Healing Death. Christopher Levan
to let things ride. Only a very few courageous ones can plan their ending with healing in mind.17
The new legal situation in Canada in which certain individuals can avail themselves of medical assistance in dying changes everything. It is now possible that some individuals could plan and prepare for their end with every expectation that it would happen within their control, that it would bring healing and offer greater hope and peace to those who are left behind. And while medical assistance in dying raises many complex ethical and spiritual dilemmas, it also offers the possibility to implement rituals and traditions that will bring healing to death. The latter portion of this text will examine what these rituals might be and how healing might take place.
A Good Death and a Bad Death
When asked, most religious leaders will confess that their best pastoral moments come during funerals. Most of us would much rather lead people through the valley of the shadow than down the aisle to a wedding.
At the graveside, we sense that matters are more real and human, since there tends to be less pretending when death is a visitor in the room. And we have been witness to both good and bad death.
During this research, I have been honored to hear the stories of the dying and have been given permission to make some of these tales public. Here’s a marvelous story of the good death. Kathryn told me of Sandy, her sister’s sister-in-law, who was living with ALS and was unable to continue.
Sandy decided to ask for medical assistance in dying. Having been given a permission and date, not only was she able to meet with friends and share some final words, she was able to invite her grandchildren to join her for one last shopping trip. Sandy loved to window shop, and so they all went to the mall, relived memories of past trips, and did some serious people watching while reveling in the life that was so evident in passersby. These grandchildren told their grandmother how important she was, how much of a difference she had made in their young lives. Finally, Sandy’s husband joined them for lunch, and then Sandy went home to die, content she had closed the circle and left her offspring with one final memory.18
Can you picture this scene? It seems so simple and unremarkable, but alas, it doesn’t happen often. Perhaps we should take a pause here. Take a deep breath and ponder how unique and yet how important it is to praise an elder for their love. And more, to know that they have heard us. Imagine this! In Sandy’s case, this leave-taking was a lively dialogue rather than the less satisfying monologue that characterizes most funerals. A granddaughter sat beside her and spoke of her love. Of course, Sandy knew she was loved, but now her granddaughter knew that Sandy had heard clearly how important that was. Is there any better way to complete the circle of compassion?
A good death!
After Kathryn finished telling the story, I was blessed with a vision . . . this is how dying can be a healing moment. ALS finally killed Sandy, but she died a healed woman, leaving behind children and grandchildren, who did not deny death or pretend it away but who incorporated it into their living. The model of this good death gave me a vision of how we might establish a better ritual practice around our dying.
In tragic contrast, I officiated at a funeral many years ago, where everyone was speechless. The actual ceremony was not exceptional—a polished casket, a large crowd, many words of gratitude and a good measure of grief. It was the potluck after the internment that was unsettling. This woman had died as she lived, denying most facts and manipulating those around her to do the same. There had been no succession planning, no final reckoning, no farewells or forgiveness. Many of the damaging dynamics of the family had been perpetuated. I could taste the animosity sparking from one side of the table to the other. It was only after that I realized the seating had not been random—the family had quite literally lined up against each other—one side of the table refusing to co-operate with the other. There was a daughter-in-law who refused to take part in anything, an ex-partner of one of the children who had co-opted the role of host and made sure to stir the pot with old memories. No one could venture a reconciling gesture, and everyone spoke of the deceased in completely one-dimensional ways for fear of causing an argument. Rather than closing the circle and bringing resolution, the funeral was like the starter’s pistol shot announcing a new race of recrimination.
As I sat eating my scraps of ham, I thanked my lucky stars that I had only to offer a prayer at their dinner and did not have to stick around for the reading of the will, which one of the siblings had produced with great flair. Let the battle begin . . . again!
This was a bad death. There was no healing in this person’s dying, but just a perpetuation of the discomfort and hard feelings that had characterized her living.
Finding a Path to Healing
It is to offer alternatives to such a “bad death” that I present this text. Of course, human beings are not programmable. We cannot always avoid the contradictions and contingencies that cause us anguish and pain. Blind self-absorption and power-hungry enmity cannot be cured by a few words, no matter how well chosen. Likewise, the bent dynamics of a family will not be healed by medical assistance in dying. After all, people spend a whole lifetime creating their own unique problems. The few brief days preparing for death will not alter those troubles very much. But, perhaps some broken relationships can be restored with adequate planning and reflection.
This text is offered as a guide to the current new situation. As mentioned above, it posits the possibility that death can be a healing moment. To explain this proposition, the first chapter will lay the groundwork for the current legislative and pastoral situation. There are essentially five sets of facts to consider as a background to the thesis that dying is a healing moment in human living. First, we must take into account the historical background to the new legislation, Bill C-14. To do this, we’ll explore a brief history of the two legal challenges which resulted in a change in the Criminal Code. In the second place, it is essential that we familiarize ourselves with the actual regulations that govern medical assistance in dying. It may come as an unsettling surprise what is and what is not actually covered by this legislation. A third “fact,” is the role health care professionals play in implementing medical assistance in dying. The legislation has been written to place a great deal of discretion and responsibility on their shoulders. And, currently, the response from medical professionals has been inconsistent across the country. A fourth factor raised by some people I have interviewed is the structural discrepancies and inadequacies faced by those who seek medical assistance in dying. This is such a new “procedure” or “service” that we do not have a consistent way of implementing and supporting it. Our health system has been oriented in the opposite direction: the preservation of life. To contemplate and plan for death runs against the grain of much health care training, and consequently, it appears initially more like a defeat than a solution. Thus, currently, our institutional and personal resources are not oriented to assist with it. Finally, any text exploring how death can be a healing event must consider the cultural and spiritual resistance to ending life. Our culture has been shaped by a religious stream that has condemned the intentional ending of life.
And this fifth fact becomes the subject of the second chapter, in which I will examine the Abrahamic religions: Judaism, Christianity, and Islam, and their respective responses to medical assistance in dying. It has been a tradition for over 3,000 years that the belief in an all-powerful Creator has meant that believers would not transgress the final divide and presume to end their lives before their appointed time, as if they were beyond the Creator’s control. Recently, some Protestant churches have nuanced this position with pronouncements that would allow for some exceptions, notably abortion and now medical assistance in dying.19 This chapter will take a closer examination of a position, taken by the United Church of Canada, which promotes itself as a “balanced” position.20
Moving from the explicit theological objections to ethical propositions, the third chapter in this book will explore how the advances in medical technology have considerably confounded a neat distinction between living and dying. The argument advanced by some conservative religious traditions that we should not “play God” by ending life prematurely or intentionally, is either unaware of or unwilling to admit the fact that we have long passed the time when God was the singular agent involved in our living and dying. Modern science has