For A Dying Christian Friend in a Hospice
An unexpected friendship forms in hospice as the end of life nears
On Sept. 24, Jen Moss (right) took Jody Wooton to Kauffman Stadium, where they cheered as the Royals beat the Seattle Mariners 10-4 to clinch the American League Central Division on their way to winning the World Series. Both kept a copy of this photo.
BY ERIC ADLER
Jen Moss took to Jody Wooton from the first moment they met.
Jen, 41, the hospice nurse. Jody, her irreverent patient, all but spitting in the eyes of her doctors.
‘Refuse treatment and you won’t live two months,’ ” Jody remembers one doctor chiding her. Jody, 64 and with a wilting heart patched together with a quilt of 11 stents, glared back at him through rectangular glasses.
“Only two months? I usually get four, you know!”
Jen, whose own life has been touched by violent death in ways few have experienced, so wants to give Jody the good and peaceful death she deserves.
Jen admires her spunk, seeing behind what even Jody’s family recognizes is a sometimes cantankerous cover.
The way Jody sees it: hell if she is going to take more of that “crap,” as she puts it, from some pissant physician who felt it was his duty to pump her full of meds and IV fluids until her body bloated and her fingers swelled blood sausage. It had happened before.
“Couldn’t wear my clothes,” Jody complains.
Three times over a decade, doctors said she might die from her bad heart. In March 2015, she actually did, but doctors jolted her back.
When she woke in recovery, oxygen and IV lines crisscrossing her body, she excoriated hospital workers.
“I said, ‘What the F are you doing?’ I had a DNR!” — a do-not-resuscitate order. But the hospital couldn’t find its copy, so the doctors brought her back to life.
After that, she was fed up.
“Wouldn’t back down for anything or anybody,” says Jody’s brother, John Kerby, 54 and a trooper with the Kansas Highway Patrol. “Everybody was a friend, unless you gave her reason not to be.”So that was it. Call hospice, Jody told her sister. Jody was already widowed, terminally ill, no kids.
“I will be here as long as I’m supposed to be here,” she says now. “Nobody is going to tell me that I have to do this right now, or that right now.”
She will die on her terms.
“If I’m doing this,” Jody says, “I’m doing it my way.”
It’s a choice that ever more people are making in the United States. From a handful of nonprofit programs in the 1970s, hospice care has exploded to more than 6,100 programs, most of them for-profit today. Hospice now is a $15 billion a year industry.
Of the 2.6 million Americans each year who die, almost half, 1.2 million, die in hospice care. Their family members can take some semblance of peace knowing they died not alone in a hospital, but among loved ones in the place they saw as home.
Jen works at Kansas City Hospice & Palliative Care, which was one of the first hospices in the area when it opened in 1980 with two nurses and 13 patients.
Today the nonprofit employs 177 nurses, along with chaplains, social workers, counselors and nurse aides, who care for some 2,300 patients a year. There’s Jen’s “blue” team for home care, a “red” team for nursing homes, a “gold” team for both and a “carousel” team for terminally ill children.
The program is only one inside a crowded field of nearly 40 Kansas City area hospices. Elaine McIntosh, president of Kansas City Hospice, calls it “one of the most competitive areas in the country.”
Job chooses Jen
Neither Jody nor Jen anticipated the connection they’d find in hospice.
On a chilly morning in February, the nurse, just over 5 feet tall and with a tumble of shoulder-length black hair, rolls her silver Ford Fusion to a stop across the street from Jody’s home in the Overland Towers Apartments, an eight-story complex for senior citizens at 86th and Farley streets in Overland Park.
She gathers her belongings, grabs her stethoscope and checks her satchel, which contains a tablet computer with the names and medical records of Jen’s 13 patients: another woman, 64, dying of congestive heart failure; a 66-year-old man with Alzheimer’s; a father of three children, age 60, with bone cancer.
Among the patients she will see later: Al Jensen, a 90-year-old Navy veteran of the Normandy invasion who until recently has been as healthy as a war horse. His goal was to live 10 to 20 more years, but that was before doctors discovered more than a dozen cancerous tumors riddling his insides.
“Morning,” Jen says cheerily as she enters the Overland Towers lobby. A smattering of residents with canes or walkers smile and wave from their chairs.Truth be known, as a self-described optimist and mother of three lively sons, Jen never in her wildest imaginings thought she’d be doing this job.
When she started her nursing career, it was in a hospital’s orthopedic/neurological unit, followed by neonatal intensive care. She moved to a dermatology practice and had a friend who’d become a hospice nurse. Jen recalled thinking, “Who in their right mind would choose to be surrounded by dying people every day?”
At Rockhurst University, one of Jen’s nursing professors spoke glowingly about it.
“My God,” Jen remembers thinking, “that sounds awful.”
But after two years with Kansas City Hospice & Palliative Care, she has come to experience the job’s grace, along with the deep, even spiritual satisfaction that accompanies her connection to patients and their families at one of the most difficult moments in their lives.
More, Jen wonders whether this is what her grandmother was talking about when she assured Jen, especially in her darkest moments, that “God has a plan for you.”
“Sometimes you don’t choose a job,” Jen says. “It chooses you.”
Who better to choose than someone Jen, with a tragic past few could fathom?
“My sister says I should have been on the Oprah show,” she says. “My whole life has been dramatic, surrounded by death. My life has led me up to this job.”
Living around death
If divine or cosmic plans exist, Jen would argue that hers was set in motion months before she was born. That’s when her biological father, at age 23, died in a car wreck. Her mother, married at age 18, was just 19 and three months pregnant with Jen. Now she was a teenage widow.
Years later, as Jen herself was turning 19 — a year after her graduation from Park Hill High School — she also became pregnant and in 1994 had Neil, the first of her sons. Becoming a nurse had been a lifelong goal, “but college went by the wayside,” Jen says.
Instead, as a single mom, she worked for years as a waitress and bartender on the County Club Plaza, where she fell in love with Eduardo Gonzalez, a handsome dishwasher from Mexico.
They married in Las Vegas. They had a son, Frankie, in 2000. The family of four was happy.
Until, on a September night in 2002, Eduardo went out with his brother. Jen had an ill feeling.
“That night I knew. I just knew,” she says. “I’m , ‘Don’t go. Don’t go.’ He’s saying, ‘Why not?’ ”
The call later broke the night’s silence: Come quickly to St. Luke’s Hospital. There had been a fight and, as Eduardo ran to protect his brother, a gunshot. Jen burst through the emergency room doors and was given word.
“I heard screaming,” Jen recalls. It filled her head but seemed far off. The voice was hers, echoing in her ears as she disassociated from the tragedy. “The next thing I know, I’m against the wall on the floor.”
Jen was 28, widowed with two children. Family and friends gathered around her, including her cousin, Tony Rios, who was Jen’s age, and Olivia Raya, Tony’s 26-year-old girlfriend, who was soon to graduate from Rockhurst University. It was Olivia who had been urging Jen to fulfill her dream: Go back to college. Become a nurse.Then, three months later and days before Christmas, Jen had a dream. It was beautiful.
“I’m sleeping,” Jen says. “It’s a white light, and we’re spinning in a circle: me, Tony and Olivia. And they’re telling me that they’re OK, everything is going to be OK. It was just this overwhelming calm. I was , ‘Oh my God, I have to call him.’ ”
The next morning, a call came her way.
Tony and Olivia were dead, slain in their Kansas City home in a robbery/drug deal. Olivia, who had just graduated from Rockhurst, had been writing thank-you notes when it happened.
Jen loved her wayward cousin deeply. She had been aware that he dabbled in drugs but had no idea how seriously deep it had become.
Still grieving after the murders, she entered nursing school, where she would hear the professor talk about hospice. Married again in 2009 — to Micky Moss, a Sprint engineer, and after having a third son, Everett — she thought she had something to give.
Jen knew grief and the complications of families. Having experienced violence in life, having seen how impersonal and undignified death could be, she thought maybe she could turn it into something more graceful.
Stories of intimate connections with death are hardly uncommon among those who choose to become hospice workers. Nurse Julie Griggs, 59, who trained Jen, came to hospice 12 years ago after spending 12 years treating patients in hospitals, where she thought so much of care, including death, had turned too clinically rote and impersonal.
Jen, colleague and social worker Crispian Paul, 37, had also experienced tragedy, the death of her 16-year-old sister in a wreck when Crispian was 12. Her mother later died of domestic violence. Crispian wanted to help others, possessing what she calls “a comfort level” with dying.
So it is with Jen.
“I do feel because I have had a lot of loss and have lost a spouse — I don’t know exactly what all families are going through — but I know I can offer them some empathy, and some support and just” — Jen pauses before continuing — “some kindness.
“I mean, I get so much it as well. I meet all these families. You know, they’re trusting me with this, this such special, horrible time in their lives. I feel I can help support them.”
Caring, not curing
At Overland Towers, the elevator carries Jen to the seventh floor. She turns right to Room 707, with the name JODY spelled out in purple, Jody’s favorite color. Black and white stickers of puppy paw prints run up and down the door.
“Jody loves animals,” Jen says.
Cats. Dogs. A ferret. Years back, Jody volunteered for a pet rescue group. Sometimes she had six or seven dogs, plus cats, before she moved to the towers.
Jen, to be sure, can’t precisely predict how much time Jody has to live.
“I’ve see her declining quite a bit in the last three months,” Jen says. “She possibly had a heart attack, a mild one, three weeks or a month ago.”
But there is no going to the hospital. That’s not how hospice works.
“I treat her pain,” Jen says.
As common as hospice has become, workers, indeed, still find it necessary to educate people on exactly how it works.A common mistake is to link hospice care to euthanasia or physician-assisted suicide. The notion that hospice workers give patients medications to hasten their deaths is utterly wrong.
Instead, the essence of hospice is caring for patients as they move toward the end of life, in peace and with minimal pain. As the National Hospice and Palliative Care Organization puts it, hospice is about “caring” for one on the journey toward death, as opposed to “curing.”
To be eligible for hospice care, a person must be judged by a physician to be terminally ill and — making the choice to no longer seek curative treatments — ly to die in the next six months. Ninety percent do. Half of hospice patients in 2014 died within two weeks.
Jody is rare. She has been on hospice for a year, which is allowed if regular medical evaluations find the patient’s health has continued to decline in a way that makes death ly, and soon.
Once someone is on hospice, Medicare, Medicaid or private health insurance picks up the tab. Hospice patients receive a host of services including regular nursing care, prescriptions for pain and comfort, a hospital bed, a wheelchair, oxygen, help with bathing, social work and chaplaincy services.
In general, there’s no rushing to an emergency room for curative care.
“Medicare won’t cover any hospitalization,” Jen says. “They won’t cover any treatments. No diagnostics. If you’re on hospice, they’re paying for hospice.”
You can change your mind. People do revoke hospice. Some even rally and improve enough to go off hospice, then come back if they again decline. Some people on hospice choose to be resuscitated, wanting to eke out every minute of life possible, even when they are terminal.
“It’s their choice. We respect it,” Jen says.
But Jody, with her DNR order, does not want that. She is not getting better. She and Jen feel lucky that the year they’ve shared has allowed them to bond.
Similarly, Suzanne Fuller, 41, has bonded with Jody as her bath aide.
One of Jody’s problems, diabetes, caused her to lose the bottom half of her left leg. Sometimes Suzanne accidentally will step on her prosthetic foot.
“Ouch!” Jody will yelp, then, “just kidding.”Big heart, big personality, no complaints. They laugh and laugh. Jen feels the same.
“I’m really going to miss her when she goes,” Jen says.
She knocks on the apartment door and calls out.
“Jody? It’s Jen.”
“Jody?” she repeats, her voice a bit more concerned.
Silence still. Jen turns the knob. The door, unlocked, opens.
No sound from the other side, and Jen calls once more.
Monday: For her own dignity and peace, Jody prays her death will be quick, no bother to anyone.
Complete Article HERE!
Serving the Dying: End-of-Life Doulas
They call themselves death doulas, or death midwives. Some prefer the term ‘end-of-life doula’ or ‘soul midwife.’ And some, me, are simply hospice volunteers. The roles vary, as do the titles. Some are paid, but most are not.
Nevertheless these people are connected by a common thread—they are all drawn towards serving the dying. And whatever the moniker, a growing number of individuals, many with a background in yoga and meditation, are joining them.
Compassion for the dying is in our bones, as revealed in the fossils of our distant ancestors… In the Republic of Georgia, the remains of an individual with just one tooth were found several years back. This Homo erectus lived around 1.8 million years ago to the incredibly then-ripe age of 40.
With a sole tooth remaining in his final years, it would have been almost impossible for this creature to have survived, and so, paleoanthropologists believe he must have been cared for. His last meal was quite ly fed to him by another.
Similarly there is evidence from Neanderthal skeletons that indicate clans 40,000 years ago cared for the sick and dying right up until their final breath.
The Lonely Death
But, fast forward to the 21st century, and our role as community caretakers and witnesses to the dying seems to have devolved.
In Western countries, thousands of elderly will die alone this year—some within the institutions that care for them, but many in their own homes.
In Japan, where one in four of its 127 million inhabitants are over the age of 65, it has become such a common occurrence—where the dead are not found for many weeks—it even has a name: kodokushi, lonely death.
In some part, the increase of the “lonely death” is the result of an aging global population where people are outliving relatives and friends—12.5 million Americans over the age of 65 live alone. And with more than 50 percent of the world now living in urban areas, the anonymous and transient culture that cities foster adds to our collective unawareness of who might be dying next door.
But we must also take personal responsibility. Our society has become increasingly fearful and intolerant of aging and dying. It is as if we would rather be immortal machines than face the rite of passage that comes with being part of nature.
“It’s not for me to say now ‘I appoint you a doula.’ It’s very personal how people want to serve, and I believe people are called to it.” – Deanna Cochran
The introduction of hospice care in the last century has sought to ease the final days of the living, but it serves just a tiny fraction of the population. Now end-of-life volunteer programs are stepping in. The volunteer-led No One Dies Alone (NODA) program was introduced by a nurse in Oregon in 2001.It involves volunteers holding “vigil shifts” for the dying in hospitals, and has been adopted in hundreds of institutions across the U.S., Singapore, and Japan.
In the last 10 years, the efforts of NODAhave been taken one step further with the introduction of tailored end-of-life volunteer training programs held beyond hospital wards.
The Deeper Lessons
Deanna Cochran, a former hospice nurse, founded Accompanying the Dying, an end-of-life doula training program, in 2010.
An end-of-life doula herself since 2005, Deanna says that most of the inquiries she received were not from the dying, but rather from those who wanted to serve them, which led her to set up the program.
Hers is one-year long, as are most program commitments for end-of-life volunteer work.
In a hospice training program, those of the doulas, practical advice is shared: Don’t tell grieving family members that their loved ones are ‘in a better place’ after passing. And don’t discuss the patient with anyone. But do take the patient’s hand and ask them questions.
These programs can also be introspective, discussing: How can we provide comfort for those in fear? How can we listen with love? As well as intense: What are the clues that a patient may soon be passing? (Mentions of past relatives, talk of serene vistas.) And how can you know if you are the one holding the patient back from moving on?
Primarily, Deanna says her aim is to empower individuals to find their own expression of service for the dying. “It’s not for me to say ‘I now appoint you a doula,'” says Deanna. “It’s very personal how people want to serve, and I believe people are called to it.”
You become acutely aware of the fragility of life, but also the strength and purpose of the spirit that the body encases.This appears to be an apt belief as an increasing number of people are being called to serve.
Juliet Sternberg, manager at The Doula Program to Accompany and Comfort in New York—which also trains volunteers—says they receive more than 300 applications a year, and choose only 12 to 15.
The slots in next year’s training are already filled. Funding is their biggest drawback, she says, not lack of volunteers.
While relatively new, the role of the end-of-life doula has been found to be helpful to the one dying. “So often the only contact the dying have is with someone who is looking at them over a clipboard, or asking about their bowel movements,” my own mentor says.
With volunteers and doulas, patients feel more comfortable sharing their celebrations on life, and their trepidations around death. It can help them process their situation.
Patients are also more ly to talk to volunteers about what music they or what religion they adhere to—this is all useful knowledge which can help a hospice team provide an art therapist, or a chaplain.
The role of the volunteer and the service they provide vary from individual volunteer to individual patient, as one may expect. Some may provide aromatherapy, meditation, or reiki. Others may help with chores at home.
“Yes, volunteers may be serving individuals who are dying, but really they are providing a service for the living,” says Juliet. Some become traveling partners for “bucket list” activities.
One volunteer within my hospice discovered her patient had never seen the Statue of Liberty, so she took him there.
Above all, it’s a healing role, says Deanna. “End-of-life companions can help relax a traumatic situation by allowing those involved to feel loved, and heard.”
Letting Go of Expectations
While training can offer some preparation, ultimately the most learning is done while in service. Learning firsthand to: Be an empty vessel. Let the person in front of you fill you up. Remember, this is a gift to you, not just from you. Listen.
No death is quite the same, after all.
Indeed, Deanna says mentoring is as much preparing an end-of-life doula on to what to expect, as it is teaching them to let go of expectations.
One story shared with me was of a volunteer who was sitting silent vigil—breathing with the patient’s breath—when she noticed that her next breath she took alone, and the next, and the next… The patient had passed without warning, and without fanfare.We often expect life-shaking moments around death. It can be alarming how passing can almost go unnoticed.
And while we want everyone to have a beautiful death, Deanna says we have to let that go too. “Deaths are different. And they are not always beautiful,” says Deanna. “It doesn’t mean the experience is a failure.” In real life, not all conflicts get resolved, nor do all life reviews get finished. And sometimes, hospice nurses say, people do choose to die alone.
The Aha Moments
These are the aha moments that you have when you serve the dying. You are let into a brief, but intimate moment of an individual’s world as they straddle the here and the there.
You become acutely aware of the fragility of life, but also the strength, purpose, and mystery of the spirit that the body encases.
There are relationships formed that are complex, beautiful, and heart-breaking.
For Juliet, the volunteers themselves cause her aha moments. “When I see the integrity of those who want to give—who believe in being part of something greater than their own lives—it gives me hope about the future of society. In spite of what we see on the news, it is comforting to know the world has good people.”
There was no fear of death, no judgment of a life, no religiosity, or even spiritual wordiness—just kindness, gentleness, and incredible gratitude and humility…
I felt similarly when I first interviewed with hospice. My trainers spoke of death as a transition. They spoke of the volunteer as “holding space” for a person as they take the next step in their journey.
There was no fear of death, no judgment of a life, no religiosity, or even spiritual wordiness—just kindness, gentleness, and incredible gratitude and humility for those who they serve. Juliet, I find it deeply comforting to know these people, these kind volunteers, are here on Earth.
I don’t feel I was “called,” I just knew this was a community I wanted to join. I wanted to learn what they had learned, and serve as they had served.
A Shift in Mindset
Deanna finds the increasing number of people wanting to serve encouraging. She is hopeful that a shift in our collective mindset towards death is occurring.
She has just returned from a retreat with Sogyal Rinpoche, a Tibetan master and author of the bestseller The Tibetan Book of Living and Dying, who, she says, advises us that death is not to be feared. Death is our friend, for it teaches us to love life more.
And so we would do well to form an intimate relationship with the dying, rather than averting our gaze. Some Tibetan monks hold a skull every day. Deanna suggests weekly visits to graveyards, and daily meditations on our own mortality.
“In the Middle Ages, the Christian monks bent over and whispered in each other’s ears—memento mori—remember death,” says Zen Buddhist and end-of-life care pioneer, Joan Halifax Roshi, in an interview with School of Lost Borders. “It’s an extraordinary opportunity for each of us to observe those who are dying in order to not just help them, but to liberate ourselves from the continuum of suffering.”She references poet Rainer Maria Rilke: Love and death are the greatest gifts given to us, but mostly they are passed on unopened.
“The fact is, love and death are about fully letting go,” says Joan. And by choosing to hold hands with the dying, we open both gifts.
Helen Avery is a Section Editor at Wanderlust Media, working on the Vitality and Wisdom channels on Wanderlust.com. She is a journalist, writer, yoga teacher, minister-in-training, and full-time dog walker of Millie.
A Christian case for assisted dying
Reverend Paul Badham is Professor Emeritus of Theology and Religious Studies at the University of Wales, a supporter of Inter-Faith Leaders for Dignity in Dying and author of Is There A Christian Case for Assisted Dying? The blog below is his recent talk to members of the Church in Wales’ Governing Body. The Church in Wales has decided on a policy of neutrality and study. They do not endorse any position at the present time but instead commend the issues for further prayer study and consideration.
Rev Badham: When people’s sufferings are so great that they make repeated requests to die, it seems a denial of that loving compassion which is supposed to be the hallmark of Christianity to refuse their requests.
I am glad that the Church in Wales is discussing this important and topical subject. In July Lord Falconer, the former Lord Chancellor, is bringing forward a bill to legalise assisted dying.
It is designed for people in the final stages of terminal illness, who are suffering unbearably and want help to end their own lives.
Safeguards proposed are that the option will be limited to adults of sound mind who have a voluntary, clear, settled and informed wish to die and who are able to self-administer the medication. Two doctors must confirm that the patient is terminally ill and expected to die within six months.
The value of palliative care
The numbers involved will be very low because with good palliative care, most suffering can be palliated. The hospice movement has been a fantastic success story and one which Christians are justly proud to have supported. But it does not meet all needs.
Baroness Finlay, the leading palliative care specialist in Wales, has acknowledged that palliative care “does not get it right 100 per cent of the time”. Unfortunately, it is also the case that some patients find the whole dying process unbearable.
We know this because new members of societies Dignity in Dying give as their principal reason for joining that they have witnessed at first hand the suffering of a parent or spouse and they want the law changed so that others do not suffer in the same way.
That is certainly my own motivation.
“I remember my father in his last days saying he had never imagined there could be so many different varieties of pain.”
Jesus’ key teaching
A Christian case for supporting assisted dying is Jesus’ teaching that the whole of religious law and prophetic teaching can be summarised as requiring us to love God and to love our neighbour as ourselves. Jesus’ golden rule was that we should always treat others as we wish to be treated ourselves.
Applying this to assisted dying the argument is: When people’s sufferings are so great that they make repeated requests to die, it seems a denial of that loving compassion which is supposed to be the hallmark of Christianity to refuse their requests.
If we truly love our neighbours as ourselves how can we deny them the death we would wish for ourselves in such a condition?
“When people’s sufferings are so great that they make repeated requests to die, it seems a denial of that loving compassion which is supposed to be the hallmark of Christianity to refuse their requests”
Do no murder
Some reject this argument because murder is forbidden by the sixth of the Ten Commandments. However the reason murder is condemned is that it is an act that deprives another person of all that life offers.
But when a dying person is already being deprived of life by a terminal illness and wants help to hasten that process, the situation is rather different. However our natural abhorrence of taking another person’s life is the reason why in Britain the campaign is for assisted dying rather than voluntary euthanasia .
In voluntary euthanasia the doctor administers a lethal drug. In assisted dying, patients must be able to self-administer so that right to the end it is their own choice.
God and the hour of our death
Some argue that only God should decide the hour of our death. But we need to be consistent.
If we truly believed that only God should determine the hour of our death, then we should think it as wrong to use medical means to extend life as to shorten it . In past ages many Christians held precisely that view.
Today if a person’s heart stops we assume that the hospital should normally attempt resuscitation even though for most of human history the time when the heart stopped was seen as the time that God had chosen to end that person’s life.
Consistency is also needed in our attitude to suffering.
We cannot say that that assisted dying is wrong because suffering is part of God’s plan for us unless we are prepared ,as Pope John Paul II was, to say that palliative care is also problematic .
He believed that dying Christians should moderate their use of pain killers so that they could share in the suffering of Christ. Fortunately few carers adopt that position.
Parallels between birth and death
Similar issues arise with contraception. The papal encyclical against euthanasia uses the same arguments as the encyclical against contraception.
Yet the vast majority of Christians today, including most catholic couples, believe in the legitimacy of planning when a new life should begin.
To be consistent we should hold that if it is morally legitimate to seek medical assistance in the timing of birth and in the avoidance of suffering during birth it should be equally right to seek medical help and assistance in the timing of death and in the avoidance of suffering while dying.
Consequences of Change
Palliative care in Europe and Oregon
The primary reason people oppose changing n the law is that they are worried about potential damage to health care following such legislation.
However we need not speculate pessimistically about what the consequences of legalising assisted dying might be. Instead we can look at what actually happens to health care in European countries and American States when they pass such legislation.
When we do this we find that many of the fears that people have lack any real foundation.
For example, on March 14th. an editorial in the Church Times suggested that legalizing assisted dying might lead to the dismantling of palliative care services.Contrary to this the European Association for Palliative Care found that palliative provision had improved in Luxembourg, the Netherlands and Belgium since they legalised voluntary euthanasia.
Indeed Belgium had actually introduced a universal right to palliative care alongside the right to die.
“absolutely none of the dire consequences that had been predicted had occurred”
In Oregon, the Hospice Association had passionately opposed the Dignity in Dying Act and had foretold it would cause all manner of problems.
But after eight years experience of it, they issued a new position statement acknowledging that “absolutely none of the dire consequences that had been predicted had occurred” .
Instead, the percentage of terminally ill Oregonians enjoying palliative care had risen from 22 to 51%.
Swiss and Dutch Geriatric Care
Opponents of assisted dying often claim that if assisted dying were to be legalised we would soon find that “ a right to die became a duty to die. “ But that hasn’t happened elsewhere .
The Swiss, who have had the right to an assisted death for over seventy years , continue to live an average two and a half years longer than we do and they live longer with terminal illnesses..
wise the Netherlands, which is the country with the most voluntary euthanasia, is also the country which spends most money on long term geriatric care.
The Euro Health Consumer Index
It seems to be the case that legalizing assisted dying is associated with substantial expansion of health care provision for the elderly and dying.
The reason for this is that If you prioritize what patients want, as you do when legalizing assisted dying, you find that what the vast majority want is not assistance to die but assistance to live more fully in the final stage of their life.
Very few take up the option: assisted deaths make up 3% of all deaths in the Netherlands, and 2 % in Belgium. There is no slippery slope. The legalisation of assisted dying is primarily welcomed for the reassurance it gives.In Oregon for every 200 people who discuss the option with their doctor, only two end up being given lethal drugs and only one takes them. The rest simply have the comfort of knowing that assistance to die would be available if their suffering became unbearable.
Key data about comparative health care are available on-line from the World Health Organization and the OECD. For Europe, the best source to google is the Euro Health Consumer index .
This index is official statistics and research reports on six areas essential to public health, These are patients’ rights, waiting times, medical outcomes, range of services, drugs available and ill-health prevention measures. Thirty-five countries are compared on the basis of these figures .
In the 2013 consumer index the four European countries which allow voluntary euthanasia are all in the top seven with The Netherlands and Switzerland in first and second places. Belgians have the most generous health care system while the Dutch have access to Health Care Centres 24 hours a day seven days a week.
There really is no evidence that allowing people to have an assisted death leads to a lowering of health standards or a decline in public safety. I can see no reason why we should expect a different result in Britain. We have the world’s sixth largest economy.
If we chose to prioritize patient choice, including the choice of an assisted death, we might see the same impact on our health care provision as it has had in European Countries and American States which have taken this path.
The Challenge to the Church
Opinion polls repeatedly show popular support for legalising assisted dying. Among monthly Churchgoers it is 78% and among weekly Churchgoing Anglicans it is 61%. Unfortunately however the Church of England Bishops in the House of Lords are all against it.
Professor Linda Woodhead’s research shows that assisted dying is the issue on which the Church of England’s leadership is most at odds with wider moral thought.
Professor Rob Warner’s research on Christian University students found that moral issues were the principal factor in their rejection of the Church at University.In particular he found that Christian undergraduates believe voluntary euthanasia to be “infinitely more humane than doctrinaire enforcement of prolonged suffering on the terminally ill. It would be wonderful if the Governing Body of the Church in Wales could demonstrate that not all Anglican Church leaders hold views that many of their laity and youth see as morally blind.
Get Busy Dying: Reflections from a Hospice Buddhist Chaplin
I am of the nature to grow old. I cannot avoid aging.
I am of the nature to become sick. I cannot avoid sickness.
I am of the nature to die. I cannot avoid death.
I will become separated from all that is dear to me.
I am responsible for my own actions.
I also have a stuffed crochet octopus on my desk. I don’t want to be of the nature to take myself too seriously.
These statements are, of course, the five subjects for frequent reflection of Theravada Buddhism. They represent for me the beginning of Siddhartha Gautama’s spiritual journey, those reflections that drove him to abandon all that was comfortable toward a freedom that was not dependent.
They are not a statement of YOLO
These statements are not a reminder to live; they are a reminder that I will die.
One of the events that influenced my process to become a Buddhist Chaplain working in healthcare and hospice was the death of a family friend. She was a talented, gregarious, joyful young woman who contracted cancer for no reason whatsoever—except, these things happen.
My parents and several more of her friends all moved to a secluded canyon in Northern California to be with her in community while she was dying. It took several years, but in the end she gave her last breath surrounded by husband, family, friends and some dogs. Everyone sang to her as she transitioned and she knew that she was loved.
I wanted to help others to die that because it was peaceful, it was kind, and it profoundly affected all of those involved.
The reality of death in this country is much different than Heather’s death. We have found myriad ways to medically extend life, but not to avoid death (unless you kill an albatross or your brother Abel).
And as a result of this avoidance, a great many of us will die in an institution, with the very tubes and machines surrounding us that we say we want to avoid.
After we die there, our loved ones may find themselves stuffing black plastic trash bags with our personal items in front of our corpse as the institution hurries us to make room for another patient.
I apologize for this grim picture, but that is the reality we face if we do not face our death.
If you do not prepare for your death, you will be unprepared for it when it comes
Everyone knows they will die. Nobody thinks it will happen to them. Our culture believes in miracles and fighting on and the underdog and “these things happen to other people, but not to me.
” We are addicted to I, me and mine. Why would we believe that this person we think we are could possibly end? And yet there on the road is a sick person, an old person, and a corpse.
Do we dare see them?
So here is the hard and disappointing thing I have learned working as a spiritual counselor for hospice:
Death is not a transformative experience because you will die as you have lived.
You will not work your shit out on that hospital bed.
You will not find forgiveness as you are dying in some big soap-opera moment, you will not become a better person, and you will not become enlightened just because you’re dying.Your chaplain, if you have one, will most ly be a well-meaning evangelical Christian divinity student resident who will not be allowed to talk to you about Jesus although they will want to save your soul.
Your family and friends will avoid the subject of your reality and mostly will try to cheer you up.
Most ly your body will be too busy taking care of dying (and the body does this beautifully), or you will be too doped up to process anything anyway.
Unless you are willing to look at your own sticky note, this is how you will die, and it will not be a kum-ba-yah moment in some California hippie commune.
You gotta find transformation on the cushion—and off the cushion in your relationship with your partner, your family, your workmates, your sangha, the least of your brethren and your friends. You are going to have to forgive your parents. You have to face the dark corners and go into the rooms you are avoiding. You have to learn what an advanced directive is and fill that shit out.
You must practice as if you are balancing a glass of artisan homebrew on your head as you walk through a crowded farmer’s market with some cosplay ninja behind you ready to cut your head off if you spill a single drop.
You are going to die. So get busy dying already.[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]
The Rev. Joseph Rogers, MDiv. (aka Pu Luo, Luminous Awakening or just Reverend Bling for casual Dharmic events) is a professional hospice chaplain, and meditation teacher in Los Angeles.
He is the co-founder of the #LoveMoreMovement along with his wife, Sarit Rogers; an ordained minister with the International Center of Chinese Buddhist Culture and Education, USA; has completed teacher training with Against the Stream Buddhist Meditation Society under Noah Levine; and received his Masters in Divinity in Buddhist Chaplaincy from The University of the West mostly so he would have something to talk about at parties and charity auctions. He s to write about himself in the third person, play fetch with his pit bull Lulu, and plans on kicking Samsara’s ass. He can be found in less than 140 characters @paralax999, and you can learn more about how #CompassionIsRevolution at LoveMoreMovement.com.
Editor: Dana Gornall[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
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