Month: January 2017

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Terminally ill Vancouver Island woman thanks Canada for a peaceful death

Noreen Campbell underwent a medical assistance in dying procedure on Thursday.

By Amy Smart

Most of us wonder, every once in a while, when we might die.

Noreen Campbell knew it would be Thursday and it was.

On Monday, she walked from her kitchen into her sun room, which looks onto a rural North Saanich property.

“I’ll go in here,” she said, sitting down in an overstuffed, beige leather chair. Her daughters, Mary and Jane, would be at either side, she said, and her husband, Cliff, would be there, too.

Campbell, 71, could still walk, talk and form coherent thoughts. She wasn’t bound to a hospital bed or so far gone that her family had to wonder about her level of consciousness. But as a registered nurse for 53 years, she had watched many people suffer in their final days and said she had reached her threshold.

“Some people might think I’m too capable, but why should you wait until you have to roll me in?” Campbell said.
“I’m ready.”

Campbell was among the first to receive approval for medical assistance in dying. That was in August, two months after landmark legislation was enacted to allow the procedure in Canada.

She chose to share her story in the hope that it might open the door for others facing death and draw attention to gaps she saw in the process. “I have this feeling that if you’re not part of the solution, you’re part of the problem. With my background, the failure to do something would be negligent,” she said.

“I believe this is the message: To reassure patients and their loved ones that there is an alternative — and give them hope and courage.”

Campbell’s health decline began with a bit of discomfort in 2012. She had a toothache that wouldn’t go away.

“One day, I was sitting and thinking and it was like a smack to the side of the head. I was the educator for the surgical unit that does oral cancer and I thought to myself: ‘What would cause the pain to stay in the same place, be consistent and get worse?’ I asked for a biopsy. And I had very extensive oral cancer,” she said.

“I think it was missed because I’m not a smoker.”

She underwent surgery to remove tissue and bone in her face and jaw, alleviating what had become horrific pain.

About a year after the surgery, she was diagnosed with chronic obstructive pulmonary disease, which is a progressive obstruction of airflow into or out of the lungs.

As a nurse, Campbell had watched many people die. Her worst fear was respiratory disease, she said, having seen, more than once, the extreme suffering of a person who is desperate for air. Faced with the same future, she began planning a trip to Switzerland, where assisted dying is legal.

A Supreme Court of Canada ruling in May 2015 meant she wouldn’t have to make the trip.

The assisted-dying movement largely began in Canada in the 1990s, with Sue Rodriguez, also from North Saanich.

Rodriguez suffered from amyotrophic lateral sclerosis (ALS) and wanted the legal right to end her life with the help of a physician. She lost her legal challenge to the Criminal Code’s prohibition on assisted death, but died in 1994 with assistance from an anonymous physician.

More than 20 years later, in 2015, the Supreme Court unanimously voted to strike down the prohibition and allow medically assisted death. It was legalized with passage of the Medical Assistance in Dying Act on June 17, 2016.

Two days later, Campbell submitted her application.

“I was ready,” she said.

Noreen Campbell underwent a medical assistance in dying procedure Thursday, here she spends time with her horse Dasha in Victoria.

Campbell told her doctor she wanted it as a backup. A respiratory infection could put her in the agony of not being able to breathe and she wanted the power to control her end, if that was the case.

“Simply put, I’d rather end it in two minutes than two days.”

Gradually, her disease progressed to the point where symptom management became a 24/7 job, she said. It had been years since her health began to decline and it became clear that she was dying.

“I think it is this perfect storm. It’s not one symptom, it’s things coming together and they just start to pile up. It’s not just my inability to breathe or my jaw pain. It’s everything. And when you know, ‘This will not get any better’ … there’s a point where you make your decision. And my point was when I was overwhelmed and I felt like I could no longer cope.

“I am dying. I am getting weaker. I can do less, symptom control is overwhelming me. I’m going to die; end of story. And I suddenly get this choice: Do I want to die in less than five minutes? Compared with [experiencing what] the people I’ve witnessed who died over hours and days went through — there is no choice. Otherwise it’s called torture,” she said.

Campbell pressed her finger over her breathing tube each time she spoke, allowing air to pass through her voice box.
Facing death made her reflective, she said.

“We all know we’re going to die, but we don’t have it in our heads. I think, culturally, we have a lot of escapism. When you look at the time before antibiotics, in the 1900s, you were grateful to be alive. But in the 2000s, we’re looking for a way to get out of this life. We have not prolonged healthy living; we have prolonged life by preserving chronic illness.”

After so many years serving at bed sides, she said being in a hospital bed and then as an at-home patient gave her a new perspective on care. Not enough attention is given to a patient’s suffering or quality of life and patients still aren’t provided with all the information they need to make informed decisions, she said.

It begins with doctors talking over a patient’s head — though in her case, she understood what they were saying. And it continues with the difficulty of obtaining information about medical assistance in dying.

Campbell said ambiguity in guidelines from the College of Registered Nurses of B.C., accompanied by recommendations to consult your employer and legal representation, for example, would discourage nurses from communicating with patients about the option unless they ask for it specifically. “I see this as an absolute conflict with suicide-prevention guidelines, which say, if someone walks in and says ‘I can’t go on,’ my question [as a nurse] should be, ‘What’s the matter?’ Not, ‘I can’t talk about that,’ ” Campbell said.

Before Bill C-14 passed into law in June, the federal government added conditions that would exclude many individuals from medical assistance in dying, arguing it needed to protect vulnerable people. It limited the right to mentally competent adults who are suffering unbearably, in an advanced and irreversible decline and whose natural deaths were reasonably foreseeable.

The law has been simultaneously celebrated for opening access, challenged on the basis that it would conflict with medical staff’s freedom of religion and criticized for being too narrow.

Justice Minister Jody Wilson-Raybould has said if assisted-dying was available to anyone suffering from a serious medical condition, then it would be an option for survivors of sexual abuse and soldiers with post-traumatic stress disorder. And the Council of Canadians with Disabilities has said the act needs more restrictions to protect people with new disabilities, who might feel hopeless before they adjust to their new reality.

A 25-year-old woman with spinal muscular atrophy has launched a constitutional challenge, with the B.C. Civil Liberties Association, to expand the right beyond those facing “foreseeable” death.

For Campbell, too, the law doesn’t go far enough. The requirement of “foreseeable death,” doesn’t take into account what can be unbearable suffering from chronic illness.

Suffering, she said, is not always a virtue.

“We should be looking more at what quality of life means to people,” she said.

“I think suffering, pain, does help people mature. That’s the difference between being a kid and an adult. Even if it’s your first broken-heart romance and you see the dud later and think, ‘Thank God,’ there’s a certain amount of pain that’s necessary to make us an understanding society and for people to develop empathy and sympathy. But the idea that suffering is always worthwhile, it’s just beyond me.

“From the time when I was approved, from the time I decided, ‘yes,’ I would say I have experienced the most calm. It’s hard to imagine, but it’s given me a chance to do things,” Campbell said, when asked if she was afraid of death.

She completed a manuscript on wound care, her specialty as a nurse. She became an honorary member of an East Coast chapter of the activist group Raging Grannies (she asked that the story end with “Rage on!”). And she published a video explaining her choice with the advocacy group Dying with Dignity.

She said she didn’t believe in bucket lists — they just cause anxiety. But the knowledge that she would get medical help in dying, when it was time, meant she didn’t have to waste time wondering.

“The other thing we don’t have is a roller-coaster. When you have people who are chronically ill, they’re desperately ill, then recover, then desperately ill, then recover. When you have medical assistance in dying, your focus can be on a comfortable death.”

On Thursday, she went into her sun room and sat down with her family. Her physician gave her a sedative, then via IV, something that would stop her heart. But first she sent the following in an email:

“This is my day — I was able to watch my grandson play hockey, we have had a string of celebrations — tears sure — but so much laughter. Thank you Canadians for making a peaceful death possible for me and sparing my family and friends from witnessing a death with fear and suffering.”

She died at 2:38 p.m.

Complete Article HERE!

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Death and the Irish: A miscellany

 Do we ‘do’ death best?

Collection features 75 perspectives on death in Ireland and whets appetite for further study

“The Humours of an Irish Wake as celebrated at St Giles London.” Original artwork: engraving by Thornton, published by Johnson c 1750.

By Bridget English

[T]he Irish wake is nearly as celebrated and stereotypical an Irish export as Guinness, leprechauns or shamrock. Its reputation as a raucous, drunken party that celebrates the life of the deceased is now regarded internationally as a desirable way to mark the end of one’s life, even for those who claim little or no Irish heritage.

It is conceivable, then, given the famous link between Ireland and death, that the Irish “do death well”. Where does this association come from? Do the Irish really “do” death better than anyone else? These are some of the questions behind a new collection of essays, Death and the Irish: A miscellany, edited by Salvador Ryan, a professor of ecclesiastical history at St Patrick’s College Maynooth.

The collection is part of a recent surge of academic interest in death and dying, as is evidenced by the publication of edited collections such as Grave Matters, Death and Dying in Dublin, 1500 to the Present (2016), edited by Lisa Marie Griffith and Ciarán Wallace, and Death and Dying in Ireland, Britain and Europe: Historical Perspectives (2013), edited by James Kelly and Mary Ann Lyons, both of which explore these themes from a historical perspective.

>Subtitled “a miscellany”, Death and the Irish is different from these publications because it features a medley of 75 perspectives on death and the Irish from historians, hospice workers, geographers, sociologists, anthropologists, theologians, priests, librarians, musicologists, and funeral directors, to name a few. It also covers a vast time span, taking readers from the fifth century to the present day.

Entertainment

The brevity of the essays (around three to four pages, including footnotes) and their pithiness, though a departure from the extended discussions commonly found in academic anthologies, is true to the form of the miscellany, which was originally intended for the entertainment of contemporary audiences.

Death and the Irish will interest readers looking for interesting tidbits of information on death and provides ample fuel for those searching for inspiration for further research.

Some tantalising morsels from the miscellany include: the tale of a young woman buried with her horse sometime between 381 and 536 AD; the variety of terms for death in the Irish language; social media’s role in keeping memories of the dead alive; an analysis of Stuart-era funerary monuments and what they reveal about women’s role in society; the 18th-century Dublin practice of laying executed corpses at the prosecutor’s door; a quirky account of the discovery of James McNally’s death by elephant in Glasnevin cemetery’s burial registers; and the story of a young cabin boy’s death by cannibalism.

Given the number of entries included in the volume, it is not possible to provide a detailed account of each, but a few entries are worth mentioning. Clodagh Tait’s Graveyard folklore and Jenny Butler’s The ritual and social use of tobacco in the context of the wake are particularly thought-provoking accounts of folk practices and the material cultures surrounding death. Tait’s gruesome description of the pieces of human remains that were collected for charms and the dead man’s hand that “could be used to make churning butter less onerous” provides readers with images that they are unlikely to soon forget.

One downside of Death and the Irish is that the experience of reading such short essays can be frustrating for anyone (particularly students) coming to the collection looking for an extended discussion of death practices in a particular era. Organising the entries by time period or by theme (burial, folklore, historical figures or events, etc) might make for more streamlined reading, but to do so would also destroy one of the collection’s main strengths, which is to bring disparate approaches together, taking interdisciplinarity to an extreme, provoking new ideas through a multilayered view of death in Ireland.

Under-represented

Despite the inclusiveness of Ryan’s miscellany, certain disciplines, such as history and theology, seem to dominate, while others are absent or under-represented. Philosophers have certainly shaped the ways that modern secular society conceives of death, yet there are no entries on the relationship between Ireland and philosophy.

Irish film, literature and drama feature some of the most insightful and humorous portrayals of death and dying in western culture, yet there are only three entries on literature, and these are limited to poetry (Irish language poetry, bardic poetry and 18th-century elegies).

These are minor criticisms and on the whole, Death and the Irish: A miscellany is commendable for its inclusion of marginalised groups such as Travellers, and for the links made between Irish practices and Jewish and Muslim beliefs. The Irish may not necessarily “do” death better than anyone else, but as this volume makes clear, the history and rituals surrounding death offer a rich and complex area of study, one that has much to tell us about Irish attitudes towards mortality and treatment of the dead.

Complete Article HERE!

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The Role Of Mindfulness In End Of Life Care

by vimhsadmin

Mindfulness assists people with their end of life process by giving them and their caregivers a tool they can use in order to be fully aware of the present moment and their own physical and mental states

[T]he Venerable Yin Kit (pictured above) has spent decades in hospitals, hospices, and homes, assisting people through their death. Through these experiences, her understanding of how to compassionately and wisely care for those dying and their families has changed as a result of constantly reflecting on what she experiences and what she learns as a Buddhist nun living in the West in the 21st century.

The end of life is a transformation from one physical existence to another existence. Similarly, mindfulness is a transformation of one mental existence into another mental existence.

Emphasis on mindfulness

Buddhist teachings have always emphasized the contemplation of death; a subject that engenders so much fear and worry for many. Mindfulness can take on a role  that  compliments advanced medical technology in end of life (EOL) care.

Mindfulness assists people with their end of life process by giving them and their caregivers a tool they can use in order to be fully aware of the present moment and their own physical and mental states. This allows them to settle into each moment and open up to a wider vision of the future.

With mindfulness, a dying person not only sees their physical changes, but also how their mind influences the perception and experience of their waning body. With an aware and balanced mind, a person is more able to cope with the vicissitudes and challenges that come with this stage of life and be at peace with these experiences. This in turns greatly helps to console the family, friends and care-givers.

Mindfulness also assists in opening pathways for healing relationships and positive life reviews. One can be more receptive and capable of planning for, dealing with and understanding the constantly changing physical and mental experiences and in the end, one’s own death.

The role of mindfulness in end of life care

Venerable Yin Kit speaks at The End of Life: Dying, Suicide, Death conference in Vancouver, November 2016

Venerable Yin Kit spoke about the role of mindfulness in end-of-life care at Simon Fraser University’s Vancouver campus on November 3, 2016. She was also a participant in a “praxis panel” that included Rabbi Laura D. Kaplan, veterinarian Dr. Jeff Berkshire, and counselor Hilda Fernandez.

Venerable Yin Kit, also known as “Sister Jessie”, has been a Buddhist nun since 1992 and is the spiritual leader of Po Lam Buddhist Association in Chilliwack, B.C. She is involved in leading numerous workshops teaching hospice care and hospital spiritual care in Hong Kong and in Canada. The Venerable is also the advisor to the Hong Kong SPGA Hospice program.

In 2005, Venerable Yin Kit established the Compassionate Centre for Health, a service for the Chinese-speaking community in the Greater-Vancouver area. This group has grown to over fifty active volunteers who visit senior homes and palliative care units at several sites. The Venerable has spent decades in hospitals, hospices, and homes, assisting people through their death. Through these experiences, her understanding of how to compassionately and wisely care for those dying and their families has changed as a result of constantly reflecting on what she experiences and what she learns as a Buddhist nun living in the West in the 21st century.

Dr. Jeff Birkshire, Rabbi Laura Kaplan, Venerable Yin Kit Sik, and moderator Hilda Fernandez
on the Praxis Panel at The End of Life: Dying, Suicide, Death (November 2016)

The End of Life: Dying, Suicide, Death

Simon Fraser University’s Institute for the Humanities hosted a conference in November 2016 called The End of Life: Dying, Suicide, Death. The conference was intended to provide space for pondering the complex and agonizing decisions regarding the end of life. Space for such conversations is especially needed given the 2015 decision of the Supreme Court of Canada declaring that the prohibition on physician-assisted dying infringes upon Section 7 of the Canadian Charter of Rights and Freedoms, and the introduction of Bill C-14 which has resulted in debate about who, when and in what circumstances an individual may make such a decision.

Speakers included academics, graduate students and practitioners who spoke from their own particular perspectives: legal, ethical, medical, and spiritual or religious. The presentations also drew upon insights from literature and art, some of humanity’s most treasured resources.

Complete Article HERE!

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Songs of farewell

In her new book, Hallowell Singers founder Kathy Leo tells how music comforts the dying, and offers lessons for the living

By Richard Henke

BRATTLEBORO—Kathy Leo, the founder and director of Hallowell Singers, last month published On the Breath of Song: the Practice of Bedside Singing for the Dying, a book that offers guidance and insight into the practice of singing for the dying and their families.

Through the telling of true stories and over a decade of experience in song and spirit with the Hallowell hospice choir, Leo has written a guidebook for anyone offering end of life care or helping a loved one die.

“After many years of teaching workshops to newly forming or active hospice choirs, the decision to write a guidebook through personal experiences of being with the dying became clear,” writes Leo at the Hallowell website, www.hallowell-singers.org.

“On the Breath of Song is a way to get close to the bedside to explore your personal relationship with death and dying. It serves hospice singers, music therapists, chaplains, compassionate caregivers, hospice workers, and palliative care professionals.”

Birthing and dying

Although Leo has now been working with hospice care for over 15 years, she was a midwife in the Southern Vermont area for more than a decade before that. She didn’t find the change too great.

“You are in the same space: birthing and dying have similar energies,” she explains.

Shortly after Leo began her volunteer work for Brattleboro Area Hospice, musician Peter Amidon and others were invited to the bedside of a Putney woman under her hospice care to sing for two nights.

Leo writes about the experience: “In a small house on a back road in southern Vermont, a woman is dying at home surrounded by her loving family. It is a winter evening in 2003, a few days before Dinah’s last, a group of friends from the community and her church, gather around her bed to sing. She joins in. She mouths the words when her voice fails her …

“As we sing around her, Dinah is held up by her loving husband Fred, a daughter on either side of her. … [Hallowell Singers] formed after two visits to Dinah Breunig’s bedside in her home, her family welcoming and present, during the final days of her life on earth.”

Hallowell is a chorus of volunteer singers trained to practice the therapeutic art of singing for the dying. Based in Brattleboro, the chorus serves hospice clients through its affiliation with Brattleboro Area Hospice and the greater community by request.

Leo, who had been Dinah’s hospice volunteer, answered the call from Noree Ennis, the patient care Coordinator of Brattleboro Area Hospice at the time, to create and organize a “hospice choir” that would be available as a service to anyone who desired singing at the end of life as an offering of comfort.

Peter Amidon and Mary Cay Brass agreed to serve as musical directors.

‘Gifts of grace’

Almost 40 singers signed up to be trained and taught how to sing at the bedside of a dying person. Usually 4 to 6 singers go to the home of a man or woman in hospice care.

“We do not want to overwhelm the space,” Leo says. “We know how to make ourselves small in energy. Before we enter a home, we quiet ourselves internally, which can take a lot of work initially. Once there, we offer songs that are gifts of grace for everyone involved, the dying, their family and the singers.

“Beautiful things happen with music. Singing also creates a special space for a family to come closer with the dying. So much happens in this space that is rich with life, death, and mostly love.”

Leo explains that Hallowell doesn’t call these events performances, but rather, “sings.”

“We tell people not to applaud, that is not what we are here for,” she says.

The name for the Hallowell Singers comes from a song Brattleboro therapist Stephen Spitzer wrote about a friend from Hallowell, Maine, who died from a bee sting. “What he wrote so embodies the spirit of our mission that we took it as our title,” Leo says.

Since its inception in 2003, Hallowell has served hundreds of families in the Southern Vermont community.

“Little did we know at the time that as Hallowell grew and evolved, it would become a central ’practice’ in our lives, a way to learn how to live fully and with deep gratitude,” Leo writes. “Our songs and our quiet presence bring comfort and offer support to the dying. The response of those we sing for is often emotional and calming.”

Hallowell still works very closely with Brattleboro Area Hospice. “They are more like family, really, and they helped to shape and form us through support and training,” Leo confesses.

But Hallowell also has its own hospice training.

A careful approach

Leo felt the need to address specific issues that arise when singing at dying persons’ bedsides. Hallowell trainings deal with how to prepare for a sing, both individually and as a group, how to involve the family, and how to approach what Leo calls “the sacred space of dying.”

“We need to learn to enter and leave the space seamlessly,” she says.

Soon enough, the word about the special work that the Hallowell Singers were doing began to spread.

“We were asked if we could do a workshop on how to start a choir in Middlebury,” Leo says. Soon more groups were forming choirs that asked for Hallowell’s help.

“We have also helped to launch a still growing number of hospice choirs throughout the New England region and across the country by teaching workshops, offering guidance and counsel, and being available for continued support for developing hospice choirs,” Leo writes. “We are honored to be a strong model for the growing movement of the practice of bedside singing for the dying.”

Besides the numerous smaller workshops, for the past six years, Leo and Amidon have given a weekend “deepening workshop” once a year at the Rowe Center in Massachusetts.

“These are always well-attended, and people come from all over the country, even someone from New Zealand who wanted to start a Hallowell choir there,” Leo elaborates. “This movement, which began in Putney, now is spreading all over the world. Who can explain it? Perhaps it was just the right time, but it is pretty amazing.”

True stories of tenderness

Leo has often been exhorted to write a book offering guidance and insight into the practice of singing for the dying and their families.

“I first was asked to write up a guidebook years ago, but I kept telling everyone and myself, ‘It wasn’t the right time, it wasn’t time, it wasn’t time,’” she says.

But finally Leo realized that she had no real excuse for delay, and the result was On the Breath of Song.

Although the book is intended to help others working with hospice choirs, this is definitely not a book a rules. Instead, Leo says she has written a book of true stories filled with tenderness and emotion.

“Singing for the dying is intuitive, where strict rules have no place,” Leo says. “Consequently, when I came to write down all that I have learned over the years working with Hallowell, I realized that the best manner was through stories which inform the teaching. At the heart of these stories are the songs we sing, and the spirit of love we bring to this practice.”

Complete Article HERE!

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When dying is a choice

By

[I]t was cold but the sun was shining when my father looked out the window and said he wanted to die.

He was lying in a hospital bed, tubes tying him to machines and drips. He was 65, wasn’t a smoker but, like a lot of firefighters, had inhaled things that embedded in his lungs, slowly strangling them. His skin was ashen, his eyes wet and hauntingly sad.

When he said he wanted to die, my immediate reaction was to reassure him, to hold his hand, to tell him that my mother, my brother, my sister, and I didn’t want him to go, that we loved him too much to let him go, that he couldn’t go just yet.

That was 29 years ago, and it took me many years to realize that my reaction to my father’s plaintive, death-bed declaration was selfish, that it was rooted in what I thought was best, what I wanted, not what he thought was best, not what he wanted.

My father lingered for several weeks after he told me he wanted to die, suffering greatly. I have no idea if he would have opted to end his life earlier, to end his suffering earlier, but I wish he had the option.

It would be helpful to know whether a majority of Massachusetts legislators think others should have that option, too, but for the last eight years they have punted on the Death with Dignity Act, bottling it up in committee so that it dies without the dignity of a full and fulsome hearing.

Five years ago, a referendum that would make it legal for physicians to prescribe medications that terminally ill people could use to end their lives was narrowly defeated. But, like all social change, like all civil rights, the right to die with dignity is moving forward, inexorably.

Last month, the Massachusetts Medical Society commissioned a survey of its members’ attitudes toward what they called “medical aid in dying.” For a group that has historically opposed what some call physician-assisted suicide, the mere act of seeking its members’ opinions acknowledges the shift, much of it generational, in thinking.

In October, Dr. Roger Kligler, a retired Falmouth physician with prostate cancer, filed a lawsuit asserting he has a right to obtain a lethal dose of medication from a doctor willing to prescribe it if he becomes terminally ill and chooses to avoid more suffering.

Dr. Kligler rightly believes he’ll get a quicker answer from a court than the Great and General Court. As it has with other highly contentious matters, including same-sex marriage and the legalization of marijuana, the Legislature has been more than happy to let the courts or the public do the heavy lifting.

But even if a court agrees with Dr. Kligler’s argument, the decision could be narrowly tailored to only his case. And as the messy rollout of marijuana legalization has shown, legislating complex matters by referendum often leads to convoluted results.

The Legislature needs to take on Death with Dignity, in all its complexity.

Nine years ago, State Representative Lou Kafka sat down with one of his constituents, a guy from Stoughton named Al Lipkind, who was dying of stomach cancer. Lipkind asked Kafka to file a bill that would make it legal for doctors to write prescriptions for terminally ill people who wanted to avoid needless suffering. Kafka refiles the bill every session. The initial dozen co-sponsors have grown to 40.

“Al was able to make me see it through his eyes,” Kafka told me. “Unless and until it becomes personalized, it’s an issue you don’t necessarily think about.”

Not long after Al Lipkind died in 2009, Kafka watched helplessly as the same disease that slowly and torturously killed my dad did the same to his father.

“I watched him gasp for breath,” Kafka said.

Like me, Lou Kafka doesn’t know if his father would have chosen to end his life before enduring months of agony. Like me, he wishes his dad had the option.

Complete Article HERE!

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Hearts removed from corpses and Renaissance mummies rewrite Europe’s history of death

Bodies were embalmed in the Renaissance not for secular but for religious purposes.

By

Lead coffins containing the skeletons found in the Jacobin convent.

Hundreds of burials discovered in a convent in Brittany, France, have shed new light on medieval and Renaissance funerary practices. Archaeologists have identified mummified corpses, as well as hearts and brains extracted from the deceased bodies that suggest that burials were still deeply rooted in superstition and religious belief.

In 2015, a team from the French national institute for preventive archaeology (INRAP) fully excavated the Jacobin convent in the city of Rennes, which had been founded in 1368 and served as primary burial site for the local aristocracy.

The archaeologists encountered around 900 burials spanning two periods – the 14th to 15th centuries and the 16th through to the 18th century. A number of studies backed by major historical evidence have previously suggested that funeral rites in Europe evolved from the Middle Ages to the Modern era through a process of gradual secularisation.

Another coffin discovered within the Convent in Rennes.

Embalming was a rare practice, usually reserved for the bodies of kings. During the Renaissance however, surgical interventions and embalming was seen as a common preparation for the display of the deceased’s remains, one that had no religious or symbolic value. Thus, archaeologists believe that burials became more secular as years went by.

But the study recently published in the journal PLOS ONE has contradicted these hypotheses. It proposes a new view of the history of death in Europe and of the rituals that go with it.

Extracted hearts and mummies

During their excavations of the Rennes convent, the researchers came across a range of notable burial practices and used imaging and autopsies to study the remains. They were able to identify more than 600 skeletons, as well as two very well conserved mummies from the Renaissance.

For the first time, the archaeologists also documented the practice of heart extraction. They found five hearts which had been removed from the bodies and placed in heart-shaped urns, dating between 1584 and 1655. There was also evidence that the brains had been extracted from some of the corpses as some skulls had been opened.

The scientists conducted autopsies on the corpses to find out more about how they were buried.

Louise and Toussaint

In some instances, the hearts had been placed in the coffin of the person’s spouse. This was the case for Louise de Quengo, a benefactor of the church who was more than 65 years old when she died in 1656, during the Renaissance. The heart of Toussaint de Perrien, her husband, was placed on top of her coffin. He had been buried in another convent in a separate location.

While the team notes that embalming and surgical operations on bodies did occur in Renaissance burials, it is unclear whether this was done for secular and medical purposes or not.

“Louise de Quengo’s internal organs had not been cleaned, no padding had been introduced, the skull had not been cut into, and there were no incisions on the upper or lower limbs, as was often recommended in medical treatises of the period,” they point out.

The removal of the heart and the good state of conservation of the bodies rather served a spiritual and symbolic purpose. In the case of Louise and Toussaint, the idea may have been to honour them in two religious sites of which they had been benefactors. The husband’s heart on the wife’s coffin also suggests the strength of their marital love.

Hearts were removed and placed in heart-shaped urns.

The fact that Toussaint de Perrien’s remains are present at two different religious sites means that he honoured different religious orders, even in death. It also means that a greater number of prayers could be made in his name, giving him greater chances of entering heaven.

The scientists also believe that the presence of well conserved Renaissance mummies at the site echoes the Council of Trent’s affirmation of the “Resurrection of the Flesh” – resurrection would come with the Last Judgement and so preserving bodies would ensure the faithfuls would rise from the dead. Bodies were embalmed to be preserved for religious purposes, but not to be displayed.

Investigations in the Jacobin convent in Rennes shows that Renaissance society’s attitude towards burials was still influenced by age-old, religious practices, while the secularisation of burials likely came later.

Complete Article HERE!

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While I still can: dementia and assisted death

By Mark Brandi

[A] friend recently lost his father to dementia, but not before witnessing a small miracle.

In his final days, despite having been non-verbal for more than two years, his father suddenly became fluent and conversational. He recognised relatives by name and regaled them with old tales, offering his grandchildren a brief, magical glimpse of the man he once was.

Even in the Netherlands, where assisted dying is well established, access by dementia sufferers is the subject of ongoing debate.

The only problem? He thought it was 1953.

Dementia is an insidious and peculiar disease. And it poses difficult questions about the nature of identity. What is it that makes us who we are? And at what point do we lose our sense of self?

As Victoria moves toward a scheme of assisted dying for the terminally ill, one of the recommended preconditions is a “sound mind”. As such, a parliamentary committee (invidiously tasked with an “inquiry into end of life choices”) has recommended dementia sufferers be excluded from the scheme.

On the face of it, this appears logical, as there are obvious risks in allowing others to decide what is tolerable for a patient. But is the potential for abuse a good enough reason to deny access to all dementia sufferers?

An alternative – which the committee does not support – is the provision of an advance directive. While still able to make decisions, we could outline future circumstances (such as the late stages of dementia) where we might consider our lives unbearable. Such measures have been in place in the Netherlands since 2002.

If an advance directive were allowed here, it could include tailored safeguards – such as the opinions of trusted family and friends – about the quality of our lives (in addition to the standard battery of medical tests).

But even in the Netherlands, where assisted dying is well established, access by dementia sufferers is the subject of ongoing debate. It remains an area of deep moral, ethical and practical complexity.

It is also one in which I have a personal stake – my father has advanced dementia.

Over the past three years, he has lost capacity for the things he once enjoyed – politics, gardening, and even freedom to leave the home unaided.

If an advance directive had been available before his illness, it is possible (if not likely) he would have opted out.

Yet my father might now be described as – what some cheerfully term – “happily demented”. He is usually in good spirits, enjoys the pleasures of food and family, and is physically active. By some measures, he might be more content than before his dementia.

Such circumstances are not isolated. In evidence to the parliamentary inquiry, one carer stated: “I know the man my husband used to be, and I know he would not want to be the man that he is today; however, he is happy as the man he is today … whose version do we hold with, or think is more valid?”

This question cannot be answered with certainty.

For example, in the later stages of dementia, we may not appreciate a film in the same way we do now. But we may find pleasure in the sight and sound of certain actors, or even the appearance of particular colours on the screen.

Still, we cannot know how the disease might manifest in individual cases. And there are risks in allowing dementia sufferers to be part of the scheme. But these risks must be weighed carefully against our right to make important choices about our lives.

Should the parliamentary committee’s recommendations be followed, my father will not face such a crucial decision. Whether there may be a small miracle near the end of his life, time will tell.

We, his family, can only bear witness.

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