Comment Comment and Features

Death is not always ‘a terrible tragedy’

Author Atul Gawande tackles our confused thinking about mortality

We must hope that the Assisted Dying Bill will not pass its second reading in the House of Commons on September 11 – coincidentally America’s infamous “9/11”. Apart from ethical considerations, it seems to me that society’s whole attitude to death and dying is a muddle, and we need seriously to re-think our end-of-life philosophies.

On the one hand, society regards death as something to be avoided at all costs. On the other, we are increasingly urged to see it as a “choice”, whereby we can have more “control” of our bodies.

This struck me forcibly after my husband’s death last spring. I much appreciated the kind words of condolence and sympathy – these are always a comfort, no matter what form they take, be it calls, letters, cards or even texts. And yet I was taken aback by some of the attitudes to a natural death at the end of a long life. This was often seen as a dreadful event which, somehow, could have been prevented – “a terrible tragedy”.

The death of a young person certainly is tragic, and all loss brings sadness and grief. Yet death, especially in old age, is also a natural process which we must all eventually face. To live into old age is an accomplishment for which we should be thankful; and to leave the stage gracefully, when nature and the Almighty beckon, is part of life’s cycle.

But modern medicine and health care have trained people to think that if we quit smoking, take our statins, keep our weight down and our brains engaged we are entitled to live forever. Even moving towards the end of life, heroic efforts are often suggested to prolong it. Doctors, terrified of being sued, will do anything to show they are keeping a patient alive – that is, never letting nature take its course.

There is such a contradiction between a horror of a natural death, and simultaneously a demand to allow doctors to kill.

The physician Atul Gawande addresses some of this confused thinking today in his book Being Mortal: Illness, Medicine and What Matters in the End. It’s an informative reflection on the end of life, though it perhaps omits the spiritual perspective which would be important to people of faith.

But he does suggest we see the cycles of life as having a natural course, rather than trying to “fix” everything by emphasis on “choice” and “control”.

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An extended version of this article first appeared in the print edition of the Catholic Herald magazine (11/9/15)

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