Her life ‘at an end,’ ill Blaine woman turns to death midwife for help with last days

Death midwife Ashley Benem, right, sits with Pam Munro at Munro’s home on Friday, July 8, 2016, in Blaine. Munro, who had Alzheimer’s, was in the process of voluntarily stopping eating and drinking with the guidance of Benem. Munro died July 17.
Death midwife Ashley Benem, right, sits with Pam Munro at Munro’s home on Friday, July 8, 2016, in Blaine. Munro, who had Alzheimer’s, was in the process of voluntarily stopping eating and drinking with the guidance of Benem. Munro died July 17.

[W]hen Pam Munro was ready, she gathered her family and friends at her bedside. There, with a tiara perched on her head, she held court in her home for an hour or two in the evenings while she still could. Together, they joked and laughed as she waited for the death she had planned.

The 62-year-old Blaine woman died July 17.

Twelve days earlier, she had stopped eating and drinking – choosing to accelerate her death instead of lingering into the later stages of her rapidly progressing Alzheimer’s.

Her father had dementia with Lewy bodies, her grandmother Alzheimer’s. She saw them deteriorate slowly until they were institutionalized. She didn’t want to end her days locked away in a care facility, a vegetable, not knowing her family and friends.

“My life really is at the end. After that, it’s not living. And there is no cure,” Pam said in an interview on her third day without food and drink, when she could still talk. “I want to die with dignity. I want to enjoy everything I can.”

Steve Munro, her husband of 15 years, looked on as she talked. Sitting near her was Bellingham resident Ashley Benem, a death midwife who helped the Munros navigate the end of Pam’s life. Benem is the founder of the nonprofit A Sacred Passing: Death Midwifery Services.

Pam already had decided to voluntarily stop eating and drinking, which is legal and also known as VSED, when the Munros met with Benem for the first time in January.

“It was pretty daunting. We didn’t know what to do, how to go about it. We needed advice,” Steve, 66, said Sept. 26. “It gave me comfort. Part of it was they knew what to do. I didn’t know what to do.”

Benem is among a growing number – exactly how many isn’t known because there is no regulatory agency – of people who help the dying and their loved ones in their walk with death. As a birth midwife ushers new life into the world, a death midwife helps ease people into death.

“They are the bookends of life. We start with an in breath and we end with an out breath,” said Henry Fersko-Weiss, author of “Caring for the Dying: the Doula Approach to a Meaningful Death,” which will be published in 2017.

Practitioners in the emerging field are known by a number of names, including death doulas, home funeral guides, transition coaches and end of life guides.

They offer a variety of services. Some are volunteers. Others, like Benem, are professionals and charge a fee.

What they share is a desire to comfort, to bring death back home into the family fold, and to once again make death a normal part of life instead of sequestering it away in hospitals and funeral homes.

A guide for the dying

Benem came to midwifery after years of medical experience as an EMT and paramedic. After the birth of her son, she became a licensed massage therapist and birth doula before becoming interested in serving as a death midwife.

Benem and her team at A Sacred Passing offer a number of services, all non-medical, that are tailored to individual needs.

They provide support and help people plan for the end of life. They work with funeral homes, hospice and others to augment existing care and services, they create vigils, they sit with the dying, they help with the practical, such as documents needed for end of life care, and they address spiritual needs.

“We go where the patient goes,” Benem said.“There’s not a single nurse or LPN (licensed practical nurse) that doesn’t want to sit at the bedside of someone that’s dying. They simply can’t because of staffing.”

She said death midwives can be advocates who help the dying and their loved ones navigate the big picture, who help them consider quality of life through the entire dying process.

“Our current models of care, though excellent at handling specific aspects of the end of life journey, leave people with huge gaps to try to navigate for themselves,” Benem said. “For example, you have an excellent physician to handle your medical care, but no one to handle the social, spiritual or economic questions or concerns.”

Such services are a convergence of two trends: People who want to die on their own terms, and the aging of baby boomers, a population juggernaut of about 75.4 million, who are driving the conversation much as they pushed for – and succeeded in getting – more personal, less institutionalized childbirth in their younger days.

We’ve lost touch with the deeper sense of what this journey is about and how to go through it.

Henry Fersko-Weiss, author of “Caring for the Dying: the Doula Approach to a Meaningful Death”

No one is tracking the number of people turning to such services but anecdotal information indicates an increase, including from people who are going to training offered by Benem.

“The sheer number of people calling, emailing with questions is on a steady rise,” Benem said. “Our classes are typically full four months in advance.”

Fersko-Weiss also reported seeing more people showing up for training and classes offered through the International End of Life Doula Association, which the former hospice social worker co-founded in 2014 to establish a standard of training and to certify death doulas.

Benem, who said she traveled and took a multitude of classes, gleaning what she needed to become a death midwife, also supported creating standards for licensing, and said she wants Washington state to certify death doulas and death midwives.

New name, old ways

The desire to bring death home is a desire to return to the old ways, those in the field said.

“We’ve lost touch with the deeper sense of what this journey is about and how to go through it,” Fersko-Weiss said.

Before the Civil War, family and friends prepared their dead for burial, according to “A Family Undertaking,” a 2004 documentary about the home-funeral movement in America.

Benem said her grandmother served as a midwife, a function common in many agricultural and rural communities in North America.

“They provided all the prenatal, birth and postpartum care for women in the town, village or community. They would fetch the doctor from the local city if there was a major situation, but most was done at home with the midwives,” she said.

“These are the same women who came to sit with the dying and tend to the very ill or injured. They were the ones who washed the bodies and prepped the body and home for receiving the wake and vigil keepers,” Benem added. “This is what she did. The training was all on the job. No formal schooling. She delivered babies and the dead. The work has not changed. Just the titles. It’s a new name for an old practice.”

“I’m at peace”

Back in the Munro household in Blaine, Benem sat near a tired Pam as she talked about her struggle with Alzheimer’s.

She would brush her teeth, forget that she had and wonder why her toothbrush was wet. She left groceries in the trunk of her car for days. She put muffins into the oven, forgot about them, and couldn’t figure out why the house was full of smoke.

Her balance was worsening rapidly. She kept falling. Benem, who had been monitoring Pam, set up a 24-hour schedule so she wasn’t left unattended and to provide some relief to Steve, who was struggling to care for her.

In the final days of her life, Pam talked about the lotion and oils her family would rub on her body after she died – giving them one last chance to touch her and be with her. She showed an ocean-themed shroud she would be wrapped in, one created for her by April Lynn, a death doula who works with Benem.

“I’m at peace. The closer it gets to my journey date, the more excited I am. I’m going my way,” Pam said.

She talked about the rocks gathered at seaside and placed downstairs in her home. She wanted loved ones to write a message or a prayer on a rock and then “huck” it – she was specific about the word – into a bay. The ritual would act as a continuation of her love for beaches and beachcombing, which included having her ashes spread at sea in the San Juan Islands.

“And when you huck it, please be sure to also huck any pain or sorrow you might be ready to release as well,” Pam said in a note. “I will be there with you. I will help you. I will always love you.”

Complete Article HERE!

Hospice volunteers find joy and wisdom in comforting others

 Volunteers at MJHS Hospice offer comfort to its residents during their final days.
Volunteers at MJHS Hospice offer comfort to its residents during their final days.

 
By Karen Frances McCarthy

[E]ach day, ordinary Riverdale residents arrive at a hospice on Henry Hudson Parkway and volunteer to sit with the young and old, rich and poor, religious and non-religious, comforting them during their last days.

Many would see this as a gloomy way to spend time, especially in a society uncomfortable with the idea of human mortality. But volunteers at the 18-bed MJHS Zicklin Hospice Residence describe the experience as anything but morbid. They unanimously agree that sitting with those approaching the end of their lives has enriched volunteers’ own lives in unanticipated ways.

One of the volunteers, Dejanee Velasquez, 23, said it is often the patients who brighten her day.

“I’ve been visiting one patient regularly and we have formed a good relationship,” Ms. Velasquez said. “One day the nurses told me that the patient hadn’t been talking too much lately. When I went to visit with him that same day, he smiled so big that it made me smile … he was talking so much and [said] he was glad that I visited him that day.”

The founding of the modern hospice system is widely credited to Cicely Saunders, who worked in the UK in the middle of the 20th century. She wrote: “You matter because you are you, and you matter to the end of your life.”

But nearly a decade before Ms. Saunders’ birth in 1918, a charity group known as The Four Brooklyn Ladies was inspired by similar ideals to found a precursor of the modern hospice in New York in 1907. After going door to door to raise money, they got a small tenement building in Brooklyn to offer compassionate, dignified and respectful end of life care to local residents.

Despite this pioneering start, New York has been slow to embrace hospice care. In 2012, 32 percent of New Yorkers were enrolled in a hospice during the last six months of their lives, compared to 51 percent nationwide, according to numbers reported by WNYC radio. Experts surmise that this may have something to do with patients› fears that a hospice referral means accepting they will never recover, according to media reports. Another reason may be New York’s medical culture that focuses on curing patients rather than caring for them and eventually letting them go with dignity, NPR reported.

For hospice staff and volunteers, this presents unique challenges in trying to make everyone feel loved, respected and comforted. Their approach sounds simple – companionship. Some find ways to use their individual abilities: in creative drawing, helping to write letters or playing music. Sometimes they will meet outdoors, especially if the weather is good and a patient would like some fresh air. The change in scenery can often provide a boost to the spirit.

“I never cease to be amazed by the quality of individuals who are drawn to offer volunteer services to our patients and families,” said Patricia Cusack, director of MJHS volunteer services. “[It] enlightens me on a daily basis to be more cognizant of the awesome reality of the goodness within people who freely give their time, talent and energy to lighten the burden for hospice families and patients.”

Susan Adler, 54, is a licensed massage therapist and long-time hospice volunteer.  She was inspired to volunteer after by the hospice care her mother received at the end of life. Ms. Adler said she decided to try to make a difference in the lives of others by offering massage to help with pain relief and relaxation.

“It can be difficult to see people struggling physically with the loss of their health and strength, and struggling emotionally with the knowledge that they are soon going to die,» Ms. Adler said. “But I am grateful to be able to provide some relief to them through massage, and help make them feel cared for.”

One of the most important parts of care is listening, and this is something volunteers are better equipped to offer than the medical team. Patients sometimes share memories they do not want to share with the doctors or even family members or clergy. They can express pride in their accomplishment and feel they can admit regrets without being judged.

More often it is the little human gestures that count. Ms. Adler recalls being given strict instructions by an often-ornery woman to make tea by grating ginger and boiling water. Doing her best and terrified she got it wrong, she returned to the room, cup in hand, to be met with a smile and the words: “No, no, dear, that’s for you.”

Volunteers such as Ms. Adler and Ms. Velasquez agree that with all the hassles and ingratitude of daily life, walking into the hospice and being appreciated by patients for making a difference in their lives has been rewarding.

But it is not without challenges. There will come a day when the people with whom they have shared their time, their life›s stories, their laughter, and their friendship will no longer be waiting. Sometimes they will sit vigil while their new friend slips away. Sometimes they will arrive the next day to find an empty bed. Fond and final farewells are part of life for those who sit with the dying.

Yet, they say they would not trade this sadness or waver in their commitment to offer simple human compassion and companionship. Many of them have found something positive in witnessing the cycle of life intimately and often. Listening to stories of people›s lives in their twilight hours, learning what it important and what is meaningless when all is said and done, have given them a perspective and wisdom, and a sense of the preciousness of life and human dignity, volunteers said.

“The experience has changed me tremendously,” Ms. Velasquez said. “The way I think about life has also changed. Death is not picky: it can happen to anybody at any age. Because of this, it’s important for me to be grateful for everything that I have and to continuously live and enjoy life.”

Complete Article HERE!

In facing death, this doctor sees a way to live well

Dr. BJ Miller does not work to heal patients, but to ensure quality of life amid advanced or serious illness. Sometimes people suggest his job is depressing, but Miller doesn’t see it that way. When people are dying it changes how they live, he says. Miller gives his Brief but Spectacular take on dying and living.

 

JUDY WOODRUFF: Now to another of our Brief But Spectacular series, where we ask interesting people to share their passions.

Tonight, we hear from BJ Miller, a palliative care doctor in the San Francisco Bay Area. He explains how working in end of life care can help inform the way we live.

DR. BJ MILLER, Zen Hospice Project: When people find out I’m in palliative care, first of all, many people — you start with, well, oh, well, what is that? The interdisciplinary pursuit of quality of life, and the context is always advanced or serious illness.

Palliative care is irrespective of the clock. You don’t have to be dying anytime soon.

The curiosity from the public tends to be — and I hear this all the time — wow, you know, that must be so depressing. You know, you must be depressed all the time.

It’s not always happy, by a long shot, but there is this side effect that seems to come. By facing mortality, it seems to inform how you live. So, the secret is that facing death has a lot to do with living well.

The whole reason I went into medicine was because I became a patient. In college, sophomore year, my dear friends and I were horsing around one night. We decided to climb a parked train. I happened to have a metal watch on, and the — and, when I stood up, the electricity arced to the watch, and that was that.

It was sort of an introduction to my own death, my own sense of mortality, my own finiteness.

You’re the object of a lot of sympathy, pity, a lot of head-tilts. At first, it’s kind of sweet, but then it starts turning a little saccharine. You quickly look down that road, and it’s not too long before you realize that’s a dead end. That’s just another way of removing yourself or being removed from the flow of society.

One of the ways that I got through some of the early days was insisting that this was a variation on a theme we all experience, and that theme is — basically is suffering. Some way, life is not going to do what you want it to do. Your body is not going to do what you want it to do. You will suffer. It’s unavoidable.

And there is this unnecessary rind of suffering, which is so — which is the demoralizing part, because it’s the invented stuff. It comes in terms of how we treat each other, sometimes poorly. It comes in those moments of abandonment.

We end up warehousing folks who are sitting on piles of wisdom and experience and just plain hilarious or good stories. If we could sort of shift that a little bit, there’s a lot more peace waiting for all of us as we age.

I think a lot of us are really worried, not so much about the fact that we die, but how we die. Very often, patients themselves, the people doing the dying, will get to a place of acceptance, beyond acceptance even, you know, ready to go. You’re done. You’re done with this body.

A lot of the effort, my effort, the team’s effort, the hospice organization’s effort, is actually not so much on the patient, the person doing the dying. It’s on the family.

In a way, it’s harder to accept the death of another person than accept your own, especially when you really love that person.

I’m BJ Miller. And this is my Brief But Spectacular take on tying dying and living.

JUDY WOODRUFF: You can watch additional Brief But Spectacular episodes on our Web site, PBS.org/NewsHour/Brief.

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Complete Article HERE!

A ‘sacred moment’: Brockville doctor talks about why he helps people die

By Joanne Laucius

dr-gerald-ashe
Dr. Gerald Ashe has assisted in four deaths since Canada’s new law passed.

Dr. Gerald Ashe has seen the kinds of things people do if they can’t get help in dying.

A couple of his patients have taken their own lives. Some have told him they are hoarding sleeping pills “just in case.” He says he has seen too many cases of terminal delirium, a condition where an agitated and confused dying patient survives through five to seven days. The patient will die, it’s just a matter of how long it will take.

“It’s common and it’s nasty and it requires palliative sedation. If given the choice, most people would say: ‘I’ll take the five- to 10-minute plan, not the seven-day plan.’”

Ashe has been a family physician for almost 40 years. He offers palliative care in Brockville and is a member of the physicans’ advisory council at Dying With Dignity Canada. He says his support for assisted dying came as the result of many years of “watching people die, helping people to die and watching them suffer and coming to the realization that we can’t relieve all suffering.”

Since assisted dying legislation passed on June 17, Ashe has assisted in the deaths of four patients, and another patient has permission. “They’re content to know they have permission.”

When a patient dies, it’s a “sacred moment,” he says.

“None of us really want our patients to do this. We understand it. We honour their request and their autonomy. We would prefer to provide relief in another way. I have a contract with a patient. I am with you until you die. I am not going to send you off when things get tough.”

Physicians still feel ambivalent about helping patients die. At the Brockville General Hospital, where Ashe works, a survey of the medical staff found about three-quarters agreed or strongly agreed that people should have a right to assisted death, and almost two-thirds felt it should be offered at the hospital. But only 30 per cent pf physicians would be willing to provide assisted death — with proper training — while 43 per cent would not, with the remainder neutral. About three-quarters said they would refer patients, while 13 per cent said they would not refer. The remaining respondents were neutral.

Ashe believes that only a small subset of people will seek assisted dying. In Oregon, laws permit qualified terminally ill adults to request a prescription for a medication to hasten death. With a population of four million people, about 150 permissions for physician-assisted suicide are sought every year in Oregon. Interestingly, only two-thirds of those who request the prescriptiom actually take it.

“Knowledge is empowering. People won’t make that decision because it is available,” says Ashe. “They will choose it because that’s what they want.”

He was nervous at first about going public with his support for assisted dying. In December 2014, he spoke out after a terminal cancer patient in his care shot himself. This summer, he spoke about helping an ALS patient die at home. But feedback from family and colleagues has been gratifying, he says.

“To live through this era and see this come to fruition has been an amazing experience. That we can allow someone to die peacefully, painlessly, speaks volumes abut how far we have come as a society and as a profession.”

Ashe believes the current legislation doesn’t go far enough. He would like to see other patients have access, including people with severe mental illness and competent children. People with mental health problems suffer terribly and Ashe said he can see no reason why they shouldn’t qualify. People over the age of  18 qualify, but not those who are 17. That’s arbitrary, he argues.

“The beauty of dying where and when you want and with whom is pretty amazing,” he says. “One of the reasons why I have been advocating for this isn’t altruistic. I would like to live in a world where this is possible for myself.”

Complete Article HERE!

More than 65 B.C. patients choose doctor-assisted death since June

by  Jeff Nagel

So far 66 B.C. residents have ended their lives through physician-assisted death.
So far 66 B.C. residents have ended their lives through physician-assisted death.

More than 65 B.C. residents have legally ended their lives with the help of a doctor since federal assisted death legislation took effect June 17.

Fraser Health officials confirm some of those deaths have been within this region, but referred requests for detailed numbers to the B.C. Coroners Service.

“Our first request was two days after the federal legislation was put in place,” said Lisa Zetes-Zanatta, Fraser Health’s executive director for palliative care, home care and residential care.

“A number of requests have come in and some have completed the service.”

Coroner Barb McLintock said it’s too soon to provide a regional or other breakdown on B.C.’s assisted deaths, which she said stood at 66 as of Wednesday.

The most high profile case so far made public has been that of author W.P. Kinsella, who lived in Yale and invoked Bill C-14’s assisted dying provisions Sept. 16 at Fraser Canyon Hospital.

The Catholic Church’s Vancouver Archbishop Mark Miller urged Fraser Health in an open letter not to mandate assisted dying as an option in palliative care wards, calling it a “cruel dilemma” for those vulnerable patients.

And Miller said it’s a “terrible conflict of interest” for palliative caregivers who may be compelled to offer “an economically expedient shortcut in the form of lethal injection” contrary to their ethical principles.

Zetes-Zanatta acknowledged that not all doctors or nurses are willing to participate, but said that has not been a barrier to finding sufficient volunteers.

“We’re very clear, as is the provincial and federal legislation, that conscientious objection is absolutely respected,” she said. “I would never force any of our staff into doing anything not consistent with their own moral, ethical or spiritual beliefs.”

Doctors can perform the assisted death injection independently if nursing staff who would normally assist are unwilling, she said.

Zetes-Zanatta noted the World Health Organization definition of palliative care is to protect and alleviate the suffering of patients until they reach a natural death.

“The number of palliative care physicians providing this service is less than other disciplines because it’s not aligned with their philosophy of care. That being said, there are palliative care physicians who are providing this service.”

More of the requests for assisted death come from people in the community than in hospices or palliative care settings, she added.

“We try to give the service where the patient is,” Zetes-Zanatta said. “They’re usually in intolerable suffering and so to move them is really difficult. We try to make this very much about the patient.”

Under the federal legislation, patients must be at end of life with death expected within the next six months to a year.

Only they – and specifically not youth or psychiatric patients – can make an initial request leading to more information on the assisted death option.

Usually those requests go through a family doctor, Zetes-Zanatta said, but Fraser Health will assign physicians to respond to patients who don’t have one.

“We ensure that they have had access to palliative care services and pain management services to see if we can alleviate their suffering prior to them making a formalized request for this.”

After the information provision stage, two doctors must conduct independent assessments, after which there is a 10-day waiting period before the patient can finally make the choice to die.

She said Fraser Health is now legally required to comply when patients qualify.

“Regardless of where people sit on this we have to recognize that there are patients requesting this. And we have to understand what that patient must be going through to put in a request like this.”

The legislation passed by the Justin Trudeau government came after the Supreme Court declared it unconstitutional to prevent suffering Canadians from getting medical assistance to hasten death.

Complete Article HERE!

These Indonesians unearth their deceased loved ones every few years

People lift the coffin of Liling Saalino to a stone grave, or Liang, during a burial ritual, or Rambu Solo ceremony, in Lemo village, Toraja, South Sulawesi, Indonesia. During the procession, people chat “Tau Tae Sengke,” which means nobody should be angry.
People lift the coffin of Liling Saalino to a stone grave, or Liang, during a burial ritual, or Rambu Solo ceremony, in Lemo village, Toraja, South Sulawesi, Indonesia. During the procession, people chat “Tau Tae Sengke,” which means nobody should be angry.

It is said that Torajans are people who “live to die.”

For this Indonesian ethnic group, funerals are such extravagant events that they sometimes attract tourists. Families can postpone burials years (and the deceased are considered sick and hosted at home until the funeral) until the family can raise enough money and gather as many relatives as possible. And then it’s a jubilant multiday social event with a parade, dances and animal sacrifices.

Agung Parameswara photographed these funerary practices when he traveled to South Sulawesi province, where the Torajans live. But often, their funeral isn’t the last time the dead are seen.

In August, crypts are opened, coffins are slid back out and bodies delicately unsheathed. This tender ritual is known as Ma’Nene, which is customarily performed every few years. In this practice, which honors the Torajans’ ancestors, corpses are washed and dressed in new outfits. They may be treated to betel nuts and cigarettes, sometimes even taken back to the place where they died. And, finally, they are wrapped in new shrouds and replaced in their freshly repaired coffins.

Parameswara was moved when he saw the family of Yohanes Tampang bring him a new pair of sunglasses, which he loved to wear while he was alive. They touched his body and introduced him to new family members.

People carry the coffin of Liling Saalino as a part of the Rambu Solo ceremony. When a person dies, pigs, chickens and buffalo are sacrificed, as the locals believe that the animals carry the soul of the deceased into heaven. The number and type of animals killed reflect the social status of the dead person.
People carry the coffin of Liling Saalino as a part of the Rambu Solo ceremony. When a person dies, pigs, chickens and buffalo are sacrificed, as the locals believe that the animals carry the soul of the deceased into heaven. The number and type of animals killed reflect the social status of the dead person.
The burial ritual for Liling Saalino.
The burial ritual for Liling Saalino.
Villagers and relatives gather as they prepare for a parade during the Rambu Solo of V.T. Sarangullo in La’Bo village, Toraja, South Sulawesi, Indonesia. After the animals are killed, a feast is thrown and the body of the deceased placed in a stone grave, or Liang.
Villagers and relatives gather as they prepare for a parade during the Rambu Solo of V.T. Sarangullo in La’Bo village, Toraja, South Sulawesi, Indonesia. After the animals are killed, a feast is thrown and the body of the deceased placed in a stone grave, or Liang.
Men gather during a buffalo fight, or Tedong Silaga, as a part of the Rambu Solo for V.T. Sarangullo in La’Bo village, Toraja, South Sulawesi, Indonesia.
Men gather during a buffalo fight, or Tedong Silaga, as a part of the Rambu Solo for V.T. Sarangullo in La’Bo village, Toraja, South Sulawesi, Indonesia.
Men gather to perform a Ma’Badong dance during the Rambu Solo of V.T. Sarangullo.
Men gather to perform a Ma’Badong dance during the Rambu Solo of V.T. Sarangullo.
Men remove a corpse from inside a Liang as they prepare to perform Ma’Nene in Pongko Village, Toraja, South Sulawesi, Indonesia. In Ma’Nene, bodies of the deceased are exhumed to be washed, groomed and dressed in new clothes. Damaged coffins are fixed or replaced.
Men remove a corpse from inside a Liang as they prepare to perform Ma’Nene in Pongko Village, Toraja, South Sulawesi, Indonesia. In Ma’Nene, bodies of the deceased are exhumed to be washed, groomed and dressed in new clothes. Damaged coffins are fixed or replaced.
A man holds the corpse of Tang Diasik, who died six years ago, as he dries the corpse during the Ma’Nene ritual in Ba’Tan village, Toraja, South Sulawesi, Indonesia.
A man holds the corpse of Tang Diasik, who died six years ago, as he dries the corpse during the Ma’Nene ritual in Ba’Tan village, Toraja, South Sulawesi, Indonesia.
A woman cries in front of the corpse of Marta Ratte Limbong during the Ma’Nene ritual in Ba’Tan Village, Toraja, South Sulawesi, Indonesia. Locals believe dead family members are still with them, even if they died hundreds of years ago.
A woman cries in front of the corpse of Marta Ratte Limbong during the Ma’Nene ritual in Ba’Tan Village, Toraja, South Sulawesi, Indonesia. Locals believe dead family members are still with them, even if they died hundreds of years ago.
Personal belongings of Marta Ratte Limbong inside the coffin including money, a necklace and two gold bracelets.
Personal belongings of Marta Ratte Limbong inside the coffin including money, a necklace and two gold bracelets.

These practices are rooted in Aluk To Dolo, or the “way of the ancestors.” Though Torajans are predominately Christian, they still adhere to these ancient traditions.

Parameswara said via email that he felt that witnessing the rituals reminded him about how important connections with family are in a time when people can be self-absorbed. “Death is not a thing that could [separate] the Torajans people [from] their loved ones,” Parameswara said. “Love for the Torajans is eternal.”

Villagers pray before they perform the Ma’Nene ritual in Barrupu village, Toraja, South Sulawesi, Indonesia.
Villagers pray before they perform the Ma’Nene ritual in Barrupu village, Toraja, South Sulawesi, Indonesia.
The Liang with Tau-Tau, or effigies made of wood in Lemo Toraja, South Sulawesi, Indonesia. These life-size representations of the dead were once produced only for the wealthy. They are guardians of the tombs and protectors of the living.
The Liang with Tau-Tau, or effigies made of wood in Lemo Toraja, South Sulawesi, Indonesia. These life-size representations of the dead were once produced only for the wealthy. They are guardians of the tombs and protectors of the living.
A boy lights incense in front of Lucas Payung’s body before the Ma’Nene ritual in Barrupu Village, Toraja, South Sulawesi.
A boy lights incense in front of Lucas Payung’s body before the Ma’Nene ritual in Barrupu Village, Toraja, South Sulawesi.
Relatives cry as the coffin containing the bodies of Tikurara, Dumak and Limbongbuak arrived at the Liang in Barrupu village, Toraja. The corpses were buried in Makassar a few years ago; this year, the family decided to move the bodies to the stone grave in their hometown. But first, the family performed the Ma’Nene ritual.
Relatives cry as the coffin containing the bodies of Tikurara, Dumak and Limbongbuak arrived at the Liang in Barrupu village, Toraja. The corpses were buried in Makassar a few years ago; this year, the family decided to move the bodies to the stone grave in their hometown. But first, the family performed the Ma’Nene ritual.
A landscape in Toraja.
A landscape in Toraja.

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Archbishop Desmond Tutu ‘wants right to assisted death’

archbishop-desmond-tutu

South Africa’s Archbishop Desmond Tutu has revealed that he wants to have the option of an assisted death.

The Nobel Peace Prize laureate and anti-apartheid campaigner said that he did “not wish to be kept alive at all costs”, writing in the Washington Post newspaper on his 85th birthday.

Mr Tutu came out in favour of assisted dying in 2014, without specifying if he personally wanted to have the choice.

He was hospitalised last month for surgery to treat recurring infections.

“I hope I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice,” Mr Tutu wrote.

“Regardless of what you might choose for yourself, why should you deny others the right to make this choice?

“For those suffering unbearably and coming to the end of their lives, merely knowing that an assisted death is open to them can provide immeasurable comfort.”

There is no specific legislation in South Africa governing assisted dying.

But in a landmark ruling in April 2015, a South African court granted a terminally ill man the right to die, prompting calls for a clarification of the laws in cases of assisted death.

Desmond Tutu and his wife have four children and seven grandchildren together
Desmond Tutu and his wife have four children and seven grandchildren together
  • Born 1931
  • 1970s: Became prominent as apartheid critic
  • 1984: Awarded Nobel Peace Prize
  • 1986: First black Archbishop of Cape Town
  • 1995: Appointed head of Truth and Reconciliation Commission
  • Became a fierce critic of South Africa’s ANC
  • Supports assisted dying for the terminally ill

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