Two books provide insights, fuel for debate about end-of-life issues - Catholic Courier

Two books provide insights, fuel for debate about end-of-life issues

A Better Way of Dying: How to Make the Best Choices at the End of Life by Jeanne Fitzpatrick, M.D., & Eileen M. Fitzpatrick, J.D. Penguin Books (New York, 2010). 222 pp., $15. Living Well and Dying Faithfully: Christian Practices for End-of-Life Care edited by John Swinton & Richard Payne. Wm. B. Eerdmans (Grand Rapids, Mich., 2009). 311 pp., $25.

"I think of death every day of my life," Dorothy Day, the cofounder of the Catholic Worker Movement, once told a friend. And, 50 years before she died, liturgical artist Ade Bethune built her own plain wooden coffin and decorated it with scenes of her earthly dwellings (as well as the slightly open doors to heaven).

While we may not yet have reached this realm of acceptance, it is good to try the terrain, in hopes of easing the final journey. These two quite different books each offer considerable illumination as well as fuel for debate.

In A Better Way of Dying, sisters Jeanne and Eileen Fitzpatrick, the former a physician and the latter a lawyer, have teamed to provide pragmatic, explicit guidelines to help us direct end-of-life care. Such instruction is essential today, because, as they write, antibiotics and other miracles of modern medicine have made sudden death fairly rare. Instead, they say, death "more often follows a long, slow decline into extreme old age marked by increasing frailty and debility, and sometimes dementia."

Through numerous real-life examples, the authors make it clear that sometimes a living will is not enough. Despite detailed advance directives, personal preferences for end-of-life care are all too often not honored. Enriched by the authors’ decades of experience, A Better Way of Dying outlines a five-step "compassion protocol" that can help guide caretakers in a clear, concrete and legally binding way to carry out our final wishes.

A Better Way of Dying will be of use not just to the elderly facing their final years, the terminally ill and those in the beginning stages of degenerative diseases such as Alzheimer’s, but also to healthy people who are mindful of life’s uncertainties. The well-written narrative with its engaging examples gives a face to the many medical and ethical issues that accompany end-of-life care and invites us to explore further.

For a deep understanding of how Christian practices — such as love, prayer, lament and compassion — can help us die well, Living Well and Dying Faithfully should be consulted, and preferably before we are face to face with our own or our loved ones’ demise.

This anthology of a dozen well-edited articles contributes importantly to the debate about the "medicalization" of death. Where once theological perspectives dominated our approach to death, we now look to medicine to shape our final days. These two approaches are not wholly incompatible, the authors write. But dying, they wisely remind us, is an art. Living confidently in the face of death means caring deeply for others at the end of life — and indeed, caring for each other throughout life, as Stanley Hauerwas of Duke Divinity School points out in an eloquent foreword.

In his piece titled "’Why Me, Lord?’: Practicing Lament at the Foot of the Cross," John Swinton notes how Western culture uses a largely medicalized "language of diagnosis, treatment and prognosis" to discuss the suffering of our final days. Such medical discourse "tends to point us away from the inevitability of death and the possibility that the suffering which Christians experienced may be shaped by another story and may have quite different meanings and expectations attached to it in terms of a hoped-for outcome."

That other story "is that the key task for Christians is not to avoid suffering and death," Swinton continues. "Rather, the key task is to learn how to face such things faithfully and with the assurance that God is with us and for us even as we suffer." This is one of the book’s most well-developed themes.

Swinton, a professor of practical theology and pastoral care at the University of Aberdeen, Scotland, has effectively joined with Richard Payne, professor of medicine and divinity at Duke Divinity School, to offer this thoughtful and readable collection.

Roberts directs the journalism program at the University at Albany-SUNY. Her books include two on Dorothy Day and the Catholic Worker Movement.

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