So much depends upon a red wheelbarrow

Or upon what the meaning of "is" is:

"Contrary to perception, death is not a specific moment but a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs and brain to cease functioning. If attempts are made to reverse this process, it is referred to as 'cardiac arrest'; however, if these attempts do not succeed it is called 'death'. In this study we wanted to go beyond the emotionally charged yet poorly defined term of NDEs to explore objectively what happens when we die."

I'm not interested in shoehorning all human experience into an empirical or positivistic frame, the better to explain that "love ain't nothin' but sex misspelled" or even that love is nothing more than neurochemistry.  The above, however, is a statement about that study of death I mentioned earlier, and the statement there is so full of ideas it needs to be unpacked slowly.

First, the real result of this study is to redefine our definition of death.  This isn't really new; we've been at that definition since the 19th century, at least.  Poe leaves us the most accessible legacy of the condition we now call "comatose," in his stories about premature burial (a key plot point in "The Fall of the House of Usher" and "The Black Cat") and, of course, his story "The Premature Burial."  People declared dead were not, after all, dead; and there was something of a cottage industry in supplying burial places the interred could escape from, should they wake up in their coffins.  We've been struggling pretty much since then to decide when someone is really, truly dead, and when they are just non-responsive.

But we've always assumed death was a moment.  Tolstoy subtly challenged that reasoning in "The Death of Ivan Ilyich," but the events of Ilyich's death point more to "death in life" as Ilyich descends into misery and despair, only to find just before the moment of death that he is at peace, and reconciled (though they may never know it) with the family he neglected long before his slow slide to oblivion.  The story ends with Ilyich embracing his fate, and leaving little doubt the last moment of the story, is Ilyich's last moment of life.  Death-in-life may be the product of Ilyich's fears and anxieties, but death itself is still that instant between the last breath, and never drawing breath again.

Now, this study tells us, we may need to reconsider our definition of death as an irreversible instant.  As Dr. Parnia says:

If attempts are made to reverse this process, it is referred to as 'cardiac arrest'; however, if these attempts do not succeed it is called 'death'.

Death is announced when attempts at resuscitation are said to have failed; but when did death occur? Before the efforts?  When they were abandoned?  Somewhere during?  We aren't really left with the question "What is death?"  Death is the cessation of life, or animation, of breath (pneuma, spirit, breath, geist).  No, the question now is:  "When is death?"  And the answer may be not a moment:  but a series of moments.  Ilyich's death begins the moment he injures his hip; his agony is self-inflicted and terrifying, until his last moments when he ceases to struggle and accepts the end of life.  In those moments he is at peace, and more, he suddenly understands his family as people he loves, wholly and unconditionally.  These last moments, his spiritual struggle turned to spiritual revelation, Tolstoy implies, are the moments of his death.

Perhaps Tolstoy got it right after all.

This study, conducted over 4 years, in 15 hospitals, in many countries, is an examination of what happens in death; but not at the moment of death.  Near death experiences present empirical evidence of life after death, or of hallucinations in the extremis of death which are only recovered by the "miracle" of modern science, only if death itself is an instant, a boundary line, truly that bourne from which no traveler returns and which to step over is to make an irrevocable step.  But if death is understood more carefully, it is a process of existence, truly a matter of time; and of time in its fullness.

Which may challenge our notions of euthanasia, of death-in-life, of suffering and prolonging life.  The argument for euthanasia presumes death is a simple cessation of life.  But what it if is not so simple after all?

I have to add, having put in that link to the Salon article, that end of life decisions are not as simple as we imagine they will be.  You may tell everyone you love exactly how you want to die; but you leave them with the burden of acting on your wishes, and that burden isn't a real one until the time comes.

I stood in the basement of a hospital with a woman whose husband had just been brought in by ambulance, the victim of a stroke that took his life a few hours later.  As I spoke to her (as her pastor), the doctor came in to ask he she wanted to keep her husband on life support, as that was all that was keeping him breathing.  She looked at me in panic and asked:  "What do I do?"

What would you tell her?

She clearly didn't want to consider herself responsible for her husband's death, even if he was all but dead already.  When is death?  It can be when you decide it is, and she wasn't ready to take that responsibility.  We imagine our loved ones will act for us as we would act, but do we really understand what that means to them, when they face the decision?  (To end the story, she denied the request and her husband went upstairs, where he died a few hours later.)  We want to be responsible for our deaths, but in the end, we can't be.  And maybe that's another lesson:  despite appearances, (and Tolstoy's story supports this, too, in the end; although Ilyich anguishes for much of the story that death is only his), none of us dies alone.  Our death is a part of our life, and our life is lived among others.

If we are truly blessed, among others who truly care for us, and for them our death is their loss, too.

"My death; is it possible?"

So apparently there was a long and detailed discussion of death (it seems the proposition for the debate was "Death is not final"), and nobody asked the obvious question:  "What is death?"

The subject raises, in part, a linguistic question:  in English we never say someone is "death" unless we mean a fictional personification of the reality of mortality (I have to be careful here not to use "death" to define "death").  We can say someone is dead; but not that they are death.  It wouldn't mean the same thing.

So, the dichotomy:  someone is alive, someone is dead.  The change in state from one to the other is death; or, more precisely, the moment of death.  But once that moment is gone, death is no more, and you are simply dead.

So what is death?  The moment of the cessation of life.  And why does that happen?  Why does that transition occur?  At best, all we can say is the organism is no longer capable of sustaining life.  Why?  Well, at bottom, that's all we can say.  Causes, of course, vary; from trauma to "old age" (rapidly disappearing as the diagnosis of choice for the deceased), but the same fundamental applies:  the organism becomes incapable of sustaining life.

Why?  What is life?  Where does it come from?

In the early 20th century, seeking to replace "soul" that comes from God and animates the body, the concept was "élan vital."  Virginia Woolf wrote a fascinating essay on the topic while observing "The Death of the Moth."  Interestingly, she had to write about death in order to write about life.  We often run up against these boundaries.  We seem to best know a thing by running it up against its limits; by observing it against what it is not.  And dead is not alive.

We seem to be going in circles here.

Alive is animate; dead is inanimate.  And still there is the moment, the instant, of death.  That is the linchpin of the discussion, the action of decoupling where "alive" becomes "dead," and the question is:  does the moment of death mark a finality, or merely a transition from animate flesh to permanent existence?

One objection that is not an objection was raised in the debate:

When Christians have near-death experiences, they often say they've met Jesus. When Hindus have near-death experiences, they meet Hindu deities. There was a little girl who had a near-death experience, and she met a portly man wearing a red cap. She met Santa Claus.

You are expecting people to report experiences in terms they don't have; in images they've never seen?  You were expecting a highly subjective experience to be completely objective, a neutral observation of an absolute thing?  The fact that Christians in NDE's have claimed to meet Jesus is neither proof they actually did, nor proof that they had no experience beyond firing synapses.  It is proof they had an experience.

What kind of experience, is the question.  The fact that it is one they report in culturally related terms is not determinative of the validity of the experience.  But then, denying reports of NDE's is also to understand these reports in cultural terms.

In the parable of Lazarus, Abraham tells the rich man that even if Lazarus were to return from the dead, the brothers of the rich man would not heed the teachings of the prophets and avoid the damned man's fate.  Likewise, if someone were to return from the dead, others would deny the reports of the resurrection, perhaps even deny the existence of the person claimed to have been resurrected, and if they were an eyewitness to the event, if they saw the dead walk, they would argue that the person was never dead.

There is always a way to look at these things that denies whatever claim is made for them.  The argument that "the evidence for such things must be 'amazingly good' " is a disingenuous one, since it starts from a principle of proof where it will never accept as "proof" any evidence with contradicts what is already accepted as true.  And this, of course, is the "objective" stance that considers only "facts."

"Facts" being a carefully defined terms whose definition is never subject to serious examination.

That observation doesn't validate extraordinary claims (who among us knows someone who has risen from the dead?), but it does challenge the easy assumption that only "extraordinary proof" can support "extraordinary claims."  Yes, it is true that to accept some claims it may seem you have "to dismiss the enormous successes of physics, chemistry, biology and neuroscience."  But what if you merely have to question the reach of those successes; or rather, question the interpretation of those successes?

Surely science can do that.  Because "extraordinary proof" is already, by definition, impossible.  If it is extra-ordinary, it will be explained in "ordinary" terms; at which point a near-death experience means you met Jesus, or even Santa Claus.  And that's so ordinary it can't be true; can it?

So what is "death"?  Cessation of life function, moment of?  If so, what does that mean?  What is life function, what, indeed, is consciousness?  This doesn't answer that question:

we don’t know exactly how the brain generates consciousness…not knowing the mechanism is not the same thing as saying it’s not possible…we’re certainly not all the way there in understanding exactly what it is…it’s not a black and white thing.

But if we're going to say that the brain "generates consciousness," perhaps we first need a sound understanding of what consciousness is.  And if we're going to identify life after death, perhaps we should examine what death is, and what life after it involves.

John Donne didn't think it involved a bright light and a meeting with Santa Claus:  "One short sleep past, we wake eternally," he wrote in his most famous Holy Sonnet.  For Donne, the resurrection came at a point in time, not at a point in an individual life.  Then again, when you are dealing in terms of eternity (which Donne certainly was, and which any discussion of life after death certainly presumes; because the very concept of immortality is that life is permanent, not death; that life, like eternity, is without end) it could be that "short sleep" is subjectively short indeed.  If you sleep without dreams, it can be as if there was no time between the last waking moment and the next.

Or perhaps it is just a matter of enculturation.  People suffering severe trauma have been known to recite the Pater Noster without conscious volition.  That is surely a matter of enculturation.  But does that mean the words are irrelevant, are merely phonemes?  It doesn't mean the words have metaphysical power; but it doesn't seem they are wholly irrelevant, either.

No more than the words we choose to discuss whether or not death is final.  But the word itself:  "Death."

What does that mean?  If "death" means "cessation of life functions observable in an organism," then yes, death is final.  We've yet to see a dead organism regain life activities (be animate again).  But that cannot be the meaning of the word in the statement "Death is not final," unless by that formulation you also mean "A square is circular."  It doesn't get any better if you say "Death is the cessation of existence," because now you have to explain what you mean by "existence".

Because if you are going to say that extraordinary evidence is necessary to prove there is an existence after the cessation of life functions in an organism, you are first going to have to define what you mean by "existence."  And before that, I suspect you'll have to explain what you mean by "consciousness."  Explaining that it is what is "generated" by the brain is no explanation at all.

All of which is not to say the claims of Platonism and Christianity are established by these gaps in scientific terminology; but rather, that the participants in this debate were speaking in two different language games, and so talking past each other.  And the only way to establish the superiority of one language game over the other, ultimately, is to say the one you accept is right because you accept it.  While the proponents of immortality or just the persistence of existence have many claims to substantiate, the "science" side has many claims to establish, too:  including solid definitions of "existence" and "consciousness."

And maybe even a better definition of "death."

If we're going to play these language games, we all need to agree on what the ground rules are.

One size always fits all

There are more things in heaven and earth, Horatio....

Philosophy, Roy Scranton (honesty compels me to note, a Ph.D. candidate in English; all English majors think they are philosophers....) says, is about learning to die.  It is an idea central to his essay at NYT, which ends with these words:

The biggest problem climate change poses isn’t how the Department of Defense should plan for resource wars, or how we should put up sea walls to protect Alphabet City, or when we should evacuate Hoboken. It won’t be addressed by buying a Prius, signing a treaty, or turning off the air-conditioning. The biggest problem we face is a philosophical one: understanding that this civilization is already dead. The sooner we confront this problem, and the sooner we realize there’s nothing we can do to save ourselves, the sooner we can get down to the hard work of adapting, with mortal humility, to our new reality.

The choice is a clear one. We can continue acting as if tomorrow will be just like yesterday, growing less and less prepared for each new disaster as it comes, and more and more desperately invested in a life we can’t sustain. Or we can learn to see each day as the death of what came before, freeing ourselves to deal with whatever problems the present offers without attachment or fear.

If we want to learn to live in the Anthropocene, we must first learn how to die.

Yes, we're all going to die, because we can't go on living like we have.  Which apparently means all of America will be Baghdad after the U.S. invasion, but frozen there in amber, in perpetuity, hell without end, Amen.

So get used to it.

First:  if philosophy is about learning how to die, I'll take theology, thanks.  Second, if philosophy is about learning how to die, then dying is some form of living, and again, I'll still take theology, thanks. 

Historian Philippe Ariès reminds us that death was a part of life. Medieval and early modern romances, chronicles and memoirs speak with one voice: when death knocked, the door was opened and the visitor was welcomed in remarkably similar ways.

Organization was essential. The dying person was responsible for the proper execution of his final exit. The doctor's principal task was not to delay death, but to guarantee that it was welcomed properly. And, indeed, the doctor wasn't alone. Family and friends gathered for the ceremony and the doctor was simply a face in the crowd. One and all understood their roles and the lesson that was imparted: they, too, would eventually be called.

The intimate relationship between life and death unfolded in unexpected places. The medieval and early modern cemetery was no less public place than the deathbed. For centuries, the activities we associate with the marketplace commonly took place in cemeteries, amongst the tombs and charnel houses. Merchants and scribes, musicians and dancers, jugglers and actors and, gamblers and the like sought to make a living in the company of the dead. When Hamlet clowns about with Yorick's skull, he's exceptional only in the fluency of his language.

By the late eighteenth century, language and attitudes began to change. Public authorities tried to stop profane activities in the newly redefined sacred spaces like the cemetery. At the same time, doctors began to sound the way they do today: the crowd of family and friends around the deathbed, they complained, complicated the job of attending to their patients.

Death thus got away from the dying person; it became the responsibility of others. It is only recently, with the rise of the hospice movement, that we're reminded of the ways in which we formerly responded to death. The recognition of death's finality, the planning for its arrival, the gathering of family and the redefinition of the physician's task: rather than confronting a brave new world, we seem to be returning to a simpler and older world. Ariès called this older understanding "tamed death." According to him, the old attitude in which death was both familiar and near, evoking no great fear or awe, [is in] marked a contrast to ours, where death is so frightful that we dare not utter its name. I do not mean that death had once been wild and [is no longer], I mean, on the contrary, that today it has become wild. And death has, in part, grown wild through the very tools with which medical science tries to domesticate it: an irony that would not be lost on Hamlet's creator.

If today, then, philosophy must be about learning to die, it is only because philosophy has first taught us that we should not die; that death is wild and untamed and terrible.  So now philosophy is about undoing what philosophy has done?  Isn't that like the "hair of the dog" cure for a hangover?

The topic always makes me think of these words from Thomas Merton:

THE cross, with which the ashes are traced upon us, is the sign of Christ's victory over death. The words "Remember that thou art dust and that to dust thou shall return" are not to be taken as the quasi-form of a kind of "sacrament of death" (as if such a thing were possible). It might be good stoicism to receive a mere reminder of our condemnation to die, but it is not Christianity.--Thomas Merton

Christianity is not, in other words, concerned with reconciling us with death.  It never was.  Martyrs didn't commit suicide to be with God; they were faithful in life to the end, knowing they were already with God.  God, as Jesus said quite pointedly, is the God of the living, not the dead.  It is not death, or even the fear of death, that Christianity either teaches or ameliorates; it is life.  The Greek phrase usually translated as "eternal life" is not really so Platonic as that.  It is more correctly rendered:  "life into the ages."

With Merton, I'm not anxious to reduce all of Western philosophy to some form of Stoicism, any more than I can agree with modern Biblical scholarship which wants to root some of Christianity's teachings in Cynicism. No more am I anxious to see human beings in terms of computers as understood by non-computer nerds:  Mr. Scranton's editor plucks out a sentence clearly thought to be insightful, but actually quite pitiful, to the effect that we humans are "hard-wired" to think tomorrow will always be like today.

First:  "hard wired"?  Does anybody use that metaphor any more?  And isn't that fear that tomorrow won't be like today the source of modern anxiety?  Aren't we quite convinced tomorrow can't be like today, because of "progress" or "technology" or "Steve Jobs!" or something?  The whole idea is as ludicrous as the generalization that philosophy has anything to do with accepting death.

"My death," Jacques Derrida wonderfully asked; "Is it possible?"   Derrida wasn't trying to make us accept death with that question; he was confronting us with the fact that we could not imagine our non-existence.  It's not quite the same thing as being "hard wired" to think tomorrow, when you are dead, will be just like today, when you are alive.  It's a bit more particular and incisive than that.  Imagining your own death without the continuation of your existence (if you deny the immortality of your Platonic soul), is simply impossible.  To imagine your death is to imagine you observing your death, and death without immortality is simply the end.  There is no you left to experience, or observe, anything.  Imagining that is virtually impossible.  Perhaps the warriors of Beowulf's day didn't have trouble imagining their own deaths, but more likely they simply didn't dwell on the question.  Life was nasty, brutish, and short, and death was very long (in Andrew Marvell's felicitous phrase, "oceans of vast eternity").  Why dwell on the inevitable?  It is only as we have managed to push death back, to overcome infirmities of cancer and infection and even heart problems, that we need to consider the reality of our own death.  It is inevitable, but it is not coming from a sword thrust or an axe blow or an illness in the bloom of youth; it is more likely coming in slow, creeping decrepitude and decline.

"Learn how to die" sounds not just fatalistic to me but positively perverse.  I think if anything we should learn how to live.  We have learned how to kill:  people, animals, species, plants, ecosystems, perhaps the biosphere of a planet.  If that hasn't taught us equally how to die, nothing will.  "How should we then die?" is never the question; it is always "How should be then live?"

And the answer, at a bare minimum, is:  "Probably not like this."

What, then?  It's not death I need to learn, or dieing.  The moment I was born I began that, and I needn't learn it; it will happen in it's own good time.  It's living I need to learn.  It's living without killing, without destroying, without causing every other thing within my reach (and as a member of a highly industrialized society, my reach is long indeed) to learn to die.  No, I think we have dieing down to an art form, to a cultural norm, to an absolute given.

It's living that we need to learn.

Finishing the "Ariel" Poems

Marina
By T.S. Eliot

Quis hic locus, quae regio, quae mundi plaga?

What seas what shores what grey rocks and what islands
What water lapping the bow
And scent of pine and the woodthrush singing through the fog
What images return
O my daughter.

Those who sharpen the tooth of the dog, meaning
Death
Those who glitter with the glory of the hummingbird, meaning
Death
Those who sit in the sty of contentment, meaning
Death
Those who suffer the ecstasy of the animals, meaning
Death

Are become insubstantial, reduced by a wind,
A breath of pine, and the woodsong fog
By this grace dissolved in place

What is this face, less clear and clearer
The pulse in the arm, less strong and stronger—
Given or lent? more distant than stars and nearer than the eye
Whispers and small laughter between leaves and hurrying feet
Under sleep, where all the waters meet.

Bowsprit cracked with ice and paint cracked with heat.
I made this, I have forgotten
And remember.
The rigging weak and the canvas rotten
Between one June and another September.
Made this unknowing, half conscious, unknown, my own.
The garboard strake leaks, the seams need caulking.
This form, this face, this life
Living to live in a world of time beyond me; let me
Resign my life for this life, my speech for that unspoken,
The awakened, lips parted, the hope, the new ships.

What seas what shores what granite islands towards my timbers
And woodthrush calling through the fog
My daughter.

This one I conclude with, because it is one of the "Ariel" poems of Eliot, and because it is echoed in this, another of my favorite poems.

Examination at the Womb-Door

Who owns those scrawny little feet?    Death.
Who owns this bristly scorched-looking face?    Death.
Who owns these still-working lungs?    Death.
Who owns this utility coat of muscles?    Death.
Who owns these unspeakable guts?    Death.
Who owns these questionable brains?    Death.
All this messy blood?    Death.
These minimum-efficiency eyes?    Death.
This wicked little tongue?    Death.
This occasional wakefulness?    Death.

Given, stolen, or held pending trial?
Held.

Who owns the whole rainy, stony earth?    Death.
Who owns all of space?    Death.

Who is stronger than hope?    Death.
Who is stronger than the will?    Death.
Stronger than love?    Death.
Stronger than life?    Death.

But who is stronger than Death?
                          Me, evidently.
Pass, Crow.

Let's talk about death

I swear to God, when you were young you used to gather your cloak about you and go where you wanted to go.  But when you have grown old, you'll stretch out your arms, and someone else will get you ready and take you where you don't want to go."--John 21:18, SV

You have to imagine a goofy-looking skinny guy in a yellow raincoat with a water-proof hat on, seated, holding a duck, and looking earnestly at the camera as he says:

"Let's talk about death."

Except he says "ducks."  It's an actor portraying a character from "Greater Tuna," the play about small-town Texas that almost made a career for the two actors who wrote and acted it for many years.  The line doesn't appear in the play; it's from an ad for the play that ran so many times I remember the ad better than most of the play itself, which I saw not quite as many times as the ad.  I do remember another line from the play, an advertising slogan for the town's (the smallest town in Texas, supposedly) gun store, run by DeeDee and named for her:  "If DeeDee's can't kill it, it's immortal!"

Let's talk about death.

Interesting book review at Slate on this topic, again concerned with how we die.  The one book I've read on this topic, back in seminary, doesn't get mentioned specifically, but does point to where these conversations usually go:  nowhere.  That book, How We Die, made a splash when it appeared, gave its author some celebrity, won some notable awards, and disappeared without a trace.    Books do that.  Rare is the book that actually changes the conversation, and it is the conversation about death that The Good Death wants to prompt.  I know this because the author of that book actually responded to comments at the Slate review, which kept the comments from descending into the usual internet blather.

The "good death," as I've said before, is our new obsession.  In the mid-19th century when coma was an undefined term and hadn't yet entered the medical lexicon, much less the common vocabulary, the concern was with premature burial.  Poe didn't invent that anxiety, he exploited it.  People who were thought dead were buried alive; at least that was the story.  Suddenly every death had the potential of being, not final, but merely postponed until a date to be announced later.  When Twain quipped that the rumors of his death had been greatly exaggerated he was picking up on this still-remembered fear as much as mocking his reappearance in public life.  And then, of course, he had the good grace to die when he wanted to; when Halley's comet returned to this neck of the solar system.

Good death, indeed.

I've actually participated in one "good death," and it was good.  The father was dying (of cancer, IIRC) and hospice care was treating him at home.  As the family pastor I was there the night he died. It wasn't easy on the family, but it was easier than standing vigil in a hospital room.  He died in his own bed.

Then again, I've known people who refused to allow the funeral of their spouse in the church they'd attended together all their adult lives, because they didn't want the memories of the place tainted by seeing the loved one there in a casket.  Imagine returning to the bedroom your spouse died in, much less the bed.  How many of us could do that?

Death is a very personal thing.  A "good death" for you might be a terrible death for me.  And then there are all the societal concerns with death.   We investigate deaths in ways we don't other incidents.  This morning there is news of a traffic jam due to the investigation of an accident that involved at least one fatality.  "Steer it clear it" is the law here; you don't wait for the police to show up to restore traffic flow, and in minor accidents there's little investigation at all.  But in the case of death, care must be taken, responsibility assessed much more seriously.  Which sets up this exchange in comments at that Slate article:

Bradley WilliamsWe do need to read and digest the language of the assisted suicide Oregon model laws/bills before we expound on our positions.

They are riddled with loopholes that work together to eviscerate the flaunted safeguards.

For example how many times have you nodded your head when the proponents declared that the lethal dose must be self-administered?

Well, read the language of the law/bill and you will find that there is no means provided to insure that marketing point. For example “self-administrate” was mentioned 6 times in the 20 page Colorado HB 16-1054 and yet there was no means provided to confirm that the lethal dose was forced on not.

In fact what is provided in all the bills/laws is that there may be no investigations allowed after the death. This is a red flag to repair our public safety net.

According to their own records in OR and WA a dangerous public policy that is being established is a low bar of "medical standard of care" is poisoning for people that "fear" the loss of autonomy.

We are all at risk of abuse by these poorly composed laws/bills.

PS: What other activities in the US prohibit investigations?

Ann Neumann @Bradley Williams There are myriad dangerous substances that we regulate quite well in society. I fear that opponents of aid in dying are stuck in a look where they demand proof of wrongdoing, coercion and elder abuse and when they don't find it, they say, Look! Just because it can't be proved doesn't mean it doesn't exist. The laws are quite specific and not a case of abuse has come out of Oregon after being on the books for more than two decades.

I looked and looked for clear cases of abuse or coercion. All those who claim it exists have ideological reasons to do so. I'd love a good argument for how these laws endanger elders, who are miserable and suffering and dying. I've yet to find one.

Pamlet @Ann Neumann @Bradley Williams Well, what is concerning is more subtle cases of coercion -- the "I don't want to be a burden" people.  Or the people whose lives could be made more bearable by appropriate mental health or palliative care.  There are so many problems with the way healthcare is delivered in this country that I'd like to be absolutely sure all of that is in place before I feel there's a level playing field where people are making this decision from the best state possible.

I'm never comfortable with claims that the law prohibits something that seems to be commonsense and especially common in all other matters of death (a cause of death must be officially established, no matter how cursory the procedure for doing so), so I can't speak to the allegation that Oregon law prohibits investigations of assisted suicides.  It seems pretty dubious to me, in fact; but the final comment raises the more serious question (and Ann Neumann ducks the issue of those legal questions entirely, which was disappointing):  the "subtle cases of coercion."

Ms. Neumann has an entire conversation in the comments about how we monetize life (and we do) and how we hide that fact from ourselves.  But that's part of the problem of the "level playing field" and how we, as a society, establish that people are "making this decision from the best state possible."  For all the talk about "liberty" in the comments, choosing to die (i.e., suicide) is not an individual decision.  Society has always had an interest in the deaths of any one of its members.  It's rather absurdly libertarian to say that it doesn't.  But I can tell you, as the child of parents still living and now living in town near me, the idea that parents are a burden on their children is a real one; and it can shape the decisions parents (and children) make.

I don't mean anything dramatic by that; but the elderly can easily feel they are more burden than blessing, and while such thoughts don't always turn to suicide, they do cloud the pleasure of living  It can be a slippery slope down to "it's better for everyone if I just die now."  It also gives us some comfort that we will be in control to the very end of our days.  But often, we simply aren't.

I have been in the room when a family member was asked by the doctor whether to remove care or continue it.  That is not a simple decision, and it shouldn't be.  The fact is, just as in the case of a suicide, you live with the consequences of that decision, no matter what it is.  Death by "natural causes" is always easier to reconcile than death by assistance, or by removing machines or restraining efforts.  My parents have "DNR" orders, but someone will still ask me, when the time comes, what I want done.  I've seen people face that question, and it's never as simple a decision as you think it will be.

And until I have to answer the question, I honestly do not know what my answer will be.  Change the facts, change the outcome, and that's the problem.  We never know the facts ahead of time, and while there are cases of people being kept alive because of some hope of recovery which has actually long passed (one such incident is noted in the Salon review, citing the book), when we review such cases we are never the ones who have to live with the responsibility of turning off the machine, of letting our loved one die.

There is a reason we struggle with that; and it's a good reason.

"Good death" sounds so good; but who is it good for?  Us?  The person who is dying?  "Whose life is it, anyway?," was once the question.  But the right question is:  whose death is it?  While everyone dies alone, death is still a social activity.  It involves people other than the person dying.  "No man is an island, separate unto himself," Donne wrote; and he was right.  Every person's death involves me, especially when that person is a family member.  I've been in the room when people died, and the relief of knowing you did all you could, and their time had simply come, is palpable.  Or the comfort of knowing you let them die as they wished, in their own bed, among family, doing nothing more than alleviating what pain you could, can also be a comfort.  But change the family, change the outcome:  one size does not fit all, and circumstances can change at every moment.  "Good death" is a good idea, but you have no guarantee you'll get that.  And you have no guarantee you'll leave that for your family.

The biggest problem with death is that it is final, and we have such a problem imagining that for ourselves, even for our loved ones.  I don't talk to my parents daily, but I still can if I choose to.  I try to imagine what life will be like when they are gone, but if I'm honest with myself, I can't.   I may find it easier to accept their deaths than they found it to be for their parents, if only because I'm older now than my parents were when my grandparents died, one by one.  But am I so old I won't miss my mother and father when they are no more?

"My death, is it possible?"  Word comes today of the funeral of Nancy Reagan, which order of service she specified from the opening tune to the closing song.   It left me wondering if she specified that women wear dresses and no clogs would be allowed.   I'm honestly glad I never had to do a funeral like that; funerals were my domain, since weddings were the province of bridezillas and their mothers (it was usually the mothers).  I could do a funeral as I saw fit, maybe working in music that was requested, but even that was rare.  No doubt such direction from beyond the grave suited the family; one less things to worry about, one more memory of the dearly departed.  But if the family had decided on their own service, on doing a memorial that remembered the woman they loved, what could Nancy Reagan have done about it?

"My death, is it possible?"

Funerals are for the living, not the dead.  I even did a funeral for an atheist.  His wife was the church organist, he had wanted nothing to do with the church.  I didn't even know she was married until he died.  It was an interesting funeral because it was at the church, as she wanted.  His friends were perplexed by the ritual, the prayers, the funeral sermon.  I didn't care.  I did it for her.  He was beyond caring, but she wasn't.  I wasn't defiant; I was just calm.  It was so much easier than doing the graveside service for my beloved uncle, while I was in seminary.  He was a preacher's kid, but he'd left the church as soon as he could and never looked back.  I did it for my aunt, for my cousins I am still closest to of all the cousins (his wife was/is my mother's twin; my father was his best friend since college).  I did it for them, but it certainly wasn't for me.

Let's talk about death.

Is it a process, or a final event?  I first realized that question while teaching "The Death of Ivan Ilyich."  Is that title about the entire story, or about the final sentence?  "The Death of a Salesman" raises the same question:  the entire play, or just the last few lines of Act II, and the epilogue?   Yes; no; maybe.

Let's talk about death.

It is Lent and two weeks from today will be Good Friday.  I will not observe it.  I will be taking my mother to see her twin sister, who now lives near her children, about 2 hours away.  My aunt has dementia; Alzheimer's, senility, call it what you like, it means the same thing.  She is not as lost as Alzheimer's patients I've known, but she lives in a world of memory and fantasy now.  She is confused.  She is lost to us.  My mother is going to see her for what will probably be the last time.

We're going on Good Friday, because it's a good day to travel.  We will be observing Good Friday.  We just won't realize it.

Let's talk about death.

There is no sacrament of death in the Christian church.  Thomas Merton pointed that out, explaining that the ashes on Ash Wednesday neither started Lent (Lent begins the first Sunday of Lent, not before) nor death.  But the closest the church comes to paying attention to death anymore is during Lent.  We stare it in the face on Good Friday.  Which is why so few of us gather together at a church. We don't want to talk about death.  We don't want to share it.  We want Easter Sunday:  candles and lilies and sunrise services and hymns about life and victory.  O death, where is thy sting?  Back there, on Good Friday.  We took that day off.  We skipped over it.  We slept in so we could get up early on Sunday during daylight savings time and see the sun come up and sing a hymn to it.

Wallace  Stevens has nothing on us.  Wallace Stevens was a piker.  Wallace Stevens as a porto-New Atheist, thinking he understood something we Christians don't.  He was wrong.  We're still pagans at heart.  We'd still rather chant our boisterous devotion to the sun than visit the domain of the blood and sepulcher.  We don't like ghosts either; we don't want to linger on the porch where they might be found, the yawning hole that is indeed the grave of Jesus where he lay.  It reminds us of death, of our death.  We'd rather plan our funerals.

Let's talk about death.

"My death, is it possible?"

God grant me a good death, and if not, at least grant me the ability to find a good death on my own.

You are going home this night to your home of winter,
To your home of autumn, of spring, and of summer;
You are going home this night to your perpetual home,
To your eternal bed, to your eternal slumber.

Sleep you, sleep, and away with your sorrow,
Sleep you, sleep, and away with your sorrow,
Sleep you, sleep, and away with your sorrow,
Sleep, O beloved, in the Rock of the fold.

The shade of death lies upon your face, beloved,
But the Jesus of grace has His hand round about you;
In the nearness to the Trinity farewell to your pains,
Christ stands before you and peace is in His mind.

Sleep, O sleep in the calm of all calms.
Sleep, O sleep in the guidance of guidance,
Sleep, O sleep in the love of all loves.
Sleep, O beloved, in the Lord of life
Sleep, O beloved, in the God of life.

Let's not talk about death.  Let's just rest.  Rest is good.

Death and Torture

[saving this from dusty obscurity]

We are sure that there are "universal" values that have always been respected by "decent people," or that what has changed is a result of "progress." We consider slavery universally reviled, even as it is still practiced in some parts of the world. We abhor torture, even as we teach other countries (our neighbors to the south, for example) to do it. We are quite sure we long ago gained the pinnacle of civilization, and yet children did not begin to be valued as "little adults" until after the Industrial Revolution and the rise of the "middle class." Child labor laws were tacitly upheld by Teddy Roosevelt (he refused to meet with "Mother Jones" when she lead a "Children's Crusade" march to his summer home in upstate New York when he was President). It was later into the 20th century than most of us think before child labor was outlawed. When Jesus said "you must become like a child" to enter the basiliea tou theou, most NT scholars today agree that meant become as worthless as a child in 1st century Palestine, not innocent as a lamb in 19th century Britain (and then only if you were white and aristocratic).

But surely on more "serious" issues, such as death and torture, there has been agreement throughout time, or at least throughout Western culture?

... the modern liberal’s revulsion toward torture is unusual. As Nietzsche and Foucault remind us, through most of human history there was no taboo on torture in military and juridical contexts, and so no need to repress the infantile sadism that nature has be-queathed us. Indeed, Judith Shklar notes a remarkable fact, namely that cruelty did not seem to figure in classical moral thought as an important vice: "[O]ne looks in vain for a Platonic dialogue on cruelty. Aristotle discusses only pathological bestiality, not cruelty. Cruelty is not one of the seven deadly sins . . . . The many manifestations of cupidity seem, to Saint Augustine, more important than cruelty." It is only in relatively modern times, Shklar thinks, that we have come to "put cruelty first"—that is, regard it as the most vicious of all vices. She thinks that Montaigne and Montesquieu, both of them proto-liberals, were the first political philosophers to think this way; and, more generally, she holds that "hating cruelty, and putting it first [among vices], remain a powerful part of the liberal consciousness." Shklar also observes that putting cruelty first, as liberals do, incurs genuine moral costs: "It makes political action difficult beyond endurance, may cloud our judgment, and may reduce us to a debilitating misanthropy . . . ."

David Luban (pdf file) makes a compelling argument. His argument, in a nutshell, is this: "I am arguing that torture is a microcosm, raised to the highest level of intensity, of the tyrannical political relationships that liberalism hates the most." The arguments against it, he points out, are based on five "illiberal" motives: cruelty; victor's pleasure ("The predominant setting for torture has always been military victory. The victor captures the enemy and tortures him."); terror ("a practice that exists to make it easier to subdue and tyrannize people is fundamentally hostile to liberals’ political philosophy."); punishment ("Foucault argues that the abolition of punitive torture had little to do with increased humanitarianism. Instead, it had to do with a change in the distribution of crime in Western Europe. As the West grew more prosperous, property crimes eclipsed crimes of passion as a social problem. This led to calls for a milder but more certain system of punishments. The trouble with torture is that when the punishment is so awful, the temptation to mercy becomes too great. Imprisonment, out of sight and out of mind, replaced the public spectacle of torment."); and for extracting confessions.

Luband's thesis is to undermine the "ticking time bomb" scenario (which he does quite well), so we will leave him there and turn our attention to death. How do you see death? Your answer depends not on your humanity, but on your culture. For example:

Historian Philippe Ariès reminds us that death was a part of life. Medieval and early modern romances, chronicles and memoirs speak with one voice: when death knocked, the door was opened and the visitor was welcomed in remarkably similar ways.

Organization was essential. The dying person was responsible for the proper execution of his final exit. The doctor's principal task was not to delay death, but to guarantee that it was welcomed properly. And, indeed, the doctor wasn't alone. Family and friends gathered for the ceremony and the doctor was simply a face in the crowd. One and all understood their roles and the lesson that was imparted: they, too, would eventually be called.

The intimate relationship between life and death unfolded in unexpected places. The medieval and early modern cemetery was no less public place than the deathbed. For centuries, the activities we associate with the marketplace commonly took place in cemeteries, amongst the tombs and charnel houses. Merchants and scribes, musicians and dancers, jugglers and actors and, gamblers and the like sought to make a living in the company of the dead. When Hamlet clowns about with Yorick's skull, he's exceptional only in the fluency of his language.

This is where it gets interesting, of course. Is human nature really a constant across time? If so, in what? Our fear of death? That's another "explanation" for religion by the non-religious. But apparently the people of the "Middle Ages," a time dominated by the Church and death, were afraid of neither. "Memento mori" may have been the medieval equivalent of "Have a Nice Day," not a grim reminder of doom and despair. Death was certainly not a boon companion; but that which you can do nothing about, you soon learn to live with. It may be another irony of the law of unintended consequences that our ability to further and further postpone death has made us even more afraid of it than our ancestors. In some ways, surely, we are better off. But in some ways....

I used to live no more than 50 feet from a graveyard. Most visitors to my house considered that "creepy" if not "morbid." Graveyards used to surround churches, which were the center of social life in a community. Now even hospitals are out of the way places we only enter as patients or as family members. Graveyards are as far from sight as possible, and funeral homes handle burials because we don't want our worship spaces "tainted" with the memories of our loved one's last repose (I actually had many church members tell me this, as a reason not to hold a funeral at the church, and, indeed, most of the funeral services I have done have been in funeral homes).

We are terrified of death. When death knocks, we flee. Robert Redford, in his one appearance on "The Twilight Zone," actually played Death knocking on an old woman's door. She spends the episode desperately rejecting his entreaties, until she finally realizes he is not an enemy. She finally yields to the inevitable. Per this historian, our ancestors could not even have imagined such a tale.

And we can still do little more about death than our ancestors could. We despise torture because, as Luban points out, it violates our sense of individual sovereignty, an idea that is fundamental to our identity as human beings. Is fear of death as innate as abhorrence of torture? Perhaps not. Notice the connection between these two, a connection lost and sought to be regained today: community.

The liberal emphasis on cruelty focusses on the treatment of the individual, the 'sovereign' whom we have all learned to honor thanks to Romanticism. Cruelty is wrong because it involves inflicting intentional pain by an individual on an individual. Cruelty is what we accuse God of, when we suffer. Ivan Ilyich's burning question as he dies is not, "why death?", but, "why me?" What have I done to deserve such suffering? Job never accuses God of cruelty; nor do his friends, or even his wife. And yet we do. Are these things right? or wrong?

Is it possible to elevate cruelty to too great a vice? Don't we abhor torture because it is cruel? And yet we don't blink at cruelty imposed on 'others.' Cruelty is the worst of vices, but it is narrowly confined: it is what is done intentionally. Death in war is unintentional. Suffering in US captivity is "unsanctioned" or the fault of a "few bad apples." We blame the individual, never the system, and so the cruelty of poverty passes us by, the cruelty of hunger and homelessness escapes us. We don't blame the victims of Katrina when they are on their rooftops, but when they are in another city, we begin to wonder when they are going to take care of themselves. The cruelty of the circumstances, of the artificial constructs of cities and economies and societies, is never to blame. It is always the person, and since systems cannot intend to harm, only people, well, there really is nothing cruel about it.

Death is never systematic, either, except when it is. Death from warfare, from pestilence, from poverty, doesn't disturb us. We hear of 200 dead in Iraq this week and, like the body counts from Vietnam, we don't throw up in our morning coffee, we reach for the cinnamon rolls. And yet when it is our turn to die, or for a loved one to die....

Death is harsh, of course. It is painful, it is sad, it is cruel. But is that because it is the nature of death to be so, or because of the nature of our understanding, our cultural response to death? What if we greeted it as our ancestors did? What if we welcomed it as a part of life? How could we do that, except in community?

The horror of death for Ivan Ilyich is that death is for him alone. Only at the very end, literally in extremis, when he screams for three days without ceasing, but is unaware of his screaming, only then does he reconcile with his family, if only in his own heart, and only then does he welcome the inevitability of death. Indeed, at that point death is gone, it is, in the words of John Donne, "no more." Death itself dies. Why? Because he is not alone.

Cruelty is cruel because it marks us as alone, as separate, as wholly apart. Cruelty is the worst vice because it is inflicted personally upon each of us, personally. But what if who we are were less important than who we are among? What if who we are were less important than who we were with? What if what we shared mattered more than what we have done, acquired, accomplished, made? What if it were more about each other, and less about each one of us? From where we are now, without "going back" (as if we could), would we be closer to removing death's sting? Would we get closer to abolishing torture and cruelty?

Or are we doomed to always struggle for power, always argue over who has the right to be in control?

Ash Wednesday 2009

ASHES, ashes, all fall down. How could I have forgotten? Didn't I see the heavens wiped shut just yesterday, on the road walking? Didn't I fall from the dark of the stars to these senselit and noisome days? The great ridged granite millstone of time is illusion, for only the good is real; the great ridged granite millstone of space is illusion, for God is spirit and worlds his flimsiest dreams: but the illusions are almost perfect, are apparently perfect for generations on end, and the pain is also, and undeniably, real. The pain within the mill-stones' pitiless turning is real, for our love for each other-for the world and all the products of extension-is real, vaulting, insofar as it is love, beyond the plane of the stones' sickening churn and arcing to the realm of spirit bare. And you can get caught holding one end of a love, when your father drops, and your mother; when a land is lost, or a time, and your friend blotted out, gone, your brother's body spoiled, and cold, your infant dead, and you dying: you reel out love's long line alone, stripped like a live wire loosing its sparks to a cloud, like a live wire loosed in space to longing and grief everlasting.--Annie Dillard

Memento, homo, quia pulvis es, et in pulverem revertis.
Remember, human, that you are dust, and to dust you will return.--Genesis 3:19

Upon the Image of Death
By Robert Southwell

Before my face the picture hangs
That daily should put me in mind
Of those cold names and bitter pangs
That shortly I am like to find ;
But yet, alas, full little I
Do think hereon that I must die.

I often look upon a face
Most ugly, grisly, bare, and thin ;
I often view the hollow place
Where eyes and nose had sometimes been ;
I see the bones across that lie,
Yet little think that I must die.

I read the label underneath,
That telleth me whereto I must ;
I see the sentence eke that saith
Remember, man, that thou art dust!
But yet, alas, but seldom I
Do think indeed that I must die.

Continually at my bed's head
A hearse doth hang, which doth me tell
That I ere morning may be dead,
Though now I feel myself full well ;
But yet, alas, for all this, I
Have little mind that I must die.

The gown which I do use to wear,
The knife wherewith I cut my meat,
And eke that old and ancient chair
Which is my only usual seat,—
All these do tell me I must die,
And yet my life amend not I.

My ancestors are turned to clay,
And many of my mates are gone ;
My youngers daily drop away,
And can I think to 'scape alone?
No, no, I know that I must die,
And yet my life amend not I.

Not Solomon for all his wit,
Nor Samson, though he were so strong,
No king nor person ever yet
Could 'scape but death laid him along ;
Wherefore I know that I must die,
And yet my life amend not I.

Though all the East did quake to hear
Of Alexander's dreadful name,
And all the West did likewise fear
To hear of Julius Cæsar's fame,
Yet both by death in dust now lie ;
Who then can 'scape but he must die?

If none can 'scape death's dreadful dart,
If rich and poor his beck obey,
If strong, if wise, if all do smart,
Then I to 'scape shall have no way.
Oh, grant me grace, O God, that I
My life may mend, sith I must die.

On Death:

Historian Philippe Ariès reminds us that death was a part of life. Medieval and early modern romances, chronicles and memoirs speak with one voice: when death knocked, the door was opened and the visitor was welcomed in remarkably similar ways.

Organization was essential. The dying person was responsible for the proper execution of his final exit. The doctor's principal task was not to delay death, but to guarantee that it was welcomed properly. And, indeed, the doctor wasn't alone. Family and friends gathered for the ceremony and the doctor was simply a face in the crowd. One and all understood their roles and the lesson that was imparted: they, too, would eventually be called.

The intimate relationship between life and death unfolded in unexpected places. The medieval and early modern cemetery was no less public place than the deathbed. For centuries, the activities we associate with the marketplace commonly took place in cemeteries, amongst the tombs and charnel houses. Merchants and scribes, musicians and dancers, jugglers and actors and, gamblers and the like sought to make a living in the company of the dead. When Hamlet clowns about with Yorick's skull, he's exceptional only in the fluency of his language.

By the late eighteenth century, language and attitudes began to change. Public authorities tried to stop profane activities in the newly redefined sacred spaces like the cemetery. At the same time, doctors began to sound the way they do today: the crowd of family and friends around the deathbed, they complained, complicated the job of attending to their patients.

Death thus got away from the dying person; it became the responsibility of others. It is only recently, with the rise of the hospice movement, that we're reminded of the ways in which we formerly responded to death. The recognition of death's finality, the planning for its arrival, the gathering of family and the redefinition of the physician's task: rather than confronting a brave new world, we seem to be returning to a simpler and older world. Ariès called this older understanding "tamed death." According to him,

the old attitude in which death was both familiar and near, evoking no great fear or awe, [is in] marked a contrast to ours, where death is so frightful that we dare not utter its name. I do not mean that death had once been wild and [is no longer], I mean, on the contrary, that today it has become wild.

And death has, in part, grown wild through the very tools with which medical science tries to domesticate it: an irony that would not be lost on Hamlet's creator.

The church year is meant to recognize all aspects of life. Why should we not also recognize death?

DEATH be not proud, though some have called thee
Mighty and dreadfull, for, thou art not so,
For, those, whom thou think'st, thou dost overthrow,
Die not, poore death, nor yet canst thou kill me.
From rest and sleepe, which but thy pictures bee,
Much pleasure, then from thee, much more must flow,
And soonest our best men with thee doe goe,
Rest of their bones, and soules deliverie.
Thou art slave to Fate, Chance, kings, and desperate men,
And dost with poyson, warre, and sicknesse dwell,
And poppie, or charmes can make us sleepe as well,
And better then thy stroake; why swell'st thou then;
One short sleepe past, wee wake eternally,
And death shall be no more; death, thou shalt die.--John Donne

THE cross, with which the ashes are traced upon us, is the sign of Christ's victory over death. The words "Remember that thou art dust and that to dust thou shall return" are not to be taken as the quasi-form of a kind of "sacrament of death" (as if such a thing were possible). It might be good stoicism to receive a mere reminder of our condemnation to die, but it is not Christianity.--Thomas Merton

"My death, is it possible?"

Apparently the mere contemplation of that question with regard to healthcare is enough to send some people over the edge into gibbering madness. Or, at least, the opponents of any change to the American health care system hope so. "Death panels" fizzled out and has now been replaced with a VA "Death Book." The real issue, however, is not death; it's living wills; it's health care directives.

I noticed this when watching the televised version of Jon Stewart's interview with Betsy McCaughey. She really didn't coin the term "death panels" (that was Sarah Palin), and she really seemed less worried with government cutting off funding for the elderly at the end of their lives (though she insisted that was part of the law). Her fundamental, but unspoken, concern, was with the entire concept of a 'living will.' And really, that's not an insignificant issue.

We all imagine, when we are hale and healthy, that a lingering death would be the last thing we would choose. We also all imagine, when we are imagining our end of days, that we will be in complete control of the situation, and the end of life, like the end of a movie, will be clear, and we'll both know it is coming, and know when it will come. We imagine, in other words, that we will be in control until the end, and that we will "pull the plug" without fear or concern about what comes 'after.' If anything comes after. What we don't imagine, of course, is "after." Or we do, but we imagine it to be simply a continuation of what we've known since we became self-aware. Perhaps we imagine a bright light, or a long tunnel, or some kind of gauzy body lifting up out of this all too-material, all-too fleshy, one. Perhaps we imagine nothing at all, but what we don't imagine, is our annihilation. We imagine our pain, our suffering, and we imagine ending it. What we don't imagine is how permanent that ending is. We think a "living will" means control over our suffering, which we fear when we are healthy. We never imagine it means the end of all sensation, permanently. We don't imagine it because we can't imagine it.

I know many people who talk about what they want for their funerals. It's funny, and I seldom remind them, but they won't be there to care. We imagine our death, but we imagine observing our death, even observing our own funeral. But you won't be there; not so far as we know, anyway. We can't imagine death as just a transition to another state of being. We have to imagine death as it really is: the cessation of life. We have to face that squarely, even those of us who consider ourselves Christians, who think we have souls which are immortal. If death is not real, then the crucifixion is not real, and Christ never died, and the resurrection was just a puppet trick. No matter the theology, we have to face the reality. Death is the end. Death is when we leave, never to return. So an advanced directive, a "living will," should, ideally, be approached soberly and seriously. Because how you feel about death when you are healthy, may not at all be how you feel about death when you are dying.

I understand in medieval Europe death was often greeted as a friend, because death could bring relief from suffering. It's understandable, with modern medicine, that we've changed our thinking about that. But we still fear chronic pain, and rightly so. I know people living in pain today which modern science cannot alleviate. It is not pain enough to make them welcome death. But I've seen people die of cancer, where the only alleviation of pain was morphine, which is as close to the embrace of Morpheus as we can get on this side of the line between living and dead. I am not arguing against living wills here; but they are curious documents we examine all too lightly, that we sometimes don't consider at all. We just assume they will put us in control, and we move on.

But when it comes down to it, what if we aren't ready to die? What if we are not prepared? Ironically, that's the purpose of all the language in the law about counseling and consultation; it's a regard, a reverence, a protection of life. The real perversion of the discussion is not the fear that the living will want to discard the dying as an inconvenience; it is that we will do it in order to save money. It is, in other words, a perfectly American obsession, where "obsession" is a euphemism for "fear."

That fear has a root, and it's not entirely an irrational one. The root is in the very nature of our healthcare system:

Alone among advanced countries, we treat health care like a market commodity to be distributed according to the ability to pay, not like a social service to be distributed according to medical need.

Ay, there's the rub: we've reduced health care to a market commodity. Why not reduce patients to commodities, too? Why, we do!

For nearly two-thirds of Americans, we rely on hundreds of private insurance companies to set prices and benefits and pay providers. They profit by refusing to cover the sickest patients and limiting services to others. In fact, we have the only health system in the world based on avoiding sick people. Insurers cream 15 to 25 percent off the top of the premium dollar for profits and overhead (mainly underwriting) before paying providers.

And now, of course, we are afraid; we are very afraid. We are afraid that if we wake up and face the monster we have created, it will devour us. We are afraid that if we challenge the system that is killing us, it will abandon us. We are afraid that if we don't sacrifice the sick in order to save the healthy, we will all perish. And that is precisely what we fear most of all: that we will perish. Our death is not really possible; and yet we fear, we know, that it is. But it isn't death we fear; it is the living death. It is death-in-life; like suffering; or having to to go the emergency room, because you have no health insurance. And being hounded, ever after, by hospital bill collectors; because we all know emergency room care is not free. But where did we get the idea that money is more important than people? I can't imagine. Maybe Neil Cavuto could explain it:

He [Obama] has a moral obligation to protect our financial dignity. He has a moral obligation to protect our currency and our system. He has a moral obligation to protect our financial way of life.

I imagine Mr. Cavuto also complains about "death panels" and "death books," with no hint of irony or contradiction. But applied to the rest of us, I'm not being caustic when I say these things. I'm serious. We fear suffering, and we fear humiliation; and we fear being out of control. But, of course, we aren't in control now; the health insurers are. They tell us who go see, what to get treated for, what drugs we can take. And if we live long enough, we all hope to get on Medicare; as long as it promises not to kill us.

Or maybe we aren't that afraid. FoxNews and conservative pundits certainly think we are; but the polling doesn't support it. Charles Grassley has already started walking back his comments about "killing grandma," claiming the audience at the town hall meeting made him talk about it, and President Obama put the objectionable words in his mouth. "Death panels" didn't last long enough to start a prairie fire in a dry month, so it's already been replaced with a "death book." Yes, our discourse is stupid, but largely because cable TV needs something to fill 24 hours with when Congress is not in session. There's precious little evidence any of this is gaining any traction in the larger public debate, or is changing the votes of any Democrats (the votes of Republicans seems to be a foregone conclusion; all signs of change there have been false ones).

Still, there is an interesting revelation in the idea that the government would urge people to die (especially veterans; apparently if the gov't didn't kill them in battle, it wants to get rid of them in the VA health care system) simply to save money. This would be the same government that is wildly spendthrift when it comes to social programs (and never when the money is spent buying weapons systems). One can point out the inane inconsistencies all day. It is the common thread that is interesting: what most disturbs these critics is the fear that their worship of money will fully take hold, and devour them and their world; that we will all finally know the cost of everything and the value of nothing. That may not be the fear that drives them to go on TV or write blog posts, but it seems to have been the fear that sparked Betsy McCaughey; and certainly the fear you feel is easier to promote than the one you don't.

"Whose life is it anyway?"

I'm not a fan of either euthanasia or assisted suicide, because I don't think the title question is correctly answered by advocates of either when they say "It is the individual's life!"

That was Ilyich's problem, according to Tolstoy; only in the extremis of death did Ilyich realize the importance of this family, and the importance of life, and the simple fact that we are not in charge, not in control, not in the position to make last determinations; that only in losing what is most important to us, do we finally understand what is most important.  Or:

"Brittany Maynard's gesture is in itself to be condemned, but what happened in her conscience is not for us to know," Ignacio Carrasco de Paula, president of the Pontifical Academy for Life, told ANSA.

"We always choose by seeking what is good, the problem is when we get it wrong," he continued "Conscience is like a sanctuary that cannot be entered. But let's reflect on the fact that if one day the project according to which all patients take their own life were to be fully realised they would be totally abandoned," Carrasco de Paula said.

"Society does not want to shoulder the cost of disease and this risks becoming the solution," he continued. "This woman (took her own life) thinking she would die with dignity, but this is the error, suicide is not a good thing, it is a bad thing because it is saying no to life and to everything it means with respect to our mission in the world and towards those around us," he said, describing assisted suicide as "an absurdity".

"...because it is saying 'no' to life and to everything it means with respect to our mission in the world and towards those around us."  In some environs, that statement is being taken as an arrogant assertion of dominion over others.  I see it as an assertion of life over selfishness, of community over individuality, of love over death.  What is the mission of the individual in the world, according to American secular thinking?  To pursue happiness?  And when you cannot do that any longer, to die with dignity?  Should the chronically poor, then, be assisted in killing themselves so their suffering will end?  No?  Why not?  Why is Brittany Murphy privileged to end her suffering, but the poor are not?  "Tell me, if you know and understand."  The poor are denied life with dignity; why do we deny them death with dignity?  Because death should be denied until it is inevitable, but before it is irreversible?  Or before it is uncomfortable?  Uncomfortable for who?

Whose death is it, anyway?

What is our mission in the world, and to those around us?  Are we sadistic to insist on pain and suffering before death?  Can we not avoid pain, too, and simply die because death is inevitable, and the knowledge of our mortality taints our pleasures?  Can we not involve others in our death, so we can be in control, so death can be comfortable, so we avoid the horrors of natural death or of the death penalty in Oklahoma?

Whose life is it, anyway?

Do we live for those around us, or for ourselves?  Is life our possession, or is life our gift?  Is death our triumph, or is death our conclusion?  Brittany Murphy wanted to be victorious over death.  Or did she?  Is that issue a matter of conscience, or a matter of interpretation?  When we have lost everything of importance, do we discover what is important; or do we find we have merely lost everything?  And how do we know, until it happens?

"Death is the only experience of life that is not lived through."--Ludwig Wittgenstein

Aye, there's the rub!  That bourn from which no traveler returns!  So does the assisted suicide embrace death?  Or cheat it?  And is the death singular and sole, and the business of the deceased alone?  Or is it the ultimate choice of life, the ultimate decision in which one chooses for all?  And if it is the choice of one for all, does the decision mean no life is valuable, no one else's life matters, because ultimately yours doesn't?  Or does it mean the value of every life is measured against your own, and if yours can be ended so you can claim "dignity," what are you saying about others?  That their deaths are undignified, or don't matter, either?  What about those around us?  What does our choosing death mean not for, but about, them?

Assisted suicide is an absurdity; and not in the way Camus and Beckett and Sartre meant the term, either.

"To conquer death, you only have to die...."--Tim Rice

The "Terri Schiavo problem" is not over. It will merely go back to being private, to being personal; it will move out of the public eye again, and the ethics of the issue will fade. Or they will be debated in the simplistic terms of "Individual Right to life" v. "Individual Quality of life." Which isn't the debate at all; the debate is not about life, or when it begins. It is about death, and when death begins.

"Life," the sage told the king, is a mystery. It is like a bird that flies into your hall out of the storm, and flies across the room, through the noise and the lights and the gaiety and above the crowd, and then flies out again, through the opposite window, back into the storm. And where it came from, and where it went, we do not know. Until the years after World War II, and the discovery of antibiotics, we accepted life and death on those terms. Now we demand life, and we deny death. We insist that death be hindered, blocked, obstructed, and postponed, as long as possible. We have become as gods, with a power of life no generation has ever known before. But we still are not good at it. We still cannot make the decisions in foresight, only in hindsight. Would it have been better if Terri Schiavo had never been revived? This much we know about brain injuries: a loss of oxygen is not one the brain recovers from. But how much loss, and how much damage? We only know in hindsight. So how do we decide?

“ ‘Curse the day someone said ‘A child is born!’ ” That has long been our standard, in the negative: Job’s cri de coeur from the midst of his pain and horror; a wish to never have been born, rather than to suffer such anguish. But “man is born to suffer as surely as sparks shoot.” If eliminating suffering were indeed the highest purpose of life, the country would be chock-a-block with suicide clubs and euthanasia centers. It is not that simple. It is never that plain.

The questions here are the most fundamental possible: what is life? What is death? When does one, turn into the other? It used to be easy to tell. And then a wave of stories of premature burials swept 19th century America (at least); brought on no doubt by infections and diseases that reduced people to death-like states, but did not take them quite yet away. And now we have technology: respirators, feeding tubes; dialysis machines: all manner of replacing the ordinary functions with extraordinary functions; and we don’t know what to do with our new toys. The medical term “persistent vegetative state” only entered the medical vocabulary 30 years ago. Before that, there was no need to define it, because people in such a state died too quickly. Now we find it easy to keep the body alive; but the mind? Is there are mind at all is a fundamental question of materialist philosophy. Is it merely neurons and synapses and a rapid spray of impressions so complex and compelling it “seems” to be consciousness, the way the screen in front of me, and you, both of us reading these words, seems to be stable. Materialism may give us the ability to postpone the final breath almost to infinity, but can it give us “life into the ages”? That has been the promise made to Western culture for two millennia now, and we are anxious for its fulfillment.

Anxious, but uncertain about what we face. Sleep, a little rest, and then awake refreshed for eternity? Is death even a power, a thing, a “part of life”? Or is it just the end of the body? If the latter, then surely the longer we keep the body alive, the more good we produce. Yet clearly that is not so. What, then, is death? A crossing? A doorway, a passage, a bridge between life and….? We don’t know. And that is why we stay afraid, and uncertain, and beat drums and cry tears and howl rages and sometimes refuse to go gentle, sometimes refuse to go at all.

The irony is, this was not possible until medical technology and materialism made it possible. And the very philosophy that makes it so, denies that there is a problem to be concerned about. “My death; is it possible?” (Jacques Derrida) To the materialist, the empiricist, the positivist, the question is absurd. Of course “your” death is possible; it is even inevitable. But what does it mean to say “mine,” or “yours.” Is death something I can possess? Let me give it away then, and own it no more! Is death mine alone, personal, wholly existential and unknown to anyone else? Funerals and the circus surrounding Terri Schiavo’s existence prove that wrong. If death can be said to be “yours” as well as “mine,” what are we talking about? A thing, an object, an idea? All can be subject to possession, materially or at law. But is that what we mean by death?

The resurrection brings these questions into focus, too; but it doesn’t answer them, either. It, too, is personal, we say. Certainly belief in it is personal; understanding of it is personal; acceptance of it, is personal. At the end of Mark’s gospel, the earliest in the canon, Mary of Magdala, and Mary mother of James (and Jesus), and Salome, come to the tomb, and find it empty, and the angel tells them they will see Jesus in Galilee. But they run away, scared almost literally to death. By Luke’s gospel, Jesus appears in a different guise, and is only recognized when he wants to be, and seems to appear and vanish at will. John’s gospel is at great pains to make Jesus whole, not a ghost: he cooks and eats fish; Thomas touches his wounds. But Jesus appears in a locked room, and vanishes, and is clearly no longer wholly human. What mystery is this? How do we accept this, possess it, grasp it with out understanding? At least three ways are offered, and none of them exclusive.

Is death the end of physical activity? Is that all we are, the sum of our actions, and so long as some activity can be maintained, we are alive? To end that, surely, is to perform an execution. To remove wind, or food, or water; those things we can supply, can do for a body that finds any one, or all of them, no longer possible. Is this the promised “life into the ages”? And if it is not, how do we know when that life comes?

I have turned these matters over in my mind, and, in the words of the narrator of the novel The Good Soldier, it is all a darkness. It is all a darkness because too much is taken for granted, too little explained, and appearance determines all. Terri Schiavo cannot communicate. Is she dead, or alive? She can feel pain, respond to “noxious stimuli.” Animal reflex; or consciousness of agony? Is that consciousness momentary, perpetual, or non-existent. Is she, like the Sybil hanging in the cage, trying to tell us: “I want to die”? It is all a darkness. These are things we cannot know. But we have to decide; and we have to have a basis, on which to decide.

Tomorrow I will celebrate the resurrection of Jesus the Christ, the Son of God, the man of Nazareth. I do not quite know what these things mean, but I know they are true, and they can be trusted. I do not quite know what life means, either; or if death is a thing, or simply the end of activities we call functions necessary to sustain life. If the latter, then death is almost wholly in our control, and while we cannot create life, we can create and control death; and we are as god, or at least demi-gods. So I think death is more than that, because if our control has extended that far, then it has extended too far, indeed. It is extended not only into things we do not understand, but has completely exceeded our grasp. Browning said that’s what heaven is for. But I think heaven is for those who die, and experience the resurrection.

Addendum: this morning, I came across this, which only underscores my point: we need an ethic of death. Not of euthanasia, or suicide, but of death.

Ash Wednesday 2013

Ash Wednesday just seems to be one of those days on which fresh words are a stain on silence; and old words can be a source of revelation, if only because they remind us we are old, too; and our problems are old; and there is nothing new under the sun.

Which is a kind of blessing.

ASHES, ashes, all fall down. How could I have forgotten? Didn't I see the heavens wiped shut just yesterday, on the road walking? Didn't I fall from the dark of the stars to these senselit and noisome days? The great ridged granite millstone of time is illusion, for only the good is real; the great ridged granite millstone of space is illusion, for God is spirit and worlds his flimsiest dreams: but the illusions are almost perfect, are apparently perfect for generations on end, and the pain is also, and undeniably, real. The pain within the mill-stones' pitiless turning is real, for our love for each other-for the world and all the products of extension-is real, vaulting, insofar as it is love, beyond the plane of the stones' sickening churn and arcing to the realm of spirit bare. And you can get caught holding one end of a love, when your father drops, and your mother; when a land is lost, or a time, and your friend blotted out, gone, your brother's body spoiled, and cold, your infant dead, and you dying: you reel out love's long line alone, stripped like a live wire loosing its sparks to a cloud, like a live wire loosed in space to longing and grief everlasting.--Annie Dillard

Memento, homo, quia pulvis es, et in pulverem revertis.
Remember, human, that you are dust, and to dust you will return.--Genesis 3:19

Upon the Image of Death
By Robert Southwell

Before my face the picture hangs
That daily should put me in mind
Of those cold names and bitter pangs
That shortly I am like to find ;
But yet, alas, full little I
Do think hereon that I must die.

I often look upon a face
Most ugly, grisly, bare, and thin ;
I often view the hollow place
Where eyes and nose had sometimes been ;
I see the bones across that lie,
Yet little think that I must die.

I read the label underneath,
That telleth me whereto I must ;
I see the sentence eke that saith
Remember, man, that thou art dust!
But yet, alas, but seldom I
Do think indeed that I must die.

Continually at my bed's head
A hearse doth hang, which doth me tell
That I ere morning may be dead,
Though now I feel myself full well ;
But yet, alas, for all this, I
Have little mind that I must die.

The gown which I do use to wear,
The knife wherewith I cut my meat,
And eke that old and ancient chair
Which is my only usual seat,—
All these do tell me I must die,
And yet my life amend not I.

My ancestors are turned to clay,
And many of my mates are gone ;
My youngers daily drop away,
And can I think to 'scape alone?
No, no, I know that I must die,
And yet my life amend not I.

Not Solomon for all his wit,
Nor Samson, though he were so strong,
No king nor person ever yet
Could 'scape but death laid him along ;
Wherefore I know that I must die,
And yet my life amend not I.

Though all the East did quake to hear
Of Alexander's dreadful name,
And all the West did likewise fear
To hear of Julius Cæsar's fame,
Yet both by death in dust now lie ;
Who then can 'scape but he must die?

If none can 'scape death's dreadful dart,
If rich and poor his beck obey,
If strong, if wise, if all do smart,
Then I to 'scape shall have no way.
Oh, grant me grace, O God, that I
My life may mend, sith I must die.

On Death:

Historian Philippe Ariès reminds us that death was a part of life. Medieval and early modern romances, chronicles and memoirs speak with one voice: when death knocked, the door was opened and the visitor was welcomed in remarkably similar ways.

Organization was essential. The dying person was responsible for the proper execution of his final exit. The doctor's principal task was not to delay death, but to guarantee that it was welcomed properly. And, indeed, the doctor wasn't alone. Family and friends gathered for the ceremony and the doctor was simply a face in the crowd. One and all understood their roles and the lesson that was imparted: they, too, would eventually be called.

The intimate relationship between life and death unfolded in unexpected places. The medieval and early modern cemetery was no less public place than the deathbed. For centuries, the activities we associate with the marketplace commonly took place in cemeteries, amongst the tombs and charnel houses. Merchants and scribes, musicians and dancers, jugglers and actors and, gamblers and the like sought to make a living in the company of the dead. When Hamlet clowns about with Yorick's skull, he's exceptional only in the fluency of his language.

By the late eighteenth century, language and attitudes began to change. Public authorities tried to stop profane activities in the newly redefined sacred spaces like the cemetery. At the same time, doctors began to sound the way they do today: the crowd of family and friends around the deathbed, they complained, complicated the job of attending to their patients.

Death thus got away from the dying person; it became the responsibility of others. It is only recently, with the rise of the hospice movement, that we're reminded of the ways in which we formerly responded to death. The recognition of death's finality, the planning for its arrival, the gathering of family and the redefinition of the physician's task: rather than confronting a brave new world, we seem to be returning to a simpler and older world. Ariès called this older understanding "tamed death." According to him,

the old attitude in which death was both familiar and near, evoking no great fear or awe, [is in] marked a contrast to ours, where death is so frightful that we dare not utter its name. I do not mean that death had once been wild and [is no longer], I mean, on the contrary, that today it has become wild.

And death has, in part, grown wild through the very tools with which medical science tries to domesticate it: an irony that would not be lost on Hamlet's creator.

DEATH be not proud, though some have called thee
Mighty and dreadfull, for, thou art not so,
For, those, whom thou think'st, thou dost overthrow,
Die not, poore death, nor yet canst thou kill me.
From rest and sleepe, which but thy pictures bee,
Much pleasure, then from thee, much more must flow,
And soonest our best men with thee doe goe,
Rest of their bones, and soules deliverie.
Thou art slave to Fate, Chance, kings, and desperate men,
And dost with poyson, warre, and sicknesse dwell,
And poppie, or charmes can make us sleepe as well,
And better then thy stroake; why swell'st thou then;
One short sleepe past, wee wake eternally,
And death shall be no more; death, thou shalt die.--John Donne

THE cross, with which the ashes are traced upon us, is the sign of Christ's victory over death. The words "Remember that thou art dust and that to dust thou shall return" are not to be taken as the quasi-form of a kind of "sacrament of death" (as if such a thing were possible). It might be good stoicism to receive a mere reminder of our condemnation to die, but it is not Christianity.--Thomas Merton

 And, for Lent, this quote Rick provided me, from Chesterton:

Historic Christianity rose into a high and strange coup de théatre of morality -- things that are to virtue what the crimes of Nero are to vice. The spirits of indignation and of charity took terrible and attractive forms, ranging from that monkish fierceness that scourged like a dog the first and greatest of the Plantagenets, to the sublime pity of St. Catherine, who, in the official shambles, kissed the bloody head of the criminal. Poetry could be acted as well as composed. This heroic and monumental manner in ethics has entirely vanished with supernatural religion. They, being humble, could parade themselves: but we are too proud to be prominent. Our ethical teachers write reasonably for prison reform; but we are not likely to see Mr. Cadbury, or any eminent philanthropist, go into Reading Gaol and embrace the strangled corpse before it is cast into the quicklime. Our ethical teachers write mildly against the power of millionaires; but we are not likely to see Mr. Rockefeller, or any modern tyrant, publicly whipped in Westminster Abbey.

Which, again, gives me the excuse to mention this:

If the leper was removed from the world, and from the community of the Church visible, his existence was yet a constant manifestation of God, since it was a sign both of His anger and His grace: "My friend," says the ritual of the Church of Vienne, "it pleaseth Our Lord that thou shouldst be infected with this malady, and thou hast great grace at the hands of Our Lord that he desireth to punish thee for they iniquities in this world." And at the very moment when the priest and his assistants drag him out of the church with backward step, the leper is assured that he still bears witness for God: "And howsoever thou mayest be apart from the Church and the company of the Sound, yet art thou not apart from the grace of God." Brueghel's lepers attend at a distance, but forever, that climb to Calvary on which the entire people accompanies Christ. Hierarchic witnesses of evil, they accomplish their salvation in and by their very exclusion: in a strange reversibility that is the opposite of good works and prayer, they are saved by the hand that is not stretched out. The sinner who abandons the leper at his door opens his way to heaven. "for which have patience in thy malady; for Our Lord hateth thee not because of it, keepeth thee not from his company; but if thou has patience thou wilt be saved, as was the leper who died before the gate of the rich man and was carried straight to paradise." Abandonment is his salvation; his exclusion offers him another form of communion.

Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, tr. Richard Howard (New York: Vintage Books 1988, p. 6-7).

Ritual served many purposes in communal life. Sometimes I think it even served to create community, however flawed that community was.  But what life have we, if we have not life together?

Ashes, ashes, we all fall down.