Book excerpt

“When I speak before lay audiences — that is, before people who are not directly involved with medicine — I ask them how they want to die. I do so because I think no question better illumines how our attitudes shape the form of medical care we receive. The presumption of many — a presumption, I might add, underwritten by many in medicine, since it underwrites their own self interest — is that medicine is basically a scientifically neutral set of skills at which all well-trained physicians are equally adept. Medicine is seen as a set of means, admittedly a very powerful set of means, that are in themselves value-neutral. The only moral questions that occur concern the use or misuse of those skills. Moral questions about medicine are about what ends those skills should serve.

“When we consider how we want to die, we begin to appreciate how this view of medicine and the moral questions surrounding medicine are far too simple. Medicine reflects who we are, what we want, and what we fear. For example, when I ask people how they want to die, they always say, without fail, ‘painlessly,’ ‘quickly,’ ‘in my sleep,’ and ‘without causing great trouble to those close to me.’ Such desires seem straightforward and rational. They reflect what any of us would want if we thought about it — namely, we rightly want to die without knowing what is happening to us and without causing great pain to ourselves and others, since we do not want to be a ‘burden’ to others.

“Nonetheless, at other times and in other places this understanding of death would have been considered irrational if not immoral. For example, medieval persons most feared a sudden-death, a death that would not allow them to make proper spiritual preparation. Elaine Tierney notes that in the thirteenth century ‘popular preaching instructed parishioners to remember death. Gottfried writes that “preachers advised people to go to sleep every night as if it was their last and as if their beds were their tombs.” Thomas à Kempis wrote of death: “He who is dead to the world, is not in the world, but in God, unto whom he lives, comfortable, and your life is hidden with Christ in God.” The preparation for death was important. To die without having confessed one’s sins would submit one to eternal damnation. So the emphasis was upon death and from this developed the concept of dying well and the guides that described the “art of dying.”’

“The medieval world preferred those illnesses that gave one a lingering death or at least time to prepare for one’s death. It is interesting to speculate whether cancer would have posed the same threat to that world which it does to ours. For our desire to ‘cure’ cancer springs not only from the large number of people who actually get cancer but also from the fact that cancer challenges our very conceptions of how we would like to die. Our understanding of violent death is based on those same conceptions. The medieval person could look forward to dying in war, since there was time prior to battle to prepare for potential death. We prefer to die in unanticipated automobile accidents.

“Our medicine, moreover, reflects the way we think about death. There are few things on which we as a society agree, but almost everyone agrees that death is a very unfortunate aspect of the human condition which should be avoided at all costs. We have no communal sense of a good death, and as a result death threatens us, since it represents our absolute loneliness.”

— from Stanley Hauerwas, Naming the Silences: God, Medicine, and the Problem of Suffering (Eerdmans, 1990).

Related reading and listening

Related reading and listening

Links to posts and programs featuring D. C. Schindler:

Links to posts and programs featuring Junius Johnson;

Links to posts and programs featuring Reinhard Huetter;

Links to posts and programs featuring Fr. Augustine Thompson, O.P.:

Links to posts and programs featuring Louis Markos:

Links to posts and programs featuring William C. Hackett:

Links to posts and programs featuring Thomas Albert Howard:

Links to posts and programs featuring Thomas Pfau:

Links to posts and programs featuring Hans Boersma:

Links to posts and programs featuring Bruce Hindmarsh:

Links to posts and programs featuring J. Budziszewski:

Links to posts and programs featuring Steve L. Porter:

Links to posts and programs featuring Norman Wirzba:

Links to posts and programs featuring Timothy Larsen:

Links to posts and programs featuring Bruce Herman:

Links to posts and programs featuring Rod Dreher:

Links to posts and programs featuring Kevin J. Vanhoozer:

Links to posts and programs featuring Esther Lightcap Meek:

Links to posts and programs featuring Alan Jacobs:

Links to posts and programs featuring Kimbell Kornu:

Links to posts and programs featuring David Lyle Jeffrey:

Links to posts and programs featuring David Setran:

Links to posts and programs featuring Peter Bouteneff:

Links to posts and programs featuring Francis J. Beckwith:

Links to posts and programs featuring Marianne Wright:

Links to posts and programs featuring David W. Fagerberg:

Links to posts and programs featuring William T. Cavanaugh:

Links to posts and programs featuring Michael Ward:

Links to posts and programs featuring Michael Dominic Taylor:

Links to posts and programs featuring Rebecca Konyndyk DeYoung:

Links to posts and programs featuring Robin Phillips:

Links to posts and programs featuring Jonathan McIntosh:

Links to posts and programs featuring Marian Schwartz:

Links to posts and programs featuring Andrew Kaethler:

Links to posts and programs featuring Donald B. Kraybill:

Links to posts and programs featuring Thomas Storck:

Links to posts and programs featuring Jonathan Chaplin:

Links to posts and programs featuring James W. Skillen:

Links to posts and programs featuring Richard Stivers:

Links to posts and programs featuring Mark Regnerus:

Links to posts and programs featuring Emma Mason:

Links to posts and programs featuring Mark Noll:

Links to posts and programs featuring David Ney:

Links to posts and programs featuring Greg Peters:

Links to posts and programs featuring David I. Smith:

Links to posts and programs featuring Jason Paone:

Links to posts and programs featuring Kelly M. Kapic:

Links to posts and programs featuring Eric O. Jacobsen:

Links to posts and programs featuring Jessica Hooten Wilson:

Links to posts and programs featuring James Turner:

Links to posts and programs featuring Matthew Rubery:

Links to posts and programs featuring Simon Oliver:

Links to posts and programs featuring Jason Blakely:

Links to posts and programs featuring Kathryn Wehr:

Links to posts and programs featuring Holly Ordway:

Links to posts and programs featuring Paul Tyson:

Links to posts and programs featuring Matthew D. Stewart:

Links to posts and programs featuring David Sehat:

Links to posts and programs featuring John Durham Peters:

Links to posts and programs featuring Oliver O'Donovan:

Links to posts and programs featuring Nigel Biggar:

Links to posts and programs featuring Margaret Harper McCarthy:

Links to posts and programs featuring Andrew Paul Davison:

Links to posts and programs featuring Alison Milbank:

Links to posts and programs featuring Brian R. Brock:

Links to posts and programs featuring Scott Newstok:

Links to posts and programs featuring Fiona Hughes:

Links to posts and programs featuring R. Jared Staudt:

Links to posts and programs featuring Grant R. Brodrecht:

Links to posts and programs featuring Antonio López:

Links to posts and programs featuring Brent Hull:

Links to posts and programs featuring Matthew B. Crawford:

Links to posts and programs featuring Kerry McCarthy:

Links to posts and programs featuring Robert P. George:

Links to posts and programs featuring Christine Rosen:

Links to posts and programs featuring Scott Cairns:

Links to posts and programs featuring Diana Pavlac Glyer:

Links to posts and programs featuring O. Carter Snead:

Links to posts and programs featuring Steven D. Smith:

Links to posts and programs featuring Jeremy Beer:

Links to posts and programs featuring James K. A. Smith:

Links to posts and programs featuring Richard Weikart:

Links to posts and programs featuring Mark Evan Bonds:

Links to posts and programs featuring Perry L. Glanzer:

Links to posts and programs featuring Dana Gioia:

Links to posts and programs featuring Thomas E. Bergler:

Links to posts and programs featuring Susan Srigley:

Links to posts and programs featuring J.A.C. Redford:

Links to posts and programs featuring Carl Elliott:

Links to posts and programs featuring Victor Lee Austin:

Links to posts and programs featuring Sørina Higgins:

Links to posts and programs featuring Steve Wilkens:

Links to posts and programs featuring Gilbert Meilaender:

Links to posts and programs featuring Martin X. Moleski:

Links to posts and programs featuring Brendan Sweetman:

Links to posts and programs featuring Allan C. Carlson:

Links to posts and programs featuring Jason M. Baxter:

Links to posts and programs featuring Barrett Fisher II:

Links to posts and programs featuring Paul Weston:

Links to posts and programs featuring Steven Knepper:

Links to posts and programs featuring Susan M. Felch:

Links to posts and programs featuring Fred Turner:

Links to posts and programs featuring Matthew Dickerson:

Links to posts and programs featuring Jack R. Baker:

Links to posts and programs featuring W. Bradford Wilcox:

Links to posts and programs featuring Bill Vitek:

Links to posts and programs featuring Adam K. Webb:

Links to posts and programs featuring Mark Bauerlein:

Links to posts and programs featuring Felicia Wu Song:

Links to posts and programs featuring Joseph E. Davis:

Links to posts and programs featuring Thaddeus Kozinski:

Links to posts and programs featuring Craig M. Gay:

Links to posts and programs featuring Mark T. Mitchell:

Links to posts and programs featuring Karen Dieleman:

Links to posts and programs featuring Tim Clydesdale:

Links to posts and programs featuring J. Mark Bertrand:

Links to posts and programs featuring Mathew Levering:

Links to posts and programs featuring Mark G. Malvasi:

Links to posts and programs featuring Kirk Farney:

Links to posts and programs featuring Bradley J. Birzer:

Links to posts and programs featuring Ralph C. Wood:

Links to posts and programs featuring Paul Heintzman:

Links to posts and programs featuring Gil Bailie:

Links to posts and programs featuring Zygmunt Bauman:

Links to posts and programs featuring Matthew Lee Anderson:

Links to posts and programs featuring Mike Aquilina:

Links to posts and programs featuring Bishop Robert Barron:

Links to posts and programs featuring Frederick Buechner:

Links to posts and programs featuring Jeffrey Bilbro:

Links to posts and programs featuring James A. Herrick:

Links to posts and programs featuring Andrew Wilson:

Links to posts and programs featuring Susan Cain:

Links to posts and programs featuring Marilyn McEntyre:

Links to posts and programs featuring Andrew Spencer:

Links to posts and programs featuring Albert Borgmann:

Links to posts and programs featuring Catherine Prescott:

Links to posts and programs featuring Maggie M. Jackson:

Links to posts and programs featuring Garret Keizer:

Links to posts and programs featuring Andy Crouch:

Links to posts and programs featuring Kyle Hughes:

Links to posts and programs featuring Philip G. Ryken:

Links to posts and programs featuring Eric Miller:

Links to posts and programs featuring Ted Prescott:

Links to posts and programs featuring Landon Loftin:

Links to posts and programs featuring Barry Hankins:

Links to posts and programs featuring Quentin Schultze:

Links to posts and programs featuring Dale Ahlquist:

Links to posts and programs featuring Paul Walker:

Links to posts and programs featuring Jason Peters:

Links to posts and programs featuring Fr. Damian Ference:

Links to lectures and commentary by Ken Myers: