In the many condolence messages that my siblings and I received after my dad died, “a life well lived” was a description often used by his friends and colleagues. Recalling the care for dad as his health failed, it occurred to me that this theme applied not just to the nature of dad’s life’s experience, but the health care communication ethic that characterized the end of that life well lived.
Dad died in April of this year from complications from lymphoma. My mom had died 15 months before, and the communicative actions involved in that experience set an important precedent for how we addressed dad’s illness. The situation was complex, reflecting the distinctive personalities and styles of two elderly parents, six opinionated children, and assorted in-laws and grandchildren. My strong-willed mother refused to accept her increasing physical and mental limitations, and my dad was hesitant to intercede out of fear of causing additional emotional and physical damage to her already frail condition. Both understood yet neither would consciously accept the“final reality” that she was dying. As a result, mom lost the ability to choose the manner in which she would “meet the inevitable” and achieve the communicative good in her care situation (Arnett et al., 2009, p. 195).
My parents’ behaviors were communicative actions that made it difficult for them to achieve quality of life, and for us to render effective care for her leading up to her death. Although my siblings and I were largely unified in our approach, a collective lack of experience and understanding hindered our effectiveness as well. The day that mom died was especially hard, as she was unwilling or unable to clearly tell us what she wanted to happen, leaving us frustrated and upset.
Although the end of mom’s life was largely unsettling, we learned a great deal from the experience that was beneficial when my dad began to decline months later. By and large, my siblings and I followed principles of health care communication ethics. Foremost, we were all committed to his care, comfort and quality of life, exhibiting the essential human trait in our desire to undertake “the labor of care (as) a necessity of our identity” (Arnett et al., 2009, p. 200). We were remarkably unified, with few disagreements about decisions and mutual support for each other emotionally. We each took responsibility for different aspects of supporting and caring for dad, from preparing his meals to accompanying him to medical appointments to having dinner with him most every night. Regular conference calls, emails and texts helped us coordinate and strategize support on his behalf, reflecting the “how” to answer the “why” of providing his optimal quality of life (p. 201).
Dad jokingly nicknamed his six children “the committee” to signify the degree to which we had rallied around him and taken responsibility for his care. Daily interaction between him and us and among committe members reflected a dialogic ethic comprised of “listening, attentiveness, and negotiation” (Arnett et al., 2009, p. 205). This constant giving and receiving of care represented the good inherent in the “pragmatic
necessity of response, readying ourselves for the final freedom – our response to the inevitability of death” (p. 197).
In stark contrast to what happened with mom, I don’t think there was anything we could or would have done differently for dad at the end of his life. He felt nurtured and prepared for what he faced. His death left us profoundly sad of course, but there also was peace and the ability to see and celebrate a life well lived. Ethical communicative practice had a lot to do with that positive outcome.
Arnett, R.C., Harden Fritz, J.M. and Bell, L.M (2009). Communication ethics literacy: dialogue and difference. California: SAGE Publications, Inc.