Living a Good Life. Dying a Good Death.
What does religion and scientific research tell us about the concept of a good death?
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Success is a binary state, right? Either you are successful or you aren’t. Now, I’ll concede that everyone defines success differently. I thought I was successful when I was done with grad school and had a well-paying job lined up.
I’ll also grant you that this binary state can fluctuate. When I was laid off from that job nine months later, I didn’t feel like much of a success.
Society largely defines success by wealth and job advancement, though others — like Harry Bailey — will assure you that success is found by having a loving family and healthy living environment1. While success is a yes/no proposition, the terms and conditions of success are extraordinarily subjective.
Death, too, is binary. You’re either alive or you’re not, right? But, can we combine the two? Can you die successfully2, or better, can you experience a good death? And what the hell does that even mean? We’re told to fight to the good fight. Advertising tries to convince us to live the good life. But, dear reader, how does one die a good death?
What does religion say?
Having been raised Roman Catholic, all death is good as it brings us closer to our Lord — the end goal for most Christians. Catholic believe the sacrament of the anointing of the sick, or last rites, is your last stop before meeting St. Peter. The sacrament is where a priests blesses the ill person with oils, recites prayers and absolves them of any sins not previously accounted for. Quite a tidy little process. There are Biblical roots in it as well3:
Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord.
— James 5:14
The rite is to prepare you for your entry into heaven and if your sins have been wiped away on the way out, like the bartender tearing up your tab, it certainly makes for a lower stress exit from this world. From The Art of Dying Well:
Hospital chaplain, Fr. Peter Harries, says a good death may involve reconciliation with God or family members.
“It’s about tidying up loose ends in their lives. For other people it’s about times with family, friends, and those who are significant to them. It’s about spending quality time together and creating memories.”
Protestants have chased the good death as well. Prior to the Reformation, it was believed that the grace of God was (allegedly) granted upon those who died peacefully, with a family and priest present. Those who died alone, well, didn’t. In the latter case, it was Satan that won by TKO at the final bell in the struggle for that person’s soul.
Doing a good deed or act of charity was also thought to bring about a good death, even for those in the gallows.
Francis Nicholson, noose around his neck in 1686, warned all children in the watching crowd at Tyburn to mind their duty to God and publicly lamented his sins. Even the condemned sought as good a death as possible.
The Reformation removed the spiritual hurdles from dying, placing the impetus for achieving a good death on the individual4. Communion and reconciliation were left behind to the Papists, so there was no final cleansing of the soul.
No, boys and girls, a good Protestant death meant a show! Christopher Sutton published Learn to Die in 1601. His book encouraged people to settle their affairs and gave them a guide to follow to create the optimal deathbed setting. You needed a crowd to watch your theatrical exit. Women, who had no voice in the church, were allowed a stage at this point. Doctors? You want doctors? BANISH THEM! They simply meddle in God’s plan and get in the way of the three-ring circus of your last hours. Your suffering is God’s and Satan’s fight, not a physical malady where you may require relief and treatment!
And I hope you’re lucid at the end, because there’s no space for delirium or pain, as Satan is obviously the only reason why one would be loud, scared, confused or crying while dying. After all, we can’t have any suffering while you’re dying. You were supposed to fall asleep and move into the next life with the Lord. Peacefully. A good death.
More than a century later, glitz and glamour gave way to a new philosophy: a good death would be granted to those who led a good life5. People who died suddenly were seen as receiving a gift from God for their life of good deeds. As for everyone else, the deathbed scenes were scaled back and doctor’s were allowed in to provide comfort to those that were suffering.
Generally speaking, Judaism teaches that every moment of life is of infinite value, even those at the end. Though it does not have a death rite like Catholicism, Jewish laws and customs state that a person should not die alone and have the support of their community around them. This not only includes family and friends, but also making peace with adversaries. Jews are also encouraged to make a final confession and declaration of faith, also known as the Viddui:
“I regret the hurts I have caused and the mistakes I have made. Forgive my sins and my soul will be pure as it returns to You. Protect those I love whom I leave behind, for their lives are in Your care.”
Islam looks at things a little more simply. You die a good death by surrounding yourself with family and seeking forgiveness from Allah. The dying person recites the Qur’an, including the final statement of faith from the dying person that there is no true god but Allah, and Muhammad is his servant and messenger. The body (or face) is turned to face Mecca and that’s that. Good death!
What does research tell us?
A team of researchers from UC San Diego published the first comprehensive study (a literature review, but still) on what successful dying looked like. Their work was outlined a series of themes for achieving a good death that you can read in the article, but they distilled them down to four that were sought by more than 50% of people from the articles they considered:
Life completion, in that they have said goodbye and accepted death.
Treatment preferences, in that they have control over their course of treatment, even if it is to have no treatment at all or to seek a physician-assisted death.
Dignity, so they are respected as an individual until the end.
Family, as in a want for familial support without being a burden.
It was a Japanese study published in 2007 that christened something called the Good Death Inventory, a questionnaire completed by bereaved family members of cancer patients who died at a regional cancer center. The GDI was established based on the Japanese concept of a good death, rated on 18 different concepts. Each concept had three questions attached to it. For example, the concept of environmental comfort asked whether the person was living in quiet circumstances, living in calm circumstances, and if the patient was troubled by other people.
The results showed that people wanted to be supported by religion first, followed by being able to stay at their favorite place, being free of physical distress, and knowing what to expect as their condition progressed. Having some pleasure in daily life, living in calm circumstances, receiving enough treatment and feeling that one’s life was completed were next.
At the bottom? Dying a natural death and being valued as a person.
Dying the good death
I think about noted philosopher Mike Tyson, who once said, “Everyone has a plan until they get punched in the mouth.6” Along a parallel path, it seems that everyone — even atheists — believes in God when they are about to die.
Religion provides most people with a sense of comfort at varying stages of their life, so it is and isn’t a surprise that the Japanese study showed that being supported by religion rated highest on their index. I don’t think of Japan’s culture as being particularly religious7, yet caregivers found their dying relatives reaching for spiritual comfort along with medicinal.
That it’s followed closely by being free from physical distress brings this full circle to pre-Reformation Christianity and Islam, marking one of the few times my cynically agnostic brain can recall religion being ahead of science.
I’ve never thought about my own death in terms of what would be good or bad. In the case of my mother, she received her last rites a few weeks before dying. Her family was with her at her final moments and our parish priest visited after she had passed that evening for one last blessing. Though she was sick and suffering, she went quietly and in the comfort of her religious beliefs.
I suppose she achieved as good a death as one could expect.
Final thoughts on finality…
I suppose dying well for me is contextualized by my life, right, I think that if I can be on my deathbed and say that there is not really one point in time where I would have done anything different, that for me is the perfect ending to my book, or to my life, having peace to just retreat into myself on my deathbed, and knowing that I’ve done a good job, I think that’s what dying well means to me.
Dirt Nap is the Substack newsletter about death, grief and dying that is written and edited by Jared Paventi. It’s published every Friday morning. Dirt Nap is free and we simply ask that you subscribe and/or share with others.
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I’m a both-sides’er in this regard. You are the sum of your parts.
Word order is important here. Everyone will eventually successfully die. I want to know whether one can die successfully.
As opposed to the wheelbarrow full of other dog shit vomited forth from the pulpit that has no religious grounding.
As if they didn’t have enough to worry about while dying.
There’s a novel fucking idea.
It’s worth noting that Mike Tyson made this statement prior to his 1987 fight with Tyrell Biggs. Remember Mike Tyson fights? It was appointment television before we knew what that meant.
According to its most recent census, 62% of Japanese citizens are atheist.