A Peaceful Death or a Perfect End: Two Visions of the Good Death in Christian Thought

Abstract

A Peaceful Death or a Perfect End:Two Visions of the Good Death in Christian Thought Paul Scherz Many people are unclear as to what a good death is, especially a good Christian death. Nearly everyone agrees on what is a bad death: a highly medicalized death in the ICU with medical staff fighting until the last minute; a death leaving little time for the patient and her family to come to terms with mortality; a death portrayed as a painful failure of medical technique; a death experienced as a loss of control. The most prominent vision of the good death today is just the rejection of such a medicalized death. For example, a group of priests asked about good or happy deaths responded with phrases like "pain-free," "dying with dignity," or "surrounded by loved ones." 1 Over the last fifty years dismay at the bad, medicalized deaths of our contemporaries has led to many attempts to help people reach this vision of the good death. One of the most valuable institutional and legal responses has been hospice and palliative medicine (HPM), which has done much to allow people to escape medicalized deaths. Recent efforts by the Pontifical Academy for Life have pressed for the expansion of HPM in part to push back against the other major response to medicalized death, assisted suicide. 2 [End Page 613] More interesting from a theological and philosophical perspective have been the attempts by many to develop practices to help people prepare for death, such as by some secular authors like Atul Gawande or in the Conversation Project. 3 There have also been Christian discussions of practices, many of which draw on the early modern art of dying tradition, the ars moriendi. 4 This tradition was embodied in pastoral manuals that were first developed in the aftermath of the Black Death but maintained their popularity in diverse Christian denominations into the nineteenth century. These manuals explained virtues, practices, sacraments, and prayers that could help a person face death well. They were how-to manuals for dying. However, the argument of this essay is that underlying these recoveries lies a secular vision of the good death, the peaceful death, which largely seeks immanent goods in the dying process, like comfort, control, and community. 5 It is an aesthetic of dying, involving a certain choreographed deathbed scene. While none of these aims are unworthy to seek at death in themselves, I will argue in the first section of this essay that they raise problems when set as major goals of the dying process, especially since most people will not be able to achieve them in their end of life experiences. If many terminal illnesses will not allow this particular scene at the hour of death, people will be tempted to seize the initiative themselves, enacting the good death they seek through assisted suicide. Though HPM does great good and is a worthwhile goal to seek for itself, it will not prevent the expansion of assisted suicide, as evidenced by the fact that nearly 90 percent of those seeking assisted suicide in Oregon were enrolled in hospice. 6 While a focus on practice is also useful, it is necessary to attend to [End Page 614] the truth claims, frequently implicit, underlying a practice because it will shape how that practice actually influences action and character. What is needed is a different vision of death, such as the one held by the earlier art of dying tradition outlined in the next part of this essay, in which death is almost always a dramatic, climactic moment. In this understanding of death, a good death was defined exclusively by whether a person repents or maintains faith, thus coming to salvation, a view summed up in the oft-cited line of John Damascene that death is for humans what the Fall was for angels. 7 This view contained two elements. First, dying well aims beyond the mere immanent practice or moment of dying towards achieving the end of eternal life. Therefore, in death, one could accomplish the end of one's life by dying in Christ, both completing the work of one's whole life and receiving eternal life...