Everyone dies. It is built into the universal design, which cannot adequately function without it. In a finite, contingent universe, evolving to perfection, growth and new life must come at the expense of existing life or overcrowding, and a lack of resources would follow. One generation must die to provide the resources for the next. Everyone in the world knows it.
People speculate on what is a good way to die. Some action-oriented individuals wish to die on the battlefield in a blaze of glory. Other people don’t want any drama at all, wishing to die peacefully in their sleep. Still others want to be in a safe, comfortable environment, surrounded by loved ones, content with having accomplished their life goals when they die. This third group, probably the largest of the three, requires advanced warning of their death. They needed to have a terminal diagnosis to get their desired death.
Some will try to get the same feeling by planning their own death through suicide, but it will not be the same. Suicide is a selfish act because it abandons those that depend on you, many of whom you may not recognize. One can simply not expect people to celebrate your killing yourself in the same way that they would celebrate your life if you are called home to God.
Does this mean that all terminally ill patients die well? Not at all. It depends on how they receive and what they do with the information. First of all, not everyone with a terminal illness is told the severity of their situation. A terminal diagnosis is as hard to deliver as it is to receive and many physicians believe that death is a failure of medicine so they may withhold the true diagnosis or even deny it, choosing instead to offer hope of a cure. This is what happened in my own case.
Almost 6 years ago, my neurologist told me, “You have Parkinson’s disease, but don’t treat this as a death sentence, you should have 5-10 years of functionality and by that time, we may have a cure.” I told this to my new neurologist recently and thankfully, he was more to the point. He estimated that with the medicines and procedures available, I would probably be able to function relatively normally for 2-3 years, but also warned me that if I stopped my activities that I would decline far faster than that. I applaud his courage in telling me that so bluntly. It allows me to plan out my path.
This now becomes a question of how to use our remaining time and energy. Every person in this situation needs to balance three things: fighting the disease, living your life and preparing for death. All three are important and cannot be neglected and there is a right way to do each.
Fighting the Disease
Turning to medical science for an answer to a terminal illness must be with the right expectations. What you can reasonably expect is control of symptoms which allow your quality of life to be high enough to maintain your obligations to others as long as possible. It is important to keep the perspective that life has meaning and purpose and that medical solutions that extend life at the cost of what gives it meaning and purpose are counterproductive and will be shown as such by extending the person’s suffering.
In the same way, it is counterproductive to spend all our time, resources, and energy in the quest for life extension if it forces us to give up what gives our lives meaning. On the other hand, medical solutions that can extend our ability to fulfill our obligations and carry out our role in God’s plan are a Godsend in the true meaning of the word. For instance, without the right medicine balance, I cannot type, which makes me unproductive. It’s therefore appropriate to expend energy and time to balance them.
Living Your Life
The second consideration is that despite the diagnosis, we can and should try to lead a fulfilling life with the remainder of our time. Our “bucket lists” should be doing things that make a difference in people’s lives, not in collecting things or experiences that will be totally inconsequential to anyone when we are dead. A few kind words spoken to a stranger will leave a better legacy than going to every state or climbing every mountain. Pass on what you have learned in life in whatever venues you have to whoever can benefit. A gift thoughtfully given or a word properly spoken can change a life.
Treat impending death as you did your high school graduation. The emotions will be similar. If you enjoyed high school, graduation can be bittersweet. There will be some sorrow for what you are leaving behind and some anxiety about what is ahead, but if you remember back, it was exhilarating considering the possibilities of what was coming on the other side. If your high school experience was rough, graduation was a great relief to be done with all the rivalries, intrigue and boredom of the experience and hope for something better in the next stage of your life.
Preparing for Death
The third consideration is to prepare ourselves and those that depend on us for our impending death. The priority here is that we have an opportunity to reconcile with God and save our eternal souls. This is a very great blessing, and it’s a shame if it’s not acted upon. God is like the father in the parable of the Prodigal Son (Luke 15:11-32), waiting for us to come home to Him with open arms. He has established the sacraments as the way to signal our desire to unite with Him. The most obvious one is baptism, which makes us members of Christ’s body, his church. For the already baptized who have fallen away, the defining step is going through the sacrament of reconciliation (confession).
For those who have been sacramentally cleansed by either of the two aforementioned sacraments, the anointing of the sick can be most helpful at the end of life. It is not focused on the healing of the body, but on the soul. The Catechism of the Catholic Church says “the first grace of this sacrament is one of strengthening, peace, and courage to overcome the difficulties that go with the condition of serious illness of the frailty of old age (CCC# 1520).” It further states that “Just as Baptism, Confirmation, and the Eucharist form a unity called ‘the sacraments of initiation,’ Penance, Anointing of the Sick and the Eucharist as viaticum constitute the end of Christian life. (CC, 1525).
In tandem with this, we need to reconcile with anyone with whom we are in conflict, out of love for them, since there will be no way for them to resolve the anger or resentment once we are gone. This should be done as expediently as possible since we don’t know the day nor hour of our passing. Out of love for our survivors, we need to update our records on how to backfill us on a regular basis and to train replacements to carry on our work. Disbursal of personal goods can take place as you see appropriate, but you should not give away things you need for everyday life, because you need to keep on living until God calls.
At the very end of life, the hospital may give you four options on how to end your life. One way is through medicalized death, trying every possibility, each more onerous than the last to survive, until finally you succumb. The second is to embrace natural death with a hospice program which no longer treats anything but pain. This is the only acceptable choice if it is not set up to sedate the person so thoroughly that the person cannot carry out his or her obligations. The third is to take the second further and sedate the person so heavily that he or she feels nothing. When this is coupled with a withholding of nutrition and hydration, it is called terminal sedation, resulting in death within a week or so, potentially limiting a person’s ability to complete their life’s work. The final choice is, where legal, to commit suicide with the aid of a physician. This, however, is never a good choice, because it usurps God’s role as master of life and death and separates us from Him.
To die well is to be able to reconcile with God and our neighbors, to feel that we have completed our life’s work, and to train those who follow to do the same. But the only thing that really matters is whether you join with God in the Beatific Vision. This is possible for all people who are so diligent in following Church teaching that they are ready for death at any time. But there is a special grace given to those who have a terminal diagnosis, because God has given us advanced warning to take the necessary steps to enter his kingdom. Rejoice in his love for you, especially if you are not yet prepared to die, since he has granted you that preparation time.