The concept of ars moriendi, or the art of dying, dates back to the Middle Ages. In today's modern world, patients and their doctors struggle to achieve this notion of a "good death" amidst a culture unwilling to accept the finality of death. Dr. Oz talks with Dr. Sherwin Nuland, clinical professor of surgery at Yale School of Medicine and the author of How We Die: Reflections on Life's Final Chapter, about how the dying, their loved ones and society as a whole can begin to approach death with more dignity and acceptance.
As a patient reaches the end of their life, Dr. Nuland says efforts to die a "good death" are thwarted by others' attempts to conceal, sanitize and prevent death. While physicians and the medical establishment typically address end-of-life care with the best of intentions, their well-meaning actions can prolong suffering and diminish the quality of life. For example, they may promote the use of a high-risk experimental procedure or medication which does more harm than good. "We physicians who are trying to provide the best kind of death actually are somewhat responsible for preventing people from having it," he says.
Dr. Nuland says some of the needs of the dying are being met through palliative care, which brings relief in the final days of a patient suffering from an incurable ailment. Still other needs can be met by those closest to someone dying. For instance, Dr. Nuland says that initiating a gentle conversation about a dying person's situation can grant them the "permission" they need to have a "good death."
"The dying are far more willing to talk about what is happening than we have ever thought—as a matter of fact, it may come as a great relief because it is no longer a secret that everybody is trying to protect everybody else from," he says.