Month: June 2021

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Why is access to medically assisted death a legislated right, but access to palliative care isn’t?

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John started his first appointment in the Neuropalliative Care Clinic with, “I want to talk about MAID.” In our clinic, his request for medical assistance in dying is common. As legislated by government, I referred him to the MAID navigator. I had one request: that John wait to make his MAID decision until after seeing a community palliative care physician.

At his next appointment, John informed us he had withdrawn his MAID request because his primary symptom —pain — was now well controlled after our suggestions and those of the community palliative care doctor. John lived for two more years, during which he became closer with his daughter and continued to enjoy the company of his siblings.

John is not unusual. Neurologic illness accounts for 18 per cent of deaths in the Canada but rarely has palliative care involvement. By contrast, cancer accounts for 20 to 30 per cent of deaths, but typically receives 75 per cent of palliative care.

Part of the challenge is that palliative care services are often hospital-based, but most people who could benefit get their care in the community. Similarly, patients have recently refused palliative care in the belief that is the same as MAID. In 2017, MAID accounted for 1.07 per cent of deaths in Canada, increasing to two per cent in 2019.

In June 2016, the passed legislation that gave all eligible Canadians the right to request MAID. Colleges of Physicians and Surgeons required physicians to refer people who request MAID to services or arrange for a physician who would make the referral.

A male doctor consulting with an older female patient
The workforce for palliative care is inadequate to meet the needs for Canadians with chronic burdensome illnesses.

Since then, every province and territory devoted resources to navigate requests and assessments for MAID. Typically, provinces have a website for self-referral, easily found by internet search and/or dedicated health-care staff to help navigate the MAID process or inform those who are MAID-curious.

Complicated referrals

By contrast, the referral process for palliative care is often convoluted. Many provincial web pages simply give a definition of palliative care (some confuse the issue by including the MAID navigation site) but do not provide a central access point for physicians or nurses. Referral forms (where available) are complex, which creates another barrier to access. Many palliative care programs have an unofficial prognosis of three to six months’ life expectancy for services, despite research demonstrating that early palliative care improves outcomes and in fact, can prolong life.

What is the disconnect? Health-care providers are an unexpected barrier as they often cling to the belief that palliative care is for the imminently dying or means to give up hope. For the public, palliative care means dying soon.

But modern palliative care is about living well now, meeting patients’ goals and finding meaning in life. For John, we helped him set goals, focused on the positive in his life, like his better relationships with his children and ongoing closeness with his siblings. His sharp sense of humour emerged despite communication challenges.

Additionally, many palliative care programs exist in the oncology (cancer) department and thus, their focus is cancer-based. Twenty per cent of people die from cancer, but receive 75 per cent of palliative care services. Current training for palliative care physicians requires exposure to other patient populations like heart failure, kidney failure and neurologic illnesses, but health-care systems are slow to change.

A man in a hospital bed and a woman holding his hand, listening to a doctor whose back is to the camera.
Placing as much importance on palliative care as we do on MAID might make navigation to palliative care less difficult.

And finally, the workforce for palliative care is inadequate to meet the needs for Canadians with chronic burdensome illnesses.

Making palliative care more accessible

The solution requires a multi-faceted approach. All health-care providers need to have general palliative care skills because, in the way we all learn to control blood pressure and read a basic electrocardiogram, palliative care is part of good medical care.

At a systems level, placing as much importance on palliative care as we do on MAID might make navigation to palliative care less difficult for patients and clinicians. Given the broader applicability of palliative care, it is time for palliative care to become an independent department. Up to 28 per cent of Canadians will be seniors, which means more people with multiple, chronic conditions that could benefit from a palliative approach.

Building the palliative care workforce is essential. The palliative care workforce in Canada is estimated to be 773 doctors for a population of 39 million. Once the palliative care workforce is established, educating the public that palliative care includes a holistic approach to wellness and meaning in life can help re-frame and increase acceptance.

There are more people like John who should connect with a palliative care team before walking down the road to MAID. Let palliative care help you live well, now.

Complete Article ↪HERE↩!

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This is what ‘tree burials’ are like in Japan due to lack of space in cemeteries

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The families place the ashes on the ground, and plant an endemic species, forming forests in memory of the deceased.

Funeral rituals have accompanied human beings since they have notion of self. The earliest recorded burial is in Kenya, dating back 78,000 years. It is one of the oldest indications we have of a transcendence-oriented thinking: to the possibility that there is something beyond our earthly understanding.

With the advance of urbanization, and the apparently irreversible trend of population growth on the planet, the spaces to deposit the organic remains of the people has been compromised. We no longer fit. Given the situation, burials in Japan have had to take a new direction, which affects less the environment and appeals to a contemplative sense of eternal rest.

Rest in the shade of a tree

Natasha Mikles has dedicated her life to exploring the alternatives that exist to face death in the world. With the climate emergency in tow, the expert in philosophy from the University of Texas considers that the appropriation of physical land in favor of funeral practices it is simply no longer an option.

In recent years, Mikles has focused his study on Buddhist funeral rituals and narratives about the afterlife. In these Asian traditions, death is not understood as an end point. Rather, it is one more phase of the wheel of karma, and a step forward in the path to enlightenment.

Many times, however, the author acknowledges that “environmental needs collide with religious beliefs“, As detailed in his most recent publication for The Conversation. Rest perpetually under the shade of a tree in a public green area it could be an option, as is being seen in burials in Japan today.

A new way to face death

burials in Japan

It is not the first time that burials in Japan have been practiced in this way. Since the 1970s, there has been a record of Japanese public officials fearing for the lack of funeral space for the population, particularly in urban areas. The problem deepened in the 1990s, when more serious alternatives began to be implemented throughout the island.

It was then that Jumokusō was thought of, which translates into Spanish as “tree burials.” In these, the families place the ashes on the ground, and plant an endemic species on site to mark its final resting space. In this way, instead of building more cemeteries, entire forests would be planted in memory of the deceased.

This principle leans from the Shinto tradition, which finds value in all the vital manifestations of the universe. For this reason, the spaces dedicated to this type of funeral rites are considered sacred: there is an intrinsic spiritual value in life that ends to make way for a new.

We suggest: Natural organic reduction: this is what ecological burials are like that turn your body into human compost

Do burials in Japan of this type interfere with traditional practices?

burials in Japan

Many of the families that have implemented this strategy of sacred greening of public spaces they don’t even practice Shintoism, or are affiliated with a specific religious tradition. However, the interest in continuing this type of practice denotes a environmental responsibility extended throughout the population.

Despite this, these burials in Japan also obey an ancient Buddhist principle. Like the plants are considered sentient beings, it is a way to continue the reincarnation cycle for the soul that departed. Seeds embody a living component of this path, and therefore, they must protect themselves with the same honor.

The practice has been so well received that various temples and public cemeteries have adopted it as part of their agenda today. The model has been so successful that some Religious spaces promote it as part of the spiritual life of people. Although they do not necessarily align with the ancient practices originally proposed by Buddhism, they do obey the precept of respect for existing forms of life, which sets the standard for all branches of this spiritual tradition.

Complete Article ↪HERE↩!

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Dr. Ruth talked about sex in the 1980s. Now it’s time to talk about death

‘The pandemic has waved death in our face. Mortality is now at the forefront’

Karen Hendrickson and Jo-Anne Haun founded the Death Doula Network of BC, an online community devoted to the death positive movement operating out of their homes in B.C in April, 2020. They started the network to help people dealing with grief during the pandemic

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Only Karen Hendrickson and Jo-Anne Haun, co-founders of Death Doula Network of BC (DDNBC), can approach the topic of death with the perfect balance of positivity, passion, and of course, dark humour.

“Back in the 1980s, Dr. Ruth talked about sex,” Haun said in a Zoom interview from B.C. “She brought education and humour to it and now our children are learning about it in schools. That’s what we would like to do with death.”

Commonly associated with births, doulas offer physical and emotional support. They often handle administration and act as a go-between for patients and medical staff to minimize stress for patients and their families.

But doulas also play a role in end of life. “Death doulas” not only fill the gaps between patients and the health-care system, but also bridge the gap between the health-care and funeral industry. Their work has become particularly important during the COVID-19 pandemic, which has isolated dying patients, interrupted death rituals and placed extra stress on families.

Hendrickson and Haun, who have been friends for 20 years, became death doulas together back in 2018. They founded the virtual group to start a discussion around death and dying for anyone interested in the death-positive movement.

DDNBC has grown quickly and continuously since their first virtual meeting in April 2020. The network now has close to 140 members throughout Canada and around the world.

Karen Hendrickson and Jo-Anne live four hours apart and saw the opportunity to work together to create the virtual network DDNBC, during the pandemic, April 2020.

Gaps in the health-care system

Hendrickson and Haun have been part of the fight to include doulas within the health-care system to help fill some of the gaps between the system as its patients.

“You have likely heard of the rock metaphor before. Basically, The big rocks are the diagnoses. The medium rocks are your support people. The small rocks are your treatments. The sand in between the rocks is the doula,” Hendrickson said.

Things like confusing paperwork, new medical teams, and unfamiliar systems have a devastating emotional impact on patients and their families.

Hendrickson described an instance where a young patient with terminal cancer kept having to renew his burial permit but the medical staff continued to insist that it wasn’t important. That form is required by funeral services to take the person’s body from their home. Without an up-to-date form, the funeral service would refuse to take the body and the family would have to call the police.

“They would arrive with their sirens on and everything, and be forced to treat it like a crime scene because that’s their mandate,” Hendrickson said. “Imagine grieving families having to witness that.”

Ingrid Ollquist, based in Los Angeles, started as a birth doula in 2017, mainly supporting people through abortions and miscarriages. She decided to become a pre-planning and post-death doula after receiving emotional support from a doula mentorship program herself.

After a 10-year battle, Ollquist lost her mother to multiple sclerosis (MS). During this process, she was in and out of hospitals dealing with lots of administration with little support. As a death doula, she hopes to prevent others from experiencing this stress and isolation.

“It brought distance between my mom and I,” Ollquist said. “It was so frustrating to just live in logistical spaces with a person that you love that you can see dying in front of you.”

Ollquist is now the founder of the free grief support group Nurture Ing after being mentored by Jill Schock, the founder of Death Doula LA (DDLA).

COVID-19 has changed how we die

COVID-19 has made the gaps between health-care and funeral industries larger. Government regulations restrict patients from having more than one support person when in a hospital.

For death doulas, these restrictions mean patients die without their loved ones by their side. Doulas and family members must connect with the dying patient virtually.

“A COVID death is horrific. It’s the worst. You are losing more than just life, but all end-of-life rituals,” Ollquist said.

Many memorial and funeral events have been cancelled, and burial and cremation services have been substantially delayed.

Olliquist hasn’t personally dealt with more clients but she has played a larger role in supporting other doulas. She says that many doulas are now experiencing death anxiety after witnessing numerous horrific deaths all over the world. People of all different ages are dying without family and without rituals.

DDNBC and Ollquist suspect that more people are going to be thinking about (and planning for) their deaths after the pandemic.

“The pandemic has waved death in our face. Mortality is now at the forefront,” Haun said.

Complete Article ↪HERE↩!

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There Are 5 Stages of Grief

— Here’s What to Expect From Each One

Everyone who grieves experiences them, but we do it in our own way on our own timetable.

By Madeleine Burry

Whether it’s the death of a loved one, the loss of a job, the end of a relationship, or any of life’s small and large tragedies, we all grieve at some point. While you shouldn’t anticipate that your grief will resemble another person’s, there are certain common stages of grief we all experience.

Where the stages of grief originated

These stages of grief have typically been classified as denial, bargaining, anger, depression, and acceptance. The five stages originate from a 1969 book, On Death and Dying, written by psychiatrist Elizabeth Kübler-Ross. Though there’s some dissent about these five stages and not everyone goes through them at the same time or the same way, they’ve been accepted by psychology experts for decades and remain the model that is applied to all forms of loss.

“Coping with a loss is a very singular and unique experience to each person,” Holly Schiff, PsyD, a licensed clinical psychologist in Connecticut with Jewish Family Services of Greenwich, tells Health. Nor is the grieving process accompanied by a timetable, although often the worst symptoms peak at the six-month mark, she notes.

The grieving process is a “messy jumble of highs and lows, ebbs and flows, steps forward and backwards,” Schiff says.

Here, a look at what happens during each of these five stages, along with coping strategies for grieving.

Grief stage 1: denial

This initial stage of grief helps us to cope and survive a loss, Schiff says. “You are living in a ‘preferable’ reality, rather than actual reality,” she says. You might refuse to acknowledge the loss by keeping it to yourself and going about your life. When emotions start to overwhelm you and urge to to face the loss, you fight back and focus your mind elsewhere.

You may experience shock or disbelief while navigating denial, Arianna Galligher, LISW-S, associate director of the STAR Trauma Recovery Center at Ohio State University’s Wexner Medical Center, tells Health. “Many people describe feeling numb,” Galligher says, or struggle to connect with their emotions.

Grief stage 2: anger

Grief-related anger may lead you to ask “Why me?” or wonder why life is unfair, Schiff says.

“This response may be directed outward, inward, or both,” Galligher says. That is, it’s not unusual to blame yourself or to feel anger toward friends, family members, and others. In the case of a bad medical diagnosis, for instance, the target might be a doctor who didn’t catch the disease early on-or, someone who is fired may feel fury at their boss.

If it’s a loved one’s death you’re grieving, you could also be angry at the person-furious that they didn’t seek help sooner for a health symptom or mental anguish. If you’re grieving the end of a relationship or job, you might feel anger toward your ex or boss, blaming them for things ending.

Anger may feel unfamiliar, or maybe immature. But don’t avoid this necessary stage of grief, Schiff says. “The more you allow yourself to feel it, the more quickly it will dissipate.”

Grief stage 3: bargaining

During the bargaining phase of grief, people seek to resume their pre-loss life. Essentially, it becomes an attempt to negotiate out of the grief, Schiff says.

Many people experience guilt during this phase, too. “This response is often punctuated by ‘what if’ or ‘if only’ thoughts that seek to regain some sense of control when a person is feeling helpless or powerless over the outcome of a situation,” Galligher notes.

These thoughts may circle around and around: What if we’d skipped that errand-then we would have avoided the car accident. Or if only I’d made time for weekly date nights, we’d still be together.

Grief stage 4: depression

Facing the new, post-loss reality can lead to sadness and despair, Schiff says. “This is a natural and appropriate response to grief,” she explains.

During this phase, you may feel lonely, cry frequently, or feel disengaged from your regular activities and relationships. Depression can affect your sleep and appetite. People in this stage might find themselves losing or gaining weight, or they could feeling fatigued during the day because they’re waking up throughout the night.

Depression isn’t always displayed with a lot of emotion, however; sometimes it mean simply feel uninterested in day-to-day life and not feeling strongly about anything. If you don’t cry, it’s doesn’t mean you aren’t in the depression stage of grief. Think of “depression” as more of a stage where your emotions are muted, with grief preventing you from finding pleasure or contentment in things.

Grief stage 5: acceptance

Reaching the acceptance stage of loss doesn’t imply that you feel happiness-it simply indicates that you’ve acclimated to the loss and your new reality, Galligher says.

That means that while your emotions may stabilize, during the acceptance stage you may still feel sorrowful. During this phase, you’re learning to live with your loss, Schiff says.

While your emotions may stabilize, and you may no longer have the extremes of other stages, sadness may still occur.

Other ways of looking at grief

The Kübler-Ross theory can make grieving seem like an orderly, step-by-step process.

But in reality, mourning a loss isn’t a math equation: You may find yourself going from one stage to another and then again, Schiff says. Or, you may “even feel like you are in multiple stages at once as you cycle through a variety of emotions,” she says.

This rigidity is one of a few reasons for critiques of the Kübler-Ross model, Galligher says. This approach also assumes that all cultures conceptualize-and therefore, cope-with grief in the same way, she notes, which is not necessarily accurate. Other modern theories of grief focus less on stages and more on grief-related tasks (think: accepting the loss), Galligher says.

When to seek help

The grieving process can feel isolating and overwhelming. “It is important for people to seek help when they are grieving, and lean on family and friends for support,” Schiff says.

Grief can understandably affect your mental health, so consider reaching out for professional help if grieving-and feelings associated with the process-are making it hard for you to handle day-to-day functions or maintain relationships, Galligher says. Attending support groups or seeing a therapist can help you navigate life after loss, she says.

“If you feel like grief is taking over your life, speak to someone,” Schiff says.

Grief coping tactics

Navigating grief is innately challenging, but here are some therapist-recommended strategies to potentially ease the process:

Let your support system go work

While your grief is personal, there’s no need for it to be a solo operation. Seek support from friends, family, therapists, and support groups, Schiff recommends. She also recommends informing people in your workplace as needed. That way, “your job doesn’t expect the same ‘you’ to show up every day.”

Feel your feelings

“Give yourself permission to feel a range of emotions without judgement,” Galligher recommends. Expect challenging days and weeks to occur. It can be helpful to allocate a certain amount of time each day to grieving, Schiff says. But give yourself the grace of grieving without a deadline-again, there’s no set end-date for the process.

Prioritize self-care

Make sure you’re taking care of your physical and emotional needs: Don’t neglect sleep, exercise, and eating, Galligher says. And, avoid self-medicating with alcohol or drugs, she adds.

Plan ahead

Anniversaries, holidays, and other milestones can trigger feelings of grief, Galligher notes. “Engage in intentional self-care in anticipation” of these moments, she recommends. That might mean, for instance, deleting social media in the lead-up, taking time off of work, or reaching out to loved ones for support.

Complete Article ↪HERE↩!

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What to Expect When Death Comes

In the wake of Covid-19, we are all grieving. How can we come to terms with death — and what does it teach us about living?

By Brandy L Schillace

In 2015, I published a book. It began like this:

“A wake,” my mother said. “To sit with the dead.”

We were on our way to West Virginia, to an unremarkable two-story colonial where my grandfather’s remains had been washed and laid out for viewing. It had been raining all night, but apparently no one in this homey funeral parlor had been sleeping. They’d been sitting up with the body. Sitting up — with the body — all night.

There are no good adjectives to describe my feelings about this. I was seventeen and grieving, but I wasn’t horrified. Shocked, yes, but the idea was strangely enticing, even fascinating. Really? We do that? This wasn’t my first family death, after all, but it was the first time I’d encountered the intimacy of this ritual.

It was also the first time I’d considered the buzzing activity that surrounds the newly dead. I asked myself what seemed like suddenly obvious questions — Why wash a body before putting it in the dirt? Why sit awake with someone now permanently asleep? Even the practice of embalming the body (which prevents decay) before interring it in the ground (where it is supposed to decay) struck me as a very strange kind of ritual. With only a minor leap of morbid imagination, care of the newly dead began to resemble care of the newly born. But it also brings us face to face with our own mortality.

When we witness death, we must grapple with its finality, but also with the knowledge that one day we, too, must die. Where once this was understood as the natural order of things, we now find ourselves conflicted and less willing to see death as “natural.” If anything, death breaks into our lives as an unexpected surprise.

We are not used to death and dying in the West, and most particularly not in the modern United States. The Victorians (in the U.S. and U.K.) had incredibly complex mourning rituals, including mourning jewelry, photographs of the recently dead (momento mori photography), and the public wearing of mourning clothing.

Like birth, death was a social event that drew communities together. In a large city, scarcely a day would go by without some visible sign of bereavement. Compare this with our modern standards, where illness and death are either hidden away in hospitals or sensationalized through popular culture, and where prolonged grief is likely to be medicated as abnormal, rather than openly acknowledged as an inevitable part of life.

Elisabeth Kübler-Ross, a Swiss American psychiatrist, developed her theory of the five stages of grief in 1969 as a response to a lack of information on death and dying in the curriculum of medical schools — but even these hardly cover the enormous range of emotions that accompany death, and they certainly weren’t a plan for how better to go about the process of grieving. Later attempts at death positive education have been on the rise, but can be blind to the way privilege often determines “positivity” about death.

Then, in 2020, the pandemic descended upon us with death tolls on a global scale. We crashed into a set of experiences most were ill-prepared to deal with — and on top of this, the nature of the virus stole away even our usual means of communal grieving. Covid-19 has precipitated three separate types of loss; first, the loss of loved ones, of friends, of connections we always assumed would be there. Second, the loss of personal contact so much a part of grieving. And third, and perhaps most jarring: the loss of an illusion. We’ve been stripped of the comfortable idea that we could plan for tomorrow, or that we will all die of comfortable old age.

Death has come. And we were not expecting it.

Looking out at the expanse of still-spiking cases in the U.K. and parts of the U.S., overwhelmed crematoriums in India, and the struggle to get higher percentages vaccinated, it’s clear that the first crisis isn’t necessarily over. But a second epidemic is coming: a shadow epidemic of psychological grief as we try to fit puzzle pieces of broken yesterdays to almost-tomorrows. We need help. So: what next?

I think it’s time for a journey. In Death’s Summer Coat, I worked backward through history, and sideways into other cultural contexts, to see how we got to “now.” Along the way, I learned how we might find paths to something better. I’ve decided to revisit those paths from a post-outbreak perspective, in hopes it might shed light on the road ahead. I hope you will join me. Sharing our stories provides hope and community so that none of us face death alone in the silent dark.

If you would like to hear a bit more from me, I gave a brief chat on the topic for the Museum of Contemporary Art, Cleveland. Until next time, go gently with yourselves.

Complete Article ↪HERE↩!

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What matters in the end?

Couple chronicles life’s final chapter in new book

Photo of Irvin and Marilyn Yalom in the entry hall of their Palo Alto home.

Authors Irvin and Marilyn Yalom probe questions around love, loss

by Chris Kenrick

Is it possible to plan a “good death?” Can one gracefully leave this world to the next generation? Can one live meaningfully until the very end?

Prompted by a serious medical diagnosis, longtime Palo Alto residents Irvin and Marilyn Yalom probe these questions in “A Matter of Death and Life,” which the duo wrote just before Marilyn died by medically assisted suicide in 2019.

Married 65 years, both Yaloms already were widely published authors — translated into many languages — when they began writing their book in spring 2019 after Marilyn was diagnosed with multiple myeloma, a cancer of the plasma cells.

Irvin, a psychiatrist and leader in the field of existential psychotherapy, had some 20 fiction and nonfiction titles to his name. Marilyn, a cultural historian, French professor and early director of Stanford’s Center for Research on Women, had published at least 10 books.

With her prognosis bleak, Marilyn persuaded her husband that they should document, in alternating chapters, the experience of her illness and likely demise from the disease.

“We now live each day with the knowledge that our time together is limited and exceedingly precious,” the two, both in their late 80s, write in the preface. “This book is meant, first and foremost, to help us navigate the end of life.”

As scholars, both Yaloms are steeped in the great philosophers’ contemplations on exemplary life and death, and have wrestled in their own work with themes of mortality.

In “American Resting Place,” co-authored with their son, the photographer Reid Yalom, Marilyn documented how 400 years of gravestones, graveyards and burial practices reflect changing American ideas about death, class, gender and immigration.

As a psychotherapist, Irv had counseled countless patients, including many with terminal illnesses, about facing death, and written extensively about their — and his own — death anxieties.

“Of all the ideas I’ve employed to comfort patients dreading death, none has been more powerful than the idea of living a regret-free life,” Irv recalls in the book.

Sitting together in their yard, admiring the trees, “Marilyn squeezes my hand and says, ‘Irv, there’s nothing I would change,'” he writes. With four children, eight grandchildren and extensive world travels in addition to their professional accomplishments, both Yaloms feel they’ve seized their days to the fullest.

Even as death approaches, the pair celebrate “magic moments,” such as the evening they abandon television and Marilyn pulls “Martin Chuzzlewit” down from the bookshelf and begins reading aloud. “I purr in ecstasy, listening to each word,” Irv writes. “This is sheer heaven: What a blessing to have a wife who delights in reading Dickens’s prose out loud.” He recalls the day — more than 70 years before — when the two had first bonded over their mutual love of books as classmates at Roosevelt High School in Washington, D.C.

When chemotherapy fails and Marilyn is placed on immunoglobulin therapy, she begins inquiring about medically assisted suicide — legal in California since 2016 — in the event the new treatment does not work.

Irv is horrified, but Marilyn is at peace. Though sad to leave the people she loves, “The idea of death does not frighten me,” she writes. “I can accept the idea that I shall no longer exist. … After 10 months of feeling awful most of the time, it’s a relief to know that my misery will come to an end.”

After some weeks the couple is told the immunoglobulin therapy, too, has failed.

Marilyn accepts various tributes and goes about saying her goodbye, and giving away her treasured books to a large network of friends and colleagues. “It’s weird to realize that if I want to do anything, I’ll have to do it quickly,” she writes.

Ultimately, about a week before Thanksgiving 2019, she chooses to end her life, ingesting lethal medication in the presence of Irv, their four children, a physician and a nurse. (She was among the 405 people to use California’s End of Life Options Act in 2019, according to the annual tally from the state health department.)

Shortly before, Marilyn had reviewed the writings of Greek and Roman philosophers on how to live and die well. “For all the philosophical treatises and all the assurances of the medical profession,” she writes, “there is no cure for the simple fact that we must leave each other.”

The final chapters are written by Irv, recounting the agony of grief and his halting attempts to resume some kind of normal life — including venturing out to a Barron Park Senior Lunch at the Corner Bakery.

After more than 70 years with Marilyn beside him, he struggles with the idea that “something can have value, interest and importance even if I am the only one to experience it, even if there’s no Marilyn to share it with.

“It’s as if Marilyn’s knowing about a happening is necessary to make it truly real,” he writes.

He rails at the irrationality of this. “I’ve been a full-time student, observer and healer of the mind for over 60 years, and it is difficult to tolerate my own mind being so irrational,” he writes.

Reached at his home in late May, two months after the book’s publication, Yalom said he’s been busy with the “strong feedback,” including virtual book talks with large audiences all over the world. The book is licensed for publication in 25 countries, some already in print and others likely between now and the end of next year, according to literary agent Sandra Dijkstra.

Yalom, who turns 90 this month, continues to work on his next book and also to do single-hour therapy consultations.

“I’m growing old now and my memory’s beginning to disappear,” he said. “I’m not seeing ongoing patients anymore but I think I’m able to do a lot for some people just in the single hour.”

His new book is intended as a training manual for young therapists. “I’m always writing, and as long as I’m writing I feel very well,” he said.

He also takes walks daily to a nearby park, where he’s had a bench installed in memory of Marilyn. Yalom said he enjoys sitting on the bench, taking in the surroundings and thinking of her.

Complete Article ↪HERE↩!

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Liberal Judaism, Modern Church join new Religious Alliance for Dignity in Dying

  • New group of interfaith leaders and laypeople following more than a dozen denominations call for change in law on assisted dying
  • Poll finds 53% people of faith felt religious leaders were wrong to campaign against last assisted dying bill, while just 22% felt it was right
  • Christian man who accompanied wife to Dignitas welcomes new Alliance

Liberal Judaism, a progressive strand of Judaism, and the Modern Church, an Anglican society promoting liberal Christian theology, are the latest faith organisations to join the new Religious Alliance for Dignity in Dying, a collection of multi-faith groups, leaders and laypeople calling for a change in the law on assisted dying. Lord Carey, the former Archbishop of Canterbury, has also joined the Alliance and the Chief Officer of the Unitarians has recognised the strong support among many of their members. The Alliance is also welcomed by a Christian man who accompanied his terminally ill wife to Dignitas in 2019 at her request.

The Religious Alliance for Dignity in Dying is formed of religious organisations, leaders and people who follow more than a dozen different denominations and who support a change in the law to enable terminally ill people the ability to determine how, when and where they die alongside high quality end of life care. This comes as a private member’s bill on assisted dying was introduced to the House of Lords last month by Baroness Meacher, Chair of Dignity in Dying, paving the way for the first debate on prospective legislation in Parliament for more than five years.

In a YouGov poll of 5,039 adults published yesterday, 53% of religious people felt it was wrong for religious leaders to actively campaign against an assisted dying bill that was debated in the House of Commons in 2015, with just 22% saying they felt it was right for them to do so.

Faith leaders including the Archbishop of Canterbury and the Archbishop of Westminster wrote to MPs in September 2015 to urge them to oppose the Second Reading of the assisted dying bill in the House of Commons. The bill was based on one introduced by Lord Falconer in 2014, which was supported by Peers both at Second Reading and at Committee Stage, where two opposition amendments were defeated by large margins. Unfortunately, the parliamentary session ended before it could progress further. Baroness Meacher’s bill, also based on Lord Falconer’s bill, was drawn seventh in the House of Lords private members’ ballot last month and a Second Reading is expected in the autumn.

A 2019 Populus poll found that approximately 80% of religious people (and 84% of the general public) support the change proposed in Baroness Meacher’s bill – namely that terminally ill, mentally competent adults in their final months would be able to request an assisted death, subject to approval from two independent doctors and a High Court judge.

Similar legislation has been in place in Oregon, USA for over 23 years, and has since been adopted by nine other American states plus the District of Columbia, three Australian states and New Zealand.

The Religious Alliance for Dignity in Dying brings together followers of the Church of England, Church of Scotland, Church of Wales, Catholicism, Baptism, Evangelism, Methodism, Unitarianism, United Reformed Church, Quakerism, Liberal Judaism, Reform Judaism and Sunni Islam.

Rabbi Charley Baginsky, Chief Executive of Liberal Judaism, said: “Liberal Judaism has a proud history of being at the forefront of progressive societal change, speaking up for much-needed liberal reforms with compassion at their heart. Much like votes for women or equal marriage – rights which now seem unchallengeable – assisted dying is a right we are proud to champion for people nearing the end of their life.”

Rabbi Danny Rich, Liberal Judaism rabbi with responsibility for hospital and prison chaplaincy and former Chief Executive of Liberal Judaism, said: “I have long been an advocate of the right of terminally ill individuals, subject to appropriate safeguards, to decide the manner and timing of their own deaths. Twenty-seven years ago my own great uncle, suffering with inoperable cancer, ended his own life with help from a relative. That dying people are still forced to contemplate dying by suicide as an alternative to a traumatic or prolonged death by their disease is shameful. I add my voice to the growing number calling for true choice and control at the end of life.”

Alan Race, Chair of the Modern Church, said: “Christians place high value on human dignity and compassion and believe we should relieve suffering where possible. We welcome medical intervention in order to relieve pain, especially when suffering becomes unbearable. Relationship with God is a freely chosen commitment and this means that we do not leave it to God to determine the time of death. Trusting in God’s unlimited compassion therefore includes the desire to relieve unbearable suffering at the end of life. In practical terms, granting permission for assisted dying often has the effect of releasing renewed spirituality for living a more fulfilled life prior to death itself.” 

Lord Carey, former Archbishop of Canterbury, said: “For too long we have turned a blind eye to the suffering inflicted on terminally ill people by the ban on assisted dying. Compassion, a central tenet of the Christian faith, should not be a crime, and yet under the current law it is treated as such. I believe a change to the law is urgently needed to enable our dying citizens the ability to go as they wish. To my mind, this is the moral, and the Christian, thing to do.”

Liz Slade, Chief Officer of the Unitarians, said: “The Unitarian movement voted in 2013 on the issue of assisted dying; in our recognition of the worth the dignity of all people and their freedom to believe as their consciences dictate, members voted to support the principle that individuals should have the right to seek support for assisted dying in certain circumstances, and that legislation should respect this choice and allow them compassionate assistance without fear of prosecution of anyone involved. Many Unitarians are passionately in favour of a change in the law, while recognising the need to allow a diversity of voices to be considered on this important moral issue.”

Rabbi Dr Jonathan Romain, Chair of the Religious Alliance for Dignity in Dying, said: “This new Alliance is a truly multi-faith rallying call for a compassionate, safeguarded law on assisted dying for the UK.

“In the 60 years since the blanket ban has been in place, medical advances have done wonders in prolonging life, but this often means prolonging the dying process too, causing suffering that may be beyond the reach of palliative care. Religious teaching evolves to deal with the challenges of modern life, so too should the options we offer people when they reach the end of it. That we continue to deny our dying citizens a choice that is now available in states and nations around the world is morally indefensible. It’s time to have a national debate on assisted dying that respects all views while recognising the strong support among religious people.”

Len Taphouse, 81, a former lecturer in engineering and father of three from Hornchurch, is a member of the Church of England and welcomes the new Religious Alliance for Dignity in Dying. Len accompanied his wife of 55 years, Stella, to die at Dignitas in Switzerland at her request in August 2019. Stella was terminally ill with Parkinson’s disease and breast cancer, and in previous years had been diagnosed with cancer of the womb and skin.

Len said: “I was brought up as a regular church-goer, and in 2014 Stella and I renewed our vows 50 years later in the very same church we got married in. Neither of us found our faith a barrier to supporting Stella’s decision, quite the opposite. But this option should have been available here at home. Stella should not have had to spend £11,000 and my daughters and I should not have had to break the law and risk prosecution to accompany her in her final moments. It’s time the law was changed so that people like Stella can die as they wish in this country, surrounded by those they love, in their own bed.”

Tom Davies, Director of Campaigns and Communications at Dignity in Dying, said: “Medical organisations are increasingly recognising the range of views among their members, with doctors accepting that whatever their personal opinion they cannot deny their dying patients the choices they want. Religious organisations and faith leaders are now doing the same, recognising the support for change among their congregations and putting the choice and autonomy of those at the end of life before doctrine.

“With an assisted dying bill in the House of Lords, the Health Secretary commissioning data on suicides by terminally ill people, Scotland due to consult on potential legislation and Jersey conducting a citizen’s jury on the subject, it is essential that parliamentarians across the British Isles understand that the vast majority of the pubic, with faith and without, want change.”

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