Deathbed Regret Is Far

“No one on their deathbed ever wished they had spent more time in the office,” the saying goes. … I have my doubts. (more)

Ben Casnocha likes palliative care worker Bronnie Ware’s “top regrets … from her patients on their death beds” (HT Tyler):

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I didn’t work so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

For ten years my wife has been a hospice social worker, supporting ten dying patients a week. And she can’t recall any of those 5000 patients ever spontaneously expressing a general life regret. She usually gives open-ended questions like “tell us about your life” and sometimes dying folk express apologies to particular people, or regret that a surprise early death prevents particular plans like visiting Europe. Sometimes patients say what they are proud of about their lives, or how they’d like to be remembered. But they just never give general regrets about their lives. Who would?

Ms. Ware said regrets are expressed “when questioned about any regrets they had or anything they would do differently”; my wife isn’t thrilled about this as a care technique.

Deathbed folks are usually far from their analytical peak – they are often in great pain, and rather muddle-headed. So why would we think their comments especially insightful? I suspect we attach unrealistic significance to deathbed words because we are terrified to think about death, and eager to show our devotion to the dead and dying.

But if deathbed regrets are less than reliable descriptions of reality, where might they come from? One theory is that they are like the famous interview question “What is your main fault?”, which evoke answers like “I work too hard” or “I’m too much of a perfectionist.” These are obviously attempts to brag about a good feature, but call it a “fault.” All but regret #4 above fit this directly – they basically say “I sacrificed so much for you people.” Regret #4 similarly declares how much the dying cares about others.

Another theory is that deathbed regrets arise from taking a far view of our lives. The far mental mode is more happy, social, and idealistic, and the above regrets express a commitment to the ideals of happiness, friend and family, and resistance to conformity pressures.

It may be good to take stock of your life and consider your basic priorities. And you might do well to listen to spontaneous comments by those experienced in life on the mistakes they’ve made. But what pain-pinned muddle-headed dying folks say when pushed to express regrets seems unlikely to be especially informative.

Added 9a: Stephen Smith suggests these regrets are the predictable result of opiate pain medication.

Added 24Nov: Andy McKenzie points to studies showing “as time since a decision grows, people tend to shift their regrets towards not making the hedonistic decision.”

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  • VinceG

    I don’t know, I found those “regrets” to actually be quite poignant lessons in life. Expressing feelings openly and honestly is like casting magic spells. It really does transform your life. And yes, being happy is indeed a choice you make, and the choice is going to make you more rational, not less. All of these lessons build on each other, and the life they create is one that’s unafraid of death.

    Maintaining pure objectivity is a fool’s game, but I don’t expect to ever convince you of that, Robin.

  • http://marketurbanism.com Stephen Smith

    Those aren’t “far” thoughts or “I’m a perfectionist”-style self-flattery, they’re high-on-opiates thoughts. “Happy, social, and idealistic” are exactly how you feel when you’re on heroin or painkillers. Doctors and politicians would like you to believe that there’s a difference between the experiences of street junkies on dope and end-of-life patients on fentanyl or oxymorphone or some other fancy opioid – that those experiencing “true” pain are somehow immune to the euphoric and mind-altering effects of the drugs – but it’s just not true.

    It’s not the pain – it’s the painkillers.

    • anon

      How’d you get started taking heroin? If you don’t mind.

      • Anon

        It’s not that weird. You get curious, try some weaker opiates go cruse the hot spots in the city.

  • cournot

    The real question is what are the nature of the regrets experienced by people who are very old (say at least 80). It doesn’t have to be a literal death bed regret for being relevant to the original quote.

  • Joseph K

    The whole deathbed regret thing is just a rhetorical or literary device to make people who have a lot of life ahead of them rethink their life, and they’re probably mostly written by people who have lots of life ahead of them. When someone uses is in a story, I think it creates a powerful message because the idea is that this regret was so important that the person dying could never forgive themselves for it, even until the day they died. So, the idea is that it’s something that’s been nagging them for a long time, but only on their deathbed do they fess up.

    By the way, I really wonder whether most people worry that they worked to hard. I’d imagine many people would regret that they didn’t accomplish as much as they’d wanted to; that is to say if lots of people had deathbed regrets.

  • http://hanson.gmu.edu Robin Hanson

    Vince, poingnant doesn’t imply “true” does it?

    Stephen, that does make a lot of sense.

    Joseph, yes, you’d expect not accomplishing to be a similar regret.

    • VinceG

      Poignancy does not imply truth. What does is the fact that I live them, right now, while I’m still young, and don’t find them to be stoned-speak.

      If you read the article carefully, you’ll find that these are not regrets expressed by dying people. They are *themes* found in the author’s experiences with said dying people. The author did not conduct a survey.

      It’s a narrative. A narrative not constructed by dying people, but by a blogger. That’s what’s missing in your analysis.

      • VinceG

        Also, the second sentence of the article indicates that the author’s patients are those, “who had gone home to die.” And that she spent 3-12 weeks at a time with them. This would, to me, indicate that the people the author interacted with were fairly lucid.

  • ff

    I disagree with your statement that all but regret #4 are attempts to brag about a good trait. I identify with multiple of those regrets (though I’m nowhere near my deathbed) and I can assure you that they *are* regrets and are true faults, not good features in disguise, and they do not remotely mean “I sacrificed so much for you people”. Frankly, I’m not sure how anyone can read those regrets and come to your conclusion, even if they didn’t have the personal experience of relating to them.

  • ravi

    Our lives are journeys filled with forks in the road. We have a good amount of detail about the roads we did take and have the luxury to idealize and fantasize about the roads we did not take. As we arrive at the end of the journey, we tend to probably color our entire memory of life with emotions and rationalizations. Read any autobuography with a critical eye and you will see all kinds of self aggrandization and very little attribution to luck or circumstances. Even admissions of luck tend to be brags about ones humility.

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  • Hrm

    It’s so ingrained, and looked upon with reverence by so many for so long, that we even have a legal construct around it: the “dying declaration”:

    “A dying declaration is considered credible and trustworthy evidence based upon the general belief that most people who know that they are about to die do not lie. As a result, it is an exception to the Hearsay rule, which prohibits the use of a statement made by someone other than the person who repeats it while testifying during a trial, because of its inherent untrustworthiness.”

    Should we really continue to consider that credible?

    • http://www.gwern.net/ gwern

      I suppose we should look at confessions of criminality to gauge general trustworthiness, because those look really bad and one would usually want to keep them secret.

      So, how many dying declarations to the effect ‘I killed 60 young women over the last 4 decades’ pan out? I would guess most…

    • Jess Riedel

      I’m not agreeing or disagreeing, but I think there is a very relevant difference between statements of fact (“I saw Alice kill Bob”) and wishy-washy expressions of regret. In particular, the near/far distinctions seems relevant.

  • Paavo Ojala

    I don’t think that they are opiate-thoughts. I regret similar things if think I’m dying.

    People work hard and cumulate wealth and power because they are worried about future. When there is no more future those things are useless.

    When people have future, but no resources they regret opposite things. They wish they had worked harder, cared less about their short term happiness, wasted less time hanging around with their idiot friends.

  • http://www.gwern.net/ gwern

    ‘JOHN OF GAUNT: O, but they say the tongues of dying men
    Enforce attention like deep harmony:
    Where words are scarce, they are seldom spent in vain,
    For they breathe truth that breathe their words in pain.
    He that no more must say is listen’d more
    Than they whom youth and ease have taught to glose;
    More are men’s ends mark’d than their lives before:
    The setting sun, and music at the close,
    As the last taste of sweets, is sweetest last,
    Writ in remembrance more than things long past…’

  • http://www.uncrediblehallq.net/ Chris Hallquist

    As soon as I saw the deathbed regrets, I got the main point of this post, but I think the “deathbed regrets as brag” theory isn’t right.

    Rather, these deathbed regrets sound like people positioning themselves as deep-down believers in high ideals. High ideals that they didn’t live up to, and can no longer be expected to live up to.

    Example: I’m a young guy trying to get a career off the ground. It would be downright self-destructive for me to put too much stock in the idea that there are far more important ways for me to spend my time than work.

    But if I work hard and become successful enough, some day I’ll be able to afford the luxury of paying lip service to the idea that work isn’t terribly important.

  • Gil

    That reminds of the Kubler-Ross’ 5 Stages of Dying – plenty of studies haven’t found such stages.

  • Redden

    I was following up on a thread where Tyler discusses Danish Film Director Lars Von Trier and on his wiki was this:

    In 1989, von Trier’s mother revealed on her deathbed that the man who he thought was his father was not, and that she had had a tryst with her former employer, a man named Fritz Michael Hartmann (1909–2000), who descended from a long line of Roman Catholic classical musicians, in order to give her son “artistic genes”.

    “Until that point I thought I had a Jewish background. But I’m really more of a Nazi. I believe that my biological father’s German family went back two further generations. Before she died, my mother told me to be happy that I was the son of this other man. She said my foster father had had no goals and no strength. But he was a loving man. And I was very sad about this revelation. And you then feel manipulated when you really do turn out to be creative. If I’d known that my mother had this plan, I would have become something else. I would have shown her. The slut!”

    #########
    Another con for the Death Bed confessionals and regrets :)

  • ad

    Regret #4 is the only one that strikes me as being remotely honest. The rest are New Age drivel, but it is easy to believe that someone dying, and probably in pain, wishes that they had more friends.

    When did you hear of someone wishing that they had fewer friends?

  • y81

    Number 4 is also a boast in disguise: I wish I had stayed in touch with the small town losers I grew up with, but instead I became a big shot who wasn’t able to pal around with the little people any more. It’s lonely at the top. Etc.

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  • Thomas

    “I wish I’d had a lower future time orientation.”

    I can feel that way myself, even though I expect I have plenty of time left. Perhaps this is better known as the mid-life crisis.

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  • Chris Rowe

    The Bronnie Ware piece has been around since at least August 2010, but appears now to be gaining ground exponentially via internet blogs. The strange thing is that at no point has anyone really bothered to find out if the any of it is true – is it completely true, partially true, slightly embellished anecdotal observation, or just a story from someone who describes herself as a storyteller? When you look at the accompanying biog – ‘nomadic lifestyle’, song-writing, speaker etc. – it doesn’t quite tie in with the ‘many years’ spent in palliative care. In the re-telling of the piece, she is a nurse, but there’s no evidence of her actually being a qualified nurse; in one blog, she’s become a doctor; and on her Facebook page, somebody thanks her for her ‘research’, but it’s not really research is it? If it’s true, then I owe her an apology, but I suspect it’s all just a story. Wait for the book to be published (soon I gather).

  • http://www.bronnieware.com Bronnie Ware

    As the author of this article, I find it interesting that you have deleted my previous comment, simply because I explained the article in more detail and addressed the misunderstandings you spoke of in your own article. If you are truly into overcoming bias, then perhaps you would have left he original, detailed, and heart-felt comment here for all viewers to read. You are welcome to debate it all as much as you wish. It makes no difference to the authenticity of my experiences, nor to the words shared with me by dying people. The fact that people have called me a doctor or other things on the Internet is out of my control. Such is the Internet.

    • http://hanson.gmu.edu Robin Hanson

      I don’t recall deleting a comment here. Perhaps it went over the word limit or had links that triggered the spam filter?

    • http://www.uweb.ucsb.edu/~criedel/ Jess Riedel

      I’d be very much interested in you reposting your comment. If it was too long or unpleasant to do so, I’d of course understand.

  • http://www.bronnieware.com Bronnie Ware

    In brief, my previous comment addressed the willingness of people to share their regrets with me. They were never pushed to do so and it was not a topic that was shared with all patients. It was simply something that came out of them naturally as our relationships developed, since they had someone sitting there listening to whatever they wished to share. What made my experiences different to your wife’s, for example, is that I worked one-on-one with dying people in their homes, not in a busy hospice. So the relationships formed between us were entirely different. I was with people twelve hours a day, at least five days per week, sometimes more, for the last three to twelve weeks of their lives. Other than family dropping in to spend time with them, it was usually just the patient and myself. Hence their willingness and more importantly, their DESIRE to share their philosophies and regrets with me. A full-length book is being released later in 2011 which may answer other questions raised here. Thanks for the opportunity to contribute.

  • Charles Drum

    Hi Bonnie,
    Thanks for clarifying. Out of curiosity, if the book you’re writing isn’t free, will any percentage of profits go to any charity or body other than yourself?

  • Charles Drum

    I’m also curious about the idea in your original article that people’s bitterness made them ill. It does’t go into detail, but what do you mean by ill? Localised illness, like stress, or ‘big’ illness, like cancer etc? If you meant the latter — how do you know? How can you tell?

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  • Noumenon

    I think it’s awesome that Bronnie showed up here!

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