REVIEWED BY SARAH E. HETUE HILL, M.A.
LIVING WELL AND DYING FAITHFULLY: CHRISTIAN PRACTICES FOR END-OF-LIFE CARE
EDITED BY JOHN SWINTON AND RICHARD PAYNE
Wm. B. Eerdmans Publishing Company, 2009
320 pages, $25
The technological imperative, discussed at length in Daniel Callahan's The Troubled Dream of Life: In Search of a Peaceful Death (Georgetown University Press, 2000), remains ubiquitous, perhaps even amplified, as advancements in medicine continue with increasing speed and breadth. Since its publication, many have asked about the role of faith and theology for people who are dying and those who care for them.
Living Well and Dying Faithfully attempts to answer that question. In 2006, John Swinton, director of the Center for Spirituality, Health, and Disability at the University of Aberdeen, and Richard Payne, director of Duke Divinity School's Institute on Care at the End of Life, convened a group of scholars to work through these seminal issues. This present work provides the fruits of that conference. It is an anthology of essays written by a diverse group of scholarly theologians, some of whom are also practitioners. Payne and Swinton expertly combine these essays into a coherent collection that seeks to provide "a different way to approach death and dying," one that is "rooted in the Christian tradition and that offers transformed understandings and practices that can work alongside current knowledge to bring healing and hope even in the midst of dying" (p. xvi).
As Stanley Hauerwas suggests in the foreword, we have forgotten the art of dying, the Christian tradition of ars moriendi. An often-repeated theme in the collection is that, in order to die well, we must learn to live well. The same Christian practices that are learned and lived throughout our lives, including prayer, love, compassion and lament, are vital companions at the end of life and enable us to die well. The various authors seek to answer the question, "How can the faithful who are dying (and those who care for them) be enabled to love God and hold on to the reality that God is love even in the midst of suffering?" (p. xviii).
In response to this question, the editors propose a new way of examining the interplay between theology and medicine. Rather than seeing them as adversaries, the editors wish to see how these can work together to promote healing, even when cure is no longer possible. As the editors suggest in the introduction, medicine and theology are both necessary for good end-of-life care. Medicine is required to relieve physical suffering. However, the significance of medicine when reframed in light of theology is more than simply relief. It is often easing physical suffering that enables the dying to experience love of God, self and others. As we or as loved ones we care for experience pain and suffering, it can become difficult to sense the love God has for us. Relieving this suffering can allow us to love and find connectedness with God and others as we approach death.
In addition to what can be offered medically, Christian practices such as lament, prayer and formation can be used throughout life to find connectedness with God and others as we approach death. Two examples of this are found in "Why Me, Lord?": Practicing Lament at the Foot of the Cross by John Swinton and in Suffering in Communion with Christ: Sacraments, Dying Faithfully, and End-of-Life Care, by M. Therese Lysaught.
Swinton examines the benefit of lament in a theological framework in his chapter. The psalms of lament themselves are an example of "a language that allows us to tell it like it is but still continue to worship God in ways that make even our experience of suffering faithful … they enable faithful sadness and a healing catharsis that need not slip into selfish moaning. By giving voice to the terrible reality of the situation of suffering and the fear of dying, the psalms of lament make the experience real, but within a context where God is also real, present, and assumed to be active" (p. 133).
Lysaught examines Cardinal Joseph Bernardin's autobiography for insight into how, for even the most faithful Christian, practices like prayer can become difficult in the midst of suffering. She expresses how important it is "to immerse ourselves daily in the sacramental life of the church" (p. 82). By becoming formed in such a manner, we have a better ability to see through pain and suffering when death approaches.
Overall, readers will find this book scholarly yet accessible. The intended audience is both academic and lay, although some prior familiarity with theological themes may be needed for full understanding of the profound and often nuanced insights.
I personally found the book immensely helpful both personally and professionally. It is a welcome addition to the body of literature on dying well.
SARAH E. HETUE HILL is program coordinator, Palliative Care Initiative, Ascension Health, St. Louis.