The art of dying in a democratic society

Palliative care policies struggle with the challenges of social diversity in modern democracies. These policies privilege aspirations toward a ‘good death’ – a death characterized by awareness, preparation, and a desire for healthcare management of prolonged suffering. However, ‘good death’ as a cultural ideal is both a medically misleading and socially unrepresentative concept. As a policy ideal, good death denies: (1) different styles of dying, and (2) its opposite and contiguous social reality – the diverse lifestyle perceptions and experiences of the ‘good life’. This review argues that the challenge and task for inclusive democracies are to create health and social care policies that reflect the characteristic pluralism of their populations, even at the end-of-life itself.