‘Duo euthanasia’

— In the Netherlands, a famous couple chooses to die together

Former Dutch prime minister Dries van Agt and his wife, Eugenie, in Den Bosch, the Netherlands, in June 1983.

By

The vow is “til death do us part.” But for former Dutch prime minister Dries van Agt and his wife, Eugenie, the aim was to leave this life the same way they had spent the past seven decades — together.

The couple, both 93, died “hand in hand” earlier this month, according to a statement from the Rights Forum, a pro-Palestinian organization that Dries van Agt created. They chose to die by what is known as “duo euthanasia” — a growing trend in the Netherlands, where a small number of couples have been granted their wish to die in unison in recent years, usually by a lethal dose of a drug.

A longtime politician who had conservative roots but campaigned for numerous liberal causes, van Agt served as prime minister of the Netherlands from 1977 to 1982. He later became the European Union’s ambassador to Japan and the United States

Photos of the couple from their decades-long careers as public figures often show them walking in step: waving to crowds through a car window, voting together at an election site and giving each other a smooch at a public event.

The van Agts’ health had declined in recent years, Dutch public broadcaster NOS reported. The former prime minister never fully recovered after suffering a brain hemorrhage in 2019, which happened while he was delivering a speech at a commemoration event for Palestinians. Eugenie’s health issues were largely kept private.

“I feel like it’s kind of beautiful, honestly, that you’ve lived your life together, you both happen to be gravely ill without a chance of getting better, you’re ready to go, and you would like to go together,” said Maria Carpiac, director of the gerontology program at California State University at Long Beach.

When it comes to the right to choose one’s own death, the Netherlands is “kind of the model” for any U.S. legislation on the topic, she said.

At least 29 couples — or 58 people — died together via duo euthanasia in 2022, the most recent year of data from the country’s Regional Euthanasia Review Committees. That’s more than double the 13 couples who did so in 2020, when the committee first started looking at partners specifically, but it still represents only a small fraction of the 8,720 people who legally died by euthanasia or assisted suicide in the Netherlands that year.

“It is likely that this will happen more and more often,” said Rob Edens, press officer for NVVE, a Dutch organization focused on research, lobbying and education about assisted suicide and euthanasia in the Netherlands. “We still see a reluctance among doctors to provide euthanasia based on an accumulation of age-related conditions. But it is permitted” in the country’s legal guidelines, he said in an email.

Assisted suicide is when a person self-administers a lethal dose while a physician is present, while euthanasia is when a medical professional administers the dose. Both are legal in the Netherlands when specific criteria are met. (Some groups prefer the term “medical aid in dying,” or MAID, due to religious and social stigma around suicide.)

Euthanasia is illegal in the United States, but assisted suicide is allowed in D.C. and at least 10 states: Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine and New Mexico. Eligibility requirements tend to be strict across the country, Carpiac said, but there are differences between jurisdictions.

The Netherlands, a country of almost 18 million people, has allowed assisted suicide and euthanasia since 2002. It requires that individuals willingly request the termination of their life in a manner that is “well-considered,” with a sign-off from a doctor that they are experiencing “unbearable suffering with no prospect of improvement.”

Another physician then has to agree that the person qualifies, and doctors can choose whether they are involved in the procedure. After every death, doctors are required to notify a regional review committee, which examines whether each case was handled lawfully. Couples who seek duo euthanasia are required to apply and undergo the review process individually, with separate doctors.

“An accumulation of age-related complaints can lead to unbearable and hopeless suffering,” Edens said, explaining the Dutch guidelines. “The expectation is that if doctors are increasingly willing to provide euthanasia when there is an accumulation of old-age complaints, the number of duo euthanasia [cases] will increase.”

Research suggests that older Americans are at a higher risk of dying after losing a spouse, particularly in the first few months after their death. While the cause of this phenomenon is unclear, studies have found that grieving partners have higher rates of inflammation and are at increased risk of heart attack and stroke, often due to stress-induced changes in blood pressure, heart rate and blood clotting.

“The first thing that came to my mind was the widowhood effect,” Carpiac said, referring to the van Agts’ choice to die by duo euthanasia. “I have a grandmother who is 96, and she’s like, ‘I’m not going anywhere!’ But if I had a partner and they were my person, and we were both kind of at the end of our lives, would it be worth it if he were to go without me? Would I die of what I considered to be a broken heart? I would want to have a choice.”

Complete Article HERE!

End-Of-Life

— The One Decision AI Cannot Predict

We often talk about personalized medicine; we hardly ever talk about personalized death.

By Dr. Tal Patalon, MD, LLB, MBA

End-of-life decisions are some of the most intricate and feared resolutions, by both patients and healthcare practitioners. Although multiple sources indicate that people would rather die at home, in developed countries they often end their lives at hospitals, and many times, in acute care settings. A variety of reasons have been suggested to account for this gap, among them the under-utilization of hospice facilities, partially due to delayed referrals. Healthcare professionals do not always initiate conversations about end-of-life, perhaps concerned about causing distress, intervening with patients’ autonomy, or lacking the education and skills of how to discuss these matters.

We associate multiple fears with dying. In my practice as a physician, working in palliative care for years, I have encountered three main fears: fear of pain, fear of separation and fear of the unknown. Yet, living wills, or advanced directives, which could be considered as taking control of the process to some extent, are generally uncommon or insufficiently detailed, leaving family members with an incredibly difficult choice.

Apart from the considerable toll they face, research has demonstrated that next-of-kin or surrogate decision makers can be inaccurate in their prediction of the dying patient’s preferences, possibly as these decisions personally affect them and engage with their own belief systems, and their role as children or parents (the importance of the latter demonstrated in a study from Ann Arbor).

Can we possibly spare these decisions from family members or treating physicians by outsourcing them to computerized systems? And if we can, should we?

AI For End-Of-Life Decisions

Discussions about a “patient preference predictor” are not new, however, they have been recently gaining traction in the medical community (like these two excellent 2023 research papers from Switzerland and Germany), as rapidly evolving AI capabilities are shifting the debate from the hypothetical bioethical sphere into the concrete one. Nonetheless, this is still under development, and end-of-life AI algorithms have not been clinically adopted.

Last year, researchers from Munich and Cambridge published a proof-of-concept study showcasing a machine-learning model that advises on a range of medical moral dilemma: the Medical ETHics ADvisor, or METHAD. The authors stated that they chose a specific moral construct, or set of principles, on which they trained the algorithm. This is important to understand, and though admirable and necessary to have been clearly mentioned in their paper, it does not solve a basic problem with end-of-life “decision support systems”: which set of values should such algorithms be based on?

When training an algorithm, data scientists usually need a “ground truth” to base their algorithm on, often an objective unequivocal metric. Let us consider an algorithm that diagnoses skin cancer from an image of a lesion; the “correct” answer is either benign or malignant – in other words, defined variables we can train the algorithm on. However, with end-of-life decisions, such as do-not-attempt-resuscitation (as pointedly exemplified in the New England Journal of Medicine), what is the objective truth against which we train or measure the performance of the algorithm?

A possible answer to that would be to exclude moral judgement of any kind and simply attempt to predict the patient’s own wishes; a personalized algorithm. Easier said than done. Predictive algorithms need data to base their prediction on, and in medicine, AI models are often trained on a large comprehensive dataset with relevant fields of information. The problem is that we don’t know what is relevant. Presumably, apart from one’s medical record, paramedical data, such as demographics, socioeconomic status, religious affiliation or spiritual practice, could all be essential information to a patient’s end-of-life preferences. However, such detailed datasets are virtually non-existent. Nonetheless, recent developments of large language models (such as ChatGPT) are allowing us to examine data we were previously unable to process.

If using retrospective data is not good enough, could we train end-of-life algorithms hypothetically? Imagine we question thousands of people on imaginary scenarios. Could we trust that their answers represent their true wishes? It can be reasonably argued that none of us can predict how we might react in real-life situations, rendering this solution unreliable.

Other challenges exist as well. If we do decide to trust an end-of-life algorithm, what would be the minimal threshold of accuracy we would accept? Whichever the benchmark, we will have to openly present this to patients and physicians. It is difficult to imagine facing a family at such a trying moment and saying “your loved one is in critical condition, and a decision has to be made. An algorithm predicts that your mother/son/wife would have chosen to…, but bear in mind, the algorithm is only right in 87% of the time.” Does this really help, or does it create more difficulty, especially if the recommendation is against the family’s wishes, or is delivered to people who are not tech savvy and will struggle to grasp the concept of algorithm bias or inaccuracies.

This is even more pronounced when we consider the “black box” or non-explainable characteristic of many machine learning algorithms, leaving us unable to question the model and what it bases its recommendation on. Explainability, though discussed in the wider context of AI, is particularly relevant in ethical questions, where reasoning can help us become resigned.

Few of us are ever ready to make an end-of-life decision, though it is the only certain and predictable event at any given time. The more we own up to our decisions now, the less dependent we will be on AI to fill in the gap. Claiming our personal choice means we will never need a personalized algorithm.

Complete Article HERE!

Vatican Museums Open Ancient Roman Necropolis To The Public For The First Time

— A Fascinating Addition to the Vatican City Museums

The Vatican Museums, located within the awe-inspiring Vatican City, are renowned worldwide for their vast collections of art and historical artifacts. Serving as a beacon for art enthusiasts and history buffs alike, these museums offer a unique glimpse into the grandeur of the Catholic Church and its rich cultural heritage. However, a recent development has taken place that has further enhanced the allure of the Vatican City Museums. The Vatican Museums have now opened an ancient Roman necropolis to the public for the first time. This exciting addition allows visitors to journey even further back in time, exploring the intriguing burial practices and customs of ancient Romans. Let’s delve deeper into this newfound treasure and dive into the wonders of the Vatican Museums.

Delving into the Vatican City Museums: A Haven of Art and History

The Vatican City Museums have long been regarded as a treasure trove of masterpieces. With an extensive collection spanning various epochs and artistic styles, these museums grant a mesmerizing experience of the pinnacle of human creativity. Every year, millions of visitors flock to marvel at the Sistine Chapel, the monumental Saint Peter’s Basilica, and the breathtaking Raphael Rooms. However, until recently, the Vatican Museums had yet to unveil an untapped gem within their vast complex: an ancient Roman necropolis.

Journalists visit an ancient necropolis along the via triumphalis, an archaeological area containing a Roman burial ground during the presentation to the press of the new entrance to the site at the Vatican, Tuesday, Nov. 14, 2023. (AP Photo/Gregorio Borgia)

Unearthing the Past: The Roman Necropolis of the Vatican

Located below the Vatican City, the Roman necropolis offers visitors a unique opportunity to immerse themselves in ancient history. The term“necropolis” derives from ancient Greek, meaning“city of the dead,” and refers to the burial grounds used by ancient civilizations. These necropolises hold immense historical and archaeological value, shedding light on aspects of daily life, beliefs, and burial practices of the people who lived during those times. The Roman necropolis beneath the Vatican City encapsulates this sentiment and offers an intriguing insight into the lives of ancient Romans.

From Tombstone to Time Machine: Exploring the Roman Necropolis

As visitors embark on their journey through the Roman necropolis, they will be transported back in time through a series of well-preserved burial chambers and tombs. The necropolis spans several centuries and allows visitors to witness the evolution of burial practices, from simple chambers to elaborate mausoleums adorned with intricate artwork. The subterranean network of tunnels and chambers showcases the diversity of tombs, offering a glimpse into the social structure and beliefs of ancient Roman society.

A mosaic is displayed inside an ancient necropolis along the via triumphalis, an archaeological area containing a Roman burial ground during the presentation to the press of the new entrance to the site at the Vatican, Tuesday, Nov. 14, 2023.

Unveiling the Ancient Art of Funeral Rites

The Roman necropolis is not only a testament to the architectural brilliance of the ancient world; it is a showcase of the artistry and reverence held for the deceased. Visitors will discover beautifully carved sculptures and intricate tomb decorations, depicting scenes from mythology and capturing the essence of the departed individuals’ lives. Elaborate frescoes, mosaics, and inscriptions add depth and texture to the necropolis, unveiling the customs, traditions, and spiritual beliefs associated with funeral rites.

Roman Necropolis: A Portal to the Past

For centuries, the Roman necropolis has remained hidden beneath the Vatican, preserved in remarkable condition. Now, with its doors opened to the public, visitors have the opportunity to traverse an underground time capsule. Walking through the narrow passageways, visitors can ponder the stories of those who lived centuries ago, imagining the lives they led and the legacy they left behind. It is an experience that not only piques curiosity but also fosters a profound understanding of our shared human history.

Preservation Challenges: Balancing Access and Conservation

The decision to open the Roman necropolis to the public was undoubtedly a challenging one. Preservation efforts need to strike a balance between providing public access and ensuring the ongoing conservation of these invaluable ancient artifacts. The Vatican Museums have vigilantly implemented measures to protect the necropolis, including environmental controls, regular maintenance, and visitor limits. This delicate equilibrium ensures that future generations can continue to enjoy and learn from this extraordinary archaeological site.

The Power of Immersive Education: Learning through Exploration

By offering access to the Roman necropolis, the Vatican Museums enrich the educational experience for visitors of all ages. Instead of merely observing artifacts from a distance, visitors can now actively engage with history, fostering a deeper understanding and appreciation for ancient Roman culture. The opportunity to explore these hidden chambers and decipher the stories they hold creates a sense of wonder and ignites a desire for further exploration and learning.

A Glimpse into the Past

The Vatican Museums’ decision to open the ancient Roman necropolis to the public provides a remarkable opportunity to step back in time and immerse oneself in the mysteries of ancient Rome. This newly accessible site adds another layer of fascination to the already captivating Vatican City Museums. As visitors traverse the subterranean corridors and stand before monumental tombs, they can forge a connection with the past, appreciating the richness and complexity of ancient Roman culture. We can only hope that this extraordinary archaeological treasure will continue to be preserved and shared for generations to come, allowing future visitors to be inspired by the wonders of the Roman necropolis.

Complete Article HERE!

Deadass Podcast’s host Bryan Perry on mission with Nicholas Smithson to talk about death openly

Deadass Podcast host Bryan Perry (left) talks with Nicholas Smithson openly about death.

By Jasmine Hines

When Nicholas ‘Nicko’ Smithson was diagnosed with stage 4 cancer, he would lie awake at night terrified of dying.

The tradesman spent years labouring in the sun and was diagnosed with melanoma when he was 38 years old.

He was given just six months to live.

“I was quite petrified of whether there was life after death,” Mr Smithson said.

“They didn’t catch it (the cancer) in time … it spread throughout my entire body, my bones, my liver, everything like that.”

Mr Smithson, who lives in Rockhampton in central Queensland, underwent intense immunotherapy and two years later is in remission.

A man with brown hair, a mustache and arm tattoos lies in a hospital bed
Nicholas Smithson at a hospital in Brisbane.

He has teamed up with his best friend, Bryan Perry, who owns a crematorium business to help demystify and start the conversation about death through their Deadass Podcast.

In denial about death

Leading palliative care researcher Adjunct Professor Elizabeth Lobb said Australians live in a “death-denying society”.

A close up headshot of a woman with short brown hair smiling
Elizabeth Lobb says it is important for people to talk about their feelings after a diagnosis.

She has spent 28 years of her life dedicated to the psychological impact of oncology, palliative care and grief.

She said people avoid the topic because it is confronting and people fear the unknown.

“It’s not something that we talk about, [but] certainly when someone receives a diagnosis of cancer, it’s one of the first things that comes into their mind,” Dr Lobb said.

She said when you did not know how to respond or help those with life-limiting diagnoses, the first step was to give people a chance to talk about their feelings.

“I often say to family members that sometimes words aren’t needed, it’s just important to listen, we can’t solve this,” Dr Lobb said.

“People who are facing a life-limiting illness can become very isolated and it can be lonely because no one wants to talk about it.”

Sharing eulogies

Mr Smithson, now 40, works for the podcast creating digital content and has been featured in episodes to share his life story, or “eulogy”.

He has been warned by health professionals that his cancer could return, and he has decided he will not seek further treatment because of the harsh impact on his body.

a man with brown hair, a mustache and blue eyes is in front of a microphone
Mr Smithson has shared his story with the podcast.

Mr Smithson said the double doses of immunotherapy led to ulcerative colitis, and his colon had to be removed.

He said working on the podcast has helped him come to terms with death.

“It’s kind of shed a bit of light and helped ease the anxiety a little bit of, if it does end up happening, I’d be OK with that,” he said.

Mr Perry, who hosts the show, said he wanted a platform to share his mate’s story, as well as other people’s eulogies before it was too late.

“We were contemplating his own mortality and discussing some of the things we’ve done together over the years and taking the opportunity to record those memories,” Mr Perry said.

“The intentions were to either keep those or to share them and even potentially have his own funeral.”

A man with facial hair and tattoos smiling bending down and posing with his medium sized white dog
Mr Perry spends so much time with death, he even named his dog Rigor Mortis.

Preparing for death

Mr Perry, who has worked in the funeral industry for more than 20 years, said people were hesitant to think about death.

He urged more people to think about it practically.

“Jot down what you want, put down what sort of songs you want, where you want to have it,” he said.

“It’s just peace of mind for the people that you’re leaving behind so that when your time does come, the family knows exactly what you want and it just lessens the burden for them.”

A man with facial hair and tattoos looks at a casket. There are stacks of caskets in the background
Mr Perry says he wants to capture more people’s eulogies while they’re still living.

Dr Lobb said not everyone was able to communicate their final wishes but she recommended those who could to consider their financial affairs and where they want palliative care to take place, whether it be at home or in a hospital.

“There’s no right or wrong and it’s very individual,” she said.

“Yes, it is devastating, it’s overwhelming, but not necessarily as fearful as [it’s] perhaps being portrayed.”

Complete Article HERE!

Third of patients given lethal drugs under right-to-die laws ‘do not take them’

By Michael Searles

More than a third of suicidal patients who are prescribed lethal drugs under right-to-die laws do not take them, data show.

Just 1,905 of the 2,895 people prescribed assisted dying pills in Oregon, US, between 1998 and 2021 took them, according to the state’s public health data.

The figures are mirrored in the neighbouring state of California, where in 2021, 286 of the 772 people prescribed a fatal dose ultimately decided against using it.

Even in Canada, where medically-assisted deaths are the most pervasive and accepted in the world, around 13,000 people of the 15,500 with lethal drug prescriptions in 2022 used them – and around 300 people changed their mind.

Experts consider the Oregon model, whereby a doctor specialising in end-of-life care prescribes a deadly drug to be taken at home by a patient, as the best option for Britain, should MPs vote for a change in the law.

They said having the autonomy to take a lethal drug to end one’s own life is like an “insurance policy”, if a terminal illness becomes “intolerable”.

Oregon was one of the first places in the world, and the first state in the US, to legalise assisted dying under a Death with Dignity Act in 1997.

Inquiry into assisted dying

It is also where MPs from the cross-party health select committee visited as part of their inquiry into assisted dying and suicide earlier this year in order to understand more about the practice and what it may look like in the UK. A full report is due in the new year.

Calls for a free vote on the issue have intensified this week, with Dame Esther Rantzen revealing she was considering using Dignitas, in Switzerland, following her diagnosis with lung cancer.

Sir Keir Starmer, the leader of the Labour Party, voted for a change to the law in a defeated motion in 2015. This week he restated that there were “grounds for changing the law” but it should be through a free vote because of the “divided and strong views”.

An expert working group from the University of Essex, made up of two consultants in palliative medicine, two lawyers, and two philosophy professors, said that nowhere that had legalised the practice had voted to go back on it.

Most notably, a 2011 referendum in Zurich, Switzerland, where assisted dying has been legal since 1941 and the home of “suicide tourism” clinics like Dignitas, voted overwhelming to reject proposals to overturn the law.

Around 85 per cent of 278,000 voters opposed the ban on assisted suicide and 78 per cent rejected a motion to outlaw it for foreigners.

About 200 people travel to Zurich to use its assisted suicide services each year – an estimated 350 Brits have taken their lives there.

Prof Wayne Martin, director of the Autonomy Project and professor of philosophy at the University of Essex, said the law had never been repealed anywhere because “there is no political force sufficiently strong to reverse the tide”.

“If anything the tendency is for access to assisted dying to be progressively expanded over time,” he said.

‘Time and place of their own choosing’

“Public records in Oregon consistently show that many of those prescriptions are never actually used,” he said.

Prof Martin added that the system used in Oregon was preferred because it lets people take the lethal dose at a “time and place of their own choosing”.

“Public records in Oregon consistently show that many of those prescriptions are never actually used,” he said. “Many Oregonians who apply for assistance in dying do not actually want assistance in dying. What they seek from that prescription is an insurance policy that will protect them from being trapped in a life they find intolerable. What they want is autonomy.”

Around 200 million people have access to assisted dying around the world, and this number is only growing.

It is an option for the terminally ill in nine US states, Canada, eight European countries, and all Australian territories except the Northern Territory and the Australian Capital Territory.

It has in the last couple of years been legalised to some extent in Spain, Portugal, Germany and New Zealand, and is being considered in France.

The drug prescribed is usually a short-acting barbiturate, which is a type of sedative taken at a high dose so that it completely suppresses the central nervous system, inducing death.

Complete Article HERE!

End-of-life clinicians are trying to shift Hollywood’s depiction of death

By April Dembosky

We’re used to seeing death on TV and in the movies, but some clinicians who work with people at the end of life say the most common depictions aren’t representative of what happens in the real world. They’re trying to shift the stories we tell about death to help people cope better. From member station KQED, April Dembosky reports.

APRIL DEMBOSKY, BYLINE: We’ve seen it so many times – a young man rushed into the emergency room with a gunshot wound, a flurry of white coats racing the clock, CPR, the heart zapper, the order for a scalpel, stat. This is Dr. Shoshana Ungerleider’s biggest pet peeve.

SHOSHANA UNGERLEIDER: Acute violent death is portrayed many, many, many times more than a natural death.

DEMBOSKY: Ungerleider practiced in the hospital and ICU for seven years. She says television tropes like this ignore the full range of end-of-life experiences and the choices people have, like dying at home instead of a hospital. And all those miraculous CPR recoveries – they create false hope. She thinks Hollywood can do better.

UNGERLEIDER: Really, our goal is to encourage them to write in different kinds of inspiring and nuanced and diverse storylines that are more representative of what’s actually possible.

DEMBOSKY: Ungerleider is the founder of End Well, a nonprofit that hosts an annual conference. It’s like the TEDx for end of life.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PERSON #1: Please find your seats. Our program is about to begin.

DEMBOSKY: It started six years ago in San Francisco. But this year, it was in Los Angeles for the first time. Ungerleider wants to harness the power of prime-time TV.

UNGERLEIDER: We’re trying to embed ourselves within Hollywood.

DEMBOSKY: In addition to the hospice nurses and grief experts, End Well invited a team of celebrities to the conference stage, like talk show host Amanda Kloots and comedian Tig Notaro. Sitcom star Yvette Nicole Brown was the emcee.

(SOUNDBITE OF ARCHIVED RECORDING)

YVETTE NICOLE BROWN: And when my mom passed, I called all my friends whose mom had passed before and apologized…

UNIDENTIFIED PERSON #2: Yeah.

BROWN: …Because I said, until this moment, I had no idea.

DEMBOSKY: Brown had no models for how to grieve or support others in their grief. Now she’s trying to set an example for the rest of the entertainment industry.

(SOUNDBITE OF ARCHIVED RECORDING)

BROWN: If you are a writer or a producer or a comedian or whatever, talk about grief.

UNIDENTIFIED PERSON #2: Yeah.

BROWN: Talk about death.

DEMBOSKY: End Well has also partnered with researchers at USC Annenberg to find out what’s stopping TV producers from using more realistic death narratives. Director of research Erica Rosenthal says they found Hollywood execs are wary that depressing stories will alienate viewers.

ERICA ROSENTHAL: Entertainment is still a profit-driven system, and the bottom line is viewership.

DEMBOSKY: She says what many viewers want from TV is escapism, comfort, humor.

ROSENTHAL: How do you make end-of-life care funny?

DEMBOSKY: A few industry outliers are convinced they can.

J J DUNCAN: I hope that we can learn that death stories don’t have to be sad or sappy or depressing.

(SOUNDBITE OF COMPAGNIA D’OPERA ITALIANA, ALBERTO GAZALE, AND ANTONELLO GOTTA PERFORMANCE OF ROSSINI’S “IL BARBIERE DI SIVIGLIA – LARGO AL FACTORUM”)

DEMBOSKY: J.J. Duncan is the showrunner for the new reality show on NBC’s streaming network narrated by Amy Poehler, “The Gentle Art Of Swedish Death Cleaning.”

(SOUNDBITE OF TV SHOW, “THE GENTLE ART OF SWEDISH DEATH CLEANING”)

AMY POEHLER: What is Swedish death cleaning, you say? Basically, cleaning out your crap so that others don’t have to do it when you’re gone.

DEMBOSKY: In the first episode, three Swedes help a 75-year-old woman sort through her belongings and her memories, including working as a singing waitress in Aspen.

(SOUNDBITE OF TV SHOW, “THE GENTLE ART OF SWEDISH DEATH CLEANING”)

SUZI SANDERSON: I sang there for 11 years.

UNIDENTIFIED PERSON #3: Oh.

SANDERSON: And then I got married. And then – well, I have to tell the truth. It ruined my sex life.

(LAUGHTER)

DEMBOSKY: Duncan says Hollywood is slowly opening up. She couldn’t believe producers were willing to do a show with the word death in the title.

DUNCAN: I mean, that alone is amazing. And we had studio people say, oh, don’t say death too much, you know what I mean? Because it’s scary.

DEMBOSKY: But Duncan says any good story has setup, conflict and resolution – maybe a hero’s journey. There’s no reason death can’t fit into the formula.

Philly’s deathcare enthusiasts want to bring back the shroud

— The idea that death and dying can be part of life, not handled by walled-off specialists in expensive facilities, has gained traction in recent years.

Attendees of a recent shrouding workshop practice on a volunteer, led by Pat Quigley, right, the supervisor of Laurel Hill funeral home.

By Zoe Greenberg

In a high-ceilinged, brick-walled space in Northern Liberties where people often host weddings, a group of strangers gathered on a recent Sunday to prepare for death.

They had come to learn how to shroud, part of a growing “death-positive” movement in Philly that seeks to demystify and de-commercialize the end of life. Many had been drawn to the hands-on workshop by fliers posted around the city that read, in part, “Yes, you heard that right! ‘Shroud’ as in wrapping a dead body for burial.”

Hosted at the MAAS building, the free event promised a shrouding demonstration (”on a live human”). It also served as the first meeting of a nascent “deathcare volunteer group,” which has aims to help Philadelphians who cannot afford funeral costs prepare and bury their loved ones. The median cost of funeral followed by burial in the mid-Atlantic region was $8,093 in 2021, according to the National Funeral Directors Association — a hefty sum for many families.

Pat Quigley, center and funeral director at Laurel Hill cemetery, teaches attendees how to shroud a dead body at a recent workshop in Northern Liberties. Kim Schmucki, on the table, volunteered to be practiced on.
Pat Quigley, center and funeral director at Laurel Hill cemetery, teaches attendees how to shroud a dead body at a recent workshop in Northern Liberties. Kim Schmucki, on the table, volunteered to be practiced on.

“I really want Philadelphia to be a death-positive hub on the East Coast,” said Isabel Knight, 29, the president of the National Home Funeral Alliance and the workshop’s organizer. In her vision, the grassroots group will wash and shroud the dead for free, and perhaps even transport bodies, in personal vehicles with burial permits, to cemeteries, Knight said.

Of actual burial or cremation, “That’s something that you’ve got to pay for, unfortunately,” she said.

The idea that death and dying can be part of life, not handled by walled-off specialists in expensive facilities, has gained traction in recent years. And the attendees at the shrouding workshop were not, on the whole, new to death — they included death doulas, a hospice music therapy worker, and a former palliative care doctor.

It was a practical meeting, but also something of a pep rally for people whose passion may not be the most popular at cocktail parties.

“I do a meditation where I visualize dying — and sometimes being cared for, and sometimes just being kind of abandoned on a cliff and decomposing,” said Natalia Stroika, 38, of South Philly, explaining to the group why she had come. “I got a lot of wisdom from that.”

Another attendee, a West Philly resident who goes by the name Ask Nicely, explained that he was in the process of growing flax in a burial ground in Upper Darby “so that I can learn to process it into fiber and then weave my own death shroud,” a comment that elicited an appreciative murmur from the crowd.

Many Jewish communities already have a volunteer burial society, or chevra kadisha, to ritually wash and prepare the dead for burial. Knight’s deathcare group will be for all religions, and particularly for those who cannot afford the high costs of the modern funeral.

Attendees of a free shrouding workshop practice wrapping a volunteer in a sheet.
Attendees of a free shrouding workshop practice wrapping a volunteer in a sheet.

Pat Quigley, 66, the supervisor of Laurel Hill funeral home and a member of the Reconstructionist Chevra Kadisha, or Jewish burial society, served as the shrouding instructor. She first reassured the group on two fronts: dead bodies do not immediately become too stiff to handle, and they do not instantly decompose.

Next was the practical matter of what to do. Everyone crowded around a pale green massage table at the front of the room; Kim Schmucki, 60, removed her shoes, revealing multicolored striped socks, and lay on the table, pretending to be dead. The group used a white linen-cotton shroud made by California company Kinkaraco, which Laurel Hill sells for roughly $900. Kinkaraco makes shrouds for a “green burial,” which means that everything about the body, the clothes, and the casket (if there is one) is biodegradable.

“Obviously we’re not going to suffocate Kim,” Quigley said, showing attendees how to roll her over and pull the shroud around her, but declining to pull it over her face. She offered a few “nifty little tricks” to keep eyes and mouths closed, advised attendees to support the head during the process, and showed the group how to tie the shroud tightly around the feet, waist, and upper body.

After the main demonstration, participants broke into smaller groups to try themselves. On the floor, a group carefully wrapped their volunteer corpse in a pale green sheet and rolled her back and forth, tied up with a bow.

“The whole death experience, like the whole birth experience, has become so medicalized and so sanitized,” said Quigley. “I think people just want something different.”

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