Cultural Fear of Death, Part 3

 …it is appointed for mortals to die once… Hebrews 9:27

Last week I reflected on the financial and emotional costs of dying. My conclusions were that (1) dying is expensive, (2) dying is emotionally trying, and (3) dying is even more expensive when death is prolonged for reasons other than for what can reasonably be expected to prolong a decent quality of life. There are at least two other types of costs, physical and spiritual, that I reflect upon below.

The physical costs of dying primarily have to do with the pain and suffering of the patient. No one wants a “cure” to be worse than the disease, but that appears to happen in some cases. Again, we must distinguish between treatments that have been shown to have a reasonable chance of prolonging a decent quality of life from those that have shown little reason for such optimism. We must also give some leeway in the case of experimental treatments that may not help the current patient, but which may provide important information for developing effective treatment protocols for future patients. Aside from those qualifying factors, the physical costs of avoiding death can be agonizing.

Surgery, chemotherapy, radiation therapy, and even physical therapy can be painful and disruptive, making it increasingly difficult for the patient to be present to the joys that might otherwise be available in their remaining days. The increasing acceptance of palliative and hospice care reflects the cultural shift to allowing those with terminal conditions to die as comfortably as possible without complicating the dying process with unnecessary, ineffective, and uncomfortable treatments.

Unfortunately, many providers feel forced into practicing defensive medicine, which is the practice of doing everything possible to extend the life of a patient, regardless of its expected efficacy. This is particularly prevalent in emergency medicine. Defensive medicine has evolved from an overly aggressive legal system where providers can be sued for enormous sums of money for not ordering every possible treatment option. Our cultural fear of death muddies the waters here. For example, if a certain terminal condition has been shown to respond positively in 1% of the cases where a certain treatment is attempted, should all patients receive that treatment? What if the percentage is 5%? 15%? What if the patient is over a certain age or has other serious health issues? What if the treatment’s price is over $100,000? These are cultural and ethical issues without firm guidelines or clear answers. They are also ripe fodder for patient families and their attorneys to accuse health providers of unreasonably hastening death.

The largest physical costs of prolonging life in the face of death accrue to the patients, who in many cases are not deemed competent to participate in decision-making about their care because they are unconscious or in a medication-induced, altered state of consciousness.

The spiritual costs of prolonging life, like the emotional costs, are impossible to quantify. They are largely dependent on the spiritual grounding of the patient and the patient’s loved ones. Those with no belief in an afterlife may prefer to extend life at any financial, emotional, or physical cost. Atheists and others with a this-is-all-there-is mentality view death as annihilation and will likely desire to extend this life until annihilation becomes preferable to the pain and suffering of continuing to live.

In some religious belief systems, death under certain conditions such as martyrdom, is preferable to this life. For such believers the underlying motivation is to get to the afterlife as opposed to extending this life. For Christians, the death and resurrection of Jesus the Christ is intended to show, among other things, that there is nothing to fear from death – that we die and are resurrected into a new life. Numerous scriptural passages affirm this message. In addition, we see death and rebirth continuously in the world around us, as well as in our own lives. The evidence is everywhere – in the springtime, in each new day, in the regeneration of cells in our bodies. God ordered creation such that there should be no fear of death because it is always followed by rebirth. Physical forms die, but the essence lives on. In that sense, an unreasonable fear of death can reflect a lack of faith.

Our culture sends the message that death is to be avoided at all costs. It is a message we absorb at an early age. One of the key lessons of initiation rites into adulthood, which were part of every culture until recent times, is that we are all going to die. Perhaps our cultural fear of death grew as those initiation rites died out. Our souls are immortal; our bodies are not.

This is the 29th in the series of Life Notes titled, If I Should Die Before I Wake. I invite your thoughts, insights, and feedback via email at ghildenbrand@sunflower.com, or through my website, www.ContemplatingGrace.com. At the website, you can also sign up to have these reflections delivered to your Inbox every Thursday morning, if you are not receiving them in another manner.

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