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Thursday, February 18, 1993.
"Death and Dying" supplement.

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Death and dying --
a part of living
By TOM RUE
Grieving the loss of one who has died is an experience common to all human cultures. In our society feelings of sadness over the death of a valued compan are often complicated by some combination of guilt, fear and other emotions. In such moments, it may be helpful to pause and reflect on the various feelings being experienced.

By not intellectualizing but by paing attention as feelings flow through us, we can heighten the awareness that leads from acceptance to healing.

It has been observed that the intensity of grief appears to be related not so much to the intensity of "love" for the lost person, but rather to the intensity of involvement. In a highly enmeshed or even conflicted marital relationship, the surviving partner often experiences grief, which family members may view as somehow incongruent with the relationship.

Guilt feelings may stem from a sens -- rational or not -- that something could or should have been done to prevent the death, or from unresolved issues involving the relationship with the deceased. "I should have been there," or If only I could have told her once more that I loved her" are common self-blaming themes heard from survivors. There may be times when statements like these are based in reality, but for the most part they are unproductive. It's usually best try and let go of them. But this is often easier said than done.

Interaction with death lies at the root of most faiths. Many religions portray death as temporary, promising that the dead and the living will meet again. Attempts to deal with the experience of death gave rise to Egypt's great pyramids, to flaming Viking ships setting out for Valhalla with their silent wariors, and to the bronze caskts with velvet trim and the careful cosmetics of modern funeral practice.

Envision our common primitive ancestors' responses to the lifeless bodies of their elders, or to young women dead in childbirth, or hunters mortally wounded by their prey. Did they scratch images on a cavern wall to commemorate the dead, or create stories to explain where the dead had gone? Although often viewed with mystery and dread, death has always been a natural part of life, regardless of the dressings that accompany it. And likewise, grief is also universal to the human condition.

For this task to be successful, it must be understood that loving a person does not mean submerging one's identity in that of the other.

Many find it helpful to believe that there is purpose in the pain that would otherwise seem meaningless and cruel, causing both mourners and those around them to each feel so utterly helpless. Spiritual practices can give voice to the pain and aid in saying farewell. Among Jews, for example, various symbolic acts of mourning, collectively known as sitting Shiva, include corporal denials and other symbolic acts. Most religions maintain traditions, customs and rituals that relieve tension, offer solace to the bereaved, and surround the process of dying with a sense of the holy.

But the experience of grief varies from person to person, as it does from situation to situation. The response to having a loved one murdered or accidentally killed while in the prime o life is drastically different from losing an aged grandparent. Even the abortion of an unknown fetus normally results in a grieving process for a woman who chooses to terminate an unwanted pregnancy.

The death of a loved on who has endured a long terminal illness may actually feel to family members like a weight being lifted from their shoulders and a conclusion to much anguish. In these cases, death can come as a relief. But feelings are rarely so simple, even in what we might think of as the most clear-cut of cases, or many life-and-death choices would be easy.
Suicide

The mass media of late has been replete with reports and commentary on the practice and ethics of doctor-assisted suicide. A newly adopted law in Holland guarantees immunity to physicians who follow strict guidelines for mercy killing, while states in this country are considering similar statutes. It is clear that American society is ambivalent about the practice of helping a person to die, or even permitting death to ocur when its prevention is humanly possible.

Public attitudes toward suicide are deeply divided. On the one hand, some hard-line theologians decry any taking of human life (including one's own) as a mortal sin. New York State law provides for incarceration of a year or more for "promoting a suicide attempt" as a class E felony, while neighboring Pennsylvania classifies "aiding or soliciting suicide" a second-degree misdemeanor.

But at the same time some people, like philosopher Derek Humphry, founder of the Hemlock Society, or SUNY Syracuse psychiatry professor Thomas S. Szasz, continue to call for greater individual choice on the question of active voluntary euthanasia, and whether the overnment should be empowered to coerce people to continue living against their will.

One of Humphry's more recent books, Final Exit (1991), aroused particular controversy by describing the how-to aspects of several dozen techniques of "self-deliverance." Columnists and pundits at the time denounced the book, but it shot to the top of the bestseller list. Information about the Hemlock Society and its publications can be obtained toll-free by calling 800/247-7421.

Those who care for a suffering patient, either as a professional or a family member, should be alert for signs of depressive mental illness, relieve pain whenever possible, and safeguard dignity and self-esteem. More than 90% of reported U.S. suicides are immediately preceded by an episode of major depression, with symptoms including feelings of worthlessness, delusions of hopelessness, and insomnia.

People must know that hope is available to allow the terminally ill to die with comfort and dignity at hospitals or elsewhere, and without the type of artificial assistance being beaten into the public consciousness by the notorious and flamboyant pathologist Jack Kevorkian, known in the media as "Dr. Death."

At the other end of the spectrum, there is the question of what types of heroc measures should be taken to preserve human life beyond its natural conclusion. Since death comes to all sooner or later, it must be asked whether it is wise, prudent or just to spend hundreds of thousands of dollars to add a few months to a rich persons' life, while children starve. At the same time when national health care policy alternatives are being examined, the implications of placing reasonable limits on life-preserving measures must be openly discussed. Rational social plicy must be rooted in sound reason -- not emotion, religious beliefs, or pecuniary profit.

People who are grieving the loss of a loved on, or feeling depressed and questioning their own desire to continue living, can often find help from a professional counselor trusted clergy member.

In the end, death must be faced by everyone. It has been said that, from the moment we are born, we begin to die. Death's visage need not be fearsome. The final transformation can be viewed as one more turning point in a never-ending spiral of physical existence.

I am reminded of one of the basic laws of physics, learned years ago in an elementary biology class: Matter and energy can neither be created nor destroyed, only changed. How this applies to flesh and blood is clear. How it applies to energy of the spirit is not readily observed, but can be surmised.

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Related external links

The Hemlock Society