Explainer
Creed
Death & life
5 min read

The lost art of dying well and what we can learn from it today

Living well in order to die well doesn’t simply happen. It takes work. It takes preparation. For All Souls Day, Lydia Dugdale asks if we are prepared for death.

Lydia Dugdale is the author of The Lost Art of Dying. She is Professor of Medicine at Columbia University and Director of the Center for Clinical Medical Ethics. She is a specialist in both medical ethics and the treatment of older patients. 

A medieval book illustration of a person dying in bed.
A 15th Century ars moriendi, or ‘art of dying’ image.
Basel University, via WikiCommons.

The first of November marks All Saints Day on many church calendars—a day when we Christians remember our martyrs together with all the faithful, both living and departed. On that day, we celebrate that our communion is not simply with one another on earth but is also with all saints of all time, including those who have died.  

For some people, the notion of fellowship with departed saints might be quite exciting. They may have pondered questions about the saints since school assemblies or RE lessons. What was racing through Abraham’s mind when he attempted to sacrifice his son Isaac? What would Mary say a sinless Jesus was like as a toddler? Did Jonah float around inside the great fish, or did he find something on which to perch himself?  

But others among us might wish to skip All Saints Day altogether. Talk of dead saints feels positively medieval, even a bit morbid. Some of us might wonder about our own saintliness—or lack thereof. Could we really experience ineffable joy in an afterlife? Moreover, the very suggestion of an afterlife implies that we ourselves must die—an uncomfortable prospect for most of us.   

Such divergent reactions to the day are revealing. On the one hand, the idea of having saints to remember is to inspire us to live well. They invite us to examine their lives and to grow ourselves in response. On the other hand, they remind us that our days are numbered. And because our days are numbered, we should attend carefully to what it means to live wisely. Saints teach us that if we want to die well, we must live well. 

But living well in order to die well doesn’t simply happen. It takes work. It takes preparation. Which is why this year on All Saints Day it’s worth asking the question: Am I prepared for death? 

Death exists as a paradox for Christians—as something at once lurking and vanquished. 

In the late Middle Ages, the ars moriendi, or ‘art of dying’ genre of literature developed in response to mass loss of life from a fourteenth-century outbreak of bubonic plague. The genre consisted of a number of handbooks on how to prepare for death. Although the earliest text was anonymous, historians believe that its authorship had a connection to the Western Church. After the Reformation, Protestant versions began to circulate, and later handbooks omitted religious particularity altogether. The handbooks grew in popularity throughout the West for more than 500 years. 

This notion of living well to die well lay at the core of the various iterations of the ars moriendi. Early texts warned readers that five temptations lead to dying poorly—temptations to doubt, despair, impatience, greed, and pride. If you don’t want to die a doubting, despairing, impatient, greedy, and proud person, you must cultivate the virtues of faith, hope, patience, generosity, and humility now. But the ars moriendi texts were very clear that virtue did not happen to a person all at once at the end of life. Rather, it required habituation. Cultivating virtues was the work of a lifetime. If you want to be remembered as a person of sound character, a generous person of hope and good will toward others, you cannot delay making such attributes a regular practice. If you are willing to be martyred for your faith—as some of those early saints were—you have got to be sure it is a faith worth dying for. 

I once met a man who had converted from the religion of radical self-centeredness to Christianity. When I asked him why, he told me that of all the world’s religions, Christianity had the best story. As with the martyred saints, it was for him a story worth dying for. And All Saints Day reminds us that in Christianity, death is stranger than you might think. 

Death exists as a paradox for Christians—as something at once lurking and vanquished. Death is the enemy that at long last will be destroyed, and death has already been swallowed up in victory. But you might ask: if death has already been defeated, what remains to be destroyed? And if death will be destroyed, how has it then been defeated? This enigma might partially explain why many regular church attenders are neither physically nor spiritually prepared for death. Researchers at Harvard University have shown that people who describe themselves as most supported by their religious communities are also most likely to reject hospice care and instead to elect aggressive life-extending technology. 

The story goes as follows. Death is an enemy because it suggests rejection of God. From the beginning, God tells our forebearer Adam that he can freely eat of any tree in the garden but one. If he eats from the tree of the knowledge of good and evil, he will die.  Thus, from the beginning, God equates the possibility of human disobedience with the actuality of death.  

Of course, Adam and Eve eat the proverbial apple. And when they do, they don’t immediately die, but they experience a sort of death. For the first time, they become filled with shame and fear. They hide themselves from God. They cast blame. God tells them that moving forward their life will be filled with great suffering. God says to Adam, ‘By the sweat of your face you shall eat bread until you return to the ground, for out of it you were taken. You are dust, and to dust you shall return.’ Disobedience is what Christians call ‘sin’—and it brings death. Sin severs that once harmonious relationship between God and people—a fact that also grieves God, which is why God does not let death have the final word. 

The story gets better. Since we humans cannot possibly undo the drastic results of our disobedience, God becomes fully human in Jesus Christ, so liable to death, while also retaining full, divinity which cannot die. Then, as a human on a cross, he dies as the ultimate sacrifice on behalf of humankind. But this God-Man does not stay dead. After three days in the tomb, Christ is resurrected, defeating death, on what has come to be known as Easter Sunday. Christ’s resurrection functions as a sort of guarantee that all God’s people will one day be resurrected and receive new bodies, that day on which the great enemy of death will be destroyed once and for all. If Adam and Eve brought death into the world, the resurrection hope is that death will be no more.  

This year on All Saints Day we have the opportunity to consider what it means to commune with ‘all saints’ extending back to Adam and forward to future generations. We have the opportunity to study the saints and then examine ourselves. What sort of people are we becoming? Are we living well to die well, as the ars moriendi handbooks teach? And of all the stories out there, which provides the greatest hope in life and in death? 

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4 min read

Are miracles real?

In miracles, as in much of life, you see what you're looking for.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A woman sees her reflection in a mirror and hold a finger up.
Ivan Lapyrin on Unsplash.

Recently, I heard a remarkable story about a friend of mine who happens to be a vicar. He had been diagnosed with a serious cancer, and the diagnosis was bleak. He was preparing himself for a difficult few months, readying himself, and his parish, for the end before too long. His body was reacting poorly to chemotherapy, and the prospects did not look good. However, he continued to try to get a balance of rest and work through the tiredness, praying when he could - little and often - but without too much discomfort.  

A short while ago, during a routine visit to the hospital to receive the results of a scan on how the cancer was progressing, something puzzling happened. 

The surgeon showed him the scan related to the original diagnosis. He asked, "Can you see the tumour?" My friend replied, "Yes, of course, it's right there," pointing to the black mass. The surgeon then showed him another scan. 

He asked again, "This is the most recent scan we’ve just taken; can you see it on this one?" My friend peered closely into the scan and said, "Hmm. I'm not sure I can." The surgeon then responded, puzzled, that somehow, between the two scans, the tumour seemed to have disappeared. 

He added: “To be honest, in my world, we don't really have an explanation for things like this. But I suspect in yours, you do.” 

Besides being delighted for my friend, since hearing the story, I've pondered what it means. Of course, miracles are by their nature rare and we cannot automatically predict them, My friend was in the kind of church that doesn't routinely demand God for miracles but simply carried on gently praying that somehow God would be with the vicar in his struggles, hardly daring to hope that the cancer would in fact vanish.  

Was it a miracle? Or was there some other explanation? It seems to me that the answer you give to that question depends on the framework you bring to it. If you are a believer in a God who might do this kind of thing from time to time, and consider that such things can and do happen occasionally, not regulated by the usual course of cause and effect, but by some extra dimension of reality unseen to us and immeasurable by the methods of science, you will probably simply accept it as one of those occasional interruptions to the normal course of things. And then give thanks to God and rejoice with my friend at this sign of God’s goodness.  

Of course, it raises the question of why this cancer was healed and others aren’t, but that takes us into other territory, which I’ve examined before in relation to Donald Trump’s narrow escape. Would we rather a world in which such things as this never happened, and my friend’s cancer had taken its usual deadly course? Or a world where just every now and again, something delightful and unanticipated happens, like stumbling on a gloriously unexpected view of rolling hills and a dramatic sunset at the end of a routine walk on a summer’s evening?  

Belief in miracles doesn’t mean an irrational rejection of science and its benefits in favour of an entirely random world. it simply means an acknowledgement of the limits of our reasoning. 

An honest doctor like the one treating my friend, might recognise that the methods of medical science, for all its brilliance, value and wisdom, on which we all depend so much, has to shrug its shoulders at this point, realising that it doesn’t have the categories to explain it, reverting to a kind of agnosticism. A more thoroughgoing materialist would say: “Of course we know there are no such things as miracles, so that’s the one thing we know it is not. There must be some other explanation, and science will one day discover why such mysterious things happen.” 

What we believe about such things is determined not by the self-evident ‘facts’, the bald evidence of what is before us, but by our pre-conceived mental map of the world, our framework of faith, what we think the world is, and what, or who we think God is, (if he exists at all). We are all believers in the end – the difference is what we believe in.  

Belief in miracles doesn’t mean an irrational rejection of science and its benefits in favour of an entirely random world. it simply means an acknowledgement of the limits of our reasoning, open to the possibility of an extra dimension of enchantment that occasionally shows its face, and that there is a bigger world out there than we with our small minds and spirits are able to comprehend.  

GK Chesterton once put it like this. "Somehow or other an extraordinary idea has risen that the disbelievers in miracles consider them coldly and fairly, while believers in miracles except them only in connection with some dogma. The fact is quite the other way. The believers in miracles accept them, rightly or wrongly, because they have evidence for them. The disbelievers in miracles deny them, rightly or wrongly, because they have a doctrine against them." 

In miracles, as in much of life, you see what you're looking for.