A magazine asked me a number of questions a while back. I don’t know if it ever got to print or not, but I thought I’d post my responses here.

“Death is all around us,” you write, in news reports and natural disasters. How does that affect us in today’s culture?
Ironically, it further separates us from death. The death that we are surrounded by is not the kind of death that really affects us. People die, as reported in the news or portrayed on TV, but these can give us the illusion that we know what it is when the patient dies in the ER on the television. This is not the death that Christ defeated. As a result, we think we know what we’re dealing with when–as in my case–Aunt Eileen is on her deathbed. When we’re standing in front of her, though, it’s something else entirely. To believe that this is the kind of death over which Christ is victor takes an earthy, well-grounded faith.
In what ways do congregations deny our mortality and the inevitability of death?
We do this in various ways, but a big one is seen in what we expect of the bereaved. In order to avoid being confronted with death, we avoid the dying and the ill. And following death, we often avoid the grieving or expect them to get back to “normal” quickly. Instead, we offer platitudes about having faith, about being comforted, about miraculous healing. I’ve spoken with people who have been told that death doesn’t matter because a loved one is in a better place.
This is the ultimate denial, hidden under a spiritual guise. If death doesn’t matter, why did Jesus go through it? To what purpose? Why wasn’t 40 days in the wilderness enough for our sins? Death is real, and if we deny its reality we also deny Christ’s victory over it.
Actor Michael Douglas says of his State IV throat cancer: “I’m an optimistic guy. I am going to beat this.” [Parade, Sept. 19] Is there a point between reasonable courage and that of preparing friends and family for what seems like a terminal prognosis? You say, “There must come a point where Christians shift their focus from extending life to preparing to die.”
Michael Douglas has every right for healing from his cancer, and he should do his best to “beat” it. I think that is the right initial approach for Christians too. Just last week, however, I was talking with a woman who has stage four breast cancer. She has been on and off treatments for around ten years, and she told me how she was tired of “fighting.” She didn’t want to fight anymore. Instead, she has been meditating and reading about heaven.
Now, this woman continues to undergo chemo and regular testing to see how the disease is progressing, or not, and how to treat it. She continues to work and care for her family. She has a lot to live for and wants to live as long as she can, but she’s realistic. Death will come. If not from the cancer, then from something else. If not now, later.
This, to me, is the ultimate in courage, “to live is Christ, to die is gain.”
Realistically, and medically, we will need to come to a place where we choose to stop pursuing medical treatments. If we don’t, we’ll end up with a painful, uncomfortable, and isolated death in a hospital or other medical environment. According to surveys, no one likes these deaths, even the people and families that–at first–choose them. It’s better for us–and according to some research for our longevity too–if we chose to live out or final days seeking comfort care rather than curative care. This means hospice or another kind palliative care. This way we can spend our last days in comfort with family and friends, in spiritual devotion.
For Christians, however, this kind of turning our spiritual attention toward God is not something we do beginning when we’re diagnosed with a terminal illness or later. A sickness may focus our attention more strongly, but we are living spiritual lives that simply continue. So, focusing on our ongoing life with God here and now helps us live better today and into the life to come.
How can the church “offer sympathetic understanding” to one going through a terrible illness?
Be present with that person. As a hospice volunteer, I have never found that it gets easier to be with someone who is dying. I got practiced at it, though. As a church, we have gotten rusty. We don’t know how to offer sympathetic understand because we don’t do it.
The most important thing is to be with that person. Don’t ask anything of him or her. Don’t ask what you can do. If you think of a way to express your sympathy, do it. Visit, call, write, whatever. Be with that person.
Is there ever a time when having “more faith” is an appropriate response to the seriously ill?
Having more faith is always an appropriate response. However, mustering up “faith” in hopes or expectation of miraculous healing is foolish. Jesus died. Lazarus died twice. We’ll all die. Our hope is not in cheating death but in the person who defeated it.
You write, “Our churches are not teaching us to die well.” How so?
The church once lived and taught the ars moriendi, the art of dying. In 19th century America, magazines and newspapers, pastors and lay believers talked about, wrote about, and most importantly, they lived what they called the “happy death.” This was a vigorous tradition of dying well. There were rituals and expectations involved, and people followed them knowing it was the best way to approach a difficult time.
People gathered around a dying person. They listened to that person say goodbye, offer words of advice and encouragement, they watched as the person expressed faith and hope in God, and they looked for signs that the dying person was entering heaven. They then told others about it in order to encourage them in their faith and teach what it meant to hope in God in the face of death. They could truly say “oh grave where is thy victory?” because they faced death with confidence. Following a death, the church community gathered for comfort and expressions of hope in wakes and visitations funerals, and church services.
No such tradition exists today. Our churches aren’t teaching it and our congregations are doing their best to face death when it occurs but not with the confidence and assurance in Christ that these earlier traditions had.
How should the church help religious people on end-of-life planning?
Again, be present and talk about it. It would help to have more pastors trained in dealing with some of the complex issues that arises in medicine today. The Center for Bioethics and Human Dignity at Trinity International University, where I am involved, is doing absolutely terrific work to help people deal in a faithful way with these tough new issues.
However, the basic issue is simple. What do you want your end of life to look like? Do you want to fight it out till the end? Or do you want to be with family and loved ones? The choices aren’t always so black and white as that, but they do direct you in different ways in terms of your medical options.
Talk it out with family, pastors, and loved ones.
What is the church doing wrong in our culture about end-of-life issues?
We are rightly opposing attempts to allow and practice more physician assisted suicide and euthanasia. We are doing this well. But we are not providing a hopeful alternative. Surveys have shown that people choose suicide at the end of life because they don’t want to be a burden to others and they don’t want to be hooked up to machines. We are not doing a good job, in a practical sense, of offering to carry others’ burdens, and we not offering a hopeful vision of what a good death is. As a result, when people don’t want the kind of death they medical system offers, they often choose these terrible alternatives.
You say that patients are “not being counseled in how to die.” What do you mean?
Studies have shown that for people facing end-of-life situations, their spiritual lives are the most important thing to them. Faith provides comfort, hope, meaning, and purpose. But for the most part, this doesn’t necessarily translate into practical steps affecting how we die. It doesn’t affect the choice people make, except sometimes when we pursue aggressive medical care in the hopes that it will give God the opportunity to work a miracle.
The Christian faith has a lot to say about the health care choices we make and the kind of deaths we should practice. But only a very few Christian doctors and pastors are helping patients to die well.
“We’re so pro-life,” you quote one Christian gerontologist, “we’re anti-death.” How so?
This doctor, and I share his belief, said that our pro-life views have been wrong transferred from the beginning of life to the end. We rightly fight for the life of the unborn. But, it’s okay to allow death at the end of life. We don’t need to fight death in any and all circumstances.
How can the church help Christians to “die well”? To have “the good death.”
I hope The Art of Dying gives people a place to start. Then we can look back more closely to see how Christians practiced the good death from the first until the twentieth century. I think there are a lot of ways we can learn and even on occasion directly borrow their practices. But for starters, a Christian death always includes repentance to God, reconciliation with family and friends if necessary and where possible, and finally and expression of hope in life eternal with God and the resurrection of our bodies.
In the last 150 years funerals have slowly lost their Christian emphasis,” you write. How so?
Funerals were once an opportunity to affirm the hope of the gospel and to journey with the deceased to his or her resting place until the resurrection. Today we’re completely confused. We have graveside services before the church service. We have funerals without the dead. One writer says this is like having baptisms without people, marriages without the betrothed. And this is when we’re having a funeral instead of a memorial, remembrance or celebration. Today, these events (if we’re not calling them funerals) are simply public opportunities to comfort the bereaved and ease their suffering. There’s nothing wrong with comforting the grieving. We must do it. But that’s only a piece of what a funeral is about.
“Dying well requires preparation,” In today’s world, what do you suggest? How is the church involved?
Our world offers a million ways to avoid preparation for death. And we’re all (myself included) happy to be distracted. However, I think that the church can do a lot to help us. Let me say that we should do these things not only so that at the end of lives we do things right. We should be preparing for death because we will live better, more closely to God and more loving of our neighbors right now!
The church can be involved first by recognizing death. In the foreword to my book, Lauren Winner suggests we should wear mourning clothes and jewelry again. It would be a good idea to find modern ways to allow those in grief the to signal to others that they are in emotional pain and ask for some special consideration. What if we could update our facebook information to “bereaved” instead of “in a relationship?”
Churches should be the site of our funerals. I’d love to have churches with cemeteries once again though that isn’t realistic in most cases. However many churches have installed columbaria, places for the keeping of cremated remains. (I applaud and support those who oppose cremation for theological reasons, but I think there’s nothing inherently unbiblical about it.) This serves as a subtle reminder for some that we are a part of a larger communion of saints. For those who’s loved ones are kept there, it offers the opportunity for reflection and remembrance.
Churches can do more subtle things. Give elderly members the opportunity to offer their life testimonies during a service. In the bulletin each week, print the names of those who have lost a loved one in the past 12 months. Have a mentoring program between older church members and the youth to encourage intergenerational relationships. There are lots of small ways in which the church can nudge us to focus ourselves on the eternal life we live today and into the life to come.

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