Euthanasia is the Worst Way To Go

Posted by on May 19, 2017 in Science

EUTHANASIA IS WORST WAY TO GO              Philip Ney.   7/9/2016

INTRODUCTION.

Although Euthanasia is hotly debated by many, and it should be, few people realize all the far reaching implications. Euthanasia is only destructive. Euthanasia is the most traumatic and the least dignified way to die. Euthanasia results in undying turmoil, guilt and depressions in family and friends. Euthanasia is rapidly destroying the medical profession. Euthanasia is increasing the cost of medical care which reduces the availability of treatment for critical illnesses, limits funds available for research and stresses national budgets at a time when population decline is making free market economies unravel. Surely you exaggerate you may say. From my point of view as a medical clinician and educator and researcher for over ½ a century working in 5 countries and a politician and a businessman, I think you should read this and carefully consider how lacking benefit and tragic euthanasia is for so many people.

 

I  OUR LIVES IN THE BALANCE

CAN YOU TRUST DOCTORS?

The usual discussions of euthanasia concentrate on the person requesting death and seldom mention its effect on the subject, namely the medical profession. You need to realize that euthanasia will put the final nail in the coffin of what we have come to accept as a noble profession. It is rapidly becoming ignoble and not trust-worthy. This is a skit we (the retiring chairman of the Department of Deontology) and I did with students at the University of Ankara, Turkey which wasn’t far from Hippocrates’s home.

Skit.  I SWEAR.

(P =Pythagoras, played by Professor….(I can’t remember his name but a warm scholar and gentleman was he).

H= Hippocrates, myself in a white lab coat with a stethoscope around my neck and carrying a shiny silver chalice.

  1. Good morning, Pythagoras, How are you old man?
  2. Good morning to you Doctor Hippocrates. (1) If you really want to know and I

suspect you don’t, I’m miserable. Can’t sleep, pained in body and troubled in

mind. Yes I’m old but you are not far behind me. Some- day you’ll be feeble

too, Doc.

  1. Your mind is quite good. I am impressed with your theorem on squares of

adjacent sides etc. Well, you can be thankful for modern medicine. Straight from

The Royal Apothecary in Alexandria, I bring you just what you need. Sit up and take

a good sip. Then repeat every 2hours.

  1. Hang on; what is in that shiny silver chalice you hold so carefully?
  2. A potent combination of ascorbic acid, and…….
  3. And hemlock.
  4. My goodness you are suspicious.
  5. I don’t trust you doctors. You think it’s a kindness to kill as well as cure.
  6. Well, I admit it is common practice among us Greek Doctors that in compassion we will send

people on their way but only when the gods have cursed them and they cannot get better.

  1. I don’t think I want to die just yet and there is no reason for the gods to curse me. On the other hand, although my mind is alert, my body is often giving me much grief.
  2. Then this is just the potion for you. It will give you a boost in body and peace to your mind.

P Yeah, a boost right into eternity. I saw you making eyes at my wife. You figure to

send me on then take her and my estate. With your attitude about dying with dignity

from hemlock, no thinking patient will ever trust you or your ilk.

  1. I promise this is to ease your pain and give you rest.

P The dead feel no pain.

  1. Look you old curmudgeon. I’m not going to spend all day trying to persuade you

to take something that’s good for what ails you.

  1. Give me time to make up my mind.
  2. My patience has run out. Take it or leave it.
  3. Your bullying me makes me all the more suspicious.
  4. This is ridiculous. But I suppose you have reason to not trust us. I do find it hard to persuade my patients to cooperate. There has got to be a better way
  5. (To himself as an aside.) Okay, let’s see if this works.

(With arms raised to the sky and shouting loudly so the gods are sure to hear him,

“By Jupiter, by Hermes, and Aesculapius, Apollo and Zeus, by the whole pantheon, I swear I will not poison you or any other patient, ever at any time. To himself, (“maybe all my patients will learn to trust me), I also swear not to have sex with patients or abort a pregnant woman.

  1. Good grief, I think you really mean it. Okay Doc. Let me have it. (Drinks noisily

and smiles) Not bad. But don’t think that because I trusted you this time, I will

always trust you. How do I know what your attitude will be a year from now?

  1. I will hang a statement of my ethics in my office so you will know what I will do

On the really big issues. Know this for sure; I will always try to make you better to the best of my ability and the limit of my resources. I will recruit my colleagues to join me in this. In fact we will make it an in dissolvable oath for all physicians. I hope for all time.

  1. May it be so, but it will take a few centuries to build patient confidence in doctors and it

wouldn’t take much to set it all back. The main problem is that you doctors want

power over life and death, healing and terminating human existence, curing or killing.

That power is too much for any man or woman. It will always tend to corrupt you so patients beware and don’t let it happen to your physicians.

The new chairman of the department wrote me later to express sincere thanks and inform me that he now uses this short skit when he lectures  around his country.

 

  1. MORE RECENT HISTORY ON DYING WITH DIGNITY

The Psychiatric Institute, Hadamar in 1941 celebrated.(2) All the staff were given

bottle of beer for the occasion. What was the occasion? Out of compassion they had

just liquidated 10,000 psychopedic patients.

By 1945, 300,000 German psychiatric and psychopeadic patients died at the

hands of “compassionate staff”.

But, you say, those were cruel Germans, not like us loving Anglo Saxons.

Or you may say that was only the nasty Nazis. Yet German euthanasia began with the

publication of the book by Hoch, a psychiatrist and Binding, a jurist, in 1928. It

was titled, The Release for Destruction of Lives Devoid of Value. This was

before the Nazis came to power. The Nazis took over the rational and killing process, which

was already well established and used it for their own nefarious purposes.

When will people learn from history?

Do you trust doctors? Do I trust doctors? Not entirely.

After 50years as a physician, teaching in 5 medical schools in 3 countries, full

professor x 4, academic and clinical department head, plenty of scientific articles and

books, including one on palliative care, (3) I have learned that doctors are foible people like

all others. Some you cannot trust. Others you can only trust under regulated

conditions. A lot are well intentioned and well trained but there is historic evidence

that they can also become self- serving and lethal.

I have treated approximately 3200 people who told me they wanted to die. I learned that

although they ostensibly wanted to commit suicide and often wished there was

someone to help them do it, none wanted to be dead. What they wanted was better

living, not oblivion.

 

When trust in physicians goes down, cost of medical care escalates.

Why? Because: a) suspicious patients take more time to persuade to take meds, undress, accept a vaginal examination, etc. Compliance in taking medication, in the long term, is 50 to 60% and diminishing.

  1. b) Untrusting patients want more tests and investigations
  2. c) They request more 2nd opinions
  3. d) People delay in seeing a doctor.
  4. e) When patients are not sure of their doctor’s benign intentions, the therapeutic placebo effect associated with all medication, diminishes.
  5. f) Physicians must take longer time to obtain informed consent for surgery and difficult examinations.
  6. g) The general population has greater preoccupation with their health and emphasize small complaints.
  7. h) Doctors must spend more time in court defending themselves against a growing number of

malpractice suits and the allegations of suspicious patients.(4)

  1. i) Patients resist hospitalization and are all too ready to complain about the quality of care and costs when they are there.
  2. j) The placebo effect of all investigations and procedures is directly proportional to a patient’s confidence in his/her physician’s good intention. As confidence and credibility in the medical profession decline, so does the placebo effect. That effect provides most to the therapeutic efficacy of medication. As placebo effect is reduced so there is the need to increase medication dosage which increases the number of toxic side effects which require additional medication to control. It is small wonder that a pharmaceutical house is the 2nd largest corporation in the world or that most countries are struggling to control the cost of medicines.

It has taken 23 centuries to establish a modicum of trust in the medical profession. The whole structure of modern medicine depends on trust. It is now being rapidly dismantled. The physicians are the largest contributors to this problem.

Recognizing they could never practice without patient trust and confidence,

Hippocrates and his colleagues swore by their gods to never poison a patient, have

sex with patients or abort pregnancies. Doctors are now doing all 3 with increasing

frequency. Nurses are not far behind them. The Hippocratic Oath is no longer required of graduating physicians. It is small wonder patient trust is rapidly diminishing and costs are spirally upward.

Legally requiring physicians to provide assisted suicides so a few people could “die with dignity” will be the final, fatal blow to modern medicine. Physicians providing doctor assisted death (dad) voluntarily would be worse. In total ignorance, governments are convinced by popular cant that euthanasia is a good thing.

What is the physician’s best recourse for refusing to be involved in providing lethal injections, terminating preborn babies lives or giving sperm for IVF? Simply to say, “I refuse to practice poor medicine”. Abortions, euthanasia, IVF and sex changes are bad medicine and if you want me to comply, you must convince me with substantial evidence.” In asserting this, the ethical physician would be supported by medical science and most colleagues. There is ample evidence that abortion, doctor assisted suicide and sex changes are not necessary and have no established therapeutic benefit. These are the most basic requirements to be met before providing any treatment

.

  1. HIPPOCRATES

Margaret Mead, commenting on Hippocrates and the Hippocratic Oath wrote that this was an amazing break with the universal dual role of curing and killing of physicians at that time. She insisted that the law and public opinion must never let physicians revert to the pre-Hippocratic times.

Modern physicians appear to substitute popularity for trust. They seem to think that now, though she distrusts me, she may cooperate with this examination because she like to be popular the physician must be agreeable to his patient’s way of thinking, particularly his morality. To gain consent and cooperation without trust, the physician must agree with his patient and tend to provide the medication in the dosage the patient chooses. They will tend to accommodate the patient’s choice of pregnancy termination and agree with the patient’s reasons she so chooses. It isn’t surprising that eventually this physician has a cupboard well stocked with samples and allows the patient to choose what they would like to try next.

We must always ask of any proposed improvement in elder, dying and infirm  care, does it work? Does it result in: better care, lower costs, and greater trust in the caring profession. None of these recent ideas about doctor assisted dying can be supported on just someone’s “bright” idea. Physicians and patients must be pragmatic and keep asking. “Is this any better than what we have had in place? What is the hard evidence euthanasia is good practice?

At the end of her impassioned lecture, I asked the person dramatically putting forward the Dying With Dignity position during a federal government traveling inquiry. “Excuse me, can you tell me if what you are advocating works?  Do you know if people when dying by the method you advocate (a lethal injection) feel more dignified?” (Silence).

“It appears that you don’t know if they die with more or less dignity when injected with a lethal concoction. Then how can you promote a process if you don’t know if it is beneficial or damaging? On the other hand, I can provide biochemical evidence that at the point of death, most people feel terrified.  The amount of their distress can be measured in the level of stress hormones found in their bodies’ post-mortem. The highest level of post-mortem catechol amines  are found in people who were poisoned”. In that room you could have heard a pin drop. This advocate for Death with Dignity, had no evidence that what she was promoting across the country was therapeutic or beneficial or necessary or done with fully informed consent.

 

II  SPECIES SPECIFIC INSTINCTUAL RESTRAINT OF AGGRESSION, (SSIRA).

 

WHAT KEEPS HUMANITY FROM DESTROYING ITSELF

Homo sapiens seems to be the only species that wants to self-destruct. Most of

society struggles to contain that tendency with life enhancing and death reducing morals and rituals. Yet a growing number of people, without much consideration, support and vote for euthanasia.

Helplessness in humans often evokes disgust, avoidance and cruel destructive tendencies. In others it promotes nurture and protection. There is very delicate balance. If it becomes unbalanced the species will be destroyed. The same delicate balance is present in other species.

A healthy seagull, if tied to the dock by one leg, flaps about helplessly. Just because it is helpless, it will be attacked by other members of its flock. The wounded in war or patients lying helplessly in a hospital bed may be bayoneted in a murderous frenzy uncharacteristic of the soldiers under usual circumstances. That tendency to mutilate and kill the “disgusting” helpless  person is countered by the Species Specific Instinctual Restraint of Aggression. The SSIRA keeps all species from killing and devouring their own kind.

She wolves in the later stages of pregnancy den up and stop hunting. By the time she gives birth, she may be ravenously hungry and want to devour her tender, warm succulent pups. What stops her is the SSIRA.

Almost any parent awakened from a deep sleep by high pitched incessant screaming at 2:30 am after a difficult day from a distressed child in the room next door, feels instant irritation bordering on blind rage. That murderous rage only increases as she or he stumbles down the hall bumping into hard objects. Yet when the parent switches on the light and looks on their unhappy baby, the anger quickly subsides. It is rapidly replaced by a feeling of warm concern. This amazing transformation is mediated mainly by SSIRA instincts.

SSIRA is strongest when other factors, religion, mores, laws are weakest. It is most powerful in protecting the young, wounded, weak, feeble, handicapped and all those whose reasons for existing seem to have no justification. If anyone overcomes their instinctual restraint (SSIRA), even once, in order to kill, their SSIRA is weakened. It is significantly easier for him or her to harm or to kill again. SSIRA is most deeply damaged when anyone kills in cold blood, especially if the victim is their own innocent infant, or enfeebled family member. The destructive urge does not need to be a violent act. It can be simply agreeing to pay someone do the dastardly deed.

It appears that the weakened or damaged SSIRA is not easily repaired. That person has  become different probably for life and they tend to know it. Soldiers who killed another man sense a change in themselves.  It makes it hard for this veteran to speak of his war experiences with any pride. A mother who has seriously attacked her child, from that point is very careful with her anger. She tends to want others to care for her child in a government approved daycare. A physician who has aborted babies feels a deep shame, not only for what he/she has done but also because of whom they have become. Doctors who assist in some old person’s suicide intuitively do not trust themselves.  Instinctively sense they are not as well trusted by their patients, especially the elderly ones.

 

III. GUILT COMPLICATED GRIEF, (GCG)

 

  1. GOOD GRIEF

 Grief is the inevitable letting go experience of almost every human. Grief is the painful process of letting go. It is necessary to free up bonds to those who are dead or dying in order that those bonds are available for new relationships. Grief is natural, normal and self- limiting if it is allowed to proceed. Recently grief has resulted in treatment resistant depressions for millions of grieving people. Sadly, most physicians, instead of recognizing mourning  and aiding their patients to deal with the root cause of the person’s apparent depression, (low mood, disinterest in the future, lack of appetite, irritability, sleeplessness and weeping) prescribe an antidepressant. Far too many doctors claim there is an underlying chemical imbalance for which their depressed, (grieving) patient must take the antidepressant for life.

 

Requirements of good grieving.

 If in fact or fantasy, anyone contributes to the death of family or friend, especially those handicapped or small or elderly, guilt inevitably ensues. This is a biologically based guilt, which has nothing very much to do with morals or beliefs. Grief mixed with guilt doesn’t easily resolve. It results in pathological, or prolonged grief. This grief is easily mistaken for depression. Antidepressants are usually prescribed. Because one must walk thru all of grief, feeling intensely the whole gamut of emotions: loss, regret, anger, abandonment, despair, etc. antidepressants that mute

these feelings, prolong or prorogue mourning.

Case illustration. Joe was referred to me by his family physician because he was depressed and suicidal. It began after his beloved mother died. His family of origin was very poor but his mother always well fed him and his sister even if it meant going without food herself. As she aged, Joe and his sister placed her in a comfortable care home and visited almost every day.

The mother deteriorated and so had to be transferred to a facility with more services. She sorely missed her friends in the previous place and began to withdraw.

Her physician places her on antidepressant, which made her regress more quickly. She stopped talking to people, even her family. She had increasing difficulty remembering names and was confused about where she was. Inevitably she was diagnosed with “Alzheimers” and because the prognosis was so poor, she had less care and fewer visitors which exacerbated her condition in a vicious cycle worsening her condition.

 

Eventually Joe and his sister agreed to the kind physician’s suggestion that it was time to let their mother “pass on”. “She’s had a good life and you wouldn’t want to see her suffer like this anymore would you?” Though his mother was being euthanized, Joe kept visiting daily. He watched his mother suffer the agonies of death by starvation and dehydration. “The nurse even refused to moisten her cracked lips. “It will only prolong her suffering she said.  I watched my mother starve to death. My loving mother who fed me when she wouldn’t feed herself. She slowly died before my eyes and it was my fault. I know I’ll never be the same. I don’t deserve to be happy again. I should die like she did.”

 

  1. THE REAL EXPERIENCE OF DEATH

Although there are a wide variety of near death experiences (NDE), no human has returned from death to describe the final experience. However examining the body and its biochemistry can give some critical clues. “The stress or agony  (death struggle) induces a rise in serum catecholamines”(5) Another study found that at post mortem, there are significantly elevated hormones regardless of palliative medication given. That study was seeking to determine, which drugs or combination of drugs was most effective in easing the pain and discomfort when dying.

Adrenaline, noradrenaline and dopamine levels found in the body post-mortem were related to the cause of death. One cause of death that resulted in high levels was poisoning(6). If this is true, then one can infer that doctor assisted death is more of a struggle than those who promote it are willing to believe. This high level of stress hormones seems to indicate that at the point of death there is either terror or extreme excitement. That final experience may depend on which way the dead one is headed.

 

  1. REASONS PEOPLE APPEAR TO PREFER DOCTER ASSISTED DEATH.(DAD)

A recent study of Oregon’s experience with doctor-assisted death found that the reasons people chose DAD was not pain control but because, “I didn’t want to be a burden to my family. They might end up hating me” Elderly people wanted to avoid losing control of their mind and or body. It seemed that to the last they wanted to control their own destiny, rather than have it plucked from their hands.

A careless or naughty child breaks his mother’s precious ancient Chinese vase. He knows that he is “really going to get it when dad gets home”. The suspense is awful. But mum hasn’t noticed and dad doesn’t punish him like he thinks he deserves. “Why don’t they just get it over with”, he mutters to himself.” It must be because they are thinking up some really awful punishment”.

Next day he decides that the anticipation of his fate is worse than the fate itself.

“I’m going to make dad punish me now”. So in full view of his parents, he deliberately breaks something else.

Maybe some dying people, in an effort to control their destiny, demand to have this one last, “pseudo-brave” choice and not be left to wonder if someone may, sooner or later,  take them to task. Maybe they tend to be “control freaks” Just maybe, there is some value in losing one’s dignity, which is usually part of pride. Maybe when people are more humble, they will finally come to grips with unresolved family and spiritual issues.

 

  1. DEATH TO PRESERVE THE DIGNITY OF FAMILY AND OBSERVERS.

For anyone with an ounce of empathy, it is painful to watch another person die.

“I can’t bear to see him suffer like this” “It tears me apart to hear her choke and groan” So the families choice to end his/ her suffering is primarily for their own benefit. There are many other very selfish reason that those into whose surrogate hands the decision to pull the plug is given

a) “I just don’t have the time to keep visiting

b) “My struggling business needs my time but I feel so guilty when I don’t visit”

c)“ My children suffer watching granny dying at our home like she wanted”

d)“ If I were her, I know I wouldn’t want to suffer any more”

e)“We are desperately in debt right now”.

  1. f) “What’s in the will would solve all our problems.”
  2. g) “She keeps pleading, ‘let me go’”

There are many more possible and plausible reasons that are contemplated, some expressed but more are privately felt. Traumatic situations like dying tend to bring out the most intense ambivalence in everyone toward life and living. Anyone can be made to despair, though it may be short lived.

What children fear more than anything is being abandoned? That fear recurs throughout life and when it does, many people respond with, “Well now that he is gone, I might as well kill myself”.  But the loss can be the anticipated loss of oneself.

It should be remembered that suicide is murder. I was often able to illicit helpful insights in suicidal people with the question, “If you weren’t going to murder yourself, who would it be?”

The most useful method I found to keep people from wanting to kill themselves is to:

  1. a) understand and empathize with the patient’s experience which is usually feeling trapped, alone and hopeless.
  2. b) To offer realistic hope and when necessary bargain for what is tolerable. This is not, “We’ll make you feel as good as new”, but “We can ease the discomfort by at least 15%. Is that acceptable?”
  3. c) Make or renew a commitment to stick with the patient to the end, be it wellness or death.

 

IV THE VALUE OF DEPENDENCY

 

  1. WHY PEOPLE FEAR BEING DEPENDANT

Most people fear becoming dependent on other’s even for short periods like having a fractured right arm. The thought of being dependent for the remainder of their lives is most distressing modern humans. “I would rather kill myself, than have my son and daughter in-law be responsible for me till I die.” If you then ask why, you will find a number of contradictory responses:

i) Fear of rejection. “They will grow to resent me; even wish I was dead

ii) Pride. “I have looked after myself and everyone else almost all my life. I would be ashamed to have anyone care for me

iii) Fear of own dependency. “I would love to be totally cared for but I’m afraid to say so.

iv) False courage. “I have been through 2 wars and nothing stopped me. I’m not going to back away from death now. Go ahead, bring it on and see if I flinch”.

v) Fear of revenge. “I know I haven’t been good to my kids. I even aborted some of them. Now is their chance to get even. But I will beat them to the punch.”

On the other hand I have heard some people say. “I’m glad my mother had to admit she could not look after herself anymore. She was always so proud; she wouldn’t let me do anything. Now I can bath and dress her. She even lets me cuddle close and lie still”

Being dependent can be a gift. After all, under normal conditions, caring for those who can no longer care for themselves brings out the best in us. It teaches us to be loving.

If people were given assisted death before they became really dependent on their family or if they were cared for only by those paid to do so, I believe that people would develop little capacity to love. They would become even more narcisstic than they are now.

 

OUR GOVERNMENT’S VAIN PURSUIT

The Canadian Federal Government was holding meetings across the country in order to find ways to stop people wishing to have doctor assisted death. If they won’t consider the spiritual parameter, they will find no satisfactory answer.

Stranger (S) “Hello chaps. What are you all doing?”

Government types. (GTs) “We are trying to find a way to make this thing fly.

What have you tried so far?

GTs. Well, we beefed up the engine”

“And we improved the landing gear”

“It’s now got new tires”

“The cabin is much more comfortable”

“I don’t want to sound arrogant but how about attaching wings.”

GTs “Who do you think you are?” “Don’t be so ridiculous.”

“Get lost”.

The fear of dying is almost universal in people. Their Creator made them with a built in aversion and abhorrence of being dead. Why? Because He wanted them to enjoy living and survive as long as possible, struggling to live even under the most extreme conditions. He did not want them to embrace death. Death was His enemy. It should be theirs also.

The fear of being dead depends on where you are convinced you are going when you die.

So unless, the government is going to help people deal with their existential questions of life after death, they may as well save taxpayer’s money.

  

  1. THERE IS AN ANSWER, THANK GOD.

 A. WHY DYING IS SO IMPORTANT FOR EVERYONE

 

Since death is the 3rd most important event in one’s life, there should be some preparation and help in dying. There are at least 10 important tasks that need to be completed before taking off. Those who do these may have some residual fear of dying but no fear of death. (7)

B. TEN FINAL TASKS

Most people are convinced that death is not the end of one’s existence. Yet they resist coming to know and forging an agreement with the author of life and the king of all creation. I have found that when I have approached directly and spoken directly, most people, friends and patients appreciate an opportunity to deal with these final tasks. Those who do die more readily and more quickly. There is no need to hang onto life when they have completed all important tasks required of them. But family must not wait until the dying member is comatose. These tasks should be done as best they may for those sentenced whether the sentence is just or not. If imprisoned alone with no one to guide them it still may be possible to send or smuggle a note outlining these tasks. Those engaged in the dangerous task of witnessing of the new life found in Jesus when that is illegal, should carry a card with these tasks and essential scripture very briefly inscribed or memorized for use if necessary.

 

Summarized from Christian Principles of Palliative Care.

  1. Negotiate the conditions, including medication, place of dying, ambient music, number of preferred visitors, room temperature etc. to achieve the optimum levels of comfort and awareness to be able to accomplish these tasks. With the families backing have a negotiation session and then try various amounts to achieve what is practical knowing that almost always there is something better. The dying person can tolerate more discomfort if the realize the importance of being cognizant for these tasks. When done they don’t need to be so conscious but make sure that everyone agrees that euthanasia is not permitted. I cannot guarantee this will always work but when the tasks are done the dying patient will not desperately cling to some vestige of life. They will relax and their mind, body and spirit will work in harmony to let go and breath no more.

Certain levels of pain help the dying person stay alert and hurry them to finish these tasks

  1. Reconciliation with God, their Creator. I am wont to say, okay old man, here is the situation and it looks pretty clear that you are dying. It is time to reconcile with your Creator. The usual response is something like this.” I was dreading to hear those words Doc, but I can’t keep fooling myself. Okay, let’s get on with it”

Although physicians are forbidden to push their religion on patients (I agree with this) they can respond to the patient’s request to discuss anything. I point out that God’s first and best intention was to have billions of mature friends but they could only be His friends by choice. To have a fair and informed choice God needed to have a smart seductive alternative. Far too many people fall into the trap set by satan whose aim is to defeat God, enslave and kill people. If you  weren’t serving God you were a slave to satan. It can only be one or the other. Now is the time to make it very clear who you choose. When you choose to become a member of God’s family, if you confess, say sorry, admit you can’t do it on your own, ask Him to be your saviour and Lord. Then Wham or whisper you become His child in this life and the next. God says in the bible ( insert your favorite passage here) that all that you must do is believe Him. He will do the rest. Think about it. When I come back we will talk about it some more, if you want to.

Of course reconciliation requires more effort to be done completely. Follow the outline of Letters of Reconciliation in Deeply Damaged

  1. Grieving the loss of the Person I Should Have Become (PISHBe)

The Bible states that God designed each person well before He created the universe. That  design is on a ‘micro -chip’ in God’s vast library of ‘People to Be Someday’ (PBS). With all those people in mind He then designed and created the universe to provide the homes to fit each one. From before birth, people are innately aware to who they are designed to be. Their parents have the rigorous and honourus task of providing each child with the necessary ingredients of matter, knowledge and experience that child needs. Since few parents bother to detect their child’s blueprint, very few children get what they need. Thus very few people have a reasonable chance to become who God designed them to become. Throughout their lives people make attempts to be themselves but most fail miserably. At the end of life each person must face the sad fact that death will stop every earthly attempt to be all they had the potential for.

This requires first helping a person to imagine themselves in all their glory of personhood: wise, content, knowledgeable, caring, accomplished, etc. During Hope Alive therapy, we then help people to imagine the lonely death and burial of their PISHBe. Then they can welcome the weary, worn, wounded and suffering person they are. Imminent death makes this all the more real. It is a deep and necessary grief but once it is finished the remaining tasks are much easier. It also facilitates the mourning of loved family and friends that have not been fully grieved before.

4. Reconciliation with those who hurt or were hurt by your dying patient or loved one. The rational, form letter and responses are found in Deeply Damaged. It is critical that no one is left out. If at all possible, have them write each letter exactly according to the form letter because this format has been tested in thousands of letters and because the legal implications have been worked out. The correct process begins with writing a letter to the person who hurt them most which is usually themselves. The patient can role play this with someone who will be their alter-ego. Once the role play is concluded with promises to compensate themselves with eg. spending more time reading their bible. Then there should be a 4 way exchange of letters or spoken words in the presence of a reliable friend or family member.

Before the letters are sent, some staff or wise family member should edit it for including all the hurts and this may be hundreds and for good spelling etc. If the dying is a prolonged process, there is time to receive replies. Because the person is dying, the rate of replies will usually be higher. It is such an act of love for the dying person to write and mail their forgiveness. It heals whole families.

 

  1. Final blessings.

Old Jewish father Jacob leaned his tottering frame leaned bent staff and blessed each of his 12 children. These blessings were not always kind but the remained as a guide post for the future of that tribe. Moreover, once that blessing was pronounced it left Jacob and became part of the tribe’s heritage.

In like manner the dying person can bequeath his/her nonmaterial possessions and know he/she no longer owns them, E.g. To my loving loyal son I give my courage. To my lively lithe granddaughter I solemnly grant my curiosity. Use them well for well used they will guide and guard you. Misused they will become snags and snares.

Best done, this is a formal occasion witnessed and recorded with joy and dignity. Then of course, each family and friend can express their thanks and appreciation and promise to be faithful to the expectations that the final blessing implies.

When the blessings are said and received and assuming there is not a lot of competition and rivalry, the will can be read. Hopefully there is then an opportunity to trade objects and assets to suit the family better than the dying person could have known. If there are questions and confusions, this is a time to iron them out. If that is the case, it is wise to go to another room and have a mediator run the proceedings.

6. Final report and flight song.

Help the dying person to go over their life. Note both the high and low points. It would be wise to record this on some type of video for later discussion and grandchild posterity. It would be good to have a colleague or war buddy present to help stimulate the memory. If possible someone with some Hope Alive savvy can be present to remind the dying person of some forgotten and forgiven incidents. When these arise, they should be included in the LORs.

The report is written to God and so should be relatively formal, much like the report the dying person made for a school assignment or for the boss. If nothing else it must be truthful. Of course there will need to be some corrections when the person stands before the judge of earthly living, (this is not the judgement of eternal damnation or life). All Christians can expect to hear some variation of “Well done my good and faithful servant. Now enter into all the joys of your eternal life for your sins have been paid for by my Son Jesus who died for you).

To accompany them at their formal initiation, native people in this part of the world are expected to have discovered their song. They may take some time alone and in contemplation but eventually, their song comes to them. They are expected to present their song for the elders and community. Maybe in a similar way, those going to heaven need to discover their song before they die. It may be crude and tuneless but God’s choir director can reshape it into something very lovely and I am absolutely convinced God would enjoy it. It should be a song of sorrow and joy, loss and finding, birth and death. I think you will find little need to coach the dying person. It will seem like a reasonable thing to do.

 

  1. Good goodbyes (GGB)

As the end approaches, each friend and family member should visit to say a final good goodbye. A GGB needs to be comprised of:

  1. i) a good bye is reciprocal; not one person say goodbye and the other saying please don’t leave.
  2. ii) There should not be any unresolved issues. The most mature family member may need to say, “And don’t forget about that insult you have been harboring of years.”

iii) Like an Irish blessing, there should be some final wish or blessing and a tiny gift as a reminder of the blessing for the dying person. It will usually be reciprocal.

The more complete the number of people who come to say good goodbyes, the easier it is for the dying person to say, “It is finished”

 

  1. Is it finished?

Before this incredibly important statement can be made, the question must be asked of the dying person. “Have you finished your life’s work?” Not many can truthfully say like Christ. It is finished. So family and friends can say, “What can I do to help you finish? The response may be “Please continue to sponsor my overseas foster children” or “Please see that my last writings get published somewhere”

Or “It would be great if you could finish renovating our kitchen. I promised my wife I would”. Or “Please tell the gang at the club that I came to know Jesus and now go confidently to my real home”

Once the person can mutter or mumble. “Yes though I never really put my best effort into it, I did what I think I could. I am finished.”

On hearing this, all family and friends can shout (a loud as the hospital or care facility will allow.) “Hear that? John says it is finished. Praise the Lord”

For God serving Christians the family can add the words of Paul. “I have finished my race. I have done the whole course. Now awaiting me is a crown I don’t deserve but it will fit me well”

 

  1. Permission to leave.

 

When all the above tasks are done, the family and friends must formally give the dying person to leave. Regardless of their yearnings for a complete recovery or “just a few more days together”, they must all say something like, “I hate to let you go but I know you are going to a much better place with no pain or worry. So you have my permission to leave. It won’t be long until I join you. Say hello to grandma”

These or similar words should be spoken to unconscious people also. It is amazing what people, who appear to come back from the dead, remember of events and works while they were unconscious.

 

  1. Committing My Spirit to God.

 

In the final throes of His dying, it is recorded that Jesus said, “Into your hands I commit my Spirit.”  And then He died. It was an amazing event. The Roman Officer supervising the execution of 3 men had seen many people die but not like this. That is why he shouted or muttered. “Truly this was the son of God”

Based on that precedent for many centuries, Christians have committed into God’s hands the spirit of the recently dead person. I believe that Christians have that unique privilege of committing their spirit into God’s care before they die. I believe if they do God will allow them to die without unnecessary further suffering. They will truly die in peace.

As nearly as possible, family and friends should gather together and pray, “Into your hands dear father of all life, we commit the spirit of John. Please receive and guard him as he flies home to you.” Now is the time for weeping. It is not the time for celebrating.

 

C. THE BEST WAY TO DIE

As with other important events, one should know how to do it. There is at least one good way to die. There are many poor ways to leave this life. Suicide is probably the worst way to finish one’s earthly existence.

I suspect that people have some intuition about the way they will die. They should be encouraged to talk about it. Almost everyone I have interviewed on the subject, have a way they desperately do not want to die.

It is my impression that those who have been able to say goodbye to their PISHBe find it easier to face death.

Those who have had a least one near death experience (NDE) seen less afraid of dying.

It seems Christians though they may be anxious about the pain of dying are not afraid to be dead. Those who are not Christians may boast about not being afraid of dying, but if honest, they will admit to a fear of being dead.

If the results of post mortem serum levels of catecholamines are correct, then the least stressful way of dying is gradually cooling. I hope to be able to verify this hypothesis with a sample of people but only when the end is in sight and when the 10 tasks are done.

D. THE DEPARTING SPIRIT IS OBSERVABLE.

Medical staff at places like hospitals has the best opportunity to witness the process of death. They can tell you if you ask, “What did you observe at the moment of their death.” They may respond with, “Don’t laugh if I tell you I saw their spirit leave”.

“I’m not laughing, tell me more”

“At one moment they were struggling for every breath. Then they relaxed. They opened their eyes and looked straight at me but I am sure they were looking at someone else. Their eyes widened, they smiled. Then they were gone even though their body kept breathing for a while. Their eyes were glazed and you could tell nobody was at home any longer. It was an awesome experience, almost holy.” Or

“I had been trying to convince them that since they were dying, they should come to terms with their creator. Their response was ‘I don’t believe there is a God. I never needed Him at any time in my life.  I don’t need Him now. Go away you religious nut.’ But on that last day when it was plain to all that he wasn’t going to last, between gasps and chokes I heard him repeatedly mutter, No, no, no. Go away I don’t need you. Then for about 10 minutes there was silence and I thought he was gone. Then in a whisper, then as close to a shout as he could manage, I distinctly heard. ‘Jesus. My Jesus’ Then the struggling stopped and a few moments later you could tell he wasn’t with us anymore.”

As soon as I can I want to do a study with hospital staff to see if they can agree on the time of their patient’s departing.  I hypothesize that with little or no coaching there will be better than chance agreement to within 5 minutes between the staff on duty about when the person left their body. Then I will ask them to briefly summarize their experience and note the signs and symptoms they observed. I think it is important to obtain the staff’s subjective experience, because the presence or absence of a person’s spirit is a sense that is not easy to describe.

E. THE LAST CONVERSATION

After the dying person has finished their Ten Final Tasks you will find they are much more at peace. They can talk about death as a departure. So you can talk to them in a somewhat jocular manner. “Have you packed all you will need to take with you?”

Don’t be surprized if they come back with, ‘Don’t be silly. I can’t take anything with me” To which you respond with, “Oh yes you can. You can take my blessing and a suitcase full of blessings that your family is giving you. And don’t forget to wrap the blessing you saw in the smile that your youngest grandson gave you yesterday. And don’t forget to practice your song for Jesus and your life’s report for God. And you should take a bone for your faithful old dog. He died yesterday after he let out the most mournful howl of loneliness for you. I told him he would be seeing you soon and together you could go for a long, long walk. He was a wise old fella and I think he understood.

Any last instructions?  “Yes, (wheeze), don’t let them cremate me. They can have any useful parts but I have always been afraid of burns.

Yes mum. I told the funeral parlor people and to make sure, I wrote it and sent it twice.

Can you see or hear anything from heaven yet?

“Shh. Stop talking so I can listen better. Yes I think I hear something like a bugle playing the last post. Did I just hear a dog barking? Was that you my oldest and most loyal friend? Take it easy old boy. I’ll be there in a moment. We will go for a walk anywhere in the universe you would like to visit and we won’t need a leash”.

Then it is time to commit your spirit to the Lord. He will take you when He thinks the time is right. Goodbye my dear mum. You have been more than life to me and my family. They all said that I should say goodbye for them.

Oh for goodness sakes. I’m talking to a lifeless body. She just slipped out like she always did when Jim and I got into an argument. Thank you Jesus. I commit her into your loving arms for ever. And I know you will never turn away anyone who comes to you in faith. Thank you Lord for being such a good friend to her through all these troubling times. May I live and die as well as she has.

F. THE FUNERAL;

Although it is increasingly popular, I don’t believe that you should celebrate after someone has just died. Grief is not easy. It can be very painful but it helps if others are also grieving and are not ashamed to show their sorrow. Their empathy, seen in their solemn sorrow and tears, is more effective than all the usual silly statements that people are wont to make. The main purpose for funerals is to ensure that people can properly start so they can finish grieving and start making new bonds.

Toward the end of the funeral, someone can make an announcement that there will be a celebration of his/her life about 1 year from now. Please write in the guest book, that you would like to be notified.

Then when you meet you can drink and laugh and dance and tell his favorite jokes. You can tell what has transpired with the linguistic, literary, monetary etc. legacy he left. He can each report on the impact he had on your life and some previously unknown events, especially the funny and even embarrassing ones. You can make a promise together that you will honor his name in following his advice or example and you will be the kind of witness for Jesus that he was.  Don’t be foolishly shy Ask friends and distant relatives if they would like to die like Jim so that the process of reconciliation can start right away. Don’t leave it because you may die sooner than you would like and more suddenly than you wish. Reconcile with all and sundry, especially you Maker”

 

  1. REFERENCES

 

  1. Edelstein I. The genuine works of Hippocrates. Bull Hist Med, 1939:

7:236-48.

  1. Wertham F. A Sign of Cain: an exploration of human violence. New

York, Macmillan, 1966.

  1. Ney,PG Ethical dilemmas in psychiatry. New Zealand Med.J. 1983, 98:

939-41

  1. Murray WGD. Increasing litigation: the size of settlements in

professional negligence. Lancet 1982,1:1063-4.

  1. Hausdorfer C, Pedal I, Zimmer G, Remppis A, Strobel G Arch

Kriminol. Catecholamine, myofibrillary degeneration of the heart muscle

and cardiac tropin T in various types of agony. Arch Kriminol. 1995; 196

(1-2):46-57.

  1. Zhu BL, Ishikawa T, Michiue T, Li DR, et al. Postmortem serum

catecholamine levels in relation to the cause of death. Forensic Sci Int.

2007; 173(2-3):122-9

  1. Ney PG, Christian Principles of Palliative Care. Victoria, Pioneer

Publishing, 2007.

COMMENT FOR WEBSITE

When the world is filling with sophisticated propaganda hype on almost every subject, who can you trust? What is truth? I believe that truth is the best description of reality. Reality is what is permanent. God is the center and essence of reality. He can say with emphasis, “I Am, I was, I always will be”. The essence of truth is an accurate description of God and HIs works. Good science provides a reasonably accurate description of reality and well recognizes its limitations. The onus of establishing truth lies with all those who promote a new idea or procedure. This is especially true in medicine. The euthanasists have no evidence that doctor assisted death (DAD) is a more dignified way to die. Ask them and they will waffle with, “But it is so much cleaner and neater”. You counter with “Please provide me with some evidence that people feel more dignified after being injected with a poison. The best evidence indicates that the opposite is true.” Catecholamine levels (stress hormones) found in the blood at postmortem are high, the level depending on the way the person died. It seems that the body and mind are programmed to fight death to the end, sometimes the bitter end.

Being poisoned, as in being injected with some mind numbing, body stopping drug, results in some of the highest levels of stress hormones. Thus being injected by a physician who is sworn to ease pain and comfort those who are suffering, is probably the least dignified way to die. The mind and body instinctively struggle against the poisoning as seen in the prolonged death of a recent criminal experiencing capital punishment by injection. In all my experience in treating people who ostensibly want to die, I have never encountered anyone who wants to be dead. They all wanted to end their suffering and loneliness and meaninglessness. Since it is almost always possible to relieve these 3 complaints, common to almost everyone at some point in their lives, that is what must be done first. As a person becomes less pain and self preoccupied, they can finish the 10 terminal tasks for life. When they do, they die peacefully with no assistance from doctors. The Christians re video of euthanasia. 7/9/2016