Good death: A critical essay on the concept in global palliative and end of life care.

Abstract

The concept of a 'good death' has long been a subject of philosophical, clinical, and cultural debate. Despite its universal relevance and importance, no consensus exists among scholars or practitioners regarding its definition. This critical essay interrogates the potential value or tyranny of the term, drawing on contemporary literature and insights from a global multidisciplinary webinar. The discussion elucidates tensions between palliative care practices and diverse cultural understandings of dying, revealing how normative assumptions may marginalise individual preferences and communal experiences. Through a synthesis of webinar contributions, the essay explores three central tensions: the dichotomy of good versus bad death, varied perspectives on suffering, and choice and control. Each panellist's perspective illuminates the complexities inherent in defining or realising a good death. The synthesis highlights how prescriptive interpretations may stigmatise and undermine personal choices and operate oblivious to the structural determinants that influence dying experiences. The essay concludes with three actionable recommendations aimed at fostering inclusive discourse and practice: (1) embracing pluralism in death narratives, (2) addressing systemic inequities in end-of-life care, and (3) expanding support for non-clinical dying environments. Ultimately, this work advocates for a reframing of the good death paradigm, one that prioritises diversity and contextual sensitivity.