Epilogue Summary

Death and Hope

  1. Death and dying have always led to strong emotions. However, in many parts of the world the experience of death is not what it was. For example, fewer people have personally witnessed the dying process.
  2. In ancient times, death was considered a connection between the living, the dead, and the spirit world. People respected the dead and tried to live their lives so that their own death and afterlife would be good.
  3. Every religion includes rituals and beliefs about death. These vary a great deal, but all bring hope to the living and strengthen the community.
  4. Death has various meanings, depending partly on the age of the person involved. For example, young children are concerned about being separated from those they see every day; older children want to know specifics of death.
  5. Terror management theory finds that some emerging adults cope with death anxiety by defiantly doing whatever is risky. In adulthood people tend to worry about leaving something undone or abandoning family members; older adults are more accepting of death.

Choices in Dying

  1. Everyone wants a good death. A death that is painless and that comes at the end of a long life may be more possible currently than a century ago. However, other aspects of a good death—quick, at home, surrounded by loved ones—is less likely than it was.
  2. The emotions of people who are dying change over time. Some may move from denial to acceptance, although stages of dying are much more variable than originally proposed. Honest conversation helps many, but not all, dying persons.
  3. Hospice caregivers meet the biological and psychological needs of terminally ill people and their families. This can occur at home or at a specific place. Palliative care relieves pain and other uncomfortable aspects of dying.
  4. Drugs that reduce pain as well as hasten dying, producing a double effect, are acceptable by many. However, euthanasia and physician-assisted suicide are controversial. A few nations and some U.S. states condone some forms of these; most do not.
  5. Since 1980, death has been defined as occurring when brain waves stop; however, many measures now prolong life when no conscious thinking occurs. The need for a more precise, updated definition is apparent, but it is not obvious what the new definition should be.
  6. Advance directives, such as a living will and a health care proxy, are recommended for everyone. However, it is impossible to anticipate all possible interventions that may occur. Family members as well as professionals often disagree about specifics.

Affirmation of Life

  1. Grief is overwhelming sorrow. It may be irrational and complicated, absent or disenfranchised.
  2. Mourning rituals channel human grief, helping people move to affirm life. Most people are able to do this.
  3. Feelings of continuing bonds with the deceased are no longer thought to be pathological, and many people with lingering depression years after a death are people who were depressed before the death.