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Death And Dying Notes

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Christian Moral Reasoning D Jones : Approaching the End T H E N E E D F O R A T H E O LO G I CAL APPR OAC H T O D EAT H Death, Grieving, and Killing Death is a moment of judgement : it is only after death that we can see someone's life as a whole - it is in this sense that Solon declared, paradoxically, that we should count no on happy until that person was dead. At least in some cases, the way some dies constitutes a final test of fidelity to or betrayal of the values sought throughout life. Death is a universal feature - in the words of the Book of Wisdom : There is for all mankind one entrance into life, and a common departure. A recognition of one's own mortality is distinctively human and we have always reflected upon death. It is ubiquitous in the literature of every age. Heidegger's characteristic of human life was as 'beingtowards-death' and this has left a lasting impression. The question of how to understand / evaluate the prospect of nonetxstiece is one that remains on the philosophical agenda. While there is a parallel between coming into existence and falling out of existence, between conception and death, there is also an important difference. Death is not only a limit to life, but it is a limit we must face. This raises two distinct questions : the concern of psychology, and the other concern of ethics. While death is suffered it is inevitable and the attitude we have to death, that of our own and others, is not inevitable. It varies between individual and cultures. Living with the near prospect of death is something that can be done well or badly. It is in this sense that a range of cultures have held that the maker of someone's death is of great significance and that Christians have talked of making a good death. In the second place, death can be the object of action more direction, in that death is something that can be deliberately brought about. Not every death is the direct consequence of human actions. Death as a deliberate action where in war or peacetime, violently or by planned omissions, has also been a feature of human history. Two well developed bodies of literature have emerged on practical questions relating to death in modern society : How can we live well in the face of death? and when is it legitimate deliberately to bring human life to an end?
First Question : At pride of place is Elisabeth Kübler-Ross with her work on Death and Dying 1969. She identified five stages in the process of coming to terms with death : Denial / Anger / Bargaining / Depression / Acceptance. This might be criticised as being too formal or from a faith perspective, as promoting acceptance of death abstracted from any specific hope from religious faith - and abstracting out the trails of faith for those believers who doubt in the face of death. Nonetheless, she performed an important service by raising the issue of what it is to die well. Disconnected from this strand of thought is a distinct body of literature concerned with the ethics of killing / end of life decisions in a healthcare context. In recent years the focal point has been legalising assisted suicide and voluntary euthanasia.

- 1984 : In the Netherlands, both assisted suicide and voluntary euthanasia have been except from criminal prosecution, subject to certain conditions being fulfilled.

- 1997 : The State of Oregon legalised physician assisted suicide.
- 1994 : UK House of Lords came out strongly against changing the law. Implicit in this decision is the deeper questions - it seems obvious that it is unfair to deprive someone else of his or her life, but what if, anything, is wrong with taking one's life?

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CMR Revision Topic 4 Related to these two questions is the third - to what extent should we strive to prolong life? A pressing practical expression of the question of how far to pursue the extension of life is the decision whether to continue with or whether to withdraw medical treatment when the treatment is burdensome or death is approaching. These kinds of decisions are troublesome when there is a clash between the need to accept death as emphasised by psychological /
philosophical reflections and on the other hand, the prohibition on deliberate killing, as emphases by those philosophers and theologians who accept the principle of the sanctity of life. In English law this tension is resolved, to an extent, by distinguishing between actions and omissions. Actions intended to bring about death are prohibited, but withdrawal of treatment is an omission, rather than an action, and omissions which cause death may be lawful. This does not excuse negligence by someone who has a duty of care.

- In Bland 1993 the judges declared that doctors have no positive duty to keep alive a patient in their care if that patient is in a persistent vegetative state because living in this state does not constitute a benefit to the patient. Hence someone in this state can legally be starved to death even with the intention / mens rea is to end the person's life. Some philosophers have sought to resolve the tension between the legitimate acceptance of death and unethical deliberate killing by drawing a different line : not between acts / omissions but between intended / unintended consequences. According to this account deliberate starvation, if it is intended to bring about death, should be prohibited. Treatment may be withdrawn even when death is foreseen. The Contribution of Theology Christian doctrine may have much to say about what is in store for the soul after death, but in the practical realm, what is lacking in the disciplines of psychology and philosophy - can it be remedied by theology? Death is a universal phenomenon not limited to Christians - it cuts us off from the world in a radical way. Furthermore, where it is wrong to bring about death it is surely not wrong only for Christians or only for Christian reasons. Killing is wrong as an offence against the individual / natural judge - due to the value of human life. There are a number of reasons for believers also to seek a specifically theological account of human death. Firstly, the perspective of faith can help to assess and evaluation the sometimes conflicting claims of psychology and philosophy. While in the natural sciences there is a detailed agreement, in psychology there are radically divergent approaches. There is a body of empirical work on cognition which has achieved some success in modelling unconscious mental process with the aid of computers. But it would be a mistaken to imagine that we all we wished to know about the human mind could be discovered through the precise but narrow filter of physicalist concepts. It is rather through a variety of methods and of schools that psychology has so much of interest to say about death. Yet the existence of these divergent / conflicting / incommensurable schools creates problems. Thomas Aquinas held that one of the reasons that human beings need a revelation from God is that the most important truths of human life are grasped only be a few, only after much study, and even the, not without mistakes. His most fundamental reason was that the ultimate meaning of life lies beyond the natural powers of human reason. He claimed that human happiness lies ultimately in communion with God. All other goods are partial or transient. To be held securely and to be perfected these goods need to be part of a comprehensive human good that can exist only in heaven. What happens after death is not something that human beings can now - It is not revealed, it lies purely on the power of God.

- Thus it is necessary to develop an explicitly theological account of human death for only this account can include truths from revelation about the end of human life.

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- This account does not seem to encompass the end purpose of human life, and thus cannot give the means to develop the right attitude to death in general, nor to judge the most difficult cases where people wonder if it is right to bring about death deliberately. If believers shy away from developing an explicitly theological account they will operated according to implicit theology that is unexamined and perhaps mistaken. For the faithful, there is no avoiding theology. This is particularly noticeable in the area of ethical discussion, where, in order to try to influence wider public policy, Christians sometimes concentrate on secular arguments that might sway non-believers. The specifically Christian rationale for the position is thus left unstated, even though many of those most actively concerned with, for example, the issues of euthanasia, are in fact motivated by religious belief. The failure to articulate a specifically Christian account can leave Christians relying on weaker arguments that fail to move their fellow believers and leave secular thinkers attributing a hidden agenda to believers. It can also mean that when non-believers attribute specially theological reasons to believers they get it deeply wrong.

- A good example of this is Glanville Williams's allegation that the reason that early Christians condemned infanticide was because of the fear that unbaptised infants who died in this way would be consigned to the fires of hell. This claim is utterly implausible. In the first place the early Christian rejection of infanticide is evident from the first century CE, where as there is little evidence that the practice of infant baptism was widespread until the late fourth century.

- Williams attributed this theological reasoning to Christians in order to dismiss their objections to infanticide. If the actual theological reasons that inspire Christians are made more explicit, then it may be possible for nonbelievers to see connections between these reasons and generally acknowledged secular values. If the theology remains unstated, then it remains possible for those like Williams to wrongly attribute to believers a theology that is alienating. A related consideration is that, where Christians are not themselves accustomed to articulate the theological basis for ethical judgments, then they are more likely to make mistakes when they first attempt to do so. The implicit theology held be an individual may be overly reliant on the authority of divine commands or of church law in such a way that could lead ethical demands to be seen as external to the person and in tension with human freedom. There is a paradox at the centre of Christian attitudes to death. On the one hand the Gospel promises eternal life now and in the world to come, and seems to relativize the badness of death. On the other hand, it contains and emphasises the commandment you shall not kill and demands that Christians should refrain from killing but also positively care for those dying.

- From the first century, Christians had been known for their opposition to abortion and infanticide, for their refusal to abandon the sick and the dying

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Christian Moral Reasoning D Jones : Approaching the End AU G U S T I N E & AM B R O S E O N T H E T H E O LO GY O F D EAT H The argument of Augustine in De Civitate Dei is similar to that of Ambrose in De bono mortis. However, while Ambrose treats death as something good in itself, Augustine sees it as bad in itself. Both mention three sorts of death - good / bad / midway (bodily death). Neither is content to see bodily death as something neutral in itself.

- For Ambrose, death must be a good thing - mortal life is a punishment for sin, so death is the remedy.
- For Augustine, death must be a bad thing, because it itself is punishment for sin. This leads Augustine to reevaluate the importance of human bodily existence. This turns on how he reads the letters of Paul, which is markedly different to that reading by Ambrose. Their contrasting attitudes have practical effects on how they regard virginity, marriage and mortification - on how each reads the letters of Paul, on their discussions of suicide / martyrdom. It leads to a noticeable shift in the Christian treatment of fear of death / grief / care of the dead. In many ways Augustine represents a real advance in the Christian understanding of death. However, in omitting 'dying to sin' from his systematic account, he impeded the development of a comprehensive theology of death. 'Dying to sin' would continue to be important in spiritual or ascetical writings but would not be integrated properly into a systematic dogmatic theology by later Latin tradition. Striking Parallels Topic Similar starting point of the Prima

Ambrose

Augustine

The third death stands midway

It can therefore be said of the first
[between good and bad] for it seems Facie Bodily Death for the Good and death that it is good for the good, good for the just and fearful to most Bad bad for the bad men. The Nature of Death Evaluation of separation of the Body and Soul

If life is a punishment (supplicio), death is the remedy

 Death itself is the penalty for sin

What is the effect of this dissolution This violent sundering of two except that the body is released and elements, which are conjoined and at rest (resolvatur et quiescat), while interwoven in a living being, is the soul turns to its place of repose bound to be a harsh and unnatural and is free experience Therefore death is in every way a

Deaths Intrinsic Evaluative Character good (omnifariam igitur mors bonum of its Own

For this reason the death of the body,

the separation of the soul from the est)…because it separates elements body, is not good for anyone in conflict

Each goes on to attribute the seemingly indifferent character of death to that fact that it is the occasion for goods /
evils that do not belong to it essentially. For Ambrose, whereas death is as such a good thing, it is the moment when

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CMR Revision Topic 4 sinners receive their just deserts. For Augustine, with death as a bad thing, it is the moment when God by his power rewards the just. Augustine responds that the reward that awaits the faithful after death is not due to death but due to the power of God that rescues us from everlasting death. In both cases, they decide what should be considered to be the essential character of death, and then explain the appearance of opposite characteristics by reference to a good or evil that comes with death but that is not caused by death:

- Ambrose : Why do we blame death, which merely pays the wages of life. Death either enjoys a good, which is its own repose, or suffers under an evil not its own.

- Augustine : Death ought not be regarded as a good think because it has been turned to such a great advantage. This happened not in virtue of any quality of its own, but by the help of God. This comparison reveals the debt Augustine owes to Ambrose. They shared not only one particular argument but a common intellectual culture. Each was persuaded of their opinions not by philosophy alone, but by a rigorous reading and rereading of the Scriptures, especially the letters of Paul. Suicide and Martyrdom It seems to follow from the claim that death out not to be regarded as a good thing (City of God) that it ought never to be chosen. It is contrary to one's natural appetite to seek one's own death. Death is an evil, a punishment for sin. Augustine is strict concerning the circumstances in which one may take life, even one's own. One may only take life when God commands it, or when justly commanded by the state acting as the instrument for divine justice. One may never seek to kill oneself, though one may willingly submit to death at another's hand if there is no moral alternative. The martyr does not seek death but chooses to witness to Christ even though this means he will suffer death. Augustine does not make the point here, but the death of the martyr is the result of a decision to kill, which is always wickedness on the part of another. The holy martyrs do not choose death but choose not to sin, even though this leads to their being killed. The clear characterisation of body death as always a bad thing gives the theological context for Augustine's treatment of suicide. He argues God can justly command someone to be killed, and we must obey such a command, acting as instruments of God's justice. Yet, no killing of an innocent party can ever be justified except on God's particular command, nor can any killing whatsoever on an individual initiative. This prohibition includes killing oneself : 'for to kill oneself is to kill a human being' . While Augustine is the first of the fathers of the Church to discuss suicide at length, a number of earlier writers had characterised suicide as a kind against God. Thus the Christian attitude to death seems at one more positive and more negative than ancient pagan or modern secular attitudes. That is why the distinction between martyrdom and suicide is key.

- If Christians are to grasp the paradox that is the basis for this distinction, are to live well in the face of death, then they require a clear and explicit theological articulation of the meaning of human death. This is especially so in a modern context where bot the hope of the Gospel and the wisdom of the commandments are commonly disputed.

- Anyone who kills himself is a murderer. Bringing about death to a body is always in itself a destructive act. This is the unspoken premise of Augustine's account.

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CMR Revision Topic 4 An important pastoral reason for Augustine to make the distinction between suicide and martyrdom as clear as possible was his struggle to reconcile the Donatist Christians of North Africa. Donatists claimed to represent the truth Chruhc which was recognised not by its apostolic descent but by its purity and martyrs. The authenticity of their claims was at best precarious, and martyrs promised to do for Donates what they had once done for Christianity - act as a witness to its authenticity. Ambrose does condemn the madness of taking one's own life; and regards it as deserting one's post. Still, his idea that heath is always in itself a gain, prevents him from attaining the clarity of Augustine on the difference between suicide
& martyrdom. Fear of Death, Grief, and Care for the Dead For Ambrose, death should not be a source of grief - and that is without hope of the resurrection. Through Christ, sinners can repent their sin - and this can excuse them from the judgment of Death, the only potential string in death, and thus there is nothing to fear. A common thread runs from Tertullian / Cyprian to Ambrose - that fear of death betrays either a failure of reason or a lack of faith or both. If it is seen for what it is, facing death should not even require courage. It should be recognised as a transition to perfect joy. It is not death that requires courage but continuing to live in this life that does. In Augustine, there are many passages that echo the traditional Christian belief that 'by his resurrection Christ has taken away the fear of death' (Sermon 147.3). The example of the martyrs and of Christ himself show that, by the grace of God, it is possible not only to overcome fear of death, but even the fear of a terrible death. Augustine still accepts that, among Christians, there can be a natural and reasonable fear of death that does not amount to a failure of faith. he is drawn to this view by a number of reasons :

- Augustine comes to see the separation of body and soul in death as itself a punishment. A certain fear, thus, is proper and natural.

- In his mature thought, Augustine becomes incredibly suspicious of the perfectionism of Pelagian forms of Christianity and of their claim that Christians could perfectly overcome human frailty.

- While death was originally imposed as a punishment for sin, its imposition upon those whose sins are forgiven cannot be punishment so it must remain for some other reason. Augustine thus comes to see the struggle with death as something salutary. In Augustine's commentary on Psalm 69 he makes the explicit link between the natural union of body / soul and the naturalness of fear of death. Whereas the martyrs wish to cleave to Christ, they do not wish to suffer death. Death is in itself repellent to the will because by it body and soul, which belong together are torn apart. Augustine appeals to the words of Paul concerning the resurrection, not to diminish the significance of death, but to point out that salvation ultimately must consist in the reuniting of body and soul, so that there separation by death contracts not only the original state but also the final destiny of human nature.

- We desire to cleave to Christ yet do not want to die - thus we suffer, because it is the only option to cleave to Christ. This means that the final state is blessed, but the passage is bitter. Even the martyrs retain a proper natural aversion to death. To show this, Augustine appeals to the text where Jesus says to Peter that he will be bound and taken where he would not go (John 21:18). Even after being strengthened by witnessing the risen Christ there is still some unwillingness to die. Another major reason that leads Augustine to reassess the traditional attitude to fear of death is his unwillingness to ascribe human perfection to any except Christ and Christ's Mother. Augustine conceives the life of grace not as the

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