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Is There Such a Thing as a Good Death?

Posted: 07/02/2012 5:02 pm

This might be a foolhardy question to ask in a culture that struggles to even talk about dying.

When it comes to dying, there is strong evidence that Americans suppress the thought of it. And then, even if logic indicates some sad prognostic news, they fight it. How many obituaries begin with the statement, "After a long battle, she died..."? The importance of the fight -- not the dying -- is emphasized.

American culture is unwilling to discuss dying openly, honestly and in a sustained way. Except for Leo Tolstoy's "The Death of Ivan Ilych," which depicts what a dying person feels about himself and his incomprehensible death, it is difficult to think of any account that attempts to portray dying in a frank way. Dying is only an appropriate topic if you use your dying to tell another story. Even then, books like "The Last Lecture" or "Tuesdays with Morrie" communicate how to live, not how to die.

But there is in fact an "art of dying." Directly facing dying has been a part of the Christian tradition since the time (and dying) of Jesus himself. From the beginning, Christians have paid a great deal of attention to the whole matter of dying.

Eventually this Christian tradition of a "good dying" coalesced into a fairly definite form and became available as a kind of handbook in many languages and dozens of editions. It consisted of practices developed by the church to help Christians ponder their mortality and prepare for the inevitability of dying. It was a rich compendium of helpful directions, encouragements, stern warnings, appropriate prayers and assurances of resurrection.

What happened to that guide for dying? Or, more importantly, what happened to its use in the church? It fell into disuse in modern times, as improvements in medicine prompted people to think that they might not die after all. The prevailing attitude toward death has become one of denial and battle.

The combination of powerful medicine and patients who fight means that the procedure of dying tends to take longer, is more painful and is exorbitantly costly. After receiving a terminal diagnosis, the average patient lives (or is in the process of dying) for another three years.

Dying is framed as something that the sick are commissioned to fight and that medical practitioners consider as failure. The successes of modern medicine and (even more) the hopes popularly placed in that medicine set us up for disappointment as patients and caregivers. This positions those in health care professions to offer futile interventions near the end of life.

As more people live longer and are engaged in providing care for the terminally ill, and as the financial, physical and emotional costs of fighting are compounded, there may be more willingness for Americans to be open to include "dying" in those things about which they are willing to talk.

Currently, Christians, like most Americans, outsource dying to caretakers who deliver care within a narrative that is fundamentally scientific and secular and at least seems to offer ways to avoid -- or at least delay -- dying. We may credit God with the marvels of creation, but we seem to think that he left the end of life open, empty and meaningless.

The Christian narrative, on the other hand, is more realistic and more positive: Dying is truly a central part of life and a part of God's intention for creation. There is nothing esoteric or hidden about the Christian understanding of dying. Dying is a part of the Christian life from the very beginning.

The Christian Gospel embraces the human condition completely with Jesus Christ as the focus. Central to that story is the death of Jesus Christ in the Eucharist. The initiatory rite of baptism begins the individual Christian's own personal journey with dying -- to sin, to self and to the way the world thinks and behaves.

Practical actions can help to incarnate a community of supportive communication in which the awe-full-ness of dying can be borne with faith and trust and hope. As worship has been described as "wasting time with God," so care for the dying may look to the world like wasted time. But that is the kind of time we spend with those who are dear. Time is the gift we have to give.

When everyone knows what is happening, the need for telling the truth forbids that we feverishly invest in a recovery plan or divert the conversation to avoid the unpleasant reality of death. Instead, what we are called to do is deeply and carefully listen, acknowledging the approach of death and all of its concerns. This will embody the larger narrative of God's loving care for all creation and Christ's call to the church to carry the dying on life's last journey.

 
 
 
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01:50 AM on 07/06/2012
My counseling work took me into and around hospices a great deal in the 1990s. I concur strongly with the author's call for us to face approaching death in terminal situations. I have intimately observed those who directly face the approach of death, and who deal with it, and talk about what is happening with their loved ones. I have also seen those who deny it's approach, and run from it, and lie about it to themselves and their sick loved one. Direct honesty is in all circumstances the better response.

I have seen families restored to peace and love, because they admitted what was happening, and then had the conversations they should have had long before. It is amazing how often forgiveness can happen, and how loves can be affirmed and renewed, when we just admit what is going on. Even when there is no outstanding business in the family, an admission that death is pending often leads to a wonderful celebration of the life that was lived. Magic can happen within a family this way.

For what it is worth, my experience is this: Those who have loved a great many things, and loved them passionately, they make a good death. Those who will not risk love through self-regard, or self-protection, they do not die well...
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ManuOB1
A voice crying in the wilderness
07:59 AM on 07/05/2012
At age 94, my mother had what we Catholics call a "happy death." In fairly good health for her age, one day she announced, "I'm tired." She declined rapidly and four days later died. What a way to go! Exit, stage left---
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12:44 AM on 07/05/2012
Thank you for a highly thought-provoking and informative essay on what is still an almost taboo subject in this country -- death.
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greytunes
99% of GOP/TPers make the rest look bad
01:13 PM on 07/04/2012
I heard an interview on NPR with a guy who does crime scene cleanup. He was asked about dying, and he said he wanted to go slow. Even cancer was fine with him as long as it was slow so he could make sure he had said everything he felt he needed to say to whomever. I found it insightful as most of my friends think fast is the way. I want to be able to manage my own death. I think Hospice is legalized euthanasia for those who can't/won't take care of dying on their own. Dignity is knowing you are dying, and still can do something about it, not lying in Hospice, out of your mind, in your own incontinence, getting shot up with enough morphine to finally cause respiratory arrest.
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psnyder325
Yep, I'm a Socialist. Deal.
10:57 AM on 07/04/2012
Until we understand that today is a good day to die, and face it fearlessly and with gratitude, we will never truly live. I think most Christians FEAR death because of the mythology of a hell and eternal pain....something that was not believed by early Christians. So, frankly, I think most Christians do a WORSE job at handling death than many other spiritual traditions.

As for me, my first choice is to die defending something or someone I love. Second choice is to get eaten by a bear. Third choice is to be shot at the age of 112 by an insanely jealous husband. Dying in my sleep or peacefully or from disease would be my last choice. But few of us get to order our own ends. Hoka Hey! Today is a GOOD day to die! (Which means it is also a great day to live.)
01:55 AM on 07/06/2012
I spent years and years in hospice work. In my experience it was the loving Christians who dealt with death with the very least fear.

Your comments take me back to childhood. A truck load of elders from the local Baptist church pulled up in front of my fathers trading post in the rockies. They called the police because one of their own had keeled over dead of a heart attack on their hunting trip. I was disturbed because they were all calm, and smiling, and totally peaceful with themselves and each other.

It took me some time to realize this was because of their faith. They were certain of their friend's continued existence, and of his destination. With respect, from childhood till now, my experience of Christians and death is exactly the opposite of yours.
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11:09 PM on 07/03/2012
"The Christian narrative, on the other hand, is more realistic and more positive: Dying is truly a central part of life and a part of God's intention for creation. There is nothing esoteric or hidden about the Christian understanding of dying. Dying is a part of the Christian life from the very beginning."

I don't see Christians embracing death more than non-Christians, even though that would usually be consistent with their beliefs. They're just as upset as the rest of us when people close to them die.

Why would Christians even attempt to mitigate risks (by wearing seat belts, various forms of safety equipment, or paying attention to safety warnings, etc.), or seek medical help when they're potentially terminally ill? Isn't death the ultimate goal? No, it isn't. Not for the vast majority of them, as far as I'm aware.
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Peter Calabrese
11:01 AM on 07/04/2012
The virtue of prudence governs why Christian don't take foolish risks. Jesus accepted death at the appointed time. Up until that time He sued wit and wisdom to escape every trap set for Him. Yet when death came He did not do it Himself but let His captors do their evil deed. When Satan tempted Jesus he challenged him to jump off the cliff since the angels would save Him. He responded that one does not put God to the test. As St. Paul says I long to be with the Lord - but He is aware that God called him to a certain mission on earth. As Christians we look forward to being with God but we joyfully accept the mission He has given us on this earth. Many Christians may not seek the "good death" described in the article. Hence it was written. As Christians have to grow in every aspect of discipleship so too in this area.
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10:59 PM on 07/03/2012
"People who think there's no good way to die have obviously never heard the phrase 'Drug-fuelled-sex-heart-attack'." -Frankie Boyle.

And there was that guy in Meaning of Life being chased off of a cliff by attractive topless women.

There are better ways, there worse ways. Personally I'd rather not be kept artificially alive when I'm going to die as soon as the machines are unplugged anyway, and when it will only extend the suffering. And I believe people have the right to choose death if they desire it, with the help of healthcare professionals who can make it as easy on them and their family as possible.
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01:49 PM on 07/03/2012
While you are able to I urge everyone to plan their exit from this life.
Watching my mother-in-law literally beg her only daughter to end her life was the worst human horror I have ever witnessed.
"I know you can do it. I know you can. Please you must find a way."
This was in a modern state-of-the-art Hospice under close medical supervision with massive doses of narcotics.
She lived like this for many, many excruciating weeks.
No Human Being should have to suffer because some believe in far fetched supernatural deities.
We all should be given the choice to decide when enough is enough.
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Kyrani99
that Eternal Flame is the source of my shrine
01:47 PM on 07/03/2012
You make a statement of "After a long battle, she died..."? The importance of the fight -- not the dying -- is emphasized/" What a lot of people don't realize is that in some cases there is a long battle, but it is not "with the disease" but with what is behind the disease, the reason why they are sick. You can see here about cancer since this phrase is often referred to someone dying of cancer. http://kyrani99.wordpress.com/2012/06/18/why-the-body-reacts-to-form-cancer-part-2/

I think the main problems are that people are afraid of dying, not realizing that it is just a transition from one sort of an existence to another. Another problem is that many don't really believe in an afterlife and for them it is a belief that they become nothing. So fear is a big problem.

If one understands that there is an afterlife and that this life is just a small stop on a long journey then one can be unafraid of dying. In that case the transition takes place effortlessly. It doesn't matter in what circumstances a person dies under these conditions. They will always have a good death.
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Peter Calabrese
12:23 PM on 07/03/2012
Gives us some good food for thought. Could this also be the source of the striving to mainstream an ersatz euthanasia (good death) by intending it in an entirely secular way - free of pain - not "burdening anyone". In this manner the dying are robbed of unifying themselves to the Suffering Servant - and the "burdened" from the opportunity to practice heroically virtue of charity in caring for the dying.
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12:04 PM on 07/03/2012
The Church is one of the groups in the most vigorous opposition to practices like euthanasia that would allow people to "die well". The narrative that we must stoically fight death is well-entrenched within Christian tradition at this point.
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Pat Pepe
09:51 AM on 07/03/2012
I believe with certainty, that the sole governing fact on death is "Faith" As a Marine I've have seen death and in many cases the coming of death to many Marines was a revelation to me and the matines that were present. Though mortally wounded this marine had a look that at that time was eerie to me and my buddies. It was a look of "Isee you and are you coming now" I am not being melodramatic in this incident but it left my and my buddys cold his eyes seem to be saying I see you. I shall always remember that incident. Its fair to say Who Knows and are we all experts on what awaits at the time of death, to me only that Marine could have answered that preceding his death. We all agreed that at the point of death he was aware of somerhing or spmeone.Also this Marine was not talking only facial moves with his eyes.
02:09 AM on 07/06/2012
I couldn't agree more brother. My counseling work took me into hospices for years. I became intimate friends with a number of people and families. Often, as the end approached people began talking to dead loved ones that they insisted were there.

Young people, very angry at their life being cut short, would suddenly be filled with laughter and a calm acceptance because their grandmother had come and told them to let go, and stop fighting it. Etc, etc, etc. In this hospice setting I have seen over and over the dying person deliver a message to a family member from someone long dead, and there was no way they could know the secret they addressed. Talk to anyone in hospice work, and they will relay how common such experiences are.

Unfortunately, many doctors will promptly drug such patients into oblivion when they see this happening, and it doesn't matter if the patient is deriving peace from it or not. Many medical people are of profoundly atheistic persuasion, and they can be as adamant in their world view as a medieval inquisitor.
09:13 AM on 07/03/2012
The article ignores the church's efforts to prolong a bad death. The main opponents of euthanasia, and the majority of people who continue to urge people to fight on, are christians. It is strangely ironic for a religion based on the teaching that Jesus willingly submitted to being put to death. Most people would call that a suicide.
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David Weidner
Ask me about my narcissism!
09:01 AM on 07/03/2012
There are plenty of people willing to talk about dying, and they do. It seems to be a christian hang up more than anything, which is kind of ironic. In their minds, dying is just a transition, so why all of the fuss?

I had to put my dog down after a long illness. It was hard, but I did it because I loved him. He's not in heaven. He's gone...forever. But he is not suffering. Sometimes life is too much, even if that is all there is. Get over it already.
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phal4875
The world is run by cats; we just feed them.
11:36 AM on 07/03/2012
Dear Mr. Weidner:

You may be entirely correct, but huge numbers of people have had experiences where their consciousness seems to depart from their bodies. This is not just in near death experiences (NDEs), either. Some people have "come back" with knowledge of events that have occurred at some distance from their bodies.

This does not prove that life continues after death because these folks were not really dead, but it may provide a hint that consciousness and one's body are not the same. I am familiar with this life and would cast my vote for an end to consciousness at the end of life. I am of the opinion that such a vote might be in vain.
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David Weidner
Ask me about my narcissism!
02:59 PM on 07/03/2012
ummm, yeah....ok.  
02:18 AM on 07/06/2012
I was a party to a death where a man was kept alive by machines for days because his lover would not let him go. His lover kept insisting "it's not over yet". The person in question had no brain at all left. A series of strokes had totally destroyed his fore-brain.

After a week, the man came totally to consciousness, turned to his lover, and said, "get me a priest". The priest came running, took the man's confession, gave last rites, and left. He had gone into his illness a very angry embittered man. When the priest left he was totally at peace, smiling, and profoundly happy. He asked his lover, "can I go now?" His lover said yes, and in one massive thrash of his body, he flat lined and was gone.

To this day, the doctor, a friend of mine, insists it didn't happen because there was no brain. He insists it didn't happen despite five witnesses in the room, the man's lover, the priest, and the nurse on duty all telling him it happened. The doctor even threatened to reprimand the nurse in her evaluations. There are none so blind...
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AndrewHall
I blog atheist comedy at Laughing in Purgatory
08:02 AM on 07/03/2012
"The Christian narrative, on the other hand, is more realistic and more positive: Dying is truly a central part of life and a part of God's intention for creation."

Realistic? The Christian idea that the good will live in heaven for eternity and the bad will be eternally tortured -- that's realitistic? I don't see any double blind studies to really support that assertion. If God (and I don't think most Christians will agree with the author's sentiments) really planned for death, then what kind of deity schemes to sculpt his children's lives in what has been traditionally nasty, brutish and short?