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Monday, 1 June 2009

Ps of V

Everything is seen through the lens of our own experiences and prejudices

Let us pray for atheists, and for all those who will die today.
My mother is fond of saying that she’ll be ready to die when she finds God. She means this to be funny; at 84, she is a lifelong atheist, and the phrase is her way of saying that since she has no intention of finding God, she has no real intention of dying, either.

I thought of my mother recently when I read a report in The Journal of the American Medical Association that the people who fight death the hardest, who refuse to accept it and who insist on heroic measures during their last weeks of medical care are those who are the most religious. What happened to being ready to die once you find God?

The study, coordinated by the Dana-Farber Cancer Institute in Boston, followed 345 advanced-cancer patients for their last months of life. Researchers found that the more religious patients, when compared with those who were less religious, were almost three times as likely to be put on a ventilator or receive CPR during the last week of life. They were also more likely to be resuscitated in the last week of life and to be in an intensive care unit when they died.

Like my mother, I have always assumed that religion exists largely to offer comfort about death, with visions of an afterlife soothing both the survivors and the people facing their final days. But the JAMA report seems to contradict that. If people believe in heaven, why are they holding on so tightly to this life?

There’s a chance that the greater likelihood of receiving aggressive, costly and ultimately futile end-of-life heroics is an outgrowth of another distinction that the researchers found between the more and the less devout: the reduced likelihood, among religious people, to have issued any advance directives about how they want to be treated as their illness progressed. It’s possible that the refusal to draw up a living will or to name a health care proxy – two steps that my mother started taking in her 50s – is part of a larger willingness to put one’s fate in God’s hands. So the heroic measures at the end of life might be not so much a proactive decision as they are the inadvertent consequence of a nondecision.

Thoughts about death are never far from my mother’s mind these days, especially since she has moved into a senior residence on the Upper West Side of Manhattan where the average age is 85. In her building, she watches her neighbors change, one by one, as they decline, diminish and ultimately disappear. She returns from their funerals saying how much she envies them their belief. It’s the atheist who finds death so frightening, she tells me somberly, so hard to visualize or comprehend. A complete snuffing out of everything, an infinite, eternal emptiness: how can anyone imagine such a void?

What a surprise, then, to see that my mother might be wrong to think religious belief makes death any less scary. Maybe death is scary for everyone.

The first commenter is a little more informed than the blogger.

And the third is wonderful.

No storm can shake....

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