(Last Wednesday Wilberforce Publications and Christian Concern published their latest book – Talking about Dying which can be purchased here. Kathy asked cancer doctor Elaine Sugden, one of its four authors, what prompted her to contribute to it.)
Elaine Sugden: Philip Giddings, a political scientist, instigated this joint effort. He had not known what to say when a friend was dying. He was challenged to write and asked my help. As a cancer doctor I was involved with the ‘Life Threatening Diagnosis’, the ‘Difficult Decisions’ and the question about ‘How and When’ death would occur. It was never easy to speak of death.
Almost no one wants to die. A doctor’s responsibility is to heal and prolong life where possible and when a reasonable quality of life can be maintained. In general doctors do not talk about death.
When the country was debating physician-assisted suicide, Martin Down, a retired clergyman, and I both wrote articles for the Church of England newspaper expressing dismay that patients without quality of life, often unable to communicate and needing artificial means to keep them alive, were denied a natural death. We wanted to help all people with these and other issues as well as stating our Christian beliefs. Martin himself was put off preaching about death when after once doing so early in his ministry, a parishioner asked him not to do so again ‘because death is morbid’.
In general, Christians, like doctors, do not talk about death. In general, the dying take their cue from those around them and do not talk about death. Given permission though, they can find it helpful.
Kathy Gyngell: Does writing a book like this run the risk of being seen as another modern ‘touchy feely’ exercise?
ES: I hope not. The authors wanted this book to be very practical. The sudden death of Philip Giddings’ wife during the writing meant that the rest of us had to learn on the job about the devastation of the death of a spouse. I would describe this as a ‘how to try to do it’ book taking into account the emotional roller coaster that death and dying brings to sufferer, relatives and close friends. The ‘try’ is important here. It is never easy; no one is ever a complete expert. But a common thread throughout all chapters and scenarios is that people need to be given the opportunity to talk which means that we must listen.
KG: Is our inability to talk about and come to terms with death a modern problem? One that has resulted from the rise of secularism and the decline of faith?
ES: On Radio 4’s Thought for the Day (9.2.17) Michael Banner reminded listeners that the extended mourning and condolences of the Victorian era were discouraged during World War One since “such behaviour was bad for national morale in the face of unprecedented loss of life.” National espousal of the Christian faith has also depleted since that time. Whatever the reason, this society has tended to push death out of the equation and the bereaved just have to ‘get on with it’.
Current statistics suggest that 1/3 UK adults believes in God and 2/3 do not, although 1/5 believe in a higher spiritual power (but not God). Our majority society can be described as secular. People of faith are aware of being thought to be at best naive and at worst deluded. When, towards the end of life, people are asked about their needs, ‘meeting spiritual needs’ is mentioned in the protocols but rarely tackled and is rather subsumed into the agreed essential need for control of pain and other symptoms. I suspect that when the taboo on talking about death has been deleted, a taboo of talking about God / ‘spiritual things’ takes its place. Rather than ignoring non-medical needs, it can be important for all people drawing near to death to remember their achievements, make peace with family and friends and feel that life is completed. Some will also want to make peace with God and value conversation about this.
KG: Or is it the outcome of medical ‘progress’ and life extension that has fed a sense of entitlement to life and immortality that ill prepares us for death?
ES: Medical progress has been and continues to be phenomenal and the general population follows the doctors in their wish for an extension to life. People vow they are going to live to 90, 100 or even longer as life expectancy continues to increase with the unspoken hope that one day there will be no need to die. In the specific case of cancer, the outcome for some is excellent, for others still compatible with years of good life but sadly for some remains dismal in spite of advances in treatment. However long we live, death is a certainty for everyone and we have to come to terms with this. Some of my cancer patients found it hard to believe that medical science could no longer help them.
KG: Do we need better marked ‘rites of passage’ after death – designated periods of mourning for example and does the C of E need to exercise leadership in this matter?
ES: This challenge is worth a discussion with the bereaved. In our village church an annual memorial service is well attended and appreciated. Many come year after year and find comfort in being encouraged or given permission to grieve and remember. I think we should consider your suggestion.
Death in Christian belief is part of life and the Christian Hope enables us to look beyond death rather than recoil from it. Those of no faith believe that death is the absolute end of existence. The strength of our beliefs, whatever they are, can never mean that we are correct in those beliefs. Christians believe in an afterlife but can differ in how they view it. Because an atheist is sure there isn’t a God doesn’t mean that there definitely isn’t one.
Life is good; it is natural to love life and fear death. So it seems contrary to want to encourage conversation about death. Whatever our beliefs it can be helpful to talk and for that reason this book was written for everyone.