Last evening I attended a lecure by Stanley Hauerwas at St Margaret’s Anglican Church here in Winnipeg.

I planned to arrive pretty close to the start time and ended up being a few minutes late. Bad move, as it put me into the overflow area in the basement along with 50 or 60 other folks. I didn’t see the sanctuary except on the video, but it must have been packed out. I don’t like overflow areas with piped-in A/V… only a small percentage of people laugh when they’re supposed to, and only 2 people in the room will clap. It’s just weird. Worse, in this case, the audio was muddy and cut out once in a while or was too quiet to be properly intelligible at other times. The video disappeared once in a while as well, but independently from the audio. Hopefully I’ll be able to get ahold of an audio tape from the evening, we’ll see. All this means that I missed stuff, but what I caught was well-worth it. I’m overstating the negatives, and now that they’re out of the way…

The title of the presentation was, “Why no one in North America wants to die.” Hauerwas talked a lot about medicine and about death. Many gems. Where I’ve used quotes below, some of it may be a slight paraphrase based on what I caught and how fast I could make notes. I’m going to just spit out an incoherent list of those notes here… some ideas and one-liners will be apparent within them. My main objective is to simply capture the ideas for further thought. Like the best of all professors, Hauerwas asked many more questions than he attempted to answer, seeming to prefer to ask questions, offer ideas, and allow them to germinate.

He talked about a transformation from “care” to “cure”, observing that where once the patient was treated, now it’s the illness that’s treated… which is the fundamental difference between care and cure.

Noting that medicine now attempts to treat or modify so much more than it ever has before, Hauwerwas asked, “Since when is baldness an illness in which a physician should intervene? Or small breasts?” He suggests that so it is with aging, which may soon be viewed as an illness in which a physician should intervene.

He suggests that we have lost the skills to know how to die… this requires training, and requires good examples.

“Kevorkian is a bad person and a bad physician,” he quips, “If I wasn’t a pacifist, I’d want to kill him.” While clearly not agreeing with his approach to medicine, Hauerwas does observe something noteworthy about Kevorkian’s practice… he was giving people permission to die. We need to be told we have permission to die, Hauerwas notes, suggesting that we want to know that our deaths are commensurate with our lives.

“Medicine’s primary purpose is to cure, to avoid death.”

Mention was made of the employment of ethicists in the medical profession. Defining death, he notes, was an attempt at a technical solution to a moral problem.

The conundrum is the result of the modernization of “story.” Modernity says you should have no story except the story you chose when you had no story. This is referred to as “freedom.” How do you get cooperation with people so formed? We have this in common: the view that death is a bad thing.

Some mention was made of Elizabeth Kubler-Ross and the development of “thanatology.” This, he says, besides seeing people kept alive long enough to accept their own death, can result in trying to help people die better than they lived… so that their death doesn’t reflect their life. In this, he observes an attempt to stay in control of our death.

Hauerwas suggests that christians don’t believe we should have a story we chose, but the story we’ve been given.

“The courageous have fears that the coward can never know.”

On martyrdom: Martyrdom is a paradigm of christian death. Christians shouldn’t seek martyrdom because they don’t want their enemies to bear the sin of their death. Martyrs don’t know who they are until we tell them… because they don’t know their own story.

On suicide: There are two primary forms of suicide. One is abandonment, being alone; the other is a “metaphysical I-gotcha” where a motivation is “I’m going to die on you… I gotcha.”

John 11, illness unto death… Q: “Does the life lived under the suffering of the illness bear out the grace of God?”

We want to interpret the meaning of our own death… (should we? can we?)

How seldom we preach about death… in so (not) doing, we leave ourselves without a language for death.

Presence is ultimate. Even Job’s friends at least sat with him for six days and said nothing. Christian friends do not give us hope. Insofar as they are present, they are our hope.

Closing statement: “Hope is real and we can die in the hope that we live in Christ.”

During the Q&A:

We now have a “morally fragmented society that shares nothing in common but a fear of death.”

“Where do we get authority to tell people that they’re ready to die? It comes from a shared liturgical life.”

“What’s at stake here is an understanding of suffering.”

How can physicians teach us to grow old?

Hauerwas questions medical intervention in the name of getting another six months to a year. When the end comes, the patient is surrounded by machines, not by people. We need to be there, to experience it. We give one another our sufferings — that’s what God wants us to do.

Hauerwas asks, “Why do people go to fertility clinics? Because they want their children. The idea that your children must carry your genetic material is pagan.”

Regarding stem cell research: “Who knows what kind of complications will come? Modern medicine has been pushed.

“What do you want to die of? Because you are going to die.”

Somewhat tongue-in-cheek, he suggests that smoking is good for the healthcare system… basically because when it kills you, the end-of-life care is less expensive that with many other diseases that you could have if you lived longer.

Obviously, he’s got some large questions, here having to do with where the line is on the extent of intervention that physicians should engage in. The underlying suggestion would perhaps be that if the medical profession would come to grips with the idea that death is a natural part of life, maybe they would be able to counsel patients concerning death and help to prepare them properly rather than attempting to prolong life beyond what is natural or reasonable. Ultimately, death is an event in which the community should be present to support the individual who is dying as well as their family. In this way the individual can be given permission to die, and given assurance that they leave their family knit into a community who will care for them.

All of this is food for thought, for consideration. Simple answers need not apply.

death, medicine, Stanley Hauerwas