Let’s talk about death

(This editorial first appeared in the November issue of the Anglican Journal.)

We are, on a daily basis, confronted with images of death: we see it in the news and on social media, on TV shows, movies and video games. We routinely hear about life-threatening diseases, mass shootings, massacres and disasters, and we witness public displays of grief and despair even from faraway places. There’s no escaping the shadow of the Grim Reaper-it is streamed 24/7 on just about every device imaginable these days.

And yet, for all its ubiquity and inevitability, most of us avoid talking about death, especially when it involves ourselves, and our loved ones. The Christian faith offers a message of hope about living well and dying well, but it is missing in the public sphere.

Only about 15 per cent of Canadians have discussed end-of-life care and funeral wishes, according to the Canadian Medical Association (CMA).

Why is death shrouded in so much silence and fear when it used to be something so real and natural? In the years 1900 to 1950, most Canadians died at home; the community assisted the family in attending to the dying and participated in rituals rooted in one’s cultural and religious background, according to Death, Dying and Canadian Families, a study by The Vanier Institute of Family.

Things shifted during the postwar years, when both birth and death took place largely in hospitals. Death came to be seen as a medical failure, notes the study, and “once all curative measures had failed, the dying person in the hospital was often left alone, their care left to nurses who were neither trained nor equipped to care for the dying.” Death became an individual and family affair that often excluded children. Today, nearly 70 per cent of Canadians die in hospitals.

Change may be afoot. Death and dying are hitting closer to home. The population is aging, but life expectancy is also rising. By 2041, seniors will comprise nearly a quarter of the Canadian population, compared to 14.8 per cent today.

Quebec’s approval in June of medical aid-in-dying legislation, recent high-profile suicides of terminally ill patients and the Supreme Court of Canada’s review of existing laws prohibiting medically assisted death have forced Canadians to confront their own views about ending one’s life. It has also raised awareness about the need for palliative care. The CMA has called for a national strategy to provide compassionate care for the dying, noting from a national consultation it held recently that “Canadians want good access to palliative care, they don’t want to die alone, and they don’t want to be a burden to their family and caregivers.” The sad reality, however, is that access to palliative care varies depending on where people reside in Canada and what they can afford.

Given these developments, the Anglican Church of Canada’s faith, worship and ministry committee has created a task force to revisit end-of-life issues. (See p. 1.)

It is a necessary move. If clergy and lay ministers are to share the journey with people as they go through life and death, they must be equipped with theological, ethical and pastoral resources that are appropriate to their local contexts.

Whether one is a believer, seeker or non-believer, there will come a time-and that may be now for some-when questions about what it means to die and how, to the extent possible, one can prepare for it will be increasingly asked and the church should be there to support people. “Death cafés,” where folks drink tea, eat cake and discuss death, have sprung up across Canada, indicating a hunger for meaningful talks about mortality.

The church can help reduce the fear of dying, but it can also help increase knowledge about palliative care. Care in Dying, a report produced by a task force of the faith, worship and ministry committee, notes that along with other Christian communities, the church has had “a long history of providing many forms of health care, healing and support of the suffering and dying.” Churches have actively supported the development of palliative care facilities and practices, including pain management. “It is through these communities that we bear witness to the possibility that life can have dignity and meaning even in the context of the realities of pain, suffering and death,” said the report, available HERE.

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