The Socio-Political Debate of Dying Today in the United Kingdom and New Zealand: ‘Letting Go’ of the Biomedical Model of Care in Order to Develop a Contemporary Ars Moriendi

Abstract

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer a compelling movement towards individuals seeking control of their dying trajectory to actualise the notion of individual choice. With this shifting landscape there is an opportunity to be grasped to change how we manage our dying trajectory away from the biomedical patterns of behaviour when dying, in order to balance life decisions. To achieve this prospect, we need to engage with a framework upon which to pin the changes. This paper offers a re-framing and re-presenting approach, using illustrative examples that draw upon British and New Zealand literature, together with over 50 years of professional nursing, and the Ars Moriendi to reflect upon the self-centricity of the contemporary Western individual to access a ‘good death’ of choice.

Applying Lessons From Ars Moriendi to Foster Dying Well in Acute Care Settings

“…1 Technology and the shift from religious practitioners as the overseers of death to the medical practitioner as the expert over the human body have driven the locus of death from the community toward the impersonal and sterile setting of the medical institution. 2 In the secular and medical environment of the acute care setting, death is often identified with illness and viewed as a purely medical event, at times a medical failure, as opposed to the historical view that death has sacred significance as a natural part of life. 3 A remedy for the current western societal approach to medicalized dying is to look back in history to a time during the late Middle Ages, when death was an accepted part of medieval life.…”

“…Medical and technological advances have made it possible to keep people alive well beyond what was once possible, leading health care providers to focus on life-sustaining measures rather than questioning the futility of such measures and considering quality of life 1 . Technology and the shift from religious practitioners as the overseers of death to the medical practitioner as the expert over the human body have driven the locus of death from the community toward the impersonal and sterile setting of the medical institution 2 . In the secular and medical environment of the acute care setting, death is often identified with illness and viewed as a purely medical event, at times a medical failure, as opposed to the historical view that death has sacred significance as a natural part of life 3 .…”