Hello everyone, I am going to make the perhaps surprising suggestion that the individualization of dying that we are seeing in palliative care and that was described in the article is parallel and similar to the paradigm of increasing choice around birthing that we are encountering in obstetrics. Indeed, there is a real trend towards having an individual “birth plan”, just as there is a trend to have input into how one wishes to die. Or to at least think about it, as we are doing now.
Although this is probably overall a positive trend, and counters the institutionalization and depersonalization that both birth and death have experienced, I think there are dangers here.
First, some patients find the choices involved overwhelming and stressful. I have especially encountered this in patients coming from less individualistic societies.
Second, there is a risk that by making dying very tailored we are implying that any deviance from the plan represents failure. And yet what is more unpredictable than how let alone when we will die?
Finally, there is a risk that tailoring death will make it more complex, not less, further increasing the need for institutionalization.
