This writing sample is from an assignment in my End of Life Ethics class. I received an A+ on the assignment.

1. Elizabeth Cartwright
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June 22, 2013
Session 10
Dignity and Death
The main thing I learned through reading Ira Byock’s Dying Well: Peace and
Possibilities at the End of Life is that there is no dignity in death. I know this will be a
controversial opinion of mine. It is my own though and just a personal opinion. When my
boyfriend asked me if I thought a soldier dying for his country died with dignity, I told him I
thought a soldier could die honorably but not with dignity. I think people can die well, die with
honor, die with personal pride and die in various degrees of emotional and physical pain, but I
don’t believe death is dignified and therefore in my mind, you cannot die with dignity.
One important lesson I felt the author tried to portray in the book was the importance of
pain management in dying well. Pain is a large contributing factor in the loss of dignity from my
personal perspective. Chapter four and ten were great examples of how pain and dignity
correlated. Chapter four told the story of Douglas Kearney who was diagnosed with “nonsmall
cell adenocarcinoma of the lung” or lung cancer. He’s continual degenerated state takes a toll on
him emotionally as well as physically until one day he started exhibiting behavior that was
abnormal. Byock (1997) stated about the situation:
Dying is important to everyone, but especially to someone who is dying and has already begun
losing control over much if his life. And while many people think of dignity in terms of
appearance, independence, and personal embarrassment, people close to a dying patient seem to
know intuitively that their loved one’s dignity does not depend on these. Dying in not inherently

2. undignified, it is simply part of being human…..But Barbara knew – and I agreed – that
Douglas’s bizarre behavior in the backyard was undignified. (p. 72)
I do not agree with Byock that death is not inherently undignified. Inherently can
be defined as “occurring as a natural part or consequence” (Dictionary.com, n.d.), and I
think the loss of dignity is a natural consequence of death. I do agree that it is a part of
being human and I also think it is not a bad thing. I have a theory that the loss of dignity
is a part of separating oneself from the physical world which the human body is attached
to; a theory which assumes dignity is not needed during or after death. Death has no need
for dignity.
Douglas Kearney’s loss of dignity was largely due to anger issues and emotional pain,
whereas Terry Matthews’ physical pain brought about a loss of dignity. Her renal cell carcinoma
that had spread ferociously too many places throughout her body caused her enormous physical
pain that lead “Terry’s final days [to] become a crescendo of agony” (p. 193). Her physical pain
lead to her loss of dignity. Her lack of autonomy in her final days was difficult for her to accept.
I also believe her unwillingness to submit to her situation made her break from this world much
more painful.

3. Byock specifically discusses dignity in chapter five entitled “Finding Dignity Amid
Disease and Disintegration: William Burke, Julia Rosauer, Hap Visscher”. All three persons are
patients diagnosed with “progressive neurological diseases” (p. 86). I don’t agree with many of
Byock’s points, but I do agree with his overall message in the book. Byock states that
“unfortunately, society reinforces the belief that the loss of normal capability and independence
renders a person undignified” (Byock, 1997, p. 86), which is a statement I agree with. I do not
agree with the assumption Byock makes that dignity is worthwhile or necessary to maintain near
the end of life.
Unlike Byock, I believe a person can have respect for themselves without having dignity.
Something is only degrading if it is viewed as degrading, just as something is only undignified if
it is deemed by others as undignified. And dignity is not necessary for a good death. Dignity, like
pride, won’t feed you or clothe you, and it definitely won’t take away the pain when you are
passing away. I repeat, death has no need for dignity.

4. References
Byock, I. (1997). Dying Well: Peace and Possibilities at the End of Life. New York, NY: The
Berkley Publishing Group.
Dictionary.com. (2009) Inherently. Retrieved from
http://dictionary.reference.com/browse/inherently.