Preparing well for death is to embrace life now

The subject of death usually lurks at the back of our minds and comes to the fore only when it is forced upon us.

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By Margaret Doherty

The subject of death usually lurks at the back of our minds and comes to the fore only when it is forced upon us.

From conversations with people from all walks of life, I have noticed a reluctance to talk about death, dying and bereavement. Next Friday, however, peers will confront these issues head on when Baroness Meacher’s Assisted Dying Bill gets its second reading in the House of Lords. It is an opportunity to open up the discussion around death and dying more generally.

Instinctively we associate death with pain, loss and hopelessness — all things we are desperate to avoid. Think of the Apostles when Jesus told them he was about to meet a humiliating and painful death. They could not accept it because they expected Him to found a glorious kingdom with them on earth. It was only after Jesus’s suffering, death and Resurrection that they understood.

For Christians and followers of the other great monotheistic faiths, the promise of eternal life with God gives hope. Yet whether we believe in God or not, we can begin to face our fears now by preparing a will; by understanding more about the process of dying, and setting out how we want to be treated when we become seriously ill.

We fear the loss of loved ones and the pain that brings, but in the course of our lives we experience loss and learn to let go of cherished ambitions, children going to live far away and the death of close friends and family. Learning to let go is an important life lesson.

The days left to a person diagnosed with a terminal illness are especially precious. Julia Riley, one of Britain’s leading palliative care consultants, says that after delivering the diagnosis she asks them about their goals for the time they have left.

In an Art of Dying Well podcast ‘Diagnosing Dying’, she tells the story of Christopher (not his real name), a lawyer who was diagnosed with a terminal illness. He lived alone in the house where he was born in and was very isolated, so she was astonished when he said that he did not want to die on his own. She persuaded Christopher to contact his best friend who lived in Kent and he urged Christopher to go and stay with them so she organised a care package there. Three weeks later she received a card from Christopher with a sketch of the house. He wrote: “This is my room. I went to Heaven before I died. Thank you.”

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Later she received a letter from the wife of the best friend. She thanked Julia for what she said was the most wonderful period of their lives. She described how each night they would have a glass of champagne in Christopher’s tiny room upstairs and one day, Christopher put his glass down, he took each of their hands, one on either side of his bed and said “Thank you I’m going now”. He then closed his eyes and died.

Julia believes that patients’ anxieties about their last days can be calmed by telling them what death is like. She explains that most symptoms, including pain, can be controlled with good palliative care and that noisy, laboured breathing that stops and starts is common in a person’s last hours but does not generally cause pain.

The essential last words to exchange can be distilled into “Thank you, I’m sorry, I love you.” Careful preparation, good palliative care and these few words form the basis of dying well, the greatest gift to leave your family and friends.

In Christianity, Judaism and Islam, people who are dying are encouraged to review their lives and to seek God’s forgiveness for anything they have done wrong. Catholics have the Sacrament of Penance, also known as Reconciliation or Confession in which the person relates their sins to a priest who forgives them in God’s name. In Judaism, a dying person is encouraged to make a final confession known as the Viddui. It includes the words: “I regret the hurts I have caused and the mistakes I have made. Forgive my sins and my soul will be pure as it returns to You. Protect those I love whom I leave behind, for their lives are in Your care…”. Muslims do not need to confess to another person, but they will often seek forgiveness directly from God.

Riley says a person’s last days are an intensely spiritual time even if they are not religious: “They may have lived with things on their chests for years and suddenly they gain clarity, they want to relieve themselves of that and they gain dignity.”

Jesus teaches that death will come “like a thief in the night” and you must be in a constant state of readiness.

“The time will come when you will want just one day, just one hour in which to make amends, and do you know whether you will obtain it?”

Strange as it may sound, then, to prepare for death is to embrace life now.

Margaret Doherty is the Director of the Centre for The Art of Dying Well at St Mary’s University, London. This article first appeared in The Times ‘Credo’ column on Saturday, 16 October 2021. Used with kind permission of The Times.