Kübler-Ross’, ”on the Fear of Death”
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In Elisabeth Kübler-Ross’,”On the Fear of Death,” she describes the different aspects of the dying process: options for the final days of the terminally ill person, the grieving process of the family, and how children are treated during this time. How grieving has changed due to the many advances in medicine that have been made is examined. The dissimilitude in “old-fashioned” death and “modern” final days are presented. She focuses on accentuating how stoically people are treated in a healthcare facility to drive her point home. She is a true advocate for Hospice but fails to mention several critical variables. I work in the healthcare field as well and I have taken care of my father in his final years, while I was a child. I have experienced both styles of the death process and one can be more appropriate than another depending on the circumstances. Sometimes one has to consider the circumstances surrounding the end of a life and a mechanical death may be necessary.
Over the past century, there has been a dramatic increase of medical advances made and a similar trend in emotional disorders. Specific advances mentioned in the essay are the creation of vaccinations and the use of antibiotics. These have caused the human population to live longer and fewer young have been dying. A great amount of faith in recent medical practices this leads to washing one’s hands clean of responsibility to care for a family member by handing them completely over to the medical staff of any given healthcare facility.
Kübler-Ross relays how the terminally ill passes on in the not so distant past. She describes it well and moves one to yearn to die with the dignity she describes. It includes family involvement and in turn, also helps them to gain closure from their participation. I helped to care for my father after an order to do not resuscitate was ignored. During these final two years my mother and I opted to care for him at home with the assistance of Hospice and we have no regrets. He passed with his loved ones caring for him and made death a reality for us. I have seen how when families cannot let go they take the path of the “modern” death.
The “modern” death Kübler –Ross describes is one that is cold, impersonal, and cruel. She conveys this message from the patient’s ambulance ride up until their final heart beat. She does leave out many important circumstances and options for dying. Nursing homes are a widely used today. They can be impersonal and with or without family partaking in care, but does not include some of the components of a “modern-day” death, namely the life support machine. Also not mentioned is the fact that the family may not be in a financial position to stay at home to care for the terminally ill or that the individual may be dying due to a traumatic incident that was unexpected and out of the question for a home recovery. In that case, life support may become a necessity, especially in the young and healthy that may have a lower risk of mortality and the prospect of a high level of quality of life after recovery. Finally, if the individual is an organ donor, it is necessary to be on life support to preserve the organs another needs to survive until they can be transplanted. On the note that organ donation is a personal decision, another critical point is that if a patient is coherent enough to make their own decisions, they are asked if they want to be resuscitated and/or placed on life support, potentially one could elect to die this way and take the risk in hopes that they may live to see another day.
Now that the terminally ill is being cared for by others in our journey of death, there is less closure and finalization for family and emotions are hindered and elicited in other manners. Children are kept in the dark and have an even more difficult time dealing with these feelings because death is made to be taboo and not mentioned. Kübler-Ross does an exceptional job in this essay relaying the obvious, but unmentioned, and helps one realize that children and the dying are treated as if their needs are non-existent.
Since a family may not have the ability to care for a sick person they leave it to the medical staff. Terminology is made softer and more technical as if to further distance one from reality, it is the same as with the bleak hope of a second chance at life to right the wrong when placing someone on life support. Death has never been pleasant through the ages and no one likes to feel guilt so it is possibly easier to blame another in the end of their loved-ones death since the individual did not die in the family’s care. Feelings of guilt and disappointment in the realization of impotence occur because of over-faith in these medical advances.
As the medical staff cares for the ill, there is more than likely an emotional disconnect. Does one consider the fact that these people would most likely have an emotional overload if they were to become personally involved with each of their patients? To care for the seriously ill or injured can be overwhelming and is best to preserve sanity by halting emotions during procedural care but should not necessarily ignore or mistreat a patient during routine care. I realize the need for taking the extra step and addressing the patients comfort and emotional needs, but not all do. One must consider their level of tolerance for pain and suffering of people and correlate it to their emotional disconnect.
Overall, Kübler-Ross is explicit in her preference for death with dignity at home, but fails to discuss many scenarios where it is impractical and does not even consider them. Death at home is practical in terminal conditions and impractical and impossible in traumatic causes of pre-mature death. Even then, families should be allotted more participation in end of life care but unfortunately due to legal backlash, is nearly impossible.