Some people put it down to the fact that a younger life sees many years stretching out before them. Therefore, being close to death is something of an alien concept. Some scientists offer a more mechanistic point of view, stating that the frontal lobes of youngsters are not yet fully developed. According to Gary Wenk, PhD, “the reason the frontal lobes are not fully engaged [with the rest of the brain]... is because they have not yet completed the process of neuronal myelination.” Myelination can be thought of as the electrical wiring that is inside all of our brains.
Women tend to finish the process of neuronal myelination in their mid-twenties. For men, on average, it happens at the age of about thirty. Further research is required into how this process impacts on views about death – and many other aspects of life. It does offer an indication as to why our thoughts can turn to the subject in later adult life compared to when we were younger.
Although he stresses that many taboo theories exist (up to six in all). He says that people can switch between them depending on the argument they are creating. For example, someone might say that it is individuals, not modern society, that denies the reality of death. Whilst – almost in the same breath – individuals discuss it, but it is not a mainstream topic for the media of healthcare professions. Ultimately, we are left with the idea of whether preparing for death is a taboo subject or not is a confused picture. In some circles, it may be, but palliative care physicians, like BJ Miller, are increasingly arguing that it should not be.
Dying can involve pain and suffering. In other words, we fear it more than death itself.Miller, who lost his lower limbs and hand in an accident in his youth, says that his relationship with dying began that day. It has informed his views of palliative care ever since. He says that we need to open a 'big conversation' about the experience of dying. This will help us to improve the way in which care is given to those nearing their final moments affording them greater happiness. “The American health care system has more than its fair share of dysfunction to match its brilliance,” he says. “[Working in]... a hospice and as a palliative medicine doc, I've seen care from both sides... but we are unwitting agents for a system that too often does not serve.”
He calls for people to be able to die in greater comfort than they are often able to in medical facilities. There they are often hooked up to monitoring equipment and various tubes.Working in a hospice, Miller has a clear view on what makes for a more dignified departure from life. It is to spend the last few months, weeks or hours doing what it was we enjoyed in life. He cites the example of one person for whom having her dog by her side was her priority. In another case, he says he knew of an individual who wanted to enjoy her smoking habit to the end since she was past any health benefit she might derive from giving up. It is hard to imagine either scenario in a standard hospital today.
Shouldn't we all, therefore, consider the merits of preparing for death? And doing that in a way that has a meaning and connection with the way we have lived? Surely, if we do, then the chances of a greater dignity in death are vastly improved. This will be of benefit not just to ourselves, as individuals, but to those around us – both professionals and loved ones – in our final moments.
The psychologist William E. Haley, PhD who works at the University of South Florida states that, psychologists are already training. This happens in the mental health treatment of major chronic illnesses in increasing numbers. These include conditions such as heart disease, cancer, AIDS, dementia and, in some cases, conditions which lead to chronic pain.
This old-fashioned conception is now being overturned by some in the medical profession, notably Atul Gawande, a practising surgeon. His book Being Mortal argues that the concept of a good death should be turned on its head. That the focus ought to be on a good life, instead.
In Being Mortal, he makes a compelling case for where medical interventions should stop and where a dignified process of death should begin for greater happiness.Echoing BJ Miller's ideas, he points out that many medical procedures make life more uncomfortable, not less. It even reduces the amount of (concious) time we have left in some cases.
Modelphotos by colourbox.com
Ed Gould is a UK-based journalist and freelance writer. He is a practitioner of Reiki.
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