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Understanding perspectives on the nature of “good” death may aid the provision of better end-of-life care for patients and their families. After reviewing the empirical health care literature in this area, Hales et al found that the quality of dying and death construct is both multidimensional and subjectively determined. It covers 7 broad domains (physical experience, psychological experience, social experience, spiritual or existential experience, the nature of health care, life closure and death preparation, and the circumstances of death), and numerous factors influence its judgment, including culture, type and stage of disease, and social and professional role in the dying experience. The authors argue that the quality of dying and death is broader in scope than either quality of life at the end of life or quality of care at the end of life, although there is overlap among these constructs. Challenges that remain for clinicians, researchers, and policy makers interested in this growing and important area of health care are also outlined.
In This Issue of Archives of Internal Medicine. Arch Intern Med. 2008;168(9):908. doi:
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