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Look For a Good Life. Decide on a Dignified Death.
- Date:
- Sunday 11 April 2010
- Time:
- 10:00am
Sunday April 11
Look For a Good Life.
Decide on a Dignified Death.
Many of you will read Vivienne Ulman's story. Her mother died at the age 84 after 15 years of Alzheimers Disease. When it seemed likely she was going to die, her husband said to the doctors, "I want you to do whatever it takes to keep her alive." They said, "Well, you have to think about what she would want. In a few months' time she may not know you." And he said, "she may not know me, but I'll know her." (p 12 The Age, Good Weekend. 10/4/10)
Such stories cause us to wonder about our deterioration and dying: how we will live and what kind of death we will die.
Of course, we would prefer NOT to think about these things. Surely there are more interesting, uplifting things to talk about on Sunday morning!
Every night, from our television screens, every day as we reflect on our experience we hear and wonder about the catastrophe of life, the chronic conditions that pervades our human existence, the crises of life and death decisions and then the closure, as one we knew closes their life.
Long before the astonishing availability of modern drugs, modern medical technology, complex intensive care units, and the beds of palliative, we knew what had to be done -
we would care for the person injured in pain or dying;
we would be there as a comfort;
we would show some genuine compassion no matter what the cost.
But with the availability of mind boggling procedures, what we can do, can outstrip what is the best compassion. We "can" takes priority over we "care". So people are kept on (artificial) support systems because to disconnect them might bring condemnation and criticism that we let them die when the goal was to keep them alive. The doctors can say "yes we can prolong their life, but is it the best and right thing to do, given all circumstances?"
Sometimes a sensible ageing across the life-span can become a vexatious delusion of immortality.
The philosophy of accepting the importance of compassion in life and death can become a dogma that exalts suffering; and preserving life is more important than dying a comfortable death.
What is a comfortable dignified death? This is not an easy question, but it is a very important one. Is there any great virtue in keeping a person alive, when their terminal illness is confirmed, places them in heavy pain, when the overzealous intentions could be better directed?
What values are being advocated here and what is their basis?
Some say our genuine sentiment to preserve life is based on Scriptural directives. That does not hold up, given the numerous examples of endorsed killings and God-directed genocide described and advocated in many parts of the Bible.
Often the church and state combine forces to assert their position with a blindfold over their eyes.
Witness their endorsement of wars where millions are sent to early graves. Witness their long silence on domestic violence and the terrible abuse of children. Witness their stance to proclaim the value of one life, alongside the multiple thousands who will die this day from malnutrition and polluted water. Who cares?
In large measure we give the individual the right to choose how he will live. He can drink himself to death, he can smoke over a lifetime and cause the state huge costs in treatment and care. But does the individual have the right to choose his own death? Yes he does - but then he is often regarded as being of an unsound mind, of being depressed or deranged - and that may be so.
But there are people who say I am in a right mind, and I can make a living and dying need to be liberated from religious judgement - it is sometimes called the principle of autonomy. He chooses to act rather than await the encroachment of helplessness.
Just as there are passages in the Bible that speak of killing and dying, there are passages that state clearly to encourage us to - choose life and live! Take the pathways to life in all its fullness.
But we get out of tune with ourselves. We get out of tune - out of harmony - with what William Jones called "a more spiritual universe."
We also know that ageing is part of our existence. So long as we live, ageing takes place both in our internal organism and our external appearance.
Along with this we develop the core values of a survivable civilization - the values of easing the pain of others; the values of being alive for a time, and the values of accepting the processes of deterioration, decline and death.
While we are in the full swing of our life, we don't want to die, nor even think about it. But life has its boundaries from birth to death, and our difficult task is to embrace and accept our boundaries and help each other with them. These are the basic humanitarian values.
Our goal is to relieve the pain on both boundaries - birth and death - and help each other find the courage to live with dignity between those boundaries, and then to die with dignity at the final boundary.
II
It is not a simple issue.
First, we must consider the situation of those with a terminal condition and who express the wish for help to die.
Second, we are aware of a large population and increasing, who have lost the mental competence to make decisions and yet clearly they are no longer a participant in the full stream of life. These are people who suffered brain damage or brain deterioration. At many points these are new phenomenon to our society -
People living longer are more likely to develop deteriorating conditions.
People living in a fast speed society, a violent society are likely to have more victims of damage.
Then there are large numbers of people who are born with serious functional conditions.
In addition I see increasing numbers of young, middle aged ex servicemen who have suffered a mental collapse as a result of war tie experience or injury.
None of these people express the wish to die - but what can we do to help them live enjoyably and with dignity over the next 40 or 50 years of their life?
The values of care, compassion, a common humanity all pay a part. A calculation of available resources and survivable quality of life.
III
Stanley Keleman in his book "Living your Dying" wrote -
There are many ways to describe the path to dying, There is acceptable dying, unacceptable dying, natural dying and unnatural dying, accidental dying, sudden dying, surprise dying, passive dying, self-destructive, and the list could go on....all these terms reflect serious attempts to talk about and understand how and why people die and in what way a death connects to this life that preceded it. (p105)
Most of us die on one of three death/dying pathways -
the eruptive death
the congealed dying
the shrinkage dying.
Does the way we live carry us toward the way we will die.
Dr Kelleway wrote -
it is possible to reach some familiarity with dying, and to learn how to gain more conscious direction over it...by learning to read our interior messages.
We try to make some sense out of life but one dying man who had achieved so much in his life, said to me, "Dying is so senseless. What a waste!"
Many of us protest there is still unfinished business. "I enjoy the grandchildren". I want to live forever". We stop reading our own signs: the time of conclusions is approaching. How to live full and die with dignity. Alas we settle for living a half lived life and dying discontented.
How to live with contentment and die with contentment.
I have sat alongside kids who were dying and now and again I have heard their stories that would bend any heart.
I have also sat alongside ageing adults who have accepted they have run their race, and now they would like to die - with dignity and resolution and before they become what W B Yeats called "a tattered coat upon a stick."
Any one of us has a glib word to say - but come with me and sit with parents whose 12 months old child has died, when there was so much living to be done, so much joy to be explored. The pain of dying and its lengthy aftermath.
Of course most of us have our regrets - some dream of the life they never had and I dream of some things I could easily have done without.
I regret I did not seize the chance to conduct Shostakovich's 6th Symphony - no not in reality, but in my dreams.
I regret the mistakes, the wrong turnings, the stupidities - all of that and then I refocus on what is now - what is of greatest importance, how to weave everything into the tapestry of my full journey and with the best dignity I can muster say - "There it is, wants and all."
For myself, as we grow older, I am affected by the pervasive thought that one day we all realize there is nothing to live for, and no passion stirs within us. I look around and see many resentments, and large spaces of emptiness.
We are living our dying and succumb to our helplessness - without realizing that the greatest dignity in death is the dignity we give to the life which preceded it.
That greatest dignity is to recognize that dying is the necessary course of life. The goal of living is to live fully and then to accept the death of life and our dying time.
IV
Dr Ken Hillman in his book "Vital Signs" wrote of the easy loss of reality when it comes to ageing and dying-
Advertisements for retirement funds portray a handsome couple, with slightly grey hair, reaping the rewards of a dedicated working life; doing the things they always wanted to do and smiling indulgently at grandchildren. They seem to be about 50 rather than 70 years old. How these people turn into the ones in the ICU is a mystery. Somewhere along the line, stiffness and decreased mobility, memory loss, chest pain and cancers gradually reduce their bodies to something disdained. They no longer live with their children and so are farmed out to retirement villages or old people's homes, where infirmity sets in and the messy dying process occurs in secret.
It is against this background...that I am approached by relatives of the dying who believe modern medicine can reverse the process. Sometimes it can, but often it simply prolongs dying in shabby ways. (p257)
All of us should actively be part of the movements of Dying with Dignity.
Who here would say they would prefer an undignified death?
But a dignified death means these things:
1. It is to live with joyful energy as long as it flows. 2. It is the acceptance of the life in its brevity or its length. 3. It is to find a contented resolve that that the door of life must close. 4. It is to be free of distress and pain. 5. It is a reuniting of body, mind and spirit. 6. It is something that deeply affects those who live on. A dignified and good death will mean that those who live on are enriched and expanded in the way they will live.
We see we need widespread community involvement to ensure that people are informed, educated, liberated.
We need continuing searching for balance in advocating a right to life so that that right reaches into the deserts and jungles of Africa, the clustered slums of South America, the war zones of the world.
We need to ensure that the heroics involved in saving one life does not remove the disgrace of the millions of dead.
We need to break free of religion dominated by imposed judgement and fear, and explore the positive values of religion that enhances life and accepts its conditions , and the realities of our finitude.
In advocating a New Faith, I advocate that Faith is really the act of the total personality as it embraces life fully, and accepts death as a reality that frequently shocks us, but always sits as one of the boundary lines in which life is lived for its time.
Living and dying can be reduced to health funds and superannuation, to hospitals, nursing homes, and funerals. But living and Dying are much more.
We need education. We need information, we need community awareness. We need political action. We need religious maturity and liberation.
So that we extend to all human kind the benefits of living fully and expansively and of the help whereby we might all die with dignity and a sense of completion.