Tag: Death And Dying

Posted on

Catholic Cemeteries to offer ‘natural burial’ option starting in fall

When Frank Schweigert dies, he doesn’t expect embalming, a burial vault or even a casket.

by

[A]fter his funeral Mass, Schweigert, 67, wants to be placed directly in the ground, wrapped only in cloth, with little of the funeral trappings many people have come to expect.

And The Catholic Cemeteries plans to be ready to accommodate him.

The Mendota Heights-based organization, which oversees five Catholic cemeteries in the Twin Cities, is preparing to offer natural burial as an option as early as this fall. The trend, also called “green burial,” takes different variations, but aims to unite the body with the earth using little if any fossil fuel or non-biodegradable materials.

“It’s so much a part of our tradition,” said John Cherek, The Catholic Cemeteries director. “That’s the amazing part of it.”

The Catholic Cemeteries’ staff began exploring the option a few years ago, as they became aware of local Catholic interest in it. In many respects, the concept is as old as death itself, but the contemporary movement began in earnest about 20 years ago with the opening of the first green burial cemetery in the U.S. in South Carolina.

The California-based nonprofit Green Burial Council, established in 2005, certifies green burial practices for funeral homes and cemeteries. Its Minnesota listing includes only Mound Cemetery of Brooklyn Center as a “hybrid” green cemetery, meaning it offers both green and conventional burials, and Willwerscheid Funeral Home and Cremation Center in St. Paul as the only “green” certified funeral home. Other Minnesota cemeteries and funeral homes, however, do offer the natural burial options without formal certification.

Cherek said he isn’t certain that The Catholic Cemeteries will pursue certification, but preparations are underway in a section of Resurrection in Mendota Heights to make about 50 natural burial plots available this year, with the potential to add more in future years.

Burying the body

Natural burial begins with the preparation of the body, which is not embalmed. Because everything buried with the body needs to be biodegradable, the body is often not clothed, but rather wrapped in a shroud. In some instances, the grave is dug by hand, to avoid fuel-dependent machinery, and the body is transported to the gravesite by non-motorized means. The body may be encased in a biodegradable casket — options include those made from wood, bamboo and wicker — or simply shrouded before being lowered into the grave manually.

At Resurrection, the natural burial area is also being restored to native prairie. That means long grasses and wildflowers will eventually cover the graves. Instead of individual headstones, the plots will be identified collectively by monuments along paved paths.

As The Catholic Cemeteries’ leaders considered whether to offer natural burial, they surveyed focus groups and found more interest than anticipated. Several of those surveyed, such as Schweigert and his wife, Kathy, now feel passionate about the option.

“Since it’s our mission to bury the dead, and we offer full body and we offer cremation [burials] … this would be another option, and it may be attractive to folks who have thought they wanted cremation, but this might give them an alternative,” said Sister Fran Donnelly, director of LifeTransition Ministries at The Catholic Cemeteries.

In many respects, natural burial is a return to common burial practices before the rise of the funeral industry in the early 20th century. Although embalming dates to early Egypt, its contemporary use gained traction during the Civil War, when fallen soldiers’ bodies were transported home for burial.

Although there are common misconceptions that embalming or vaults are necessary for public health, that’s not the case, Cherek said.

Done properly, natural burial does not endanger the water supply or put bodies at risk of being dug up by animals, or spread disease, according to the GBC.

Funeral vaults — structures that surround the coffin in standard graves — are used as a way of stabilizing the ground around a grave for ease of grounds maintenance, preventing the otherwise inevitable sinking of topsoil, which displaces the coffin and bodily remains as they decay.

Embalming, meanwhile, puts chemicals into the ground, and vaults prolong or prevent natural decay, and many elements included in the burial — from suit coat buttons to casket hinges — aren’t biodegradable.

According to the Green Burial Council, American burials annually put into the ground 1.6 million tons of reinforced concrete, 20 million feet of wood, 17,000 tons of copper and bronze, and 64,500 tons of steel. Add to that 4.3 million gallons of embalming fluids, which contain toxins that could negatively impact the health of embalmers.

While some people think of cremation as a simpler option, it also requires chemicals, and toxins linger in the cremated remains.

Cremation is permitted for Catholic burial, and its use is on the rise. However, the Church prefers burial of the body. The Catholic Cemeteries’ leaders think that natural burial might appeal to Catholics not only because of theologically-rooted ecological commitments, but also because it allows them to have a full body burial in a simpler form.

“Faith-wise, I think it says something about the resurrection of the body, that the body is intact, and it’s just going to return to the earth,” Sister Donnelly said.

Dust to dust

Schweigert, an administrator at Metropolitan State University in St. Paul, remembers reading decades ago about traditional Muslim burial, in which the body is placed directly in the ground. It struck him as a very natural way to approach death and honor the deceased, and over the years, the idea germinated in his mind as something he would prefer to the standard use of embalming, a casket and a burial vault. A parishioner of St. Frances Cabrini in Minneapolis, he contacted The Catholic Cemeteries a couple years ago to see if it was possible. He found out that “green burial” was becoming a trend, and that The Catholic Cemeteries was exploring the option. The organization later asked him to participate in a focus group on the topic.

The idea of placing the body directly into the ground with nothing to impede its return to the earth reminded Schweigert of something he observed as an altar boy: that the body and blood of Christ, if not consumed, were buried or drained directly into the ground.

“The earth was the most sacred place for the body of Christ, and the parallel between that and putting a loved one in the earth just seemed to me convincing spiritually,” he said.

And although Schweigert has strong feelings about not being cremated, which he sees as too industrialized and destructive of the body, he said his decision to choose a natural burial is also not a reaction to the funeral industry, which he respects, as he noted funeral directors have treated him and others well during times of grief.

He does, however, question the long-term sustainability of common methods, and he sees natural burial as a way to honor the environment, the dead and the Catholic faith.

Green or natural burial practices complement Catholic teaching about death, Sister Donnelly said, as well as the Church’s social teaching on caring for creation, which Pope Francis articulated in his 2015 encyclical “Laudato Si’: On Care for our Common Home.” Already, several Catholic cemeteries in the U.S. offer green burial options, and a 2011 survey by U.S. Catholic Magazine found that 80 percent of respondents would prefer a green burial.

Some religious communities are adopting natural burial as part of their commitment to caring for creation. Among them is Sister Donnelly’s community, the Sisters of Charity of the Blessed Virgin Mary, which has a cemetery at its motherhouse in Dubuque, Iowa.

In “A Reflection on Changes in Burial Practice” in The Catholic Cemeteries’ summer newsletter, retired priest of the archdiocese Father James Notebaart looks to Scripture and Church tradition and what they say about the sacredness of a burial place, recalling the words spoken in the Ash Wednesday liturgy: “Remember you are dust, and to dust you shall return.”

After noting that the natural burial process is the way most people — including Catholics and their Jewish ancestors — were buried for thousands of years, he wrote, “So the core of natural burial is to acknowledge our innate closeness to the earth as a creature of God’s own making. It acknowledges that the earth itself is holy because it is an icon of the One who created it.

“Today we have begun to step back to much earlier practices, those of the preindustrial world in which there was a more organic sense of how all things are related, both the natural resources and the human use of them. This awareness is shaping a new articulation of ecological ethics, of which Pope Francis is a leading proponent.”

Practical considerations

Choosing natural burial, however, does mean eschewing other common aspects of funeral and burial beyond the casket and vault.

According to state law, a person needs to be embalmed, buried or cremated within 72 hours of death, but refrigeration of the body allows burial to take place up to six days after death, said Dan Delmore, who owns Robbinsdale-based Gearty-Delmore Funeral Chapels and sits on The Catholic Cemeteries’ board. State law also requires embalming for a public open-casket wake, but an in-home or closed-casket wake is a possibility.

Delmore has been a funeral director for 42 years, and for the first 15 years of his work, no one questioned the practice of embalming; it was an assumed part of the funeral preparation, he said.

“There’s been a lot of change of heart in people, and it goes more along the lines of chemicals in general, not necessarily at the time of death, but wanting a life free of chemicals in general,” he said, comparing it to the organic food movement. A Catholic, he also sees natural burial as an appropriate accompaniment to the Church’s funeral rites, and he said he’s excited to see it embraced at Resurrection.

As it prepares to open its natural burial section, The Catholic Cemeteries is working on logistics, including cost, which is among the aspects that The Catholic Cemeteries’ focus groups said would affect their decision whether or not to have a natural burial. While 41 percent surveyed said they were likely to consider natural burial, complicating factors included already owning plots elsewhere; wanting to be buried next to a loved one who already has been buried in a conventional grave or wants to be; and wanting an individual headstone, which The Catholic Cemeteries’ current natural burial plan precludes.

Schweigert admits the idea of not having an individual headstone has taken some getting used to, but while that alone has dissuaded others, he’s not deterred. He recalled seeing a family burial plot in France that had a collective monument, and it’s reminded him that burials have been handled differently in different times by different cultures.

He puts it in perspective with the knowledge that after three generations have passed since a person’s death, his or her grave is not likely to be frequented by loved ones, and that there are other ways to leave a final mark on the world. For him, it’s more important to remove any barriers — physical and symbolic — between the body and the earth.

“This is a sacred moment for us,” he said of death and burial. “We want to have a way to do this with dignity, [and] we want a way to do this with our Catholic religion, so I’m very happy, too, that the Catholic Church has gotten involved in it.”

Complete Article ↪HERE↩!

Posted on

Breaking the silence: are we getting better at talking about death?

As the media brings us constant news of strangers’ deaths, grief memoirs fill our shelves and dramatic meditations are performed to big crowds, we have reached a new understanding of mortality, says Edmund de Waal

A 2016 performance of An Occupation of Loss. Artist Taryn Simon gathered professional mourners from 15 countries to demonstrate how they perform grief.

[B]ereavement is ragged. The papers are full of a child’s last months, the protests outside hospitals, the press conferences, court cases, international entreaties, the noise of vituperation and outrage at the end of a life. A memorial after a violent death is put up on a suburban fence. It is torn down, then restored. This funeral in south London becomes spectacle: the cortege goes round and round the streets. The mourners throw eggs at the press. On the radio a grieving mother talks of the death of her young son, pleading for an end to violence. This is the death that will make a difference. She is speaking to her son, speaking for her son. Her words slip between the tenses.

Having spent the last nine months reading books submitted for the Wellcome book prize, celebrating writing on medicine, health and “what it is to be human”, it has become clear to me that we are living through an extraordinary moment where we are much possessed by death. Death is the most private and personal of our acts, our own solitariness is total at the moment of departure. But the ways in which we talk about death, the registers of our expressions of grief or our silences about the process of dying are part of a complex public space.

Some are explorations of the rituals of mourning, how an amplification of loss in the company of others – the connection to others’ grief – can allow a voicing of what you might not be able to voice yourself. The actor and writer Natasha Gordon’s play about her familial Jamaican extended wake, Nine Night, is coming to the end of a successful run at the National Theatre. The nine nights of the wake are a theatre of remembrance, a highly codified period of time shaped to allow the deceased to leave the family.

Theatre of remembrance … Hattie Ladbury and Franc Ashman in Nine Night, Natasha Gordon’s play about a Jamaican wake.

Julia Samuel records in Grief Works, her remarkable book of stories of bereavement, a woman who “asked friends and family to sit shiva [the Jewish mourning tradition] with me at a certain time and place”. And that there was anguish when these particular times were ignored: two friends came at times that were “convenient for them rather than when she was sitting shiva, thus ‘raising all the issues I was temporarily trying to keep contained’”.

As an academic writes in the accompanying notes to artist Taryn Simon’s performance An Occupation of Loss, recently staged in London, “communication between the living and the dead is possible only in mediated forms”. There are obligations we have to fulfil to those who have died. Simon gathered professional mourners from 15 countries (Ghana, Cambodia, Armenia and Ecuador, among others). The mourners wailed and sobbed and keened, the intensity of their expression, their sheer volume, a challenge to the idea that there has to be a silence that surrounds bereavement.

There are silences. Contemporary books on death often take as their premise that to be writing in the first place is a breaking of a taboo. “It’s time to talk about dying,” writes Kathryn Mannix in her book about her work in palliative care, With the End in Mind. “There are only two days with fewer than 24 hours in each lifetime, sitting like bookmarks astride our lives: one is celebrated every year, yet it is the other that makes us see living as precious.” These books record the silence that we in the west have created. By removing dying into a medical context, where expertise and knowledge lie so emphatically with others, we have made death unusual, a process clouded by incomprehension. And by novelty.

So one kind of language we need is that of clarity. A lucidity that allows for the involvement of family and friends alongside healthcare professionals. Clarity, writes Mannix, around the questions such as “when does a treatment that was begun to save a life become an interference that is simply prolonging death? People who are found to be dying despite the best efforts of a hospital admission can only express a choice if the hospital is clear about their outlook.” Conversations about palliative care need extraordinary skill and empathy. These are skills that can be learned.

But for someone writing about their own grief, there are no guidelines. You might have read Thomas Browne’s Urn Burial, or the poems of John Donne, the theories of John Bowlby or Donald Winnicott, Freud’s Mourning and Melancholia, but it simply doesn’t register. Being well read doesn’t help when someone who matters dies. Part of this attempt to start again, to find a form out of the formlessness of grief, is a reluctance to take on the generic language of sympathy, the homogeneous effect of cliche. Bereavement is bereavement, not a masterclass in being well read in the classics. “The death of a loved one is also the death of a private, whole, personal and unique culture, with its own special language and its own secret, and it will never be again, nor will there be another like it,” writes David Grossman in Falling Out of Time, his novel about the death of his son. A death needs a special language.

The language of loss and the framing of sympathy in everyday life is so impoverished, so mired in cliche and euphemism, that deep metaphors of “passing” become thinned to nothing, to sentimentality. The iterations of “losing the battle” and the valorising, endlessly, of “courage” is a way of making the bereaved feel they need to enact a particular role. And then there is the “being strong”. If you are told how wonderful you are for not showing emotion, or for continuing as before, where does that leave being scared? How about denial? Or anger, terror, desolation, loneliness? How about confusion? Why only endurance, resilience, strength? In this need to name, to find precision, accuracy is a measure of love. I think of Marion Coutts’ book The Iceberg, on her dying husband Tom Lubbock’s language, Joan Didion’s The Year of Magical Thinking, charting everything, weighing her responses to her grief. This is different, they say, writing this is a work of mourning.

The greatest of these books find a language that encompasses the sheer confusion of bereavement. In her forthcoming book Everyday Madness: On Grief, Anger, Loss and Love, Lisa Appignanesi writes that “Death, like desire, tears you out of your recognisable self. It tears you apart. That you was all mixed up with the other. And both of you have disappeared. The I who speaks, like the I who tells this story, is no longer reliable.” This is the other loss, that of selfhood, of control, of a forward momentum, of certainty. Appignanesi’s grief at the untimeliness of her husband’s death makes time itself deranged. Her days and weeks and months go awry. Her sense of the past is also called into question. It is excoriating: “My lived past, which had been lived as a double act, had been ransacked, stolen.” Bereavement, she notes, has a deep etymology of plunder. It tears you apart. Where all these registers go wrong, you oscillate between kinds of behaviour that are disinhibited, a derangement of self. It can be physical, a falling, a losing your way. I think of the crow in Max Porter’s Grief Is the Thing with Feathers as the deranged, ransacking presence in a family where the mother has died.

A deranged, ransacking presence’ … Cillian Murphy in Grief Is the Thing with Feathers.

These are images that go deep into history. In the Book of Lamentations we read that God “has made me dwell in darkness … he has walled me in and I cannot break out … He has weighed me down with chains … He has made my path a maze … He has forced me off my way and mangled me.” The Hebrew word eikh (how) opens the Book of Lamentations and then reappears throughout the text. This how is not a question, more a bewildered exhortation. You are beyond questions. All you can do is repeat.

In Anne Carson’s poem Nox, a response to the death of her brother, she refused to accept any conventional form. So the poem comes like a box, a casket, of fragments, attempts at definitions, parts of memories. This seems appropriate. The shape of grief is different each time. That is why the shard – the pieces of broken pottery that are ubiquitous across all cultures – is often used as an expressive image of loss. Think of Job lamenting to God, sitting on a pile of broken shards. In my own practice as a potter, whenever I pick up pieces of a dropped vessel I notice that each shard has its own particularity. Each hurts.

In her study of the deaths of writers, The Violet Hour, Katie Roiphe writes that “moving on, as a concept, is for stupid people, because any sensible person knows grief is a long-term project. I refuse to rush. The pain that is thrust upon us let no man slow or speed or fix.” Bereavement takes a pathway that is different for each and every one of us. It takes different registers, different words. And that is what I take away from this very particular nine months of reading and reflecting on mortality. That there is change in the public space around death. This change is remarkable and wonderful when it comes to end-of-life care: the hospice movement and the training in palliative care are one of the greatest and most compassionate changes to occur in the last 30 years.

And, more slowly, it is happening outside the hospitals and clinics and hospices. People do want to read and talk about grief. For this we have to be grateful to those writers who are trying to find their own shard-like languages to express their own bereavements.

Complete Article ↪HERE↩!

Posted on

Acceptable Ways to Dispose of My Body

By

[I] might die at any moment. My roof might collapse when my millennial neighbors throw a party that is too cool! I could finally freeze to death from never buying a winter coat! We could all die from (insert terrifying thing Trump is doing today)! So it’s important to plan ahead. While most Americans opt for cremation or embalming, five years of living in Brooklyn have made me much too alt for either. Here are some other suggestions.

Donate my body to pranks.

Spray-paint my bones gold and sell them at Free People.

Let doctors use my body to practice surgery, but make sure they’re not plastic surgeons. I spent a lot of time and effort while alive making sure I wasn’t hot; I don’t suddenly want to be hot when I die.

Roll me into the ocean—it seems like fun for both of us!

Donate all my organs to science, except for my eyes. It’s not that I’m sentimental about my eyes, it’s just that I want them to be used in that spooky “put your hand in the bowl” Halloween trick, in lieu of peeled grapes.

Cremate me, but only if you find a very hip ceramic, block-painted urn that costs three hundred dollars and was made by someone in Brooklyn who somehow makes pottery as a living.

Add me to the “Bodies” exhibit, and make my skeleton do a gnarly skateboard trick. Have the explanatory plaque read, “Blythe was able to do this in real life and did it constantly.”

Put me in a big jar of formaldehyde, like Stannis Baratheon’s wife does with those fetuses on “Game of Thrones.” When you see people getting creeped out by it, say, “Oh, yeah, I bought that at Free People.”

Compost my body and use the resulting loam on my succulents. It doesn’t matter if I’m the wrong kind of soil for the succulents; I’m already killing them while I’m alive.

Keep losing and re-finding my bones, setting off a media frenzy every time with headlines like, “SKELETON DISCOVERED UNDER PARKING LOT.”

Plant a memorial cactus on top of me. I swear to God, I am going to be reincarnated as a succulent.

Use me as a crash-test dummy to prove that it’s actually not dangerous to put your feet up on the dashboard.

Don’t embalm me, and bury me in a natural coffin in a natural cemetery. See if you can find a plot inside a national park. Make my gravesite a geotag on Instagram.

Complete Article ↪HERE↩!

Posted on

Perspectives on Death

Today we are talking about death, looking at philosophical approaches from Socrates, Epicurus, and Zhuangzi. We will consider whether it’s logical to fear your own death, or the deaths of your loved ones.

 

Posted on

What happens at the end of life?

By Rachel Schraer

[S]cientists are expecting a spike in deaths in the coming years. As life expectancies increased, the number of people dying fell – but those deaths were merely delayed.

With people living longer, and often spending more time in ill-health, the Dying Matters Coalition wants to encourage people to talk about their wishes towards the end of their life, including where they want to die.

“Talking about dying makes it more likely that you, or your loved one, will die as you might have wished. And it will make it easier for your loved ones if they know you have had a ‘good death’,” the group of end-of-life-care charities said.

Where to die?

Surveys repeatedly find most people want to die at home. But in reality the most common place to die is in hospital.

Almost half of the deaths in England last year were in hospital, less than a quarter at home, with most of the remainder in a care home or hospice.

What happens to human remains?

Dying wishes don’t just extend to where you die but to what happens to your body after death too.

Cremation overtook burial in the UK in the late-1960s as the most popular way to dispose of human remains, and more than doubled in popularity between 1960 and 1990.

Since then it has remained fairly stable at about three-quarters of the deceased being cremated, although it has been creeping up gradually year on year – in 2017 it hit 77%.

Although cremation is thought to be more environmentally friendly, it is not without its own costs. The process requires energy. And burning bodies releases carbon dioxide into the atmosphere.

There are hundreds of “green” burial grounds in Britain where coffins must be biodegradable and no embalming fluid or headstone markers are permitted. Instead, loved ones of the deceased often plant trees as a memorial.

The Association of Natural Burial Grounds says: “Many people nowadays are conscious of our impact on the environment and wish to be as careful in death as they have been during their lives to be as environmentally friendly as possible.”

At natural burial grounds, bodies are generally buried in shallow graves to help them degrade quickly and release less methane – a greenhouse gas.

Some people want to go further than this.

A form of “water cremation” is currently available in parts of the US and Canada, and could come to the UK.

This eco-friendly method uses an alkaline solution made with potassium hydroxide to dissolve the body, leaving just the skeleton, which is then dried and pulverised to a powder.

Sandwell Council, in the West Midlands, was granted planning permission to introduce a water cremation service, but these plans are currently on hold because of environmental concerns.

In December 2017, water providers membership body Water UK intervened and said it feared “liquefied remains of the dead going into the water system”.

Cremation by fire or burial remain the two options for most people, but those that want to do something a bit different could opt to have their ashes turned into a diamond or vinyl record, displayed in paperweight, exploded in a firework or shot into space.

The cost of death

Traditional cremation is cheaper than burial, particularly as space is short, driving up the cost of grave plots. But the cost of funerals in general has been rising.

Insurance firm SunLife, which produces an annual report on the cost of funerals, says prices have risen 70% in a decade.

It put this down to lack of space and the rising cost of land as well as fuel prices and cuts to local authority budgets leading to reduced subsidies for burials and crematoria.

A survey of 45 counties, conducted by the Society of Local Council Clerks, found half of respondents’ local council run cemeteries would be full in 10 years and half of Church of England graveyards surveyed had already been formally closed to new burials.

The same problem faces Islamic burial sites.

Mohamed Omer, of the Gardens of Peace cemetery in north-east London, says the problem is compounded by a growing population and by the fact that Muslims do not cremate their dead.

The Jewish community also do not traditionally practise cremation. David Leibling, chairman of the Joint Jewish Burial Society, says all of the four largest Jewish burial organisations have acquired extra space in recent years.

However, he says it’s not such a problem for the community since synagogue members pay for their burial plots through their membership. This means the organisation can predict how many people it is going to have to bury.

“As we serve defined membership we can make accurate estimates of the space we need,” he says.

What about our digital legacy?

There are growing concerns over what will happen to people’s social media profiles after they die.

The Digital Legacy Association is working with lawyers to produce guidelines on creating a digital will, setting out people’s wishes for what happens to social media profiles – and “digital assets” such as music libraries – after death.

Three-quarters of respondents to the DLA’s annual survey say it’s important to them to be able to view a loved one’s social media profile after their death.

But almost no-one responding to the survey had used a function to nominate a digital next of kin, such as Facebook’s legacy contact or Google’s inactive account manager functions.

Both Facebook and Instagram allow family and friends to request the deceased’s account is turned into a memorial page, while Twitter says loved ones can request the deactivation of a “deceased or incapacitated person’s account”.

Complete Article ↪HERE↩!

Posted on

Is the cemetery dead?

Mount Auburn Cemetery in Cambridge.

By David Sloane

[I]N 1831, ARCHITECT Jacob Bigelow built a radically new kind of cemetery at Mount Auburn in Cambridge. It was much larger than its forebears, located on what was then the suburban fringes, and designed to create a romantic space of death that also served as a horticultural, sculptural, and even recreational place. Mount Auburn and the many cemeteries that followed were a rousing success, making the American cemetery a major tourist site for much of the 19th century.

However, in the 20th century, Americans medicalized and privatized dying and death, creating a death taboo that isolated cemeteries. The dying were put in hospitals or nursing homes, visiting hours were moved to funeral homes, and cemeteries were professionalized and standardized. While Mount Auburn remained a popular spot with locals because of its natural and artistic beauty, even it could not retain the cultural prominence that it and the other great urban cemeteries, like Green-Wood in New York and Spring Grove in Cincinnati, had had in the previous century.

Today, American funerary practices are undergoing dramatic and sudden change. This year, cremations surpassed burials for the first time on record. By 2030, cremation may reach 70 percent. That’s shifted the locus of the rituals associated with death from cemeteries to corners of the world that hold particular meaning to the departed or their survivors, from backyards to bodies of water. At the same time, social media are changing the way we deal with grief — once a deeply private affair, it has increasingly become a public process online.

As customs change, cemeteries are trying to keep up.

Events such as the Run Like Hell 5K in Atlanta’s Oakland Cemetery and the beer baron tour in St. Louis’s Bellefontaine show how these places are becoming more accessible to the public. Hollywood Forever’s Life Stories where a family can submit photographs for a remembrance video suggest their new digital savvy. And, at Forest Lawn Cemetery in Buffalo, a family can scatter their loved one’s ashes, something cemetery operators have opposed including for decades.

In 2014, Mount Auburn Cemetery began offering “natural burials” that do not include embalming and other popular procedures. It was an iconic moment, for an esteemed, yet very traditional institution to adopt a practice popularized by the contemporary death reform movement. But it was actually not so contradictory. Cemeteries, even ones as august as Mount Auburn, have been trying to adjust and renew their connection to the broader public even as reformers either question the very need for a cemetery or convince them to adopt such reform measures.

Cemeteries face a sort of life-or-death crisis. The increasing popularity of cremation has meant that cemeteries are no longer critical to storing remains, while mourning on social media has removed the necessity of cemeteries as a primary place to mourn. Public mourning also has re-emerged with the widespread acceptance of roadside shrines, ghost bikes (white bikes placed on the roadside where a cyclist died), memorial vinyl decals for the back windows of cars, and memorial tattoos. While zombies roam the big and small screen, real death has returned to our streets, building walls, vehicles, and even bodies.

While these new practices relocate mourning and remembrance out of the cemetery, other trends, such as natural burial, provide new opportunities for cemeteries. Natural death advocates promote the practice as a more environmentally sensitive mode of burial that eschews embalming, hardwood caskets, and steel or concrete vaults as pollutants. Reformers have succeeded in getting widespread notice, though relatively few Americans have chosen green burial thus far.

Green advocates have often met cemeteries halfway. Some cemeteries offer natural burial adjacent to conventional sections, but have to maintain their whole cemetery without pesticides and herbicides. As a result, cemeteries such as Mount Auburn see an opportunity to offer consumers choices.

Confronting death is painful and upsetting. We lose a person we love in an act of finality which has no comparison. Yet how we did things before may not be how we will do them in the future. Consumers just need good, unbiased information, and a willingness to overcome any family hesitancy about unconventional choices.

Cemeteries can embrace change — even radical change, as the founders of Mount Auburn demonstrated. The signs of successful adaptation are mixed so far. But there are glimmers of hope.This fall, Mount Auburn will host Death Salon, a festival of alternative approaches to death and mourning, including lectures and a demonstration of green burial. That Death Salon is coming to Mount Auburn suggests cemeteries can remain beautiful, natural, historic, and artistic places, even as they embrace new practices that allow them to attract new lot-owners and reconnect them to a broader public.

Complete Article ↪HERE↩!

Posted on

Die like a dog

Pet dogs often have a peaceful death that forestalls protracted suffering and pain. Why can’t we do the same for humans?

Cris Cristofaro holds his dog Dino as his beloved pet is sedated during an in-home euthanasia on 9 May 2012 in New York City.

By Joseph Pierre

[I] killed my dog last year. Mika was a shelter mutt, so she was around 10 or 12 years old; I can’t be sure. Twelve dog years would have put her at around 80 human years, which is a pretty good run. But what’s strange about having a dog is how quickly they age relative to us – they start out younger than we are, catch up for a time, and then pass us by, declining into their twilight years, all in the space of a decade or so. As witnesses to that accelerated timeline, having a pet means that we often end up experiencing their eventual demise and learning something about death in the process.

Mika was a great dog. Obviously abused before ending up at the shelter, she had scars on her head when I rescued her and, whenever I took a broom or rake in my hand, she would cower in fear. She was easily overwhelmed when other dogs came up to sniff her, and would often growl defensively. But with time she grew to be less apprehensive and almost pathologically affectionate, if there is such a thing with animals, demanding to be petted by anyone who happened to be near. She was a great companion watching TV on the couch during my single years, and she helped me win the attention of the woman, a veterinarian, who would eventually become my wife. In fact, my wife has often joked – and maybe it isn’t a joke at all – that she would never have gone out with me in the first place if I hadn’t had a dog.

For whatever reason, the way I’d always pictured the proper death of one’s dog was like a scene taken from the 1957 Disney film Old Yeller (1956): after years of steadfast companionship, when man’s best friend no longer derives joy from chasing rabbits and can barely lift his head, his owner has to muster the resolve to get out the rifle to put him out of his misery. Although an oddly bucolic fantasy for someone living in Los Angeles, at least part of it was no doubt influenced by how I’d learned to think about death as a physician.

In human medicine, we’re used to implementing any and every life-saving intervention right up to the very end. As a medical intern 20 years ago, I remember thinking about the futility of that approach with patients in pain and suffering from multisystem organ failure, sustained only by machines and a regimen of some 30 or 40 medications, and unlikely to ever make it out of the hospital. What was the point? Whatever happened to quality of life? But those reservations be damned, we never gave up, and among the interns who transferred care to each other from shift to shift, the dictum of patients ‘not dying on my watch’ was something to which we all held fast.

As long as there were no ‘Do Not Resuscitate’ orders in the chart asking us to withhold ‘heroic efforts’, we rarely considered doing anything less to prolong life, and financial cost was never part of the equation either. As far as hastening death, that was never even mentioned. After all, the original Hippocratic oath states: ‘I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.’

[W]hen Mika, who’d had hip dysplasia from the start, developed increasing difficulties walking and was in obvious pain much of the time, my wife and I put her on medications and even tried acupuncture, which helped for a while. But one day, at the start of our morning walk, she ambled to the end of the driveway, sat down, and refused to go on despite me pulling the leash. It was the same the next day and the next, so I stopped trying. It was at that point that my wife first brought up the possibility of putting her down, but that seemed ridiculous to me because between Old Yeller and my experiences as a human doctor, I envisioned Mika struggling through the pain, fighting for her last breath to the very end. In other words, it didn’t seem right to think about letting her go because she hadn’t yet suffered enough.

As a veterinarian, my wife viewed things altogether differently. To her, putting our dog to sleep didn’t represent throwing in the towel as it seemed to me, but a compassionate way to preempt unnecessary but inevitable pain and suffering down the line. As she saw it, we owe this option to our pets as stewards of their care, especially given that animals can’t understand pain or decide for themselves just how much suffering they are willing to tolerate.

Indeed, the American Veterinary Medical Association Guidelines for the Euthanasia of Animals (2013) acknowledges that ‘there is no consensus on when it is appropriate to let [a] life go’, but notes that: ‘Euthanasia may be considered to be the right course to spare [an] animal from what is to come … if medical intervention would only prolong a terminal condition, or if current health conditions cannot be successfully mitigated.’

When we were dating in the years before we got married, my wife would often come home from a long day at work and say: ‘I killed my patient today.’ This, I came to understand, was a kind of self-reproachful statement of defeat as well as a starkly factual statement that reflected how she’d actually administered the medications that ended a dog or cat’s life that day, typically with tearful owners and their bawling children huddled around.

This strange admixture of guilt from failing to save a life, along with the resolve to be the agent that takes it, comes with the territory in a veterinary clinic where euthanasia is a daily occurrence. Although euthanasia literally means ‘good death’, it was totally foreign to me in my training as a physician. Human doctors might feel guilty losing a patient in the end, but that guilt is almost always tempered by the reassurance that while we might have lost the battle to cancer, nature, God or whatever, we did everything we could in the process. Being a physician means that doctors must sometimes admit defeat, but in doing so, we don’t go on to be the hand of death.

[A]s time went on, medications and acupuncture had less of an impact on Mika, and her hind legs would often give out so that she would walk only a limited distance before collapsing. She seemed to be slipping cognitively too, and one day even fell into the swimming pool while we were away at work, requiring rescue from a neighbour. In what seemed like a short amount of time, her muzzle turned fully grey, and she would often sigh heavily with a distant look in her eye. Finally, she began to lose control of her bowels, with increasingly frequent accidents around the house.

And so, discussions about euthanasia became more about ‘when’ than ‘whether’.

The difference in attitudes towards euthanasia for animals and human beings is understandable. After all, people have been killing animals without remorse for food, to avoid becoming food ourselves, and for sport long before we began domesticating animals or keeping them for companionship. Whereas traditional Judeo-Christian and Islamic teachings include strong proscriptions against murder and suicide for humans, religious doctrine questions the animal soul. And while euthanasia is used as an ethical means to preempt suffering in veterinary medicine, it’s not unusual for some owners to simply abandon their pets by the side of the road, put puppies in garbage bags, or refuse to pay for life-saving medical procedures based on both economics and expediency. No wonder the expression ‘die like a dog’ has historically referred to the most miserable of ends.

In 2009, US legislation that would have allowed physicians to be compensated by Medicare for providing voluntary counselling to patients about options for end-of-life care was defeated due to political uproar over ‘death panels’. And yet, as I discuss in the World Journal of Psychiatry in 2015, human euthanasia is being increasingly considered and sanctioned both in the US and abroad. As life-extending medical advances over the past 50 years have fuelled growing concerns about prolongation of suffering and loss of autonomy, the euthanasia movement of the 1930s has gained momentum, evolving into the modern ‘right to die’ and ‘death with dignity’ movements that challenge us to consider what constitutes a ‘good death’. Today, some form of voluntary active euthanasia – death by administration of a lethal dose of medication to avoid pain and suffering – is legal in several states in the US, as well as in Japan and parts of Europe including Belgium, Luxembourg, Switzerland and the Netherlands.

Still, if the historical divide between our attitudes towards euthanasia for humans and for animals is narrowing, the devil in the details of cultural sanctioning involves who can actually administer, or is willing to administer, the medications that end life. With existing legislation to date, the sanctioned individual – whether a physician, family member, some neutral third party, or the person seeking to end their own life themselves – varies by jurisdiction. Although ‘death with dignity’ is increasingly supported in many parts of the world, often neither doctors nor patients seeking death want to ‘push the plunger’ and take responsibility for being the hand of death. In this sense, euthanasia remains a hot-potato issue in human medicine.

Consequently, we now find ourselves debating a range of possible end-of-life care options, including passive euthanasia (withholding life-sustaining interventions including food or water), physician-assisted suicide (providing the means for a patient to end their own life), and active voluntary euthanasia (administering a lethal medication to a patient). Palliative sedation is an increasingly popular option within medicine, which involves administering medications that are intended to relieve suffering through sedation and pain control to the point of possible unconsciousness. Although death is a potential side effect, palliative sedation avoids the moral objections of suicide and euthanasia through the ethics of the so-called ‘double effect’, which argues that death is an acceptable outcome if unintended and in the primary service of relieving suffering among the terminally ill. Pushing the envelope of what it means to die a ‘good death’ for humans even further, my colleagues at the University of California, Los Angeles have been investigating the use of psychedelic drugs such as psilocybin to relieve anxiety and depressive symptoms and to find meaning at life’s end.

[A]fter hemming and hawing for weeks, my wife and I finally decided to pick a date to have Mika put down. We asked a veterinarian friend to perform the euthanasia in our home. On the agreed day, it was my wife who put off making the call until I couldn’t take it any longer, and had to prod her to do so. The vet came to our house, started an intravenous line, and filled a syringe with Euthasol as we sat on the floor by Mika’s bedside, petting her with long strokes and saying our tearful goodbyes.

When we were ready, I asked if I could push the plunger, and the vet allowed me to place my hand with hers as we did it together. I was worried that Mika might show signs of discomfort, but seconds after the medication went in, she simply took a single, long, deep breath, and then let it out slowly for the last time.

‘Good dog,’ I told her. ‘Good dog.’

It was a good death. We should be so lucky.

Complete Article ↪HERE↩!