Not surprisingly, the human brain does not like to consider death – especially its own – which is why many people never discuss their desires with their families. As a society, we are much less comfortable than past generations in dealing with death. The reason to discuss death in this podcast is because one of the most difficult areas of overlap between Science and Religion occurs at the end of life. Today, Death is often a highly technical event – with lots of medical test results and advice from numerous doctors and specialists. But at the same time, death holds a number of spiritual questions. It is best to figure all this out during your life, not at its end. Put your desires down in writing and then come to terms with what you have written. Though they may initially object to having the discussion, share those desires with your spouse and adult children, so they too know your wishes.
Email: scottrfrazer@Gmail.com
Website: scottrfrazer.com
S2E11 – Death - A Life Well-Lived Deserves a Good Ending
This is the podcast “Science and Scriptures”, Season 2, Episode 11, or “Death - A Life Well-Lived Deserves a Good Ending”.
Hello again, this is Scott Frazer, and welcome to the podcast “Science and Scriptures”. The title of today’s podcast is “Death - A Life Well-Lived Deserves a Good Ending”. If, good listener, you are reaching for your cell phone to jump to the next podcast, please wait. This episode is not designed to depress you. Granted, discussions about death can be a downer, but I we will try to avoid that. Seriously, there are a few things you ought to know. First, not surprisingly, the human brain does not like to consider death – especially its own – which is why you are still considering jumping to another podcast. While we all know that ghosts aren’t real, cemeteries are still creepy. Funerals and funeral homes are depressing. People naturally shy away from death – it is a scary unknown. Most of us cannot understand why morticians would ever choose such a career.
I understand this hesitancy. As a whole, our society has rather forgotten how to deal with dying and death. It wasn’t always that way. The experience of advanced aging and death used to occur in the home and around family. In 1945, most deaths occurred in the home. Often, Grandma and Grandpa lived with their children and grandchildren, so younger generations witnessed both aging and death. But by the 1980s, things had changed. Aging grandparents were moved to retirement homes, nursing homes, and, at the end, hospitals. In 1980, only 17% of deaths occurred in the home. As a personal example, I never knew my maternal grandparents and my paternal grandparents moved to Florida upon their retirement. I have few memories of them or of their funerals.
So, as a society we are much less comfortable than past generations in dealing with death. Death is a stranger to us. We don’t even want to plan for this major event, thinking it is something we can plan for when we are really, really old. We let our fears overcome our mental need to prepare for the future.
The reason I want to talk about death in this podcast is because one of the most difficult areas of overlap between Science and Religion occurs at the end of life – whether it be yours, a beloved parent, a friend or, most difficult, a child. Today, Death is often a highly technical event – with lots of medical test results and advice from numerous doctors and specialists. But at the same time, death holds a number of spiritual questions.Why is my loved one dying now?What is really waiting on the other side of death? Will the transition be scary, or will it be peaceful? Is there really a heaven? Will I really see my loved ones? This particular mix of medical testing results, emotions and fears of the future can be overwhelming.
Death is a transition. Birth is a transition too and we celebrate like crazy when it occurs. But rather than thinking about dying only when we have serious health issues, I suggest we should prepare ourselves mentally and emotionally for its most certain arrival. As a people, we believe in being prepared – and maybe we should be more prepared for death. For example, the people of Ammon in the Book of Mormon were reconciled with their own deaths. We read in Alma 27:28 that:
“…they never did look upon death with any degree of terror, for their hope and views of Christ and the resurrection; therefore, death was swallowed up to them by the victory of Christ over it.”
We should probably try to follow this example. But, in reality, we don’t. Fewer elderly people are discussing their deaths with their families, apparently convinced that the increasing life expectancies will give them plenty of time to have that conversation later.
*** Now one would think that faithful Christians might be better at dealing with death than others. We are living our lives on earth with the knowledge that there is an afterlife.One might think that Christians would consider the transition from earth life to afterlife as an introduction to an exciting and blessed new existence. But that does not seem to be the case. It appears that Christians are as poorly prepared for death as anyone else.
Because death is such a huge event for each of us, many people simply cannot accept it as a random event. Though there is no scriptural proof for the theory, many Christians believe that God decides when we die. They believe that God makes the decision on the moment to end the life of a loved one.
Over the history of earth, many religions have shared this opinion. In Greek mythology, for example, the Fates, three old women named Clotho, Lachesis and Atropos, decided when mortals die.These three sisters were charged with the destinies of all living beings, each life being represented by a string. Clotho spun the thread of life that represented the life of a living being. Lachesis measured its length to determine the lifespan of that the person, and Atropos would decide where to cut the string with her shears, thus ending with that person's life.
Our modern society does not believe that Clotho, Lachesis and Atropos control the length of our lives, but many believe that our Heavenly Father does. People seem to have an image of God, standing by a large bank of switches, each of which will end the life of one of His children. Checking His planner to see if this is the day scheduled for your death, in this flawed vision of God, He flips the switch that kills you. In reality, the Fates certainly do not schedule your death - nor does God.
But the belief that God cuts life short is widespread. For example, in the popular DVD “Trek”, a father is talking to a young man about his son who had died in a white-water rafting accident the year before. He says, “I wish I could tell you why Kent died that day, but I can’t.” I don’t mean to be cruel because the video is entertaining, but in the movie, Kent died because he drowned. To try to assess some decision by God that explains WHY Kent died that day continues the false perception that God arranges our deaths.
The belief that God ends our lives can easily generate… anger at God.Whether it is your own death or that of a loved one, you will be angry at the person or entity responsible. And dealing with someone’s death is not a time when you want to be angry with anyone, especially God.
There are plenty of other reasons to explain lifespans and death. Some of it is genetic. If your parents lived long lives, you most probably will too. If your family is genetically susceptible to cancer, you have a higher chance of getting cancer. Some deaths are simply due to bad choices. If a young man falls and dies while free-climbing up a sheer rock wall, we should not ask why God took him at such an early age. The young man made a fatal mistake.
There is no scripture that supports the idea that our deaths are scheduled by God. In D&C 29:43 we read:
“And thus did I, the Lord God, appoint unto man the days of his probation—that by his natural death he might be raised in immortality unto eternal life, even as many as would believe;”
This scripture indicates that God appoints unto “man” (not each individual man, but mankind) the days of our probation. The verse also specifies man’s death is a natural death by natural causes, not a supernatural death caused by God.
The errant belief that God cuts our lives short has caused many painful experiences at many funerals. For example, when a young man dies in the prime of his life, the sympathies often expressed to the grieving parents are, “God called him home” or “God has another mission for him in Heaven” or “It is all in God’s plan.” What a terrible concept to suggest to grieving parents! In such sympathies, mourners essentially express their opinion that, “Yes, God did take the life of your son, but I’m sure it was for a very good reason.” If they actually believed that God had taken their son, could his loving parents ever forgive Him? To all parents who have lost a child, let me assure you that it was never God’s will that such a thing should happen. God joins you in your grief. He did not cause it.
There are other examples of condolences that do more harm than good. When an elderly woman is going through serious health issues, I cringe when I hear someone tell her to, “Have faith!” I realize this seems like a nice, spiritual encouragement, but one has to ask, “Faith in what?” Faith that God loves this sister and wants the best for her? Absolutely true, but that statement has been true all this woman’s life. It is barely relevant to her present situation. Should this woman have faith that God is going to bless her so she never dies? Well, of course not. Everyone dies. Or should this woman have faith that God is going to cure her of her latest health problem? While this sister might indeed survive this immediate threat to her life, should she have faith in continued individual cures that will someday surely not happen?
Many family members of a young man who “died before his time” never forgive Heavenly Father for the tragedy. Their reasoning is that they had faith, they fasted and prayed, but God let them down. Until we eradicate the misconception that God takes lives, families will continue to blame God for the loss of loved ones.
If You Decide not to Fight Death any longer, is it Suicide?
One hundred years ago, most people had the luxury of not having to make life and death decisions. Treatments simply did not exist for serious health conditions, so most elderly people died with little or no warning. But today, with improved remote monitoring technology and major improvements to our medical emergency response capabilities, sudden deaths are rare. Thus, you may well have to make the decision about when you want to end your life.
When my family and I first moved to Flagstaff, Arizona, an elderly man in our ward, Clyde, became our friend and home teacher. Clyde’s legs were so unsteady that I worried that he would not make it up our front stairs when he came to visit. Within the year, Clyde’s health declined to the point he could no longer attend church or visit our home. Clyde was in constant pain for a long time. His kidneys were failing, and he was undergoing painful dialysis. Finally, Clyde decided to discontinue all medications and medical treatments. My son Trent asked me if Clyde’s decision was not the same thing as suicide. This is a common misperception. I assured him that, no, choosing to discontinue treatments and medications that are extending a pain-filled life is certainly not suicide. We should all know this. Human philosophy is simply not keeping up with our medical technology.
When considering death, most of us think, “I will fight it every step of the way!” The goal of this podcast is not to suggest that you consider otherwise.However – you must also realize that, even if you do fight death every step of the way, in the end, it is a losing battle. There is a good deal of peace in accepting that fact and making plans for it.Facing death is not defeat. It is preparing yourself for the inevitable.
We live in a time when people must consider and make decisions about long-term care and death. You should make those decisions now, while you are clear-headed enough to do so, about the person you want to be as you approach death. To be the person you want to be doesn’t sound hard… now. But as you get older, continuing to be the person you want to be gets more difficult – and then impossible. After major surgery, you will not be the person you want to be during your recovery.If you are taking a medication that helps you stay alive, but clouds your brain, you will also be a different person.
Old Age Is Not a Temporary Condition
I have a son-in-law who battled back from melanoma cancer when he was between 28 and 34 years old. He and my daughter found the most promising treatment they could find for him and then moved to San Diego for him to receive those treatments. There was, of course, no question that he was going to go through the pain, nausea, and expense of four treatments and six surgeries. He had his whole life ahead of him, a life that has included four children, a loving wife, and a successful career. Whatever pain and suffering he endured in cancer therapy, it was worth it.
But the story and the decisions are different as a person enters their elderly years. Pharmaceuticals and medical procedures have pushed life spans well into our eighties and nineties. This is wonderful at first. But as an elderly father is first confined to a wheelchair, then becomes bedridden, then falls into senility and dementia, the joy abates.
At first, as with my son-in-law, it is obvious that we should take all medical steps possible to keep our elderly loved ones alive for as long as possible. But when is doing so interrupting the normal flow of life? Long term comas are truly a suspension between life and death, so how long should we keep a loved one there? As quality of life diminishes, the heart-wrenching question that may need to be answered is, “Should the flow of medications and life-extending technology be turned off?”
When you consult your scriptures, you will find that there is no commandment to take your pills or to allow surgeries that may or may not extend your life. As I approach the end of my own life, I realize there will be a point where I will stop fighting the fate of old age. Though such a decision may lead to a slightly earlier end to my life, the remaining time I have on the earth will be a much higher quality without the drugs and recoveries from surgery. Every case is different, and you have the right – actually you have the obligation - to make your own decisions. You may or may not have to make a hard choice. But in today’s world it is becoming more likely you will have to consider the question, “When does the cost to a person’s health, dignity, and happiness outweigh the benefit of staying alive”? There are always trade-offs. Certainly, with enough medication, any pain can be dulled at the expense of a clear mind and mental acuity.
I realize that this is a difficult topic to consider. Yet, as you think about it and make decisions about it, you can find a calmness in knowing that the decisions are made. Lastly – and I want to repeat this thought - no elderly person should be burdened with the guilt of thinking they are committing suicide by halting painful surgeries, long-term dialysis, or drugs that hamper mental acuity. That is not what our Heavenly Father wants for us.
The Decisions
There are so many questions to answer. Do you want to be buried or cremated? Where do you want the plot? Do you have a will or a family trust? Do you have a living will?
As a quick aside, a Living Will is a very good idea. First, a Living Will documents your desires. If you DON’T want to be hooked up to a respirator, a Living Will helps assure that you won’t wake up someday and find yourself attached to a respirator - and, even worse, unable to communicate your objection.
For my own part, I don’t want extraordinary efforts to be made to keep me alive. Do I want to be trapped in a body where the most interesting thing I can do is watch daytime television? I get bored very easily, so No, thank you. I believe in the afterlife. I’m even looking forward to it.
The second effect of a Living Will is to allow my wife or children to feel no guilt at turning off a machine or medication that is keeping me alive. I have told each of my children my desires in no uncertain terms. If I am in a hospital bed with a machine keeping me alive, they all know I want them to turn it off. They should feel no guilt for carrying out their father’s wishes for his mortal body.
Then there are the Emotional Preparations, which can be harder
As you get older, your body is desperately trying to tell you something. As explained by author Sherwin Nuland in his book How We Die: Reflections on Life’s Final Chapter
“Old age is the preparation for departure, the gradual easing out of life that makes its ending more palatable not only for those who are elderly but for those to whom they leave the world in trust.”
Life on earth should be wonderful. We love our earthly lives and our families, and we never want to leave. But the pains of old age, the frustration of losing your mental acuity, and perpetual exhaustion all have their effect. Perhaps these difficulties should not be seen as a curse… but more as a kindly reminder. We are being given fair warning that our time is about up. It’s a transition that we may fear, but the pain of those last years can help us understand that… maybe it won’t be so bad to move on to the next plane of existence. We can slowly release our desperate grip on life. Children and grandchildren witness the gradual deterioration of the bodies of their loved ones and they too can come to realize that death may be a release rather than a tragedy.
The point of my podcast is illustrated by a story from the 2014 book “Being Mortal - Medicine and What Matters in the End” by Dr. Atul Gawande. Dr. Gawande is a surgeon and best-selling author of several books about the challenges of being a doctor or of being a patient.
Dr. Gawande starts out this book by telling us the story of Joseph Lazaroff, a man in his sixties and suffering from cancer. Mr. Lazaroff had two options – comfort care (hospice) or surgery to remove a growing tumor in front of his backbone. The operation (and I quote)…
“…couldn’t cure him, or reverse his paralysis, or get him back to the life he had.No matter what we did, he had at most a few months to live, and the procedure was inherently dangerous… The operation posed a threat of both worsening and shortening his life. The neurosurgeon had gone over these dangers, and Lazaroff had been clear that he wanted the operation. “Don’t you give up on me”, he said. “You give me every chance I’ve got.”
The eight-and-a-half-hour operation was a technical success. But Mr. Lazaroff never recovered from the procedure. He developed respiratory failure, systemic infection, blood clots, and internal bleeding from the blood thinners.
Dr. Gawande then states,
“I believed then that Mr. Lazaroff had chosen badly, and I still believe this.He chose badly not because of all the dangers, but because the operation didn’t stand a chance of giving him what he really wanted; his continence, his strength, the life he had previously known.”
Dr. Gawande continues.
“We (his doctors) could never bring ourselves to discuss the larger truth about his condition or the ultimate limits of our capabilities, let alone what might matter most to him as he neared the end of his life.”
Dr. Gawande concludes that the medical community needs to be better at communicating the ultimate limits of its capabilities. I wish doctors everywhere success in those efforts.However, I think patients need to be asking these questions as well. In the end, it is the patient who will have to endure the results of any decision. Your doctor may, as Dr. Gawande mentions, “avoid talking honestly about the choice before you”. You may have to convince your physician that you want to know the whole truth, not just the easiest, more comfortable aspects of your condition.
A second book about this same subject is “The Conversation – A Revolutionary Plan for End-of-Life Care”, by Dr. Angelo E. Volandes. The Conversation specified in the title is the brutally honest one that must be held between the patient, the doctor, and the immediate family.He notes that, due to our continued avoidance of death, we aren’t having the discussions with our doctors that we need to have. I quote…
“The first necessary step towards a remedy lies with a return to the oldest tool in medicine’s proverbial black bag: talking with patients about their wishes for how they want to live their remaining time.”
I have chosen this topic for my podcast today because dying and death are very complex issues that overlap both science and religion. Whatever your condition, I can guarantee that the medical science behind your health problems will be complex. You will struggle to understand what is happening to your body, what the test results mean, and what the doctors recommend. On top of that complexity, you may be struggling to understand your own personal and religious philosophy around death. If possible, it is best to figure all this out during your life, not at its end. Put your desires down in writing and then come to terms with what you have written. Though they may initially object to having the discussion, push back and share those desires with your spouse and adult children, so they too know your wishes.
One of the greatest expressions of a strong testimony of the gospel of Jesus Christ is being able to look into the face of death with no fear. If you truly believe in eternal life, death is just a portal. Yes, the portal is one-way and you will terribly miss the people you leave behind. But you have been separated from loved ones before. Fear of death is mostly just a fear of the unknown. If you have a strong testimony of the Savior, then you must also believe in the resurrection. Otherwise, what is the point of the entire gospel? In the end, the largest “leap of faith” in life is in accepting death.
That is all I have for you today. I thank you for listening to this podcast. It’s a difficult one to think about, but I hope you were able to take away some thoughts. Please think about your friends and family members, who might benefit from this episode and share it with them. It might be a good way to initiate a necessary conversation. And if you haven’t subscribed to my podcast, please do – it will help others find the podcast. And send me email at scottrfrazer@gmail.com with any suggestions for discussion topics. This is Scott Frazer from the podcast Science and Scriptures. Take care and have a good week.