In physiology . . we say that fear triggers a “flight or fight” response. When we feel threatened, we either fight back or run away . . . but how do we run away from death?Page 100
Dr. Dugdale follows this question with a discussion of assisted suicide as a way of fleeing from death. She also acknowledges that assisted suicide is not the way that “the vast majority of dying patients” respond to fear of death. I will come back to the consideration of assisted suicide. First, I want to give an answer Dr. Dugdale’s question: how do we run away from death? Or rather, given that suicide is a minority flight response, how do the majority of people run away from death?
I think we run away from death by ignoring it. We deal with our fear of death by not dealing with it. I’m sure most people do fear death and, in some way or other, are aware of their fear. But I doubt whether most people pose the question of how to deal with it. I don’t just mean that most people are relatively uneducated and don’t ask self-reflective questions about how they deal with emotions. That is probably true. But I think it is also true that most people in our highly educated American society ignore questions about death and the fear of death. Our culture generally values psychological therapy and encourages people to examine their feelings therapeutically. I think of the movie Good Will Hunting‘s depiction of the Matt Damon character’s engagement with his feelings of guilt when he breaks down in tears as the Robin Williams played therapist repeatedly tells him, “it’s not your fault.” I can’t think of any ways in which popular culture encourages people to think about death or the fear of death. Maybe you can. And I would be interested to read your thoughts about this. It seems to me that, as a society, we don’t want to talk about death or the fear of death because we don’t have much to say.
Many people have argued that the practice of physician-assisted suicide, also known as aid in dying, offers a reasonable escape route from the dying process.Page 100
About 90 percent [of Oregon patients who have requested lethal prescriptions] say they worry about losing their autonomy . . . About three-quarters fear a loss of dignity . . . Only about a quarter fear the possibility of inadequate pain control.Page 101
Perhaps when patients in Oregon say that they fear losing dignity, they are really describing the humiliation they feel when others have to assist them.Page 101
For such patients, physician-assisted suicide offers the possibility of controlling death by choosing when and where and with whom they will die. . . . But does control of death truly mitigate fear? Or does it simply displace fear in the moment?Page 102
How are the vast majority of of dying patients–who desire neither futile medical treatments nor the premature termination of life–to deal with their fear?Page 102
We have talked about assisted suicide before and I believe I have had previous occasion to link these articles (this and this) that I wrote on the subject. Here is another one you might like. In those first two articles, I touch on the relationship between assisted suicide and the desire for control that Dr. Dugdale writes about in this chapter.
The Oregon statistics that Dr. Dugdale relates are striking to me. The desire for assisted suicide seems not so much to be fueled by fear of pain but by fears of losing autonomy. I love Dr. Dugdale’s supposition that the Oregon patients’ concerns about dignity might be more precisely described as concern about humiliation due to dependancy. Does our society tend to identify dignity with independence? What are the consequences of that identification? What alternative, better definitions of dignity might we want to propose?
Dr. Dugdale seems to suggest that the answer to her question about assisted suicide mitigating fear of death is ‘No’ and the answer to her question about assisted suicide simply displacing fear is ‘Yes’. I think those answers are probably correct. Choosing assisted suicide might successfully mitigate fears related to the unknown circumstances of one’s death, but I don’t think it would lessen the fear of death itself. Dr. Dugdale’s next question is whether anything can mitigate or help people “deal with” this fear.
Those who have read this far will be disappointed that I prescribe no magic poll or incantation to conquer the fear of death.Page 109
There have been social authorities–particularly religious authorities in the ars moriendi tradition–who have suggested that those who fear death have not truly submitted themselves to God. On this point, the ars moriendi gets it wrong. Who wouldn’t feel some reservation about a heretofore unexperienced life-altering event?Page 108
[20th century poet Christian] Wiman pushes us to walk courageously–with those we love–toward the terror of sadness, toward the holes we will inflict. . . . Wiman’s counsel is to die into life rather than away from it. And the challenge for all of us is to figure out what that means.Page 111
Dr. Dugdale acknowledges that she doesn’t have any easy or complete answer to this question. She does, however, suggest some answers and reject others. While I respect her dismissal of easy answers and her attempts to suggest some kind of answer that is in keeping with non-religious nature of her book, I must confess that I am not well impressed with those attempts.
For one thing, I think there is more in the ars moriendi answer than Dr. Dugdale seems willing to grant. It is true that fear is a natural human emotion and that even Jesus wept with grief and experienced the fear of death in the Garden of Gethsemane. But many Christian saints and martyrs seem to have faced death without fear and even to greet it with a cheerful hope. Dr. Dugdale seems to assume that medieval Christians would have the same feelings as modern people do. I don’t think that is necessarily true. I think of Charles Taylor’s consideration of what he called “social imaginaries” in his book A Secular Age. He suggests that people living in an age when belief in God was unquestioned necessarily believed differently than believers in the modern secular age. Would the fear of death also be different in an age when life after death was imagined as an unquestionable truth? I don’t know but that seems possible to me.
Finally, I find that Wiman’s reflections, though replete with beautiful and suggestive language, don’t provide any answers about the reality of human death that could help us to deal with our fears.