Death and dying: perspectives and cultural contexts

Death and Dying

'My new body was weightless and extremely mobile, and I was fascinated by my new state of being. Although I had felt pain from the surgery only moments before, I now felt no discomfort at all. I was whole in every way -- perfect," (Eadie "Embraced" 30). In her groundbreaking book Embraced by the Light, Betty J. Eadie writes about her own near-death experience to help dispel the universal fear of dying. Eadie's body was clinically dead during a surgical procedure, but her consciousness remained vital and alive. Not only did Eadie live to tell the story, but her encounter with death was a spiritual awakening, an experience that positively changed her perspective on life. Personal accounts such as Eadie's abound in the literature, demonstrating that death and dying need not be the fearsome processes many would believe them to be. In the 1960s, author Elisabeth Kubler-Ross garnered personal testimony from numerous dying patients, attesting to the spiritually transformative powers of the dying process for both the patient and the bereaved. Case studies of near-death experiences, ubiquitous in popular reading self-help books as well as in peer-reviewed scholarly journals, draw attention to the efficacy of current right-to-die laws in the United States. Based on the case studies of near-death experiences, which frequently include religious imagery and being "embraced by the light," assisted suicide should be an inalienable right for citizens of the United States.

The case studies included in autobiographical works like Betty J. Eadie's Embraced by the Light and George Ricthie's Return from Tomorrow, and compilation texts such as Elisabeth Kubler-Ross's On Death and Dying, Maggie Callanan and Patricia Kelley's Final Gifts, Raymond Moody's Life After Life, Ira Byock's Dying Well, illustrate that current legal policies regarding the right-to-die are outmoded. Death is an absolute and immutable certainty: all things that live, including human beings, die. The aim of all physicians and all loved ones should not be to extend the life of those suffering from terminal illness, but rather to ensure as peaceful and painless transition from life to death as is possible. Ira Byock calls the assurance of a peaceful death "dying well," and in his book bearing that title, Byock recounts numerous case studies in which patients are caught in the middle of legal and personal battles over their own lives. Byock cuts to the core of the issue, nothing that American policy has been constructed to prevent individuals from dying well and therefore prolongs the suffering of both victim and family members. "The concept of dying well can provide a vision of a realistic and affirmative goal for life's end," (Byock 246). Changing public policy regarding the right-to-die will not be simple, but rather will entail a wholesale revision of American cultural values, norms, and beliefs. Byock states, "Cultural values and expectations related to dying must shift away from the denial of death, and the viewing of dying as a time of inevitable emotional distress ... toward an understanding of dying as part of a full, even healthy, living," (246). Unfortunately and ironically, given the spiritual imagery concurrent with the near-death experience, it is often those in religious Christian communities that would deny the suffering the right-to-die.

For example, a Florida woman named Terry Schiavo spent fifteen years in a "persistent vegetative state." Almost universal medical opinions testified to the impossibility of her recovery based on the extensive brain damage she had suffered in her persistent vegetative state. Nevertheless, religious members of Schiavo's family begged for her to remain hooked up to feeding tubes and other forms of life support: just so that the shell of Terry's body would be kept "alive." Thus, central to the right-to-die issue is the definition of "alive," and the definition of "consciousness." Terry Schiavo was alive in the narrowest possible way: the term "persistent vegetative state" spells out clearly that Terry's mental state was akin more to a plant than to an animal, let alone a human being. In sharp contrast to the persistent vegetative state endured by Schiavo, Eadie's encounter with angels denotes the exact opposite: a body declared dead, but a mind so fully aware that the patient saw angels. Although Eadie's body was declared clinically devoid of life, in her brief moment of death she encountered an esoteric, mystical realm. Her experience, which prompted her to write the book Embraced by the Light illustrates that dying is not in itself a bad thing and therefore cutting the feeding tube off of someone who has lost the essence of their human nature might be the morally correct thing to do. The spiritual experiences that are shared by many who have had near-death experiences show that dying can allow the individual to encounter God in ways that living often cannot. Denying individuals the right to die in cases of terminal illness demonstrates a lack of understanding of death as well as an infringement on personal civil liberties.

In his book The Rights of the Dying: A Companion for Life's Final Moments, David Kessler lists several rights that can be used as guidelines to form public policy. Among those rights include "the right to die in peace and dignity," "the right to participate in all decisions concerning one's care," and the "right to die" in itself (Kessler 147). The right-to-die usually pertains to cases of terminal illness, and does not extend to the rights of depressed teenagers to slit their wrists; there should be a clear differentiation in right-to-die legislation between physician-assisted suicide for the terminally ill and self-administered suicide for the discontented. Patients who are terminally ill should be allowed to confront their impending death from a realistic standpoint, given the spiritual and psychological tools they deserve. Such tools include counseling in the "art" of dying well, which necessarily entails coming to terms with their death in a constructive framework.