Wednesday, April 29, 2009

Dying with dignity

Dying with dignity does not mean a pain-free death, or a quick death, or a death that is not a burden on others.

First, though suffering is a result of a broken world and ought to be minimised where possible, nevertheless, in God's redemptive grace even the darkest experiences can become reflections of his faithfulness and manifestations of his love. That is one of the many lessons of the cross.

Second, if it is not about the pain, the anxiety many of us feel about a slow death arises from knowing that I am dying. But a slow death with one's eyes open need not be more terrifying than a sudden one; our fear of death and dying is met by the word of the risen Lord: "peace be with you".

And third, the process of dying will most likely be a burden carried not only by me, but also by those I love. But this is one of those points at which we are to bear one another burdens, to share the experience of ill-health and dying so that the load is lightened in being shared. Indeed, to withhold this from those around you is not a blessing, but a missed opportunity to allow others to participate in your dying. Death is the ultimate exile, the final isolation, the conclusion of all relationships. But by sharing even our dying with one another, we express our hope in the God whose love is stronger than death.

Dying with dignity means a death in which one's identity is not destroyed; it means a death in which one's humanity is not shattered; it means dying without losing your self. The martyr dies with dignity because she refuses to conform to the dehumanising powers that demand a divided self. Christ died with dignity because he trusted his Father, even when it appeared he was abandoned. "Into your hands I commit my spirit": a bloody, brutal, nasty death, yet one that utterly failed to degrade the dignity of the obedient Son.

17 comments:

Megan said...

good stuff. Dignity is an interesting concept.

duncandrews said...

That sculpture is incredible. I found your post really helpful too, by the way, but that image is haunting.

Where did you take it?

byron smith said...

Megan - yes, I wouldn't say that dignity is the first criteria of a good death. I simply picked the phrase from common use in order to critique and (hopefully) Christianise it.

Dunc - I love it too. Perhaps I should offer points, but I doubt anyone would get it except Matheson, since he was there when I took it. It is a sculpture on the door of S. Maria degli Angeli e dei Martiri in Roma (St. Mary of the Angels and Martyrs). On the other door is a great sculpture of an angel, which I'm sure I'll post at some stage, but this is one is obviously a martyr. In fact, this post initially lacked the final (positive) paragraph and was merely going to be a critique of common notions of dying with dignity. I then started looking for an image and this picture led me to reflect on martyrdom and so led to the final few lines.

gbroughto said...

thanks Byron. I have an old friend (but he is not very old) who is living under the death sentence of a cancer that has returned, that will almost certainly be his death in the next 1-2 years.
As a person of deep and impressive faith, his journey so far mirrors your post, so I look forward to sharing it with him.

I too was struck by the evocative image. the problem is I can't quite put my finger on what it evokes...

Jaime Dickson said...

Hy Byron. Glad to see you posting your blog comments on FB. That might remind me to read them more often! Anyway, I spoke about this recently. The whole 'dying with dignity' mantra of the euthanasia campaigners saddens me. It's their substitute for dying with hope which I think is the far better (proper) way to die. When one dies without hope or certainty of what lies beyond death then I think 'dignity' (whatever that means) is the best one can 'hope' for. Jaime D.

Andrew Chirgwin said...

Byron> Dignity... a very big topic. I have always viewed Dignity in Death being similar to courage under pressure/fire. Generally dignity seems to come with courage and confidence. Be confident in the Lord's promises and have the courage in the face of your fears.

Another aspect on death which I found interesting was that going through the experience of death personally allows others to express their gifts (for nurturing, caring for the sick, caring for others who are affected) etc.

Anonymous said...

"Dignity is a term used in moral, ethical, and political discussions to signify that a being has an innate right to respect and ethical treatment" (source completely unacademic Wikipedia).

However, I see much dignity in my great grandmother when she knew it was her time to go. She was in hospital then and refused treatment (and food). It took 6 weeks but not a complaint from her, only love and care to her family prior to and post her decision. I throw that in as a curious side to the euthenasia thought that seems to be floating here as when she knew her purpose was done it was done. Our family remembers what a wonderful lady she was and the strength she had to finish things when time, and believe it or not, a most lovely Christian.

Purpose in life and dignity in death.

If there is no purpose seen in life how is there no dignity in choosing one's death and respecting, as much as possible, the beliefs of others whilst being true to one's own understanding?

I hold that question to you for anyone who chooses to die, as much with dignity as possible, without deciding to follow today's conventions and Christian or no. I also hold that question to you and anyone regardless of there having been a perceived finalisation or loss of purpose either physically or mentally or spiritually.

Drew said...

I tried to deal with some approaches to death recently for CPX. I'm not sure how well it turned out... but I like your approach here - especially your thoughts on identity.

Dying with dignity means a death in which one's identity is not destroyedAnd so, if one's identity is not yet been given back undivided, unshattered, dignity would be unobtainable - and could perhaps lead to those very things - the pain free, the quick, the obscure - that are sincere, but failed, attempts to achieve some dignity for oneself.

Dignity is received.... not innate?

cyberpastor said...

Is it possible to rail against the evil of death in a dignified way? To condemn death as having no place in this good creation and yet accept it as "something we all have to go through?"

byron smith said...

Geoff - we are all living under a death sentence. Some of us have the privilege of having a better idea when that might be. Some of us have the privilege of the likelihood that it is still many years distant.

As for what the image evokes - for me, if evokes a life (and death) marked by Christ, sharing in his suffering and being wounded by and for him. It is an image of a martyr (the corresponding door has an interesting image of an angel too).

Jaime - yes, hope is a much better term. Though dignity is not irrelevant.

Andrew - that is true, though this is another one of those situations in which God brings a good (the sharing of gifts) out of an evil (dying) without making the evil into something good.

Anonymous - thanks for sharing that story about your great grandmother. I am not sure I have understood your question. Do you mean that even a life without purpose can end in a death that is dignified through being deliberately chosen? I would like to hear you say more on this. I might have misunderstood you.

Drew - I am sure you are correct about dignity being a gift just as much as life is. Nothing we have is our own; it is all received.

Cyberpastor - yes, that is the question. What does it mean to treat death as the last enemy and yet as as an already defeated enemy?

Anonymous said...

"even a life without purpose can end in a death that is dignified through being deliberately chosen"

Pretty much.

I believe you can have purpose in life but when you feel you've fulfilled it (or if, yes - even to not have felt you've had purpose), then yes I believe that death can be a dignified response should that be your view on life.

Even if we are given everything (from life, to dignity and to death) - we are also given choice regardless of purpose.

If someone should choose to die then why should it be discouraged if affairs, financial/emotional/other, are best put in order to minimise effect on those it could? If it wasn't such taboo and generally downright difficult for an average person to do in a discrete and dignified manner, would not society start to accept it?

Perhaps this dignity is not only in how an individual tackles death but how society does/does not accept a personal choice.

Harikiri (happy despatch) would be an example of where it is seen in a society, though at what I would see as a more macro level.

And please excuse the wafffled response. I've not unfortunately the time today to make it pleasantly concise.

Anonymous said...

Forgot to mention - why does death need to be regarded as an enemy if we can all accept it happens regardless of our beliefs? - again, a societal leval thing.

byron smith said...

we are also given choice regardless of purpose.I believe that choice is only a relative good. It is possible for people to make choices that are disastrous for them and for others. It is more important that we discern what is good and pursue it. Not every choice is good, and our laws rightly limit our choices. However, what is good is not always obvious, and so it is important that laws remain fairly minimal safeguards against grave wrongdoing.

If [suicide] wasn't such taboo and generally downright difficult for an average person to do in a discrete and dignified manner, would not society start to accept it?Does social acceptance signify that a practice is ok? I am not sure we want to go down that particular path.

It is possible to acknowledge that one is going to die and to depart in peace, but there is a difference between this and seeking death.

why does death need to be regarded as an enemy if we can all accept it happens regardless of our beliefs? - again, a societal leval thing.The fact that something happens, and happens to all, does not make it a good thing. We all suffer, but suffering in itself is not a good thing (even if it can sometimes have some good results).

Death is an enemy because it is the undoing of so many good things. It is a defeated enemy because Jesus rose from the dead. I have discussed the metaphor of death as enemy at more length here and in the series that followed that post.

Anonymous said...

Ok i gotta say anyone who uses religous sources for their vote or opinion on what laws should be passed has no right to one. People in any town led alone city state and country all have their own beliefs and to use your religion as a source is to say they should be forced to follow the rules of your religion. I for one believe that much as doctors have specialties there should be one for dying. A process should be involved including two seperate pysch interviews and 4 2nd opinions all documented before this is possible. however i think that at some point assisted suicide may well be a good thing. If you had to go through mind shatteringly torturous pain for 2 years just to die because someone made it illegal to die early would you really think its right. Though they may be making you use whats left of your life they are also forcing you to experience horrible pain. Remember also pain is emotional as much as physical and emotional can often hurt worse. Now obviously most forms of pain will come and go however there are some that won't and among these some cause pain that is itself impossible to block without completely numbing someone. If you are completely numb in this sort it would be a miracle if your in your right mind enough to talk with family led alone get your affairs in order. Some people don't think of ending their life early and some refuse. If you refuse that is your choice but you have no right to tell others not to. I gotta say with this example did you know jumping off a building in new york is illegal and punishable by a jail sentence? Now tell me what is the point of that jail sentence if when they get out they succeed. The smarter thing in this situation is obviously pysch care but once again the government does it wrong. I will agree that the government does need minimal safeguards hence my process to see if theres any way to give them hope. However a flat out ban on anything(even murder) is ridiculous and overbearing. Its called self defense people the reason for murder(i define murder as taking a humans life regardless of the conditions) The point is this as long as you don't kill someone yourself or refuse to give them any other option than killing themself i don't believe you should be jailed(in my ideal system jail would be only one of the possible sentences among various therapies that are far more effective than jail at repeating crimes.) furthermore i must say all choices are potential goods and potential evils. if you learn to lock pick but never do it except to help people who locked their keys inside are you doing wrong? If you hot wire a car to get people medical treatment in time did you make the wrong choice? Dignity is not received or innate it is a mix of the two. You learn what it is but until independence your not permitted much. You attain your own dignity but you can only have a certain amount without losing it depending on your environment. ex(a boss destroys your dignity daily are you going to keep attaining it?) Furthermore i'd like to remind you we are all on a death sentence we just don't know when it will be executed. As such forcing someone to live is a waste of time and resources if there is no chance they will ever get better. Further if unassisted suicide was legal do you think people would be seeking help? Id like to close on the fact that my dad was once so sick he thought about seeking assisted suicide and that he survived against all odds. I'm not saying that supporting my case either. I'm well aware if he committed suicide he'd be gone today but even then he had a chance all be it 5 percent. Hence my reason for approval specialists 2nd opinions etc. FYI he's so religious i can barely stand him though this has gotten much better since he stopped forcing me to go to his church. I am 21 years old attending community college from home and hoping to graduate this fall.

by penname Last Dietrich

byron smith said...

Last Dietrich,

Thanks for taking the time to comment. I appreciate the passion you feel about this topic. Please make sure you have not misheard me. I said nothing in this post about voting or about laws. It is a discussion of what dignity in the face of death means. I am trying to give a brief account of how it is possible to face death and dying with integrity and without fear.

Ok i gotta say anyone who uses religous sources for their vote or opinion on what laws should be passed has no right to one. People in any town led alone city state and country all have their own beliefs and to use your religion as a source is to say they should be forced to follow the rules of your religion.
I think that if you consider the implications of this approach, you may find that it is not as attractive as you initially thought. You are suggesting that we restrict voting rights on the basis of someone's beliefs. This was precisely what most democratic movements have been fighting against for a long time. Although it may initially seem good to remove those with whom we disagree from the electoral process, if we are going to restrict voting rights on the basis of beliefs, why stop at religious beliefs? Why not also include political beliefs? You can see where that line of argument could lead.

It is quite possible for someone to participate in a public discussion (including elections) and to do so from a position with which not everyone agrees. Indeed, that is more or less always the case. It is also quite possible to put forward a position without implying that everyone else ought to be coerced into believing the same things. People can agree on particular actions and yet have different reasons for doing so.

However, as I said, I was not particularly interested in this post to discuss the legality of euthanasia. Nonetheless, since you have raised it and it is also a much discussed topic, I will reply to your comments.

I for one believe that much as doctors have specialties there should be one for dying.
A thanatologist? An interesting idea. However, there already exist specialists in palliative care, who seek to reduce the physical suffering in those dying slowly and who cannot be cured. Yet there is a gap between this and actively seeking to cause death.

A process should be involved including two seperate pysch interviews and 4 2nd opinions all documented before this is possible. however i think that at some point assisted suicide may well be a good thing.
It is good that you aware of potential abuses and see a need for careful safeguards.

If you had to go through mind shatteringly torturous pain for 2 years just to die because someone made it illegal to die early would you really think its right.
Although I have in the past been very ill, I have not had to go through a situation like the one you describe. It would indeed be a very difficult time for everyone involved. However, if there was anger involved at such a situation, my hunch is that mine would be directed primarily at the illness rather than the legal system. It is important to note that it is generally not illegal to "die early". In most countries it is currently illegal for a doctor actively to kill a patient, even if the patient wishes to die.

It sounds like the period of your father's illness was a very difficult one for you all. I am glad to hear that he survived.

byron smith said...

did you know jumping off a building in new york is illegal and punishable by a jail sentence?
I didn't know that. It does seem a little odd.

(in my ideal system jail would be only one of the possible sentences among various therapies that are far more effective than jail at repeating crimes.)
I agree that gaol is not the only option available to the criminal justice system. Many places make use of alternative or supplementary strategies. As you say, the rate of recidivism is often quite high amongst those who are simply incarcerated.

furthermore i must say all choices are potential goods and potential evils. if you learn to lock pick but never do it except to help people who locked their keys inside are you doing wrong? If you hot wire a car to get people medical treatment in time did you make the wrong choice?
I agree that actions need to be understood carefully within their proper context. This is not to say that intention alone determines the moral evaluation of an action. It is quite possible to desire to do good, but actually to do evil.

Dignity is not received or innate it is a mix of the two.
You may well be right about this. There is both a sense in which dignity remain possible even in the most degraded of circumstances, and yet another sense in which dignity is a social virtue, learned through our interactions with others.

Furthermore i'd like to remind you we are all on a death sentence we just don't know when it will be executed.
Do you mean that we are all mortal? That none of us can ensure our continued existence indefinitely? Or do you mean something more, that we all deserve to die?

As such forcing someone to live is a waste of time and resources if there is no chance they will ever get better.
It depends on what you mean by getting better. Many people live with incurable illnesses or conditions that will ultimately kill them and yet do not consider the resources spent caring for them to be wasted.

Further if unassisted suicide was legal do you think people would be seeking help?
Unassisted suicide is generally not illegal in most developed countries.

Id like to close on the fact that my dad was once so sick he thought about seeking assisted suicide and that he survived against all odds.
As I said, I am sad your father was ill. Sickness can be extremely upsetting and disorienting. A few years ago I had cancer and came close to dying for a while. Knowing that even there Christ was with me made a big difference. Sickness can be a very isolating experience, both for the ill and for those who care for them. But sharing suffering and dying helps to re-humanise them. Thank you for sharing your own experience.

byron smith said...

Guardian: How doctors choose to die.

I'm sceptical (given the lack of evidence) for the claims about the practices and beliefs of "doctors" (as a whole), but it is still an interesting article.