THE LOST ART OF DYING

A physician draws wisdom from a late medieval text to transform our thoughts and fears about dying.

When a terminal patient’s life is prolonged with desperate medical procedures, that individual’s final moments may be sadly compromised. Yet reliance on modern medical interventions has become increasingly common in our culture. As Dugdale, the director of Columbia University’s Center for Clinical Medical Ethics, writes, “in failing to die well, we fail to live well.” Beginning with a case study example, the author relates how woeful such a failure can be. The patient was an elderly man approaching the end of a lengthy battle with cancer, and no one in his family was prepared to acknowledge his approaching death, insisting that every effort be made to keep him alive. In his final hours, he suffered through several unnecessary resuscitations, resulting in a long, painful death. Such examples led Dugdale to seek out a more compassionate alternative. In her studies, she was inspired by the holistically grounded approach to dying examined in ars moriendi (“the art of dying”), a 15th-century text that contains intriguing reflections on death as an essential aspect of living requiring careful preparation. “Although more than six hundred years have passed, I have been repeatedly struck by the need for a similar handbook today,” writes Dugdale. “That’s why I wrote this book. Although some of the original ars moriendi content is less relevant to the diverse and global twenty-first century, it nevertheless offers rich wisdom on how we might die well.” Throughout the book, Dugdale balances her clinical experience with an openly holistic mindfulness, and she thoughtfully expands on the relevant lessons of ars moriendi: acknowledging our human finitude, or what it means to be mortal; embracing a meaningful community; facing a fear of death; and giving consideration to the decision of whether to die at home or in a hospital or other setting.

A wise and reassuring guide for confronting death.