Why Americans Die So Much

U.S. life spans, which have fallen behind those in Europe, are telling us something important about American society.

By Derek Thompson

America has a death problem.

No, I’m not just talking about the past year and a half, during which COVID-19 deaths per capita in the United States outpaced those in similarly rich countries, such as Canada, Japan, and France. And I’m not just talking about the past decade, during which drug overdoses skyrocketed in the U.S., creating a social epidemic of what are often called “deaths of despair.”

I’m talking about the past 30 years. Before the 1990s, average life expectancy in the U.S. was not much different than it was in Germany, the United Kingdom, or France. But since the 1990s, American life spans started falling significantly behind those in similarly wealthy European countries.

According to a new working paper released by the National Bureau of Economic Research, Americans now die earlier than their European counterparts, no matter what age you’re looking at. Compared with Europeans, American babies are more likely to die before they turn 5, American teens are more likely to die before they turn 20, and American adults are more likely to die before they turn 65. At every age, living in the United States carries a higher risk of mortality. This is America’s unsung death penalty, and it adds up. Average life expectancy surged above 80 years old in just about every Western European country in the 2010s, including Portugal, Spain, France, Italy, Germany, the U.K., Denmark, and Switzerland. In the U.S., by contrast, the average life span has never exceeded 79—and now it’s just taken a historic tumble.

Why is the U.S. so much worse than other developed countries at performing the most basic function of civilization: keeping people alive?

“Europe has better life outcomes than the United States across the board, for white and Black people, in high-poverty areas and low-poverty areas,” Hannes Schwandt, a Northwestern University professor who co-wrote the paper, told me. “It’s important that we collect this data, so that people can ask the right questions, but the data alone does not tell us what the cause of this longevity gap is.”

Finding a straightforward explanation is hard, because there are so many differences between life in the U.S. and Europe. Americans are more likely to kill one another with guns, in large part because Americans have more guns than residents of other countries do. Americans die more from car accidents, not because our fatality rate per mile driven is unusually high but because we simply drive so much more than people in other countries. Americans also have higher rates of death from infectious disease and pregnancy complications. But what has that got to do with guns, or commuting?

By collecting data on American life spans by ethnicity and by income at the county level—and by comparing them with those of European countries, locality by locality—Schwandt and the other researchers made three important findings.

First, Europe’s mortality rates are shockingly similar between rich and poor communities. Residents of the poorest parts of France live about as long as people in the rich areas around Paris do. “Health improvements among infants, children, and youth have been disseminated within European countries in a way that includes even the poorest areas,” the paper’s authors write.

But in the U.S., which has the highest poverty and inequality of just about any country in the Organization for Economic Cooperation and Development, where you live is much more likely to determine when you’ll die. Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same—12 deaths per 100,000. In America, the problem is not just that poverty is higher; it’s that the effect of poverty on longevity is greater too.

Second, even rich Europeans are outliving rich Americans. “There is an American view that egalitarian societies have more equality, but it’s all one big mediocre middle, whereas the best outcomes in the U.S. are the best outcomes in the world,” Schwandt said. But this just doesn’t seem to be the case for longevity. White Americans living in the richest 5 percent of counties still die earlier than Europeans in similarly low-poverty areas; life spans for Black Americans were shorter still. (The study did not examine other American racial groups.) “It says something negative about the overall health system of the United States that even after we grouped counties by poverty and looked at the richest 10th percentile, and even the richest fifth percentile, we still saw this longevity gap between Americans and Europeans,” he added. In fact, Europeans in extremely impoverished areas seem to live longer than Black or white Americans in the richest 10 percent of counties.

Third, Americans have a lot to learn about a surprising success story in U.S. longevity. In the three decades before COVID-19, average life spans for Black Americans surged, in rich and poor areas and across all ages. As a result, the Black-white life-expectancy gap decreased by almost half, from seven years to 3.6 years. “This is a really important story that we ought to move to the forefront of public debate,” Schwandt said. “What happened here? And how do we continue this improvement and learn from it?”

One explanation begins with science and technology. Researchers found that nothing played bigger roles in reducing mortality than improvements in treating cardiovascular disease and cancer. New drugs and therapies for high cholesterol, high blood pressure, and various treatable cancers are adding years or decades to the lives of millions of Americans of all ethnicities.

Policy also plays a starring role. Schwandt credits the Medicaid expansion in the 1990s, which covered pregnant women and children and likely improved Black Americans’ access to medical treatments. He cites the expansion of the earned-income tax credit and other financial assistance, which have gradually reduced poverty. He also points to reductions in air pollution. “Black Americans have been more likely than white Americans to live in more-polluted areas,” he said. But air pollution has declined more than 70 percent since the 1970s, according to the EPA, and most of that decline happened during the 30-year period of this mortality research.

Other factors that have reduced the Black-white life-expectancy gap include the increase in deaths of despair, which disproportionately kill white Americans, and—up until 2018—a decline in homicides, which disproportionately kill Black Americans. (The recent rise in homicides, along with the disproportionate number of nonwhite Americans who have died of COVID-19, will likely reduce Black life spans.)

Even then, Black infants in high-poverty U.S. counties are three times more likely to die before the age of 5 than white infants in low-poverty counties. But Schwandt insists that highlighting our progress is important in helping us solve the larger American death problem. “We are wired to care more about bad news than about good news,” he said. “When life expectancy rises slightly, nobody cares. But when life expectancy declines, suddenly we’re up in arms. I think that’s a tragedy, because to improve the health and well-being of our populations, and especially of our disadvantaged populations, we have to give attention to positive achievements so that we can learn from them.”

We’re a long way from a complete understanding of the American mortality penalty. But these three facts—the superior outcomes of European countries with lower poverty and universal insurance, the equality of European life spans between rich and poor areas, and the decline of the Black-white longevity gap in America coinciding with greater insurance protection and anti-poverty spending—all point to the same conclusion: Our lives and our life spans are more interconnected than you might think.

For decades, U.S. politicians on the right have resisted calls for income redistribution and universal insurance under the theory that inequality was a fair price to pay for freedom. But now we know that the price of inequality is paid in early death—for Americans of all races, ages, and income levels. With or without a pandemic, when it comes to keeping Americans alive, we really are all in this together.

Complete Article HERE!

She’s 51, a mother and a devout Catholic. She plans to die by euthanasia on Sunday.

Martha Sepúlveda is pictured with her son, Federico Redondo Sepúlveda. The mother, now 51, plans to end her life by euthanasia on Sunday.

By Samantha Schmidt and Diana Durán

It began with a strange feeling in her hand, a weakness in the thumb that made it difficult to hold a pen or grip a computer mouse.

In November 2018, a doctor gave Martha Sepúlveda her diagnosis: amyotrophic lateral sclerosis, the progressive neurological disease known in the United States as Lou Gehrig’s disease. In the months that followed, the Colombian woman lost control of the muscles in her legs — and she knew it would only get worse.

She would cry at night, overwhelmed by the thought. “What happens once I can no longer get into bed or use the bathroom without help?” she would ask her son. “How far am I going to go?”

Sepúlveda started reading about an option that could relieve her fear of what was to come: Euthanasia. Colombia, she learned, is the only country in Latin America — and one of only a few worldwide — that permits patients to end their lives.

Until this year, the option has been available legally only to those who are expected to live for six months or less. On Sunday, Sepúlveda, who considers herself a devout Catholic, plans to become the first person in Colombia without a terminal prognosis to die by legally authorized euthanasia.

Colombia’s constitutional court ruled in July that the right to euthanasia — recognized here in 1997 — applies not only to terminal patients, but also to those with “intense physical or mental suffering from bodily injury or serious and incurable disease.”

The ruling has divided the faithful in this majority-Catholic country. Church officials have described euthanasia as a “serious offense” to the dignity of human life; a member of the national bishops’ conference urged Sepúlveda to “calmly reflect” on her decision and invited all Catholics to pray that God will grant her mercy.

But Sepúlveda, 51, has been resolute in her response to those who question her plan — or her faith.

“I know that God is the owner of life,” she told Colombia’s Caracol News. “But God doesn’t want to see me suffer.”

This South American nation is an unlikely pioneer in euthanasia. An estimated 73 percent of the population is Catholic. Eleven Catholic feast days are national holidays. Access to abortion is sharply limited.

And yet Colombia was one of the first countries in the world to decriminalize euthanasia, and one of only a small number — alongside Belgium and the Netherlands — to extend the right to non-terminal patients. No U.S. state permits euthanasia; 10 states and the District of Columbia allow medically assisted suicide for terminally ill, mentally capable adults with a prognosis of six months or less to live.

Now, advocates here are hoping their movement will spread across Latin America, according to Camila Jaramillo, a lawyer representing Sepúlveda with the Laboratory of Economic, Social and Cultural Rights (DescLAB). Campaigns are underway in Uruguay and Chile. In Peru this year, Lima’s superior court ruled that a woman with polymyositis should be permitted to die by euthanasia when she decides she is ready.

How did a country of Catholics, often led by center-right politicians, become a leader in euthanasia rights?

Eduardo Díaz Amado, director of the Bioethics Institute at Pontifical Xavierian University in Bogotá, traces the development to the country’s long civil war and the violence wrought by drug lord Pablo Escobar. In 1991, in response to the country’s instability, Colombia rewrote its constitution. Unlike its “paternalistic” predecessor, Díaz said, the new constitution expanded individual rights, emphasized “the respect of human dignity” and underscored the separation of church and state.

The document also established a constitutional court to help define these newly recognized rights. Within six years, the new court, now with several progressive judges, took up a case from a plaintiff who argued that “mercy killings” should carry the same penalty as any other homicide.

The court disagreed. Instead of increasing the penalty, it moved to decriminalize euthanasia — becoming the only country to do so on the basis of constitutional arguments, Díaz said.

But it took more than 15 years for authorities to apply the ruling. As political leaders sought to avoid the subject, doctors such as Gustavo Quintana met growing demand for the practice. Known as the “doctor of death,” Quintana is said to have provided euthanasia to close to 400 patients before his recent death.

In 2014, the court ordered the government to issue guidelines so that hospitals, insurers and health professionals would know how to proceed with euthanasia requests.

The movement for euthanasia rights has drawn unexpected allies: Catholic priests. Alberto Múnera, a theology professor and Jesuit priest at the Pontifical Xavierian University in Bogotá, lectures his students on the “exceptions” to the “absolute value of human life” in church teaching. When Catholics follow their own consciences, even when that means choosing to end their own lives, he argues, they will “behave well” in the eyes of God.

Since the government began regulating the practice in 2015, 157 people have died by euthanasia in Colombia, according to official data. One hundred and forty-one had some type of cancer. But many others, including Sepúlveda initially, were denied requests because their illnesses were not deemed terminal in the short term. Last year, a team of lawyers filed a lawsuit asking the constitutional court to extend the right to patients with non-terminal diagnoses.

The court went further, recognizing a right to euthanasia for those with “intense physical and mental suffering.” That was a surprise even for the lawyers, who did not mention mental illness in their complaint. And it drew immediate rebuke from church leaders and conservative politicians.

“It opens up the possibility for people who are depressed or simply don’t want to live anymore,” said Sen. María del Rosario Guerra, a member of the Democratic Center party of President Iván Duque. “We are promoting a culture of death

Bishop Francisco Ceballos, a leader within the national bishops’ conference, has criticized news outlets here for depicting Sepúlveda “heading toward death with so much joy.” He has emphasized the church’s support for palliative care as an alternative to euthanasia. “We believe that death cannot be the solution to suffering and pain,” he said.

The court’s ruling in July came less than a month after the death of Yolanda Chaparro, a 71-year-old Colombian woman with ALS who had requested euthanasia a year earlier but was rejected because her prognosis was not deemed terminal. She continued to deteriorate until she could no longer breathe without oxygen, struggled to move on her own, and lived with a fear that she could drown in her own saliva, according to her daughter. She was granted her wish to end her life in June.

Shortly before her death, Chaparro sat down with her relatives to explain her decision. “For me, to live is to fly,” she said, in an interview recorded by relatives. “To live is to walk, to create. To live is to commit to dreams you’ve formed your whole life. So seeing that each day everything is more difficult … all of that is over.”

When Federico Redondo Sepúlveda learned of the court ruling, he broke down in tears. The 22-year-old law student, Martha’s only child, had spent months helping his mother file a request for euthanasia.

“I didn’t think it would happen so soon,” he said. He had tried to find the strength to support his mother in what for him has been an excruciating choice.

“She kept saying the same thing, that if I loved her then I would support her,” he said.

They have spent his mother’s final days mostly watching Netflix — a joy she discovered during the coronavirus pandemic. They’ve watched and re-watched “The Pianist,” “Forrest Gump,” and “The Shawshank Redemption,” movies that remind them of years past.

The family doesn’t have special plans for his mother’s final night Saturday. She hopes to spend it as she always does, by going to bed early. She plans to end her life at 7 a.m. on Sunday, when she would normally be heading to church. Her son will be the only person in the room with her, he said.

Her body is to be cremated immediately. Federico plans to spread her ashes in the Caribbean Sea, off Colombia’s northern coast. But first, he will join with their family, her remains beside him, and take the Eucharist

Complete Article HERE!

4 ways to improve the lives of older people

By Prakash Tyagi

  • By 2050, it is expected there will be more humans over 60 than under 15 for the first time in history.
  • Older people are harder hit by poverty and ill-health, necessitating better support structures be put in place.
  • The UN Decade of Healthy Ageing gives a framework for improving older people’s lives.

Population ageing and the resulting demographic transition around the world present complex challenges. It is estimated that the global population of older persons will rise by 56% between 2015 and 2030, from 956 million to 1.4 billion, and hit the 2.1 billion mark by 2050. Between 2015 and 2050, the proportion of the 60+ age group globally is expected to rise from 12% to a staggering 22%. People over 60 will outnumber those below the age of 15 for the first time in history.

The transition is rapid and dramatic, and uneven in different parts of the world. While it took France about 150 years to rise from 10% to 20% of the population being older than 60, a similar transition will occur India, China and Brazil in about 20 years. In high-income countries, the proportions of older people have been rising gradually, with over 28% of Japan’s population already being over 65 years of age.

The proportion of older people worldwide is ageing
The proportion of older people worldwide is ageing Image: UN

Large numbers of older people, particularly in lower- and middle-income countries, live in severe poverty and in poor health, with no or limited access to basic health services and social protection benefits. There are gender disparities too, with older women experiencing greater deprivation. Research suggests that in sub-Saharan Africa households headed by older women live in greater poverty compared to households headed by men of equivalent age. Furthermore, the correlation between ageing and disability is clear, with over 46% of older people worldwide living with some form of disability. Over 250 million older people have moderate to severe disabilities. These numbers are likely to rise further, causing more hardship.

This significant demographic transition means there is unprecedented need for age-friendly and responsive healthcare systems and a range of coordinated services to address the complex needs of this ageing global population.

The proposal of observing a Decade of Healthy Ageing from 2021 to 2030 was adopted by the UN General Assembly last December. This global collaboration is led by the World Health Organization (WHO) and will bring together governments, civil society, international agencies, professionals, academia, the media, and the private sector, in alignment with the Sustainable Development Goals (SDGs).

To foster healthy ageing and to improve the lives of older people, the Decade of Healthy Ageing will focus on four action areas. The first is to create and strengthen age-friendly environments by removing physical and social barriers and by converting them into better places to live and to age. The second is to combat ageism: Older people, despite their significant contributions to society, are often overlooked and subject to prejudice. Such stereotyping and discrimination must be addressed.

The third is to provide integrated care. All older people should have non-discriminatory access to integrated care, which should include but is not limited to: prevention, promotive, curative, rehabilitative, and palliative and “end of life” care – which must be safe, affordable and of good quality. The fourth is to support long-term care (LTC). With significant decline in their mental and physical capacities, many older people are unable to live an independent life or to actively participate in society. Hence, access to good LTC services is essential to maintain their functional ability, to ensure that they enjoy basic human rights and that they live a life with dignity.

Numbers of older people above 60 by world regions
Numbers of older people above 60 by world regions Image: UN

Four further enablers will be critical to the Decade of Healthy Ageing: engaging directly with the voices of older people; leadership development and capacity-building at all levels; connecting all stakeholders; and strengthening research, data and innovation.

The decade, its action areas and enablers lay out a solid framework to foster healthy ageing around the world. However, stronger efforts will have to be made into converting a theoretical framework into practical and measurable actions. To date, progress has been limited and further delayed by priorities imposed by the pandemic. On 1 October, International Day of the Older Persons (IDOP), which this year has a theme of Digital Equity for All Ages, is an important opportunity to take stock of what has been achieved.

Looking ahead, it may be worthwhile to categorize basic needs into groups. The first is to design a comprehensive communication mechanism and to deliver the decade of healthy ageing messages to all stakeholders, most importantly to older people themselves. The sooner the information disseminates and is well understood, the more active the stakeholder participation should be.

A second key group of needs is to develop a strategy for partnerships that are going to be crucial in engagement of key groups, delivery of services and for research and advocacy. Civil society, government agencies and the private sector are three important constituents of the partnerships spectrum, and a clear plan for involving them must be developed at both macro and micro levels.

A third is to create guiding groups at national level (and at provincial or sub-national levels too in the case of larger countries) comprising representatives from different sectors who can ensure dynamic planning, implementation and monitoring of actions.

Fourthly, the decade also provides an important opportunity to strengthen LTC services and improve integrated care – fundamentally important blocks of healthy ageing that require greater attention. Community-based LTC will have to be reinforced by promoting self-care and by training and capacity-building of formal and informal caregivers. Primary care needs must be addressed in remote and rural settings, assuring integrated care for older people. Existing models and past experiences from Help Age Global network and from organizations like GRAVIS in India may provide replicable insights. The knowledge accumulated by senior-age people’s organizations, especially how to strengthen intergenerational exchanges to ensure lifelong application of healthy ageing principles, is a valuable resource worth utilizing.

COVID-19-related challenges are already a hindrance and will likely continue to hamper progress on healthy ageing for many years. Mitigation strategies will have to be worked out in advance in the context of community education and delivery of care services using digital education, telemedicine and within COVID guidelines, keeping the local context and situation in view. Existing healthcare infrastructure overburdened by the pandemic will have to be used judiciously. Future of Work

What is the World Economic Forum doing about including older people in the workforce?

There is a global myth that productivity declines as workers age. In fact, including older workers is an untapped source for growth.

The world has entered a new phase of demographic development where people are living longer and healthier lives. As government pension schemes are generally ill-equipped to manage this change, insurers and other private-sector stakeholders have an opportunity to step in.https://www.weforum.org/videos/promoting-an-age-inclusive-workforce-living-learning-earning-longer

The World Economic Forum, along with the Organisation for Economic Co-operation and Development (OECD) and AARP, have created a learning collaborative with over 50 global employers including AIG, Allianz, Aegon, Home Instead, Invesco and Mercer. These companies represent over two million employees and $1 trillion in annual revenue.

Complete Article HERE!

Africa’s religious traditions: In praise of the ancestors

Animism and its veneration of the ‘dear departed’ have a human scale absent from the ‘great’ faiths. Drew Forrest makes the case for Africa’s religious traditions.

Egungun spirits perform during a Voodoo ceremony on January 11, 2012 in Ouidah, Benin. The Egungun are masqueraded dancers that represents the ancestral spirits of the Yoruba, a Nigerian ethnic group, and are believed to visit earth to possess and give guidance to the living. Ouidah is Benin’s Voodoo heartland, and thought to be the spiritual birthplace of Voodoo or Vodun as it known in Benin. Shrouded in mystery and often misunderstood, Voodoo was acknowledged as an official religion in Benin in 1989, and is increasing in popularity with around 17 percent of the population following it. A week of activity centred around the worship of Voodoo culminates on the 10th of January when people from across Benin as well as Togo and Nigeria decend on the town for the annual Voodoo festival.

By Drew Forrest

Those who stayed away when Geoffrey Oryema headlined at Womad in Benoni in 2000 – the poor turnout spoke of South Africa’s cultural isolation – missed more than a luminous musical performance.

At the height of his powers the “Orpheus of Acholiland” made a compelling statement about the continent’s religious beliefs.

At the age of 24 Oryema was smuggled out of Uganda in the boot of a car after his father, a cabinet minister, was denounced as a plotter and murdered by Idi Amin. Geoffrey did not return for 39 years.

Hence the persistent note of sorrow in his songs: since Ugandan independence, the Acholi minority he sprang from has been trapped in endless cycles of regional and ethnic violence.

In this land of Anaka [his father’s ancestral village]… we had dreams of a clear, green land… /Dead sand, dead sand,” he lamented on his first album, Exile.

Central to Oryema’s performance on the Womad night stage were the songs of his magisterial fourth album, Spirit. Released in France the previous year, it revolved around the death of his father, Erinayo… 

Late in the evening I walked down
Down by the river
Plunging my hands in the water
I felt the spirit moving
The spirit of my father protects me
Guides me
                                 (“Spirits of my Father”)

… and of his brother, John, who died during Geoffrey’s exile:

I can hear your voice
From a distant place
Among the flowers and grass
I can hear your steps beneath
The stone…

                                  (“Omera John”) 

In “Save Me” we meet the same idea: to a repeated, hypnotic motif the song tells of a man who, in a dream or trance, falls under the paralysing thrall of a star. He calls out to the sun and the moon, who come to his aid.

This is animism, the belief, pervasive in Africa, that the cosmos teems with innumerable spirit beings that share human concerns and can be harnessed to the human project.

The result, wrote the originator of the term, anthropologist Edward Burnett Tylor, was a vision of “universal vitality” whereby “sun and stars, trees and rivers, winds and clouds become personal animate creatures”.

“The whole psychic atmosphere of the African village is filled with belief in this magical power,” wrote the father of African theology, Kenya’s John Mbiti, who described Africans as “notoriously religious”.

It is a noble idea, simpler and more dignified than the esoteric contortions of Christian theology and better suited to an age when people are striving for a new relationship with the natural world.

An ‘Egungun’ spirit stands during a Voodoo ceremony on January 11, 2012 in Ouidah, Benin.

Animism has no doctrine of the soul’s immortality and no eschatological expectations, such as judgement in the afterlife or the evangelical fantasy of “the Rapture”.

It has no central authority, no set liturgy or creed and no interest in doctrinal compliance – the main source of religious conflict and persecution down the centuries.

It takes many forms specific to different ethnicities, meaning that unlike Christianity and Islam it has no global ambitions and does not try to stuff itself down the throat of unbelievers.

Despite the imposition of the coloniser’s beliefs, it has proved extremely durable. In many parts of Africa and the New World it has fused with Christianity in syncretic hybrids that enshrine the traditional practices of ancestral veneration, ritual purification by water, prophecy, exorcism, healing and the interpretation of dreams.

Victorians like Tylor thought of animist belief in Darwinian terms, as the earliest stage in the evolution of religion and a window on the “primitive mind”. This was a step forward, at least, from the notion of an unbridgeable gulf between the “civilised” and the “savage”.

Later scholars turned against such evolutionary thinking as deeply misconceived. They also rejected the “degradation theory”, according to which animist beliefs are degenerate borrowings from high cultures such as ancient Egypt.

“All contemporary cultures and religions [are] regarded as comparable,” writes anthropologist George Kerlin Park.

Most traditional African religions hold with a single Creator – but in a way that recalls the deism of the European Enlightenment. The widespread belief is that God created the universe, but is so remote that he does not engage with it and cannot be approached directly.

The Oromo of the Horn of Africa, for example, reject the Christian ideas of the God of love, God the Father and the Trinity as implying weakness. According to historian of religion Julian Baldick, their Waqa is the all-powerful demiurge of the great forces of nature, “the sky, the stars, the clouds, the god of thunder and lightning”.

Their proverbs convey the deity’s deafness to human cries and the need for resigned submission among his creatures: “A man does not stop praying and God does not change what he has decided”; “People are right to praise God when someone is killed by lightning”; “One does not understand the deeds of God or the laughter of dogs”.

In a widespread tradition, the Dinka of South Sudan hold that God withdrew from the world when the first woman lifted her pestle to pound millet and struck the vault of the sky.

Kenya’s Kikuyu believe the deity has: 

No father, no mother, nor wife
nor children
He is alone
He is neither a child nor
an old man
He is the same today
as he was yesterday 

For this reason, worship of the high god is rare in African tradition ­­– it is the multitude of secondary divinities, who throng the sublunary sphere, that are the objects of veneration, propitiation and service. Foremost among them are the ancestors or, in classical mythology, the shades.

For many non-Africans, this is not a remote idea. Ancestor veneration is practised in Japanese Shinto, Hinduism and Chinese patriarchal religion. Roman Catholicism, the oldest form of Christianity with many pagan borrowings, incorporates remnants of it in All Soul’s Day and Halloween, when the spirits walk abroad, and in the cult of saints.

In Africa, Ghana’s Asante people, for example, acknowledge an inaccessible creator, while their ritual life revolves around the veneration of their matrilineal forebears, conceived of as guardians of the moral order and intercessors with the great spiritual powers.

The Yoruba religion tells of orishas – tutelary spirits subject to the unapproachable supreme being, Oludumane – believing that 401 of them “line the road to heaven”.

Many African theologians resent the term “ancestor worship” as a paternalistic misconception. What is offered to the dead through prayer, offerings and sacrifice is not the worship of deities, but an extension of the honour and service due to living parents. The purpose is to reassure them they are still remembered and loved.

Ancestral spirits are seen as the invisible but most important part of the kinship network. Dead relatives and community members preside over landmark events, including such rites of passage as the Xhosa imbeleko (ritual inclusion of the newborn in the clan), ukubuyisa (reincorporation of the dead), and ukwaluka (initiation into adulthood), and must be cared for and kept favourably disposed.

Former Kenyan leader Jomo Kenyatta distinguished different ancestral spirits in Kikuyu belief, including those of one’s parents, who continue to advise and reproach, and those linked to the wider clan.

Feelings towards the shades are not straightforward: they are objects of love and reverence, but also of fearful placation and numinous dread.

In Totem and Taboo, Sigmund Freud deals with this complexity, noting that people in traditional societies also “fear the presence and the return of the spirit of the dead person”, and offer propitiatory ceremonies not just out of love, but “to keep him off and banish him”.

A Kenyan scholar relates that once they have placated the spirits by offering them sacrifices, villagers expect them to move away.

But “the living dead” are mainly invoked to use their superior resources for earthly ends. One writer notes that ancestor veneration is about “supporting fertility and sustaining the community, by maintaining a harmonious relationship with divinities and channelling cosmic powers for good”.

One conduit is the igqirha (Xhosa) or mganga (Swahili) – the diviner/seer/healer with the gift of access to the spirit world. In traditional society this is enhanced by a strict initiation in which the novice is said to fall ill and dream of “beings in an endless westward march across the heavens, arrayed in feather headdresses and carrying sleeping mats”.

The dead live, but not ­– as in some creeds – for all eternity. University of London scholar Alice Werner points to the grandparents in Maurice Maeterlinck’s play The Blue Bird, who wake from the sleep of death only when someone remembers them.

The ancestors survive and retain their potency as long as they are held in the communal memory. As this rarely stretches back further than grandparents, they become increasingly attenuated and fade away after a few generations.

Once forgotten by the living, they are assimilated to the great impersonal forces of nature ­– storm clouds and the eclipse.

My wife’s ashes are buried in our garden, overhung by an elderberry tree that is strangely frequented by the same robin. At our rural plot, which we bought and built together, I feel her presence.

Habit and tricks of the imagination, no doubt. But one can understand the power and tenacity of animist belief – It has a human scale rooted in one’s kin, free of great frowning cathedrals or high priests in snow-white vestments pronouncing infallibly “from the throne”.

It has no Grand Inquisitor, Day of Wrath, purgatory or everlasting hellfire. It does not practise forced conversion, foster racial hatred, or call for the violent overthrow of other people’s gods.

With its vision of an intimate cosmos, it is more likely to engender respect for the natural world than a faith that tells men to subdue the earth and have “dominion over every living thing”.

Above all, animist beliefs, particularly in ancestral spirits, provide continuity of the ties that bind the living and the dead. For the bereft, like Geoffrey Oryema, this must help to staunch the dripping inner wounds of grief.

Complete Article HERE!

This woman guides dying Mainers through the end of their lives

Molly “Bones” Nelson, a certified end-of-life doula, stands at her pumpkin farm in Cornish. Nelson is a death doula credentialed by the International End of Life Doula Association, and the subject of a new documentary screening as part of the Camden International Film Festival.

by Nick Schroeder

There once was a man who lived on a hill in rural Maine. He was 97, and had no living family and few friends. He had neighbors, but most of them were half his age or younger, and the man could sense that they viewed him with reserve. This bothered him, so he hired someone to help him figure out the problem.

“He said, ‘The neighbors don’t understand me,’” said Molly “Bones” Nelson, who offered her services to the man during his final days. “‘I’ve been here for 50 years and they fish on my land but they still think I’m the crazy old guy they can’t talk to.’”

Her solution? Throw a party.

“He kept telling me, ‘I’m not dying; I’m graduating,’” Nelson said.

Nelson is a death doula. She helps people with the emotional and psychological work of confronting the terminal stage of life, whatever that entails. Often, her work looks like talk therapy, working through death’s thorny questions with those facing them. She also works with clients who have lost someone suddenly, such as in a miscarriage or abortion. In this case, it meant helping a man find a kind of happiness at the end of his life.

To prepare for the party, the man and Nelson baked cupcakes that looked like skulls, crafted a tasseled cap for him to wear, and painted a mural of scenes from his life. They had partygoers write questions they had about death — even unanswerable ones — and throw them in a bowl. Then they played a game: pick a stranger at the party and take turns answering questions from the bowl.

“We played that game for three and a half hours,” Nelson said. “People didn’t want to stop.”

Nelson is the subject of a locally screening documentary, “death and her compass” by the California-based filmmaker Annie Munger. The film is part of the Camden International Film Festival, which runs virtually through Sept. 26.

While they aren’t considered medical professionals, death doulas perform a work that has existed around the world for centuries. In present-day America, the kind of end-of-life care work they provide is something of a lost art.

“Our elders get put off to the side,” Nelson said. “Older people have a ton of wisdom and experiences to share about their lives.”

The cost of in-home elder care has skyrocketed in the U.S. even before nursing homes began facing staffing shortages and enhanced risk of infection with the coronavirus. The trend leaves little time and resources for talking through the end of life.

But it’s often no easier at home. The vast majority of older people — 88 percent — prefer to receive government assistance to age at home rather than receive care in a full-time nursing home or senior living facility, according to a study by the Associated Press-NORC Center for Public Affairs Research published in May. That can push the expensive and time-consuming work of caring for elderly people onto families, who struggle to absorb the often-invisible costs of managing a family member’s physical and mental health, memory loss, food and other needs while juggling their personal and professional lives.

“Death is a huge part of life,” she said. “You’ve had all this amazing growth, adventure and experience. If you don’t process it and have those difficult conversations, it’s like skipping dessert.”

Nelson likes to let her clients lead the process. In the initial phase, they hang out, talking through fears and memories, anything of significance. The dying person supplies their own spiritual beliefs, and she works with what they give her. Big religious and existential questions inevitably come up, but Nelson mostly works with relationships on the mortal plane. (Nelson keeps information from clients confidential, but others, like the 97-year-old, allow her to discuss their cases in general terms after their passing.)

Then, Nelson works with them to design a “legacy project,” something they can leave behind to friends and family, or to the world, that doesn’t neatly fit in a legal will. It might be a party or it might be a quilt, a donated plot of land or a long poem she writes with the dying person’s help and reads to them when fear rides high.

Nelson learned the trade with the International End of Life Doula Association, a training organization founded by New York hospice worker Henry Fersko-Weiss in 2003. Fersko-Weiss was a social work manager at the largest hospice in New York City, accepting roughly 500 patients a day. While he saw them receive adequate medical care, the sheer volume of patients needing hospice care meant that some needs were going unattended.

“I kept seeing these gaps,” Fersko-Weiss said. “As dedicated as the clinicians are, unfortunately the structure and logistics of hospice made it difficult for clinicians to spend a great deal of time and do deep work with people who are facing death.”

Something clicked when Fersko-Weiss talked with a friend who was becoming a birth doula. He trained to become one too, eventually modeling an end-of-life doula program from its teachings about helping expecting parents usher babies into the world. He could train volunteers to be present for dying people in a way similar to those learning to be birth doulas.

Nelson is the only one in the state formally credentialed through international association, which offers a rigorous certification process. There are roughly a dozen working death doulas in Maine who have trained through the association or the End of Life Doula Alliance, which was founded in 2017.

Nelson, 57, took a long road to this line of work. The nickname “Bones” is unrelated to her profession — a scrawny child, she’s had it since youth — but many clients find as much humor in it as she does. She moved to rural Maine from New Jersey at age 18 and has been farming ever since. Today, she primarily grows pumpkins.

Death has been a part of Nelson’s life since birth. She was born with a heart condition, a thin-walled aorta that’s “shaped like an hourglass.” Doctors have told her that it “could explode at any moment.” In 2007, she had a stent put in her heart, and it tore through two layers of her aorta. But she survived and continues to farm, hike and ride dirt bikes.

She’s also lost those close to her. Nelson’s mother died by suicide at the age of 82, after multiple attempts during her life, and her father died of cancer in 2013.

“I’ve had a lot of healing to do,” Nelson said.

Nelson takes death seriously, but doesn’t necessarily see it as a grave subject. It’s easy to imagine her combination of folksy wisdom and well-timed humor softening some thick layers of fear. As shown in “death and her compass,” Nelson’s sessions with clients seem much less like a psychological evaluation or transcendental ritual than two old friends just talking.

Nelson said that she “doesn’t believe in death” after a life spent outrunning its shadow.

“I got a T-shirt that has a picture of a sloth on it. It says: ‘Live Slow, Die Whenever,’” she said with a laugh.

The sentiment captured the way Nelson has come to think about the subject.

“I don’t feel rushed because I don’t feel like there’s an end,” she said. “If I don’t get to ride my dirt bike across Mongolia by the time I’m 60, so what. I’ll just do it next time.”

Complete Article HERE!

Everything Dies

It’s the Buddha’s basic teaching. It’s life’s universal truth. It’s what we most want to deny. Sallie Jiko Tisdale on how this hard but liberating truth can transform your life.

Death and Life” by Gustav Klimt.

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Most Buddhists put flowers on the altar. We know flowers are beautiful, but that isn’t their purpose here. Flowers begin to die as soon we cut them; we carefully lay death in the place that symbolizes our awakening. We bow and make offering to this crucial truth, built into the bones of the world.

The Buddha spoke volumes of words, an immense canon, but most of what he said comes down to this: Things change. Change cannot be avoided. Change hurts. The fundamental teaching of all Buddhism can be stated as everything dies. The Buddha taught this, it fills the sutras, it is repeated by our teachers. But most of all, we learn this from our own daily lives.

Do we believe that we will dissolve? No. Not deep down in the root of the small self, because the small self plans to live forever.

You have probably learned a traditional formula or two for this insistent teaching about the transitory nature of all things:

Anicca vata sankhara: “Impermanent, alas, are all formations!”

Sabbe saokhara anicca: “All conditioned factors of existence are transitory.”

In the Maha Satipatthana Sutta: “[One] abides observing the phenomenon of arising…abides observing the phenomenon of passing away…”

As a new practitioner, I learned the catechism this way: “All compounded things are subject to dissolution.” The language was strange when I first heard it, and as a young practitioner I found myself parsing the words: Compounded. Dissolution. Notice, I was told, how everything is put together from other things and will be taken apart. I began to notice. A table, a house, a nation—I could see this.

But if all things are compounded and will dissolve, then I am compounded and I will dissolve. And this was not something I could easily accept.

I pretend to accept my own death. Most senior practitioners do; many of them may even believe they accept it. Buddhists have their own peculiar points of pride, outside the usual stream of things we pride ourselves on, like humility and asceticism. Plenty of us are proud of our equanimity in the face of extinction, at least until we see the headlights bearing down.

So how deep does this acceptance really go? It’s not just Buddhists who kid themselves about being prepared for death. It’s people. It’s all of us who don’t want to admit that we are organisms fighting for life, that we can sagely repeat, “Annica, annica, all compounded things are subject to dissolution,” without really confronting what it means.

Do we believe that we will dissolve? No. Not deep down in the root of the small self, because the small self plans to live forever. When we say that “Everything dies,” we mean everything dies but me. And we can get kind of fancy about this point: Everything dies, including my body (but not my awareness—not me). Everything is subject to dissolution, but something passes through to a new form and doesn’t ever go away (that’s me). In a thousand ways, most of them not entirely conscious, we hold on to the hope that something of this self, somehow, will remain, and we hold on to that even as everything we touch slides away like sand in running water.

Why should we pretend to more confidence than we feel? Everyone is a beginner when it comes to death. We can’t practice it. When my mother died, it was the very first time that my mother died, and I didn’t know how to do that, to be a daughter whose mother was dying, to be a daughter whose mother had ceased to exist. When my best friend died—when my teacher died—I didn’t know how to do it. Each death I’ve known has been the very first one of its kind. Even with experience—I know how grieving feels, I know the altered state of a vigil, I know a lot about that—I can’t entirely prepare. And when I die, it will be the first time this particular me dies, and I will be a beginner.

Yes, I know that we are all dying all the time. That’s what it means to be a compounded thing dissolving—this self, this moment, gives way to the next as the girl gives way to the woman who gives way to the crone. I know that the me of today is not the me of yesterday, and I was also taught that if you die once, you never need to die again. But the real teaching of that formula, the falling away of body and mind for a ceaseless moment, is that you are already dead. I know this, but I don’t think my body does.

Slay the demons of hope and fear. My teacher would say this to me at a time when I was knocking up against deepening anxiety. My stubborn refusal to submit to the meaning of that anxiety made me more anxious still. The stronger I resisted, the deeper my anxiety became, until I sank well into true fear. How could I slay that demon when I was afraid to walk out the door?

We need to talk about death bluntly, honestly, and often.

“Vanitas Life, Death, and Resurrection by Ezio Gutzemberg.

The original Pali word for aversion, dosa, is various and shaded. It can be translated as anger or hatred, denial, projection, distortion, aggression, repulsion, even disgust. That is how it can feel to talk about death, about our own death. But I want you to think about it and I want you to talk about it. Even if you have considered your own death deeply, how often do you talk about it? Do you talk about your private conflicts or confusion, your questions, your plans?

How do we begin? Begin with the fear. Begin with the resistance. We know the question. It is why we begin to practice in the first place: Why do we suffer? And we know the answer. It is why we keep practicing: We suffer because of change and resistance to change.

But knowing the answer does not stop the question from being asked, and knowing an answer today doesn’t mean we will remember the answer tomorrow. Ignorance is the first link in the twelve-fold chain of causation—ignorance of impermanence, of anicca, of anatta, of no-self. This chain feeds itself endlessly—our ignorance of the ephemeral nature of the self building a self over and over. The chain is broken only by the transformation of that first mistake, being ignorant about the compounded nature of the self, which is not separate or bounded at all.

What do you fear about death? Make a list. Be honest. Autopsy? Being alone? Pain? Loss of privacy? Do you fear soiling your bed? Do you fear needles? For what do you hope? Make a list. Be honest. Do you want to see it coming? Do you want to be asleep? Do you want to be very old?

Ask the question again. Why am I afraid? Because I will die. What does that mean? (Wait a minute. Will I die? Do I have to die?) Ask yourself: Are you ready to die? Don’t answer too quickly, because that last one is a doozy. Even people who have made great strides in accepting the fact of their own inevitable dissolution will be flooded with adrenaline when the headlights bear down. The body has its own hopes.

Talk about death. Talk about everything. Imagine it. Write a description of the scene of your death. Where are you? What do you see? What do you smell, taste, touch? Who is there? Are you inside or outside? Is it warm or cool? Is there music, or words?

Imagine it. Write it down. Then tell everyone who needs to know—your family and friends and teacher and doctor—what you want. Make a record of your wishes and don’t forget to decide how your body should be handled after you’re done with it. Make copies and pass them out.

Then tear it up. Let it go with all your heart. This will be the work of the rest of your life.

We can do all this. We can make a plan, buy a plot, fill out the advance directive, decide what music we want to hear as we go. But we can’t plan not to die. The essence of dying is the loss of control. This is the hardest part for many of us—not that death will happen, but that it will happen without our hand on the controls. It will happen as it happens, when it happens, where it happens, and chances are it won’t go according to plan. The only thing we can control, and only with practice, is how we face whatever happens.

These days it is common to talk about a “good death.” (There are many official, even government-issued, definitions of a good death.) A good death is usually defined as one where a person is comfortable and at peace.

For myself, I want to think about a right death, a death that fits the life I’m trying to live. Most deaths include what anyone might call good moments and bad moments, desired and undesired consequences. So it is with our lives, and so it is with death. Right deaths are all different; you can’t define the details. For me, it means a death unhidden—from me and from those who love me. It means a death met with grace and willingness when the time comes. Achieving this will be the work of the rest of my life.

If we can face it, recognizing the reality of death will transform our lives.
Flowers are beautiful because they are brief. Beauty is a measure of fragility and brevity and transformation, created in part by our awareness of the precious value of this moment—this moment is what we love. Death is utterly natural, shared by all; it is also heartbreaking. That equation isn’t dissonant; it’s the nature of love. With our eyes open to change, each thing we meet is luminous and sparkling. To love means to lose. To lose means to love. The last breath allows us to cherish another without reservation, holding nothing back.

Slay the demons, my teacher told me. That meant accepting my anxiety, my fear. It meant coming to see that hope and fear are one thing: fantasies of the unborn future. Hope pulls and fear pushes and together they keep us stuck in what has not happened, living a half-life of imaginary events. I exhausted myself on that mountain, until I gave up. Giving up was the key. Accepting the demons of hope and fear until they slew me, which was what my teacher had been saying all along.

The parable of the burning house told in the Lotus Sutra is a familiar one. The children do not know the house is on fire, so they won’t leave until their father tempts them with carts full of treasure. So we are with our own suffering, our ignorance. The Buddha offers us treasures, including one so great we couldn’t even imagine it.

Some years ago, I had a brief, vivid dream. I saw a room completely engulfed in flames, and several people were walking calmly through the room, smiling. One turned and looked at me and said, “I can’t tell you how safe I feel in this house.”

When I begin to truly accept myself as this compounded thing—a dewdrop, a bubble, a cloud—when I really believe for a moment that my precious me is a passing sigh in the oceanic cosmos of change, then I begin to find safety inside the burning house. I don’t need to escape if I know how to live inside it. Not needing to escape, I no longer need rewards. I just walk through it, aware of dissolving.

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Goodbye and Good Journey

Buddhist funeral traditions around the world help both the dead and their loved ones let go and move on.

Funeral ceremony at Jigenji Soto Zen temple in Yamanashi, Japan.

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Final Ordination

At the heart of a Zen funeral is ordination. In the ceremony, the deceased is ritually ordained in the same way that living monks and nuns are. This is done because total dedication to spiritual life, of the kind undertaken by monastics, is seen as the natural endpoint of life, even if that wasn’t the case when the person was alive. Ordination is also seen as increasing the probability of a favorable rebirth.

To begin the funeral ceremony, a vigil is maintained by relatives for a day and a night while Zen priests chant from scripture and an altar is prepared in the household. Attending mourners offer okoden, or “condolence money,” to the family of the deceased. The centerpiece of the altar is a portrait of the deceased, alongside candles and offerings of flowers and fruit.

The dead’s ordination is the same as a living nun’s or monk’s. The precept master asks the body three times if the deceased will observe and embody the five precepts. Where a living monk or nun would offer their vow, the corpse’s silence is interpreted as acceptance.

The deceased is then given a Buddhist name and presented with a lineage chart connecting them with enlightened masters stretching all the way back to the Buddha himself. The family of the newly ordained is provided with their own tablet with the deceased’s Buddhist name on it, and the tablets are either kept in the local temple or displayed in the family’s household altar afterward.

Some Zen funerals also feature a shout which is meant to sever the deceased’s bond to the earthly plane. Those who have attended such ceremonies say this also provides a moment of catharsis for the mourners. The funeral concludes with the cremation of the deceased’s body.

What, then, are Zen funerals like for those who are already ordained? The funeral of a monk or nun can take different forms, both long (involving a procession including the deceased’s robes and lineage papers) or very short. The funeral for the founder of the Soto Zen, Dogen, is famously said to have consisted of just a short moment of chanting by his most senior disciple.

Sharing Merit with the Dead

White cloth, a symbol of virtue, marks a Theravadan funeral in the Sri Lankan tradition. Fringed palm fronds and white banners, often with a picture of the deceased, mark the way to the home of the deceased. A white banner declares in large writing: “All conditioned things have the nature of decay.” In the house, mourners in white are greeted by relatives of the dead, the men dressed in sarongs of white cloth and white shirts, the women in white saris. Having been washed by family members, the body of the dead is also attired in white.

The wake, during which the deceased’s family greets and feeds the guests, lasts for several days, which allows those traveling to reach the funeral house. Guests sometimes bring gifts of food for the family.

The funeral ceremony truly begins with the arrival of the monks. They enter the front room of the funeral house, where their feet are washed by a male member of the household. The monastics are guided to chairs draped in white cloth and the deceased’s family kneels before them in respect.

Then the coffin is brought to the front room, or remains in a tent in the front yard if there isn’t room in the house, and a salutation chant to the Buddha is offered, followed by the chants of the three refuges and the five precepts. Parcels of white cloth are presented to the monks, and the mourners chant, “We offer the ‘cloth of the dead’ to the community of monks.” This gift of cloth has a practical origin. Monks in Sri Lanka, as elsewhere in Theravadan societies, rely on the community to feed and clothe them. Payment for presiding over the ceremony comes in the form of white cloth.

In this merit-sharing culture, the Theravadan funeral also features a bowl filled with water by the deceased’s family until it overflows, representing giving merit to the dead so their rebirth will be a promising one. As the water is being poured, the monks chant: “Just as rivers full of water fill the ocean full / Even so does what is given here benefit the dead.”

After a sermon based on Pali scripture is delivered by the senior monk, the mourners chant “Sadhu!” three times, an expression of gratitude connected to the attainment of arahatship. Speeches by family and neighbors follow and then the coffin is conveyed to the burial ground or crematorium under a white umbrella.

Two important dates continue the remembrance ceremonies after the day of the funeral: Mataka-bana, when a monk returns a week later to deliver a sermon to the family and other mourners, and Thun masa-dana, an alms-giving three months after the funeral to support the monastics who officiate at funerals and other ceremonies in the community.

Guiding the Dead Through the Bardo

A Tibetan thangka painting of the pure land of the primordial buddha Amitabha, known as Amida in Japanese.

The Tibetan approach to death and dying is guided by the teachings of the Bardo Thodol, popularly known in the West as The Tibetan Book of the Dead. This text describes what happens to us in the bardo, an intermediate period or gap between death and rebirth. During this time, it is possible to advise and help the deceased so they can achieve enlightenment or at least a favorable rebirth.

In Tibetan Buddhism, there are a number of meditations and rituals that can be performed after someone dies or during their dying process. These include reading them the Book of the Dead over a forty-nine-day period to guide them through the various stages of the bardo journey, and powa practice, in which an accomplished master can help the dying person transfer their consciousness directly into an enlightened state.

The sukhavati ceremony is traditionally performed shortly after a person’s death. In this ceremony, their loved ones, friends, and fellow practitioners, guided by a Buddhist teacher, pray they will be reborn in Sukhavati, the Western Paradise or Land of Ultimate Bliss. This is the enlightened pure land of the primordial buddha Amitabha in which they are free of all karma, defilements, and suffering.

In this ceremony, the congregation generates loving-kindness and compassion toward the deceased, who may be suffering confusion and fear in the bardo. They urge the deceased to let completely go of their previous identity and karma and ask the buddhas and bodhisattvas to guide them to the pure land. Here is a prayer that is typically recited in Sukhavati ceremonies in the Kagyu school of Tibetan Buddhism:

Wonderful Buddha of Limitless Light [Amitabha], to his right the Lord of Great Compassion and to his left the Bodhisattva of Great Power, surrounded by an infinite retinue of buddhas and bodhisattvas.
The joy and happiness is limitless and wonderful in this pure land called Dewachen [Sukhavati].
As soon as this life has passed away, without the diversion of other births,
May [name of the deceased] be born there and thus behold the face of Amitabha.
All buddhas and bodhisattvas of the ten directions, please grant your blessing that the wish expressed in this prayer be accomplished without hindrance.

In some versions of this ceremony, a photograph of the deceased is burned at the climax of the ritual so the deceased does not hold on to their former identity. As the photograph becomes ash, the prayers conclude and in the silence, the teacher intones the single syllable HUM, the mantra of great compassion. All pray their loved one will take the excellent opportunity of the bardo state to enter Sukhavati, the paradise that is freedom from karma and suffering.

Taking Refuge in Amida Buddha

The funeral rituals of Jodo Shinshu Buddhism, as practiced in the Buddhist Churches of America, remind practitioners that through taking refuge in Amida Buddha, the central figure in Pure Land Buddhism, one can transcend time and space, and join together in the pure land as buddhas before returning to samsara to help others. In this way, death is understood to be a beginning rather than an end, and funeral rites offer comfort, solemnity, and the opportunity to express gratitude to the surviving family and friends.

After a person’s death, the minister is contacted by the family and the Makuragyo (literally “pillow service,” or bedside service) is performed. The home altar is decorated with white cloth and flowers, as is the body. The minister will chant one of the gathas from the Larger Sutra of Immeasurable Life, such as Juseige or Sanbutsuge.

Often, relatives live too far away for the body to remain long enough for them to travel to the funeral, so a cremation is done and the funeral takes place with a photo and urn. The funeral service itself begins with the ringing of the calling bell, reminding listeners of the impermanence of all things, an important remembrance in times of death.

Next, the presentation of the Buddhist name occurs. If the dying person has not already received a Buddhist name, the chanting of Kisamboge, by Shan-tao, helps to confirm the person; for those who have already received their name, the chanting is considered a rededication.

Then there is a chanting of Shoshinge, by Shinran, during which guests come up to burn incense, symbolic of the purification of one’s heart and mind to receive the truths of the Buddha. After this, there is an opportunity for eulogies by friends and family, followed by a dharma teaching and the recitation of Rennyo’s “White Ashes” from the minister, which concludes with the line: “By so understanding the meaning of death, we shall come to fully appreciate the meaning of this life, which is unrepeatable and thus to be treasured above all else.”

Traditionally, the service ends with some words of acknowledgment and a meal afterward, held at the temple or a nearby restaurant.

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