does not depend on these. Dying in not inherently
undignified, it is simply part of being human…..But Barbara knew – and I agreed – thatDouglas’s bizarre behavior in the backyard was undignified. (p. 72)I do not agree with Byock that death is not inherently undignified. Inherently canbe defined as “occurring as a natural part or consequence” (Dictionary.com, n.d.), and Ithink the loss of dignity is a natural consequence of death. I do agree that it is a part ofbeing human and I also think it is not a bad thing. I have a theory that the loss of dignityis a part of separating oneself from the physical world which the human body is attachedto; a theory which assumes dignity is not needed during or after death. Death has no needfor dignity.Douglas Kearney’s loss of dignity was largely due to anger issues and emotional pain,whereas Terry Matthews’ physical pain brought about a loss of dignity. Her renal cell carcinomathat had spread ferociously too many places throughout her body caused her enormous physicalpain that lead “Terry’s final days [to] become a crescendo of agony” (p. 193). Her physical painlead to her loss of dignity. Her lack of autonomy in her final days was difficult for her to accept.I also believe her unwillingness to submit to her situation made her break from this world muchmore painful.
Byock specifically discusses dignity in chapter five entitled “Finding Dignity AmidDisease and Disintegration: William Burke, Julia Rosauer, Hap Visscher”. All three persons arepatients diagnosed with “progressive neurological diseases” (p. 86). I don’t agree with many ofByock’s points, but I do agree with his overall message in the book. Byock states that“unfortunately, society reinforces the belief that the loss of normal capability and independencerenders a person undignified” (Byock, 1997, p. 86), which is a statement I agree with. I do notagree with the assumption Byock makes that dignity is worthwhile or necessary to maintain nearthe end of life.Unlike Byock, I believe a person can have respect for themselves without having dignity.Something is only degrading if it is viewed as degrading, just as something is only undignified ifit is deemed by others as undignified. And dignity is not necessary for a good death. Dignity, likepride, won’t feed you or clothe you, and it definitely won’t take away the pain when you arepassing away. I repeat, death has no need for dignity.
ReferencesByock, I. (1997). Dying Well: Peace and Possibilities at the End of Life. New York, NY: TheBerkley Publishing Group.Dictionary.com. (2009) Inherently. Retrieved fromhttp://dictionary.reference.com/browse/inherently.