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Is There Such a Thing as a Good Death?

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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.