End of life care is in desperate need of spiritual renewal

Outside the National Gallery last week I watched a living statue of the Grim Reaper. There was something slightly medieval about this figure, with his grinning skull and scythe, among the tourists milling in the sunshine. But he conveyed to me at least, a sombre truth: that we are all going to die one day, pantomime reminder or not.

If you are a billionaire in your early 30s, you might well have the philanthropic impulse of Mark Zuckerberg, founder of Facebook, who has recently announced that he and his wife plan to give away most of their fortune to cure, manage or eradicate all diseases in the world by the end of this century. But we all still have to die of something, even if it is merely old age; surely none of us seriously wants to be immortal?

Seamus O’Mahoney, consultant gastroenterologist at Cork University Hospital, raises this whole subject in his book The Way We Die Now. He makes a powerful plea to bring common sense, medical wisdom and compassion into end of life care. Although from an Irish Catholic background he is not arguing from a religious viewpoint but from the perspective of a doctor who has witnessed too many undignified deaths, where the patient is given unnecessary, intrusive interventions, where relatives refuse to face reality and where doctors persevere with “The Lie”: not telling someone the truth of their condition, which he calls the “Difficult Conversation”, often because of fears of litigation.

O’Mahoney is not an advocate of euthanasia; nonetheless, depending on the patient’s condition, “you don’t have to treat all acute illnesses, such as pneumonia.” Cancer treatments such as chemotherapy also come at a high price; they seem to offer some patients “a toxic combination of false hopes and a bad death.”

Modern medical advances, he reflects, have made pain unendurable and assisted suicide a human right. For O’Mahoney the phrase “death with dignity” strips death of its “awesome grandeur”. Indeed, fear of death has replaced fear of God. He believes that we live in an age of spiritual poverty and have forgotten the consolations of religious ritual which, in the past, have given strength to the dying and support to the bereaved.

“Our needs are spiritual”, he concludes, and what is needed is a “spiritual renewal”; in other words, that “Difficult Conversation” between the individual and God.