Existence beyond death? Encouraging those who face death

Journal of Pain and Symptom Management, 1998

We accept this thesis as conforming jfo tlifcr^CfuMed standard in THE UNIVERSITY OF BRITISH COLUMBIA

Psycho-Oncology, 2012

Objective: Suffering frequently occurs in the context of chronic and progressive medical illnesses and emerges with great intensity at end-of-life. A review of the literature on suffering and distress-related factors was conducted to illustrate the integrative nature of suffering in this context. We hope it will result in a comprehensive approach, centered in the patientfamily unit, which will alleviate or eliminate unnecessary suffering and provide well-being, when possible.

There is a pattern to the way most humans live, that of how their actions will affect their future, and in most cases, how their actions will affect their journey after death. Different cultures and religions may have formulated different benchmarks or guidelines to this effect, but one thing remains clear, the purpose of these rules and guidelines for the way we live are done keeping in mind what we want to happen to us after death. We know for a fact that Human beings, like all other organic creatures, die and the physical body perishes. But, there is a widespread and popular belief that in some way this death is survivable, that there is a possibility of life after death. This concept of some kind of journey after death has become possibly the most debated topic, and has created countless theories over time. On different levels, human actions are guided by the enigma of what will be in store for them after death. This paper looks in to the various teachings and beliefs of different cultures and religions and how they have shaped the understanding of death and how this thought process was furthered through literature and has been used to manipulate the emotions of audiences through history and changed the way people perceive death and the consequences on the way they live their lives.

Palliative & Supportive Care, 2006

Objective: A meta-summary of the qualitative literature on spiritual perspectives of adults who are at the end of life was undertaken to summarily analyze the research to date and identify areas for future research on the relationship of spirituality with physical, functional, and psychosocial outcomes in the health care setting.

JAMA, 2006

Mr W is a 54-year-old man with a history of hypertension, bronchitis, and nephrolithiasis who presented 3 months prior to admission with increasing pain in his upper back. A magnetic resonance imaging study revealed a T7 vertebral body lytic lesion, suggesting malignancy. He was admitted to the neurosurgical service of a university hospital in late June 2005 for resection of the lesion, which proved to be adenocarcinoma. Further evaluation revealed a 2.8-cm lesion in the tail of the pancreas, multiple lung nodules, and rib lesions. Immediately following his T7 corpectomy and fusion, his course was relatively uneventful. The oncology and general internal medicine services were consulted. One week after the operation, during preparation for discharge to a rehabilitation facility, Mr W's respiratory status began to worsen. A pleural effusion was noted and a chest tube placed, draining 2 L of fluid. Despite drainage, however, the patient's oxygen requirements increased rapidly from 2 L/min of oxygen to 80% oxygen by facemask plus 6 L/min via nasal cannula. He was transferred to the medical service for further management. The medicine team was made aware of Mr W's wishes that he not be intubated or resuscitated and attempted to treat the possible underlying causes for his rapidly worsening respiratory status. Although he showed some improvement with bilevel positive airway pressure (BiPAP), it was extremely uncomfortable for him. After continued chest tube drainage, broad-spectrum antibiotic coverage, and diuresis, computed axial tomography showed no pulmonary emboli, stable parenchymal nodules, improving effusion, and possible pleural metastasis. He experienced minimal improvement in his dyspnea. Eventually, however, his condition stabilized with 30 L/min of high-flow, vapor-phased, humidified oxygen by nasal cannula, which allowed him to talk, eat, and interact. After consulting with the oncology team, the medical team determined that Mr W would be a candidate for chemo-therapy only if he were discharged successfully to home (that is, if his oxygen requirements could be reduced substantially from his inpatient requirements, and if he could undergo rehabilitation). This information combined with consistent inability to wean Mr W's oxygen left the medical team with few treatment options. At this juncture, the team initiated discussions with Mr W regarding his ultimate goals of care. He was very clear that he wanted to pursue all options available to him. The palliative care consultation service team was called in for consultation and assistance with end-of-life discussions and discharge options. Mr W stated CME available online at www.jama.com Spiritual issues arise frequently in the care of dying patients, yet health care professionals may not recognize them, may not believe they have a duty to address these issues, and may not understand how best to respond to their patients' spiritual needs. The case of a patient with a strong religious belief in a miraculous cure of metastatic pancreatic cancer is used to explore how better understanding of this belief and more explicitly spiritual conversation with the patient by his treating team might have provided opportunities for an improved plan of care. This article distinguishes spirituality from religion; describes the salient spiritual needs of patients at the end of life as encompassing questions of meaning, value, and relationship; delineates the role physicians ought to play in ascertaining and responding to those needs; and discusses the particular issue of miracles, arguing that expectations of miraculous cure ought not preclude referral to hospice care.

Life After Death: A Biblical Overview, 2019

This paper seeks to provide a summative overview to the following questions by examining passages from the seven storylines of the Bible: Is there life beyond the tombstone? If there is, what does it look like? Does how we live our life today have repercussions in our future beyond the grave?

2024

The concept of "dying of old age" almost does not exist today: it is always death from some illness. The religious world became captive to the concept that we must do everything to prolong metabolism for every additional moment. In most cases, a person is separated from the world while in an alienated environment, connected to transfusions and machines. While we deny euthanasia in an absolute and unconditional manner, our practical suggestion is encouraging palliative medicine. This type of care is focused on providing relief from the symptoms and stress of the illness rather than attempting to cure. We wish to instill the understanding that natural death from old age is a gift from God, not a punishment.

Journal of Palliative Medicine, 2005

Authors are asked to review information at the expert level for physicians practicing as a subspecialist in palliative medicine. Subsequent updates will focus on the most up-to-date literature that has been published since the last version.

Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications

Elizabeth Kubler-Ross wrote the book On Life After Death to give her findings on what happens when a person dies. Over the course of 20 years, she found that no matter age, sex, religion, or culture, everyone spoke of the same things happening upon death. The insights and revelations that Kubler-Ross talks about will give a minister help when they speak with someone who is dying or has had a near-death experience.

The Gerontologist, 2002

This article presents a model for research and practice that expands on the biopsychosocial model to include the spiritual concerns of patients. Design and Methods: Literature review and philosophical inquiry were used. Results: The healing professions should serve the needs of patients as whole persons. Persons can be considered beings-in-relationship, and illness can be considered a disruption in biological relationships that in turn affects all the other relational aspects of a person. Spirituality concerns a person's relationship with transcendence. 'therefore, genuinely holistic health care must address the totality of the patient's relational existence-physical, psychological, social, and spiritual. The literature suggests that many patients would like health professionals to attend to their spiritual needs, but health professionals must be morally cautious and eschew proselytizing in any form. Four general domains for measuring various aspects of spirituality are distinguished: religiosity, religious coping and support, spiritual well-being, and spiritual need. A framework for understanding the interactions between these domains i s presented. Available instruments are reviewed and critiqued. An agenda for research in the spiritual aspects of illness and care at the end of life i s proposed. Implications: Spiritual concerns are important to many patients, particularly at the end of life. Much work remains to be done in understanding the spiritual aspects of patient care and how to address spirituality in research and practice.

In this brief essay we will explore the holy scriptures, the ascetical tradition, and the history of the Church to discuss the central role of the remembrance of death in the spiritual life of Christians, as well as demonstrate the applicability of this precept for both monastics and lay. We will first frame death itself within the competing views of modern culture and historical Christianity. We will then draw from the holy scriptures, ascetical tradition and patristic writings, and the history of the Church in order to ground the remembrance of death firmly within the context of Orthodox tradition. Finally, we will present remembrance of death as something both positive and compelling within the context of Christian spirituality, and as such something that can appeal to both monastics and lay, as well as Orthodox and non-Orthodox lay persons living within the context of a secular culture which denies death. We will conclude with a discussion of how one can apply this spiritual precept to one's personal and professional life on a daily basis, including interactions with the healthcare system.

Mortality, 2023

Kenneth Doka's two seminal contributions to Death Studies and loss include the term Disenfranchised Grief, which initiated many studies on Transparent Bereavement, as well as raising extensive clinical attention to the phenomenon; and his book (with Terry Martin) 'Men Don't Cry, Women Do' on gender-based differences in the processing of loss, and specifically men's difficulty to express distress and be assisted by social networks during times of grief. By way of generalisation, I argue that Doka is a pioneer in what can be referred to as the study of 'Grief Regime'. Even more than that, and without him having meant to do so or maybe even been aware of it, he is also the leading contributor to the study of the 'Sociology of Grief'. Following his contributions hundreds of studies were initiated on topics involving the impact of social discourse on the ability to grieve. At the centre of Doka's new book, we find not the grievers, nor society or discourse, but the dying person. Here we see a clear transition from focusing on grief, to focusing on the 'phenomenology of the dying'. The dying person is the main character of the book, dictating its themes, its chapters and even its scientific concepts. Had Thomas Kuhn, the Sociologist of Science, who discussed how scientific paradigms are formed and how they closely and even violently protect their borders to prevent 'subversive' texts from penetrating scientific fields been alive today, he would undoubtedly have been intrigued to follow the book's reception in hegemonic scientific community, maybe even writing its preface. Each chapter of Doka's book 'captures' a delineated theme consistently recurring in the incredible life journey that Kenneth Doka has undergone. Into each theme he has deduced the most relevant moments, conversations and interactions that best correspond and illustrate it, showing how each theme exists in and characterises the dying person. Thus showing himself in a unique and exclusive matter (through conversations he held with those he accompanied, exceptional requests, memories that left their mark), while on the other hand, presenting themes that can be used to identify those who are in an 'End of life condition', having what can be identified as an 'End of life conversation'. This type of discourse is characterised by the persistent questions, passions, emotions and longings of this unique and emotional point in life. These themes, that have become the chapters of the book, were developed through unique interactions held by a unique researcher, who has dedicated his life to 'End of life interactions' with special people who have found in him the perfect partner to whom to expose their deepest emotions during this unique time. It should be said: as theoretical constructs, these chapters may have been perceived as quasi-legitimate in some academic circles, had they been included in a book on loss which is based on anything other than an ethnographic journey. But of course, Doka did not choose to include theoretical chapters in a deductive-scientific book about loss. The chapters were essentially dictated to him by his patients, following an inductive process. Those same chapters and themes are the organising and consistent categories which summarise the topics of conversation, the deliberations, thoughts and associations raised by his partners in dialogue, as they approached the end of their lives. They are an organisation of the empirics which the MORTALITY

Death Studies, 2011

The Lancet, 2005

In a letter to Fr. Thomas Merton, the young Orthodox convert Eugene (later Fr. Seraphim) Rose wrote: “Above all, the Christian in the contemporary world must show his brothers that all the ‘problems of the age’ are of no consequence beside the single central ‘problem of man’: death, and its answer, Christ … Let the contemporary sophisticate prattle of the childishness of seeking ‘future rewards’ and all the rest – life after death is all that matters.” Although modern man enshrines death as supposedly natural he has no understanding of the reality of death. In the Orthodox Church alone is preserved the authentic Christian teaching on man’s paradisiacal condition, his fall and consequent death, Christ’s death-destroying Resurrection, and life after death.