Reflections on the Art of Dying
Living Well, Confronting Death
Presentations on the Ars moriendi
FARR A CURLIN, MD, is Josiah C Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities and History of Medicine, and the Duke Divinity School, at Duke University. Before moving to Duke in 2014, he founded and was Co-Director of the Program on Medicine and Religion at the University of Chicago. At Duke, Farr practices palliative medicine and works with colleagues in the Trent Center and the Divinity School’s Initiative on Theology, Medicine, and Culture to develop opportunities for study and scholarship at the intersection of theology, ethics and medicine. He is interested in the moral and spiritual dimensions of medical practice—particularly the doctor-patient relationship, the moral and professional formation of physicians, and practices of care for patients at the end of life.
JOANNA COLLICUTT, PhD, is Karl Jaspers Lecturer in Psychology and Spirituality at Ripon College, Cuddesdon and former Oxford Diocesan Advisor for Spiritual Care for Older People. She is also a supernumerary fellow in psychology of religion at Harris Manchester College and lectures in this subject for Oxford University, where she is Co-director of the Centre for Reception History of the Bible. She is an associate priest in a west Oxfordshire parish. Her most recent books include The psychology of Christian character formation (SCM, 2015), Being mindful being Christian (Monarch, 2016), Thinking of you (BRF, 2017), When you pray (BRF, 2019), Seriously Messy (BRF, 2019), and Neurology and religion (CUP, 2019).
Lydia Dugdale, MD, MAR (ethics), is Associate Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons and Director of the Center for Clinical Medical Ethics. She also serves as Associate Director of Clinical Ethics at New York Presbyterian Hospital/Columbia University Irvine Medical Center. A practicing internist, Dugdale moved to Columbia in 2019 from Yale University, where she previously served as Associate Director of the Program for Biomedical Ethics. Her scholarship focuses on end-of-life issues, medical ethics, and the doctor-patient relationship. She edited Dying in the Twenty-First Century (MIT Press, 2015) and is author of The Lost Art of Dying Well (HarperOne, 2020), a popular press book on the preparation for death.
Hospice and Palliative Medicine’s Attempt at an Art of Dying
Farr A Curlin, MD
The institutions of hospice and palliative medicine provide a helpful alternative to the default pathway of dying in medical institutions—kept alive by technology long past any reasonable hope of recovery. By mitigating distressing symptoms, maintaining healthy functions, locating dying in the home and community, and providing both realistic information and reassuring presence, hospice and palliative medicine can create conditions that help patients to practice what in the middle ages was called ars moriendi (the art of dying). Yet, we should not mistake the death that hospice and palliative medicine can provide—a death with minimal suffering and maximal patient control—for a “good death." This mistake leads medical practitioners to undervalue the consciousness and relational presence that make it possible for patients to participate in the tasks of dying well. In this talk, Dr. Curlin, a palliative medicine physician who teaches about the moral and spiritual dimensions of medical practice, will argue that the practices of palliation should be situated within and governed by medicine’s traditional orientation to the patient’s health. So situated and governed, palliative medicine offers modest but worthy resources to help patients, as well as clergy, family, and friends, recover the practices of living well, and faithfully, in the face of death.
Pandemic, Agency, and Aging: What the Lost Art of Dying Can Teach Us
Lydia Dugdale, MD, MAR
The COVID-19 pandemic has disrupted life as we know it. The disease has consumed more people in a short period than does seasonal influenza and has been especially vicious toward the elderly. The virus has magnified pre-pandemic concerns that Western society cares little for its oldest members. Headlines such as “Why Are We OK with Old People Dying?” or “Why Are So Many People Ready to Let the Elderly Die?” underscore this point. The virus has reified Jean Améry’s most dystopic fears; not only does aging rob the aged of agency, it targets them for certain death.
But is certain death of the elderly something new, ushered in for the first time by COVID-19? Or has death always been a certainty? This paper draws from the late medieval texts of the ars moriendi, or “art of dying,” to show that (1) death is a paradox; (2) aging does not rob the elderly of agency but rather provides opportunity to reimagine agency; and (3) participation in lifelong community-based practices to prepare for death offers the ultimate exercise of agency—an agency that persists after faculties wane. I conclude that a revival of the ars moriendi would both empower the elderly and thwart the temptation to cast blame for future deaths.