Cottrell Laura, Duggleby Wendy
PhD Student Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
Palliat Support Care. 2016 Dec;14(6):686-712. doi: 10.1017/S1478951515001285. Epub 2016 Jan 6.
The "good death" is a dynamic concept and has evolved over time to become a "revivalist" good death: a planned, peaceful, and dignified death, at home, surrounded by family members. As the "good death" continues to evolve, the key questions are: How do cultural perceptions of death and dying change? What are the forces that shape Western attitudes and beliefs around death and dying? And how does the "good death" discourse frame the dying experience in contemporary society? The purpose of this manuscript is to describe the underlying discourse in the literature on the "good death" in Western societies.
An integrative literature review of data from experimental and nonexperimental sources in PubMed, CINAHL, PsychINFO, and SocINDEX of 39 articles from 1992 to 2014.
Four main themes emerged from reviewing 39 articles on the "good death": (1) the "good death" as control, (2) the wrong "good death," (3) the threatened "good death," and (4) the denial of dying.
Evolving in response to prominent social attitudes and values, the contemporary "good death" is a powerful, constraining discourse that limits spontaneity and encourages one way to die. Social, political, and demographic changes now threaten the stability of the "good death"; dying is framed as an increasingly negative or even unnecessary process, thus marginalizing the positive aspects of dying and rendering dying absent, invisible.
“善终”是一个动态概念，且随着时间推移已演变成一种“复兴主义”的善终：在家中，在家人陪伴下有计划地、安详且有尊严地离世。随着“善终”概念持续演变，关键问题在于：文化层面对于死亡及濒死的认知如何变化？塑造西方围绕死亡及濒死的态度和信仰的力量有哪些？以及“善终”话语如何构建当代社会中的濒死体验？本文的目的是描述西方社会关于“善终”的文献中的潜在话语。
对1992年至2014年期间来自PubMed、CINAHL、PsychINFO和SocINDEX的实验性和非实验性来源数据进行综合文献综述，共39篇文章。
在对39篇关于“善终”的文章进行综述后出现了四个主要主题：（1）作为掌控的“善终”，（2）错误的“善终”，（3）受到威胁的“善终”，以及（4）对死亡的否认。
当代“善终”是为回应突出的社会态度和价值观而演变而来的，是一种强大且具有约束性的话语，它限制了自发性，并鼓励一种特定的死亡方式。社会、政治和人口结构的变化如今正威胁着“善终”的稳定性；死亡被构建为一个越来越负面甚至不必要的过程，从而使死亡的积极方面被边缘化，并导致死亡变得不被提及、难以察觉。
