The following is the first in a series of articles exploring the concepts of “a good death” and optimal palliative care.

EDINBURGH, Scotland (LifeSiteNews) – One of the quirks of the COVID-era church closures in Scotland is that the last day we were permitted to have Mass as usual was on March 19, the Feast of Saint Joseph. When Mass had ended at my own little wooden church in Edinburgh, the congregation sang a hymn to St. Joseph with the following refrain:

Dear Saint Joseph, spouse of Mary, blest above all saints on high,

When the death shades round us gather, teach, o teach us how to die.

I recalled this hymn during a meeting with an authority on the ethics of clinically assisted nutrition and hydration (CANH) for those with severe brain injuries. We approach this question, among others, from different directions, but we agree on at least two things: that everyone should come to terms with the fact of their own future death and that the dying should have excellent palliative care.

My interlocutor, like most non-Catholic Britons I have met, has limited knowledge about Catholicism and was pleasantly surprised to learn that we believe the sufferings of the dying should be relieved as much as possible. Frustrated by people who refuse to admit that they will ever die, she was also pleased to hear that Catholics who pray a daily Rosary mention “the hour of our death” over 50 times.

Unfortunately, even some Catholics have decided that they, not God, will determine the hour of their death. Some years ago, I reported on the medically assisted suicide of a cancer patient who attempted to book his funeral in advance with his parish priest. He invited his church choir along to his suicide party and, apart from the syncretic religious elements, died in a manner that called to mind Petronius, the cultured pagan of Henryk Sienkiewicz’s Quo Vadis. He, too, committed suicide in the middle of his own party.

With an increasing number of Canadians committing medically assisted suicide, and a massacre of elderly Scots who-don’t-want-to-be-a-bother just waiting on the other side of our current legal frontier, I am concerned that governments will stint on proper palliative care for the dying, euthanasia being so much more cost effective. I am also worried that advances in palliative care will slow to a stop for the same reason. And naturally I am afraid that the most moral, most selfless people who care for the dying will give up their vocation once hospices are forced to offer lethal injections or chemical cocktails.

It seems to me that now — when countries like Scotland still have a choice to reject medical murder in favor of better care for the dying — is the time to find out how far palliative care has advanced and if, as I hope, the Christian way of death is vastly more attractive than death-day parties, ancient and modern.

To begin my research, I wrote to Alex Schadenberg of Canada’s Euthanasia Prevention Coalition. I asked him what best palliative care looks like and if it is(still) available in Canada. Coming so soon after my debate about CANH, his answer surprised me. His focus was not on water, nutrition, breathing or drugs, but on companionship.

“Excellent palliative care focuses on the whole person,” Alex began.

Excellent palliative care focuses on one’s physical pain and symptoms, but it also recognizes that human beings experience psychological, emotional, and spiritual pain.

Excellent palliative care recognizes that the care of the whole person includes ensuring that someone journeys with the person as they near death, since loneliness and isolation will often be worse than the potential physical pain that one experiences.

Excellent palliative care recognizes that people go through difficult times in their lives and helps people explore personal healing.

Excellent palliative care recognizes the spiritual needs of a person. To truly die a death with dignity, one needs to have their spiritual needs met.

Interestingly, when one focuses on the spiritual, the psychological and the emotional needs of the person, they will also find that the physical pain, if it is present, is greatly lessened.

Does this exist?

Certainly, it exists in some places, but, sadly, palliative care has become far too oriented to the medical discipline of dealing with pain and symptoms. Obviously, good pain and symptom management is important, but the thing that makes us human, the things that help us die a true death with dignity, often have little to do with the drug dosages that were used to deal with the pain and symptoms and more to do with being with the person, caring about the person, and helping them work through the final issues of living.

This is the kind of palliative care that Dame Cicely Saunders created. This is the kind of palliative care that we need.

Dame Cicely Saunders (1918 – 2005) was a Christian woman (Anglican, married late in life to a Polish Catholic painter) who founded the first modern hospice for the dying in England. Among other accomplishments, she pioneered a pain-management philosophy that didn’t wait until a dose had worn off before the patient was allowed more analgesics.

I was surprised to discover this had been an innovation; according to Catholic ethics, the dying may be given significant amounts of painkillers, even if these speed up their earthly journey. As St. John Paul II wrote in Evangelium Vitae, “Pius XII affirmed (in 1957) that it is licit to relieve pain by narcotics, even when the result is decreased consciousness and a shortening of life, ‘if no other means exist, and if, in the given circumstances, this does not prevent the carrying out of other religious and moral duties.’^”

But I have turned from Alex’s focus on companionship to the problem of physical pain. To continue my quest to find for the best possible palliative care, I will next study Dame Cicely’s philosophy and career.