Article Series

So You Say You Want to Die in Peace

Article submitted by Bart Windrum, author and speaker.

Everyone wants to go to heaven. No one wants to die to get there.

90% of us say we want to die in peace, and define that as “at home.” To which I add, “with the dog licking my fingers.”

Most of us do not reach our goal. 50% die in hospitals. 20% die in other institutions. 35-45% of those enrolled in hospice are in for only the last 4–7 days of life. Since several days are taken up with active dying (when the body physically shuts down) and since hospice eligibility begins 6 months out from a prognosticated death, this tells me that another large percentage fail to die peacefully because the weeks preceding their brief hospice stay were likely devoted to curative treatment attempts. Factor in deaths due to accidents and homicides and I estimate that 10–15% of us actually die in peace according to our common definition.

Even those of us with advance directives or living wills declaring a desire to avoid protracted mechanized or institutional dying, that’s what we end up experiencing. I know this through exprience; this is what both of my parents’ endured in 2004 and 2005. I learned a few things from those two 3-week terminal hospitalizations, during which I shared responsibility for making pull-the-plug decisions that we never thought we’d have to make.

I learned what it really takes to increase our likelihood of dying in peace. I’d like to share some of that learning with you in this series. I’ll cover aspects of dying that seem never to get addressed by writers, reporters, presenters, and panelists, including:

  • how we misunderstand heroicism and heroic action
  • how to revision the last quarter of life from a medically heroic viewpoint
  • the multiple uses life support technology are routinely applied to
  • the forces that lead us onto a slippery slope culminating in curative and heroic treatment paths we had previously stated we wished to avoid
  • aspects of the culture of resuscitation that make avoiding erroneous resuscitation challenging
  • how and why deaths are timed in hospitals
  • why and how hospitals generally fail to provide care, and what they actually provide
  • several aspects regarding how to advocate (act as a proxy) in the hospital environment
  • the relationship of medical error to dying in America
  • why even palliative and hospice doctors fail to offer guidance far enough in advance to help us obtain a peaceful demise (where “demise” means peacefully experiencing the weeks and perhaps months leading to death).

These are challenging topics, and I will present them unvarnished, beginning next month.

Posted June 2012 on